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UN experts hail move to ‘depathologise’ trans identities

29 May 2019


GENEVA (29 May 2019) – UN experts say the World Health Organisation’s move to end the categorisation of trans-related conditions as mental and behavioural disorders is a major step towards full respect for human rights connected to gender identity and diversity.

Following last week’s approval of an updated International Classification of Disease (ICD-11) by the World Health Assembly, trans-related categories have now been added to a new chapter on conditions related to sexual health.

“We expect that this reclassification will impact very positively the wrong perception that some forms of gender diversity are pathologies, or sickness, and that it will facilitate access to better health care,” said Victor Madrigal-Borloz, Independent Expert on protection against violence and discrimination based on sexual orientation and gender identity, and Dainius Pῡras, Special Rapporteur on the right to health.

“For years, and intensively over the last decade, different civil society groups and other stakeholders have worked systematically to challenge this stigmatising and scientifically unfounded classification of trans identities. The revision of ICD-11 has only been possible thanks to the leadership and the mobilisation of hundreds and hundreds of trans and gender diverse people who must be commended for their tireless efforts and persistence.

Madrigal-Borloz and Pῡras reminded that the World Health Organisation also considered homosexuality as an illness until almost 30 years ago, when it removed it from the International Classification of Diseases.

They said the misperception of some forms of sexual orientation or gender identity as pathologies has deep impact on public policy, legislation and jurisprudence, penetrating all realms of State action around the world and permeating the collective conscience. They noted that pathologisation has historically been, and continues to be, one of the root causes of human rights violations against persons who identify as trans or gender diverse.

“Although the reclassification is a major improvement, there are a number of problematic issues that remain to be addressed to achieve full depathologisation of trans and gender-diverse people, while guaranteeing equal access to health-care services,” the UN experts said.

The World Health Organisation International Classification of Disease contains codes that are used globally for various purposes, including legal gender recognition, access to specific healthcare (e.g. gender affirming procedures) and healthcare coverage. Some countries use other classificatory systems for the same purposes.

“We welcome this major breakthrough and we call on States to review their medical classifications and adopt strong proactive measures, including education and sensitisation campaigns, to eliminate the social stigma associated with gender diversity. It often takes years before global classifications have full effect on the lives of people. We are, for example, dismayed that homosexuality continues to be pathologised by some national medical associations despite clear and univocal views from all quarters and for decades that homosexuality is not a disease.

“Diversity in sexual orientations, gender identities and gender expressions are part of human nature, and have always existed, everywhere in the world. Denying the existence of diversity or promoting the idea according to which gay, lesbian, bisexual, trans and gender-diverse people ‘choose a lifestyle’  leads to violence, including so-called ‘corrective rape’ and ‘conversion therapy’, and to forced, coercive and otherwise involuntary treatments and procedures to ‘normalise’ sexual attraction or human bodies. It is time for the world to recognise and celebrate the rich diversity of human nature,” Madrigal-Borloz and Pῡras said. 


Mr. Victor Madrigal-Borloz (Costa Rica) assumed the role of UN Independent Expert on Protection against violence and discrimination based on sexual orientation and gender identity for a three year period starting on 1 January 2018. He serves as the Secretary-General of the International Rehabilitation Council for Torture Victims (IRCT), a global network of over 150 rehabilitation centres with the vision of full enjoyment of the right to rehabilitation for all victims of torture and ill treatment. A member of the UN Subcommittee on the Prevention of Torture from 2013 to 2016, Mr Madrigal-Borloz was Rapporteur on Reprisals and oversaw a draft policy on the torture and ill-treatment of LGBTI persons.

Dainius Pūras, a medical doctor with notable expertise on mental health and child health, took up his functions as UN Special Rapporteur on 1 August 2014. Dainius Pūras is the Director of Human rights monitoring institute in Vilnius Lithuania, a Professor of child and adolescent psychiatry and public mental health at Vilnius University and teaches at the Faculties of Medicine and Philosophy of the same University.  He is also visiting Professor at the University of Essex (United Kingdom) and a Distinguished Visitor with the O'Neill Institute for National and Global Health Law, Georgetown University (USA).  As a medical doctor, he serves as a consultant at the Child Development Center, at Vilnius University Hospital.

The Special Rapporteurs and Independent Experts are part of what is known as the Special Proceduresof the Human Rights Council. Special Procedures, the largest body of independent experts in the UN Human Rights system, is the general name of the Council’s independent fact-finding and monitoring mechanisms that address either specific country situations or thematic issues in all parts of the world. Special Procedures experts work on a voluntary basis; they are not UN staff and do not receive a salary for their work. They are independent from any government or organization and serve in their individual capacity.

Read the report of the Independent Expert on classification of some forms of gender as a pathology and gender recognition at:

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