On Saturday, May 25, the World Health Organisation (WHO) finally declassified gender nonconformity as a “mental illness”. In a development that has brought much relief to the international transgender community, the WHO has removed being transgender from its list of mental illnesses in the latest edition of International Classification of Diseases (ICD) guidelines.
The ICD said that gender nonconformity is “characterized by a marked and persistent incongruence between an individual’s experienced gender and the assigned sex”. This simply means that when someone does not identify with the sex they are born with—either male or female—they are transgender.
Transgender individuals can choose to identify as either male or female or non-binary; this means they do not subscribe to the gender spectrum at all.
Coordinator of WHO’s Adolescents and at-Risk Population team Dr. Lale Say said, “It [transgender identity] was taken out from the mental health disorders because we had a better understanding that this wasn’t actually a mental health condition and leaving it there was causing stigma.”
History of transgender as a mental illness
USAToday says that queer identities—lesbian, gay, bisexual, transgender, and more—have been conflated with mental illness for eons. In 1974, the American Psychiatric Association partly removed homosexuality as a mental disorder; a complete removal came only in 1987.
However, the WHO only stopped defining homosexuality as a “mental disorder” in 1992. It has now changed its stance on transgender identities as well.
Dr. Jennifer Conti said, “We’ve historically misclassified a lot of conditions in medicine because of a combination of stigma, fear, and misunderstanding.” For example, women used to be diagnosed with “hysteria” because doctors believed that uteri wandered through their bodies.
The APA explains that one of the reasons being transgender is not considered a mental illness is that not all trans people “experience their gender as distressing or disabling”.
Trans individuals are more in need of strong support systems, medical resources like counselling, and accepting and safe spaces for them to express their identities openly.
How is India’s trans community faring?
India’s trans community is still fighting persecution despite the historic 2014 NALSA judgment, wherein the Supreme Court declared that for a trans Indian to be accorded their preferred gender, they need only self-declare it.
However, the Transgender Persons (Protection of Rights) Bill 2016 undermines SC’s ruling and requires trans Indians to undergo medical procedures like hormone treatment and sex reassignment surgery, and then acquire certification from government officials proving the same before they can legally change their gender identity.
India’s trans activists and community have been agitating for equal treatment, including protection at workplaces, from violence in and out of the home, and more representation in positions of power at academic institutions, businesses, and the government.
In the Lok Sabha elections 2019, AAP was the only party to field a trans candidate. However, four trans women, including Radha from Tamil Nadu, contested the elections as independents. Although none of them won a seat, their initiative was crucial.
Earlier in May, a new clinic run by and for trans people opened up in Mumbai. Humsafar Trust, an HIV awareness and support group for LGBTQ Indians and sex workers, opened the Humsafar Clinic for pre- and post-HIV testing, support, and counselling.
CEO of Humsafar Trust Vivek Anand told the Guardian that stigma is one of the key reasons that trans people don’t seek medical treatment and counselling or suddenly stop treatment altogether.
“Half of them [trans people] never even showed up. More than discrimination, self-stigmatisation keeps the community away from accessing treatment,” he added.
WHO’s declassification of “transgender” as a mental illness is one large, much-needed step towards reducing the stigma and internalisation of discrimination that Anand talks about.
The SC striking down the archaic Section 377 that criminalised homosexuality was also an overdue landmark for the LGBTQ community in India.
Rhea Arora is a Staff Writer at Qrius.
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