The WHO ICD-11 health manual removes transvestic fetishism. Being trans is no longer a mental illness.

Yesterday the World Health Organization released the new version of its International Classification of Diseases, the ICD-11. The new edition brings some very good news to transgender people.

Being transgender is no longer considered a mental illness by the international medical community (Photo: Wavebreakmedia)

"Transvestic fetishism" is no longer included

First of all, the diagnoses of "transvestic fetishism" and "dual-role transvestism" are no longer included.

Several countries, including the Nordic ones, have already removed the transvestic fetishims of the list of "paraphilias" from their national versions of the ICD-10 , arguing that crossdressing is just an unharmful expression of gender variance, and that including it in the manual causes needless stigmatization and suffering.

According to the WHO crossdressing and crossdreaming are no longer considered  mental illnesses.

Being transsexual is no longer a mental illness

Furthermore, being transsexual (in the sense of suffering from a mismatch between your biological sex and/or expected gender role and your experienced identity) is no longer classified as a mental illness, either.

No, this blog is not telling transgender people that they should not transition

A recent reddit-discussion indicates that some trans people have interpreted this blog to mean that crossdreamers are not gender dysphoric and that they do not have to transition. 

For  a couple of years now I have experienced som rather nasty attacks over at the reddit transgender subreddit.

The comments themselves have never been very clear about what it is that causes this animosity.  I have suspected the attackers have been truscum or transgender separatists who hate the idea of "real transgender people" having anything in common with "transvestites" and "fetishists".

That may still be true, but a recent discussion over at the forum indicates that there is something more. Some of them clearly blames me for having put their transitioning process on hold.

I wish there was simple test to determine if you should transition,  but there isn't. Photo: natasaadzic

One participant, Denika Mae, put it this way:

It has been 4 years since I've been on your site. Up until the point I had to come out, I absolutely used your site and essays to believe I wasn't "That kind of trans person" in relation to needing to transition, and that normal people live with these feelings every day until I was suicidal. 

You can't control what people do with the stuff you put out there, so I can't blame you for that, but your rhetoric is responsible for giving me excuses to delude myself for years until I was in a very dangerous emotional place, and couldn't lie to myself anymore. In fact, the only sites that've done me more of a disservice are the COGIATI test site and the old sites for WPATH and Benjiman protocols. 

I take this very seriously, as my goal with my blogs have been very much the opposite: To give closeted transgender women and men the language and facts needed to determine for themselves.

Here is my reply:

"I am truly surprised that people may read my site to mean that gender dysphoric transgender people should not transition.

"Transvestism" is on its way out of the WHO health manual, but its makers leave a loophole for further invalidation of transgender people

It seems the WHO health manual, the ICD-11, will remove the "fetishistic transvestism" diagnosis from the chapter on paraphilias. This is good new for the transgender community, as is the fact that being transgender is no longer considered a mental disorder. Unfortunately the current text proposal may still be used to reduce a transgender identity to a paraphilia.

The new medical manual from WHO removes the "fetishistic transvestism" diagnosis, which is great. Unfortunately, its makers still seem to think there is a clear divide between crossdressers and those suffering from what it calls gender incongruence. (Photo: Creatista)

Transvestism is out

As I have reported before, it is now pretty certain that "Fetishistic Transvestism" will to be removed from the paraphilia chapter of the international WHO health manual, the ICD-11 (International Statistical Classification of Diseases and Related Health Problems, 11th Revision).

Richard Krueger, Geoffrey M. Reed, Michael B. First and Peer Briken, members of the ICD The Working Group on the Classification of Sexual Disorders and Sexual Health (WGCSDSH), put it this way:

What Transphobic Norwegian Doctors can Teach Us about the Diversity of Transgender People

The major Norwegian clinic for transgender people is run by  doctors who are invalidating large sections of the transgender community. This  tells us a lot about how old stereotypes and prejudices among  gate keepers can ruin the lives of young trans people.

You'd better live up to the stereotypes if you want to get help from the transgender university clinic in Oslo. Photo: olgakr.

A progressive country...

As a Norwegian I am happy to say that we have some of the most liberal gender identity laws in the world. A trans person who wants to get legally recognized as their true gender, fills in an online form,  and that is all there is to it. There are no gate keepers in the legal sphere.

