May 6, 2014

What happens to crossdressing and crossdreaming in the ICD-11 manual?

As noted in my previous post, the recent edition of the Amercian psychiatric manual, the DSM-5, has gone a long way towards depathologizing some transgender conditions. Gender dysphoria, for instance, is no longer considered a mental illness.
Peggy Cohen-Kettenis

Note that DSM subworking-group members Peggy T. Cohen-Kettenis and Jack Drescher are also members of the World Health Organization’s Working Group on the Classification of Sexual Disorders and Sexual Health.

This group will address sex and gender diagnoses in WHO's forthcoming revisions of the International Classification of Diseases (ICD-11).  That manual is expected to be published in 2017. The WHO most often follow up changes made in the DSM.

The current manual has two different sections on crossdressing,  one clearly referring to what I call crossdreaming, and one referring to the mythical mirage of the asexual crossdresser. It is all pretty bizarre, if you ask me. (More about this here!)

Some countries have already made changes to the current ICD-10 edition, removing the sections on "transvestism".

In a recent paper the ICD-11 Working Group on the Classification of Sexual Disorders and Sexual Health, states that it "believes it is now appropriate to abandon a psychopathological model of transgender people based on 1940s conceptualizations of sexual deviance and to move towards a model that is (1) more reflective of current scientific evidence and best practices; (2) more responsive to the needs, experience, and human rights of this vulnerable population; and (3) more supportive of the provision of accessible and high-quality healthcare services."

Before the a preliminary WPATH consensus meeting the working group had proposed the term "transsexualism" to "gender incongruence", moving gender incongruence out of the chapter on mental and behavioral disorders, and deleting the categories "dual role transvestism" and "fetishistic transvestism".

In other words: Not only is the ICD-11 process moving in the same positive direction as the DSM; it is taking this process further, suggesting that one removes crossdressing and crossdreaming altogether.

If the ICD-11 takes crossdressing and crossdreaming out of its manual, it will be very hard for the Americans to keep the "transvestic disorder" in the  DSM.


  1. crossdressing is not psychopathological but is only a way for a person who is dysphoric to express their internal sense of gender. I used to believe that I myself suffered from a pathology that I needed to cure myself from but I know better now.


    You and I both believe that there is a biological origin for gender dysphoria and this will be eventually be proven.

    Tranvestic fetishism falls more into the realm of a person who develops an obsession with wearing women's underwear for example rather than about having an internal female identity.

    Clinicians know this now and the DSM and other documents will eventually be edited to reflect this.

    Fear not Jack!

  2. joanna, like interbingung?


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