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Is Transgenderism a Mental Disorder?

The World Health Organization’s International Classification of Diseases (ICD) contains several codes and definitions related to transgender individuals. While some would say that these classifications refer to a “disease” diagnosis, the truth is, most refer to medical history for insurance billing purposes; for example, a history of sexual reassignment surgery or transgender identity. Just as with homosexuality, once referred to as a “disease” in outdated medical texts, transgenderism is not a “mental disorder” according to the American Psychological Association (APA).

Terms Associated With Transgender

According to the American Psychological Association (APA), transgendered people have always existed. They have been documented in many world cultures from ancient times to the present day; however, the meaning of gender differences does vary from culture to culture.

In our current culture, transgender people may refer to people who were assigned as either male or female gender at birth, but who wish to live as a different gender from the assignment. People who cross-dress, are gender-queer, or who identify as drag queens may also fall under the definition of transgender. None of these people, by their self-identification, has a “mental disease” as understood by current mental health professionals.

Individuals may also self-identify as androgynous, multi-gendered, gender nonconforming, third-spirit, and also two-spirit people. These differing terms enable a fluid definition of alternate and blending genders. Many people who identify in these ways believe that traditional, binary (male or female) definitions of gender are restrictive.

Gender Identity and Sexual Orientation

Some people may believe that sexual orientation and gender identity are one and the same. However, according to the American Psychological Association, this is untrue. Sexual orientation refers to a person’s physical or romantic attraction to another person. Gender identity refers to a person’s internal sense of being a certain gender, whether male, female, or another gender identity. Just as with non-transgender people, transgenders can be straight, lesbian, gay, bisexual, or have no sexual feelings (asexual). Some studies have shown that transgender people remain attached to their loved ones after gender transition, and also that transgender people identify their sexual preference based upon their transition gender.

Can a Transgendered Person Have Mental Disorders?

A trans- or non-binary gender-identified individual can be diagnosed with a mental disorder, just as a binary-identified gender can, according to the American Psychological Association. However, when a person is transgender, the APA says that many mental disorders have been found to be related to the behavior and treatment of others or society. Significant problems can occur for transgendered individuals in their relation to society, family functioning, and economic issues. For example, a transgendered individual could feel significant anxiety and distress due to the lack of resources for counseling, hormone therapy, and medical procedures. Discrimination is also a significant concern leading to depression, anxiety, and other related disorders.

In 2016, TIME Magazine reported on a number of studies that determined that transgenderism was not a mental disorder. UCLA’s Williams Institute reports that approximately 1.4 million Americans identify as trans- or other alternative genders, and encouraged physicians to recognize a gender-affirmative approach that accepts the gender chosen by patients in diagnosis and treatment.

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