Morevoer, "transvestism" has been removed from the Norwegian version of the international medical manual, the ICD-10, and is no longer considered a mental illness. The same applies to being transgender in general.

...with a reactionary trans clinic

But getting your true gender legally recognized does not necessarily get you the medical assistance you need.  The National Treatment Unit for Transsexualism (Nasjonal behandlingstjeneste for transseksualisme, NBTS) at The University Hospital of Oslo has controls people's access to  surgery and does so in a very restrictive way.

I know of many trans people who have been denied any kind of help if they have admitted to erotic crossdreaming fantasies, for instance, or if they have not lived up to gender stereotypes as regards dress code, interests and mannerisms.

In the end it got so bad that Amnesty International got involved, arguing that the whole policy was in violation of trans peoples' human rights. (I have written more about this here.) 

A white paper has proposed a whole new regime, basically arguing that more clinics should provide services of this kind, in that way removing some of the power The National Treatment Unit for Transsexualism  has today.

Doctors show their true face

That has turned out to be a very wise recommendation, indeed. In a recent article in the major Oslo newspaper Aftenposten, leaders of the NBTS express opinions that are undeniably transphobic.

Among traditionalists Jazz Jennings is the perfect
transgender girl. God bless Jazz Jennings, but
the fact is that a large number of trans kids
are forced to hide who they are. 

The arguments they use to invalidate trans people are the  ones readers of this blog will know far too well:

Trans people who come out during puberty or later, and who do not visibly express their true gender through gender stereotypes throughout childhood, are not considered the right kind of transgender.

Anne Wæhre og Kim Alexander Tønseth from NBTS address the minister of health, Bent Høie, in their article, arguing that his liberal policy for transgender people has backfired.

The recent upsurge in young people approaching the clinic is, as they see it, the result of a "misguided and misplaced kindness mixed with minority activism and professional conflicts."

On why some trans people do not come out until after puberty

The main reason for why some transgender people do not seek help until after puberty is found in social repression and stigmatization.

According to conservative gate keepers real
transgender people come out before puberty.
Photo: Wave Break Media

In my article on Anne Wæhre og Kim Alexander Tønseth and the transphobic attitudes found at The National Treatment Unit for Transsexualism (NBTS) at The University Hospital of Oslo, I have argued that there is no mystery why some transgender people do not come out, and seek help, before after puberty has had some effect.

Here are some alternative explanations:

The identity-defence model

Dr. Jaimie Veale and Dr. Terri C. Lomax have suggested that this is about personality profiles. The late bloomers are people pleasers who have desperately tried to live up to the expectations of family and friends, unlike the more extrovert and uninhibited trans kids who refuse to adapt.

Their "identity-defence model" looks at the degree of gender-variant identity developed, and whether defense mechanisms are used to repress this identity.

They put it this way:

We believe that an introverted child is likely to have less confidence to express this gender-variant identity, and it is also possible that children with greater impulse control, agreeableness, or conformity are more likely to cognitively avoid their gender variance. 

They suggest that as far as transgender people goes, the outgoing personality types are more likely to become attracted to people of the opposite sex (male to female loving men and female to male loving women), while the shy and introvert transgender people – those who repress their true gender – are more likely to find members of their target gender "exotic" and therefore "erotic".

Natalie Wynn takes an open-minded and critical look at the autogynephilia theory

ContraPoints (AKA left wing video blogger Natalie Wynn) has made a very interesting and well made video on the autogynephilia theory and its influence on sexology, medicine, and transphobic propaganda.

Vanity. 1890. Auguste Toulmouche.
I have uploaded more images of "female vanity" to CDL.

I have written extensively about the pseudo-scientific and transphobic nature of the autogynephilia theory on this blog, and is not going to repeat those arguments here (summary here).

Natalie also gives you the main scientific arguments against the theory, but this is not the main focus of the video. Instead she uses her own life and her own feelings to explain why the theory falls short and why it is so destructive.

She is a brave woman, indeed.

In real life we are all deviants

Her common sense approach to the sexology of perversions is liberating. She puts the lives of both trans women and non-transgender women into a real life context -- a context where no one adheres to the simplistic stereotypes of this kind of researchers.

As she explains, her sexuality as a transgender woman -- now that she is living as a woman -- is very much the same as the one of the her cisgender sisters.

The reason some trans women may feel or behave differently at some point in their lives, is that their options to express their true identity are pretty limited when presenting as a man.