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Title: Gender incongruence of adolescence and adulthood: acceptability and clinical utility of the World Health Organization’s proposed ICD-11 criteria
Authors: Beek, Titia F.
Cohen-Kettenis, Peggy T.
Bouman, Walter P.
de Vries, Annelou L.
Steensma, Thomas D.
Witcomb, Gemma L.
Arcelus, Jon
Richards, Christina
Elaut, Els
Kreukels, Baudewijntje P.
Keywords: Gender incongruence
Gender dysphoria
Gender identity disorder
Clinical utility
Diagnostic classification
World Health Organization
International classification of diseases
Issue Date: 2017
Publisher: Public Library of Science / © The Authors
Citation: BEEK, T.F. ... et al, 2017. Gender incongruence of adolescence and adulthood: acceptability and clinical utility of the World Health Organization’s proposed ICD-11 criteria. PLoS One, DOI:10.1371/journal.pone.0160066
Abstract: The World Health Organization (WHO) is currently updating the tenth version of their diagnostic tool, the International Classification of Diseases (ICD, WHO, 1992). Changes have been proposed for the diagnosis of Transsexualism (ICD-10) with regard to terminology, placement and content. The aim of this study was to gather the opinions of transgender individuals (and their relatives/partners) and clinicians in the Netherlands, Flanders (Belgium) and the United Kingdom regarding the proposed changes and the clinical applicability and utility of the ICD-11 criteria of ‘Gender Incongruence of Adolescence and Adulthood’ (GIAA). A total of 628 participants were included in the study: 284 from the Netherlands (45.2 %), 8 from Flanders (Belgium) (1.3 %), and 336 (53.5%) from the UK. Most participants were transgender people (or their partners/relatives) (n = 522), 89 participants were healthcare providers (HCPs) and 17 were both healthcare providers and (partners/relatives of) transgender people. Participants completed an online survey developed for this study. Most participants were in favor of the proposed diagnostic term of ‘Gender Incongruence’ and thought that this was an improvement on the ICD-10 diagnostic term of ‘Transsexualism’. Placement in a separate chapter dealing with Sexual- and Gender-related Health or as a Z-code was preferred by many and only a small number of participants stated that this diagnosis should be excluded from the ICD-11. In the UK, most transgender participants thought there should be a diagnosis related to being trans. However, if it were to be removed from the chapter on “psychiatric disorders”, many transgender respondents indicated that they would prefer it to be removed from the ICD in its entirety. There were no large differences between the responses of the transgender participants (or their partners and relatives) and HCPs. HCPs were generally positive about the GIAA diagnosis; most thought the diagnosis was clearly defined and easy to use in their practice or work. The duration of gender incongruence (several months) was seen by many as too short and required a clearer definition. If the new diagnostic term of GIAA is retained, it should not be stigmatizing to individuals. Moving this diagnosis away from the mental and behavioral chapter was generally supported. Access to healthcare was one area where retaining a diagnosis seemed to be of benefit.
Description: This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Details are available here; https://creativecommons.org/licenses/by/4.0/
Sponsor: Ministerie Buitenlandse Zaken (Foreign Affairs), Ministerie van Onderwijs, Cultuur en Wetenschap (Education, Culture and Science), Ministerie van Volksgezondheid, Welzijn en Sport (Health, Welfare and Sport), Nottinghamshire Healthcare NHS Foundation Trust.
Version: Published
DOI: 10.1371/journal.pone.0160066
URI: https://dspace.lboro.ac.uk/2134/22525
Publisher Link: http://dx.doi.org/10.1371/journal.pone.0160066
ISSN: 1932-6203
Appears in Collections:Published Articles (Sport, Exercise and Health Sciences)

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