* Any views expressed in this opinion piece are those of the author and not of Thomson Reuters Foundation.
Children exploring their own gender identity are being put in a box labelled ‘sick’
What do the United Kingdom's National Health Service, an infamously inquisitive TV presenter and a recent conference in Belgium have in common? They have all raised awareness and stimulated debate on trans issues. More specifically, trans children and their interaction with healthcare practitioners.
Figures published last week in the UK showed that the number of trans children seeking advice from NHS support services has quadrupled over the last six years. These statistics from the NHS’s Tavistock and Portman centre, a unit working specifically on youth gender issues, came in the wake of an engaging BBC programme where documentary maker and presenter Louis Theroux met with trans kids and their parents in the US. Both these topics received wide-spread media coverage and awakened public consciousness to the real decisions faced by gender variant children.
The fact that more families are accessing support services is very welcome. What we - and many other European organisations working on trans issues, like our colleagues in Transgender Europe (TGEU) - are worried about is the lingering stigma associated with gender variance in children. We are anxious that children who exploring their own gender identity are being put in a box labelled ‘sick’. The UN’s World Health Organisation is currently deliberating how to revise its International Classification of Diseases document with potentially damaging consequences for trans children.
ICD – a seemingly innocuous acronym. But its three letters carry a lot of weight. The International Classification of Diseases and Related Health Problems is a diagnostic tool used by medical practitioners all over the world. The list of categories was last updated in 1990, an edition commonly referred to as ICD-10. The next classification is due to be published in 2017 and initial recommendations include moving trans-related diagnoses out of the mental health disorders chapter. This move would be very encouraging and we hope it appears in the finalised ICD-11 edition.
However, the proposed ICD-11 has some worrying knock-on effects for children as a new category of ‘gender incongruence in children’ will possibly be added to the text. This would replace the current ‘gender identity disorder in childhood’ category but there are several reasons why this new format is not a good idea.
ILGA-Europe are very discouraged by the fact that the WHO experts are introducing this classification. It is superfluous and stigmatising. Superfluous - because gender variant children who have not reached puberty do not need medical intervention, such as hormone blockers or surgery. What they do need is time and a supportive space in which to fully explore their gender identity. Another danger with classifying gender incongruence in children in this way is that it implies they are sick or medically/mentally disordered in some way.
Such a move by the WHO would not adequately respect the rights of gender variant children and their families. NGO’s and trans activists, such as GATE – Global Action for Trans* Equality, have been flagging this problem for a long time. TGEU, who have advocated for trans people’s human rights since 2005, also voiced disquiet in their 2013 position paper. It stated that a gender incongruence diagnosis for children would be unnecessary as “...the clinical needs of pre-pubescent children for psychotherapy and/or psychosocial counselling can be adequately covered in chapter XXI (Z) factors Influencing health status and contact with health services.”. Sam Winter of the University of Hong Kong recently spoke at the first EPATH conference in Ghent and pointed out the need to avoid pathologising trans children or stigmatising children who are ‘different’.
The sooner we start listening to trans children to find out what they want, rather than labelling and pathologising, the better.
Sophie Aujean is Senior Policy and Programmes Officer with ILGA-Europe and Emma Cassidy is the organisation’s Communications and Media Officer. ILGA-Europe works for equality and human rights for lesbian, gay, bisexual, trans & intersex (LGBTI) people at European level. For more information on their work, visit www.ilga-europe.org or follow @ILGAEurope on Twitter.
