Next year the World Health Organisation intends to approve the ICD-11 diagnostic manual; the first ICD revision in over a quarter century. Some of the changes proposed in areas of sexual disorder and sexual health are highly controversial. In this presentation I examine some of the proposals, drawing on my experience as a member of the WHO Working Group from which most of the proposals have come. Focussing on proposed revisions to the following ICD-10 diagnostic blocks; ’psychological and behavioural disorders associated with sexual development and orientation’ (proposal to remove the block entirely); ’disorders of sexual preference’ (proposals for significant revisions), and ’gender identity disorders’ (proposals for renaming and relocation). I adopt a critical perspective, and will share previously unavailable information with the audience.
By paying attention to WHO’s proposal for an ICD-11 gender incongruence diagnosis for children below the age of puberty, I argue that, given the needs of such children, diagnostic categories for these children are medically unnecessary, are potentially harmful, and are inconsistent with WHