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Diagnosing Gender Incongruence and Gender Dysphoria Understanding ICD-11 Criteria

Introduction

Under some healthcare services, access to gender affirming treatment may require a formal diagnosis of gender dysphoria or gender incongruence. Gender incongruence and gender dysphoria are distinct but related concepts. While the 11th revision of the International Classification of Diseases (ICD-11) uses gender incongruence, the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) uses gender dysphoria. At GenderGP, we tend to use the ICD-11 diagnosis of gender incongruence.

Gender Incongruence and Gender Dysphoria

  • Gender Incongruence is characterised by a marked incongruence between an individual’s experienced gender and the gender assigned at birth.
  • Gender Dysphoria refers to the distress caused by this incongruence.

ICD-11 Criteria

The ICD-11 (World Health Organization, 2019) defines gender incongruence as follows:

Gender incongruence of adolescence and adulthood is characterised by a marked and persistent incongruence between an individual’s experienced gender and the assigned sex, which often leads to a desire to ‘transition’, in order to live and be accepted as a person of the experienced gender, through hormonal treatment, surgery or other health care services to make the individual’s body align, as much as desired and to the extent possible, with the experienced gender. The diagnosis cannot be assigned prior the onset of puberty. Gender variant behaviour and preferences alone are not a basis for assigning the diagnosis.

Importantly, ICD-11 states that gender incongruence is not an illness or a disorder. Rather, it is recognised as a healthy part of our diversity.

The Role of Diagnosis

  • While not a medical illness, a formal diagnosis of gender incongruence is often necessary to access medical interventions such as hormone therapy or surgeries.
  • The diagnosis recognises the healthcare needs of transgender individuals, facilitating appropriate medical and psychological support.

Formal Diagnosis

GenderGP can provide a diagnosis of gender incongruence. If a consent session indicates that a person meets the diagnostic criteria, GenderGP can issue a letter stating the diagnosis. For those seeking a more detailed letter that outlines their personal history, booking a session with one of GenderGP’s independent specialists is recommended. This allows for a more comprehensive and personalised documentation of their journey and diagnosis.

Conclusion

While it is not an illness or a disorder, a diagnosis of gender incongruence or gender dysphoria can facilitate access to gender affirming treatment and other resources. One of the purposes of the Information Gathering and Capacity to Consent Sessions is to establish that you have a diagnosis of gender incongruence according to the ICD-11 diagnostic criteria.

Updated on May 10, 2024

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