Françoise Askevis-Leherpeux1, Marie de la Chenelière2, Antoine Baleige3, Sarah Chouchane3, Marie-Jeanne Martin4, Rebeca Robles-García5, Ana Fresán5, Alexandre Quach3, Anne-Claire Stona3, Geoffrey Reed6, Jean-Luc Roelandt7. 1. EPSM Lille-Métropole, WHOCC for Research and Training in Mental Health, 211 rue Roger Salengro, 59260 Hellemmes, Franc; Equipe INSERM - ECEVE (UMR 1123), 75011 Paris, France. Electronic address: fleherpeux@epsm-lille-metropole.fr. 2. EPSM Lille-Métropole, WHOCC for Research and Training in Mental Health, 211 rue Roger Salengro, 59260 Hellemmes, Franc; Maison Dispersée de Santé, 167 Rue d'Arras, 59000 Lille, France; Association Nationale Transgenre (Transgender National Association), 54097 Nancy, France. 3. EPSM Lille-Métropole, WHOCC for Research and Training in Mental Health, 211 rue Roger Salengro, 59260 Hellemmes, Franc. 4. Maison Dispersée de Santé, 167 Rue d'Arras, 59000 Lille, France. 5. National Institute of Psychiatry "Ramón de la Fuente Muñiz", Calz México-Xochimilco 101, Huipulco, 14370 Tlalpan, Mexico City, Mexico. 6. National Institute of Psychiatry "Ramón de la Fuente Muñiz", Calz México-Xochimilco 101, Huipulco, 14370 Tlalpan, Mexico City, Mexico; World Health Organisation, 1211 Geneva, Switzerland. 7. EPSM Lille-Métropole, WHOCC for Research and Training in Mental Health, 211 rue Roger Salengro, 59260 Hellemmes, Franc; Equipe INSERM - ECEVE (UMR 1123), 75011 Paris, France.
Abstract
BACKGROUND: For the 11th version of the International Classification of Diseases, the WHO recommended to rename transgender transidentity as "gender incongruence", to remove it from the chapter of mental and behavioral disorders, and to put it in a new category titled "Conditions related to sexual health". This should contribute to reduce stigmatisation while maintaining access to medical care. One argument in favor of depsychiatrisation is to demonstrate that essential features of gender identity disorders, namely psychological distress and functional impairment, are not necessarily reported by every transgender person, and may result from social rejection and violence rather than dysphoria itself. Initially confirmed in Mexico, these hypotheses were tested in a specific French medical context, where access to care does not require any prior mental health evaluation or diagnosis. METHOD: In 2017, 72 transgender persons completed retrospective interviews which focused on the period when they became aware that they might be transgender and perhaps would need to do something about it. RESULTS: Results showed that psychological distress and functional impairment were not reported by every participant, that they may result from rejection and violence, and especially from rejection and violence coming from coworkers and schoolmates. Additional data showed that the use of health services for body transformation did not depend on distress and dysfunction. Finally, participants preferred ICD 11 to employ "transgender" or "transidentity" rather than "gender incongruence". CONCLUSION: Results support depsychiatrisation. They are discussed in terms of medical, ethical, legal, and social, added values and implications of depsychiatrisation.
BACKGROUND: For the 11th version of the International Classification of Diseases, the WHO recommended to rename transgender transidentity as "gender incongruence", to remove it from the chapter of mental and behavioral disorders, and to put it in a new category titled "Conditions related to sexual health". This should contribute to reduce stigmatisation while maintaining access to medical care. One argument in favor of depsychiatrisation is to demonstrate that essential features of gender identity disorders, namely psychological distress and functional impairment, are not necessarily reported by every transgender person, and may result from social rejection and violence rather than dysphoria itself. Initially confirmed in Mexico, these hypotheses were tested in a specific French medical context, where access to care does not require any prior mental health evaluation or diagnosis. METHOD: In 2017, 72 transgender persons completed retrospective interviews which focused on the period when they became aware that they might be transgender and perhaps would need to do something about it. RESULTS: Results showed that psychological distress and functional impairment were not reported by every participant, that they may result from rejection and violence, and especially from rejection and violence coming from coworkers and schoolmates. Additional data showed that the use of health services for body transformation did not depend on distress and dysfunction. Finally, participants preferred ICD 11 to employ "transgender" or "transidentity" rather than "gender incongruence". CONCLUSION: Results support depsychiatrisation. They are discussed in terms of medical, ethical, legal, and social, added values and implications of depsychiatrisation.
Authors: Sarah M Peitzmeier; Mannat Malik; Shanna K Kattari; Elliot Marrow; Rob Stephenson; Madina Agénor; Sari L Reisner Journal: Am J Public Health Date: 2020-07-16 Impact factor: 11.561
Authors: Rebeca Robles; Jared W Keeley; Hamid Vega-Ramírez; Jeremy Cruz-Islas; Victor Rodríguez-Pérez; Pratap Sharan; Shivani Purnima; Ravindra Rao; María Inés Rodrigues-Lobato; Bianca Soll; Françoise Askevis-Leherpeux; Jean-Luc Roelandt; Megan Campbell; Gerhard Grobler; Dan J Stein; Brigitte Khoury; Joseph El Khoury; Ana Fresán; María-Elena Medina-Mora; Geoffrey M Reed Journal: Int J Clin Health Psychol Date: 2021-11-30