Gender Incongruence of Childhood Diagnosis in ICD-11
The controversy over the diagnosis of Gender Incongruence of Childhood (GIC) continues in anticipation of the proposed revisions to the International Classification of Diseases and Related Health Problems (ICD-11).
Arguments for retaining the diagnosis include issues of reimbursement and scientific inquiry. Many clinicians believe that accurately diagnosing the issue at hand is not only crucial for attaining reimbursement but also provides the most robust data for ongoing discoveries about the occurrence and progression of any phenomenon. Honestly notating that the child exhibits gender incongruence seems a valuable piece of datum to include. The concern is that without the diagnosis there would be no reimbursement for and no accurate research about children who experience gender incongruence.
Opponents of retaining the diagnosis note that children who are diagnosed with Gender Incongruence of Childhood are being pathologized. For some of these children the behavior is part of a normal developmental exploration of gender identity and expression. Most children require no treatment for this diagnosis and those that do likely meet criteria for some (other) emotional or behavioral problem. Furthermore, there is concern that the diagnosis can lead to attempts at reparative therapy.
The debate about the diagnosis of Gender Incongruence of Childhood often includes discussion of other diagnoses in order to make a point. The former diagnosis of Homosexuality, (and later, Ego Dystonic Homosexuality) is often invoked. The point is made by those opposing the GIC diagnosis that many children who exhibit gender incongruence later identify as homosexual and that the diagnosis seems to be a thinly veiled attempt to continue to pathologize variance in not only gender expression but also affectional orientation. They note that as cultural acceptance evolves, diagnoses rightfully change or are discarded. Using homosexuality as a parallel, opponents of retaining the diagnosis also point out that since the diagnosis of Ego Dystonic Homosexuality was removed, research on sexual orientation has not decreased but has increased significantly.
Those who wish to retain the diagnosis reply by suggesting that if a diagnosis can be used as a stigmatizing label, the solution is not to discard the diagnosis but to educate and advocate, thereby changing the societal view of the diagnosis. The diagnoses of learning disabilities and mental impairments are often cited as examples of such diagnoses.
A compromise of sorts has been reached; the diagnosis will be retained in ICD 11 but will be removed from the chapter “Mental and Behavioural Disorders" and will be included in a proposed new chapter called “Conditions Related to Sexual Health".
Those opposed to retaining the diagnosis presented an alternative solution which would have had the diagnosis placed in a chapter " Factors Influencing Health Status and Contact with Health Services"
which describes the reason for an encounter by an individual whom may or may not have a diagnosable condition. To read more about the arguments against retaining the diagnosis and this alternative proposal see the following: http://tgeu.org/the-gender-incongruence-of-childhood-diagnosis-revisited-a-statement-from-clinicians-and-researchers/
For those who are interested, the rationale for retaining the diagnosis can be found at: https://www.researchgate.net/publication/296683386_Gender_incongruence_of_childhood_in_the_ICD-11_Controversies_proposal_and_rationale
Arguments for retaining the diagnosis include issues of reimbursement and scientific inquiry. Many clinicians believe that accurately diagnosing the issue at hand is not only crucial for attaining reimbursement but also provides the most robust data for ongoing discoveries about the occurrence and progression of any phenomenon. Honestly notating that the child exhibits gender incongruence seems a valuable piece of datum to include. The concern is that without the diagnosis there would be no reimbursement for and no accurate research about children who experience gender incongruence.
Opponents of retaining the diagnosis note that children who are diagnosed with Gender Incongruence of Childhood are being pathologized. For some of these children the behavior is part of a normal developmental exploration of gender identity and expression. Most children require no treatment for this diagnosis and those that do likely meet criteria for some (other) emotional or behavioral problem. Furthermore, there is concern that the diagnosis can lead to attempts at reparative therapy.
The debate about the diagnosis of Gender Incongruence of Childhood often includes discussion of other diagnoses in order to make a point. The former diagnosis of Homosexuality, (and later, Ego Dystonic Homosexuality) is often invoked. The point is made by those opposing the GIC diagnosis that many children who exhibit gender incongruence later identify as homosexual and that the diagnosis seems to be a thinly veiled attempt to continue to pathologize variance in not only gender expression but also affectional orientation. They note that as cultural acceptance evolves, diagnoses rightfully change or are discarded. Using homosexuality as a parallel, opponents of retaining the diagnosis also point out that since the diagnosis of Ego Dystonic Homosexuality was removed, research on sexual orientation has not decreased but has increased significantly.
Those who wish to retain the diagnosis reply by suggesting that if a diagnosis can be used as a stigmatizing label, the solution is not to discard the diagnosis but to educate and advocate, thereby changing the societal view of the diagnosis. The diagnoses of learning disabilities and mental impairments are often cited as examples of such diagnoses.
A compromise of sorts has been reached; the diagnosis will be retained in ICD 11 but will be removed from the chapter “Mental and Behavioural Disorders" and will be included in a proposed new chapter called “Conditions Related to Sexual Health".
Those opposed to retaining the diagnosis presented an alternative solution which would have had the diagnosis placed in a chapter " Factors Influencing Health Status and Contact with Health Services"
which describes the reason for an encounter by an individual whom may or may not have a diagnosable condition. To read more about the arguments against retaining the diagnosis and this alternative proposal see the following: http://tgeu.org/the-gender-incongruence-of-childhood-diagnosis-revisited-a-statement-from-clinicians-and-researchers/
For those who are interested, the rationale for retaining the diagnosis can be found at: https://www.researchgate.net/publication/296683386_Gender_incongruence_of_childhood_in_the_ICD-11_Controversies_proposal_and_rationale
