GENEVA (29 May 2019) – UN experts say the World Health Organisation’s move to end the categorisation of trans-related
conditions as mental and behavioural disorders is a major step towards full respect for human rights connected to gender
identity and diversity.
Following last week’s approval of an updated International Classification of Disease (ICD-11) by the World Health
Assembly, trans-related categories have now been added to a new chapter on conditions related to sexual health.
“We expect that this reclassification will impact very positively the wrong perception that some forms of gender
diversity are pathologies, or sickness, and that it will facilitate access to better health care,” said Victor
Madrigal-Borloz, Independent Expert on protection against violence and discrimination based on sexual orientation and
gender identity, and Dainius Pras, Special Rapporteur on the right to health.
“For years, and intensively over the last decade, different civil society groups and other stakeholders have worked
systematically to challenge this stigmatising and scientifically unfounded classification of trans identities. The
revision of ICD-11 has only been possible thanks to the leadership and the mobilisation of hundreds and hundreds of
trans and gender diverse people who must be commended for their tireless efforts and persistence.
Madrigal-Borloz and Pras reminded that the World Health Organisation also considered homosexuality as an illness until
almost 30 years ago, when it removed it from the International Classification of Diseases.
They said the misperception of some forms of sexual orientation or gender identity as pathologies has deep impact on
public policy, legislation and jurisprudence, penetrating all realms of State action around the world and permeating the
collective conscience. They noted that pathologisation has historically been, and continues to be, one of the root
causes of human rights violations against persons who identify as trans or gender diverse.
“Although the reclassification is a major improvement, there are a number of problematic issues that remain to be
addressed to achieve full depathologisation of trans and gender-diverse people, while guaranteeing equal access to
health-care services,” the UN experts said.
The World Health Organisation International Classification of Disease contains codes that are used globally for various
purposes, including legal gender recognition, access to specific healthcare (e.g. gender affirming procedures) and
healthcare coverage. Some countries use other classificatory systems for the same purposes.
“We welcome this major breakthrough and we call on States to review their medical classifications and adopt strong
proactive measures, including education and sensitisation campaigns, to eliminate the social stigma associated with
gender diversity. It often takes years before global classifications have full effect on the lives of people. We are,
for example, dismayed that homosexuality continues to be pathologised by some national medical associations despite
clear and univocal views from all quarters and for decades that homosexuality is not a disease.
“Diversity in sexual orientations, gender identities and gender expressions are part of human nature, and have always
existed, everywhere in the world. Denying the existence of diversity or promoting the idea according to which gay,
lesbian, bisexual, trans and gender diverse people ‘choose a lifestyle’ leads to violence, including so-called
‘corrective rape’ and ‘conversion therapy’, and to forced, coercive and otherwise involuntary treatments and procedures
to ‘normalise’ sexual attraction or human bodies. It is time for the world to recognise and celebrate the rich diversity
of human nature,” Madrigal-Borloz and Pras said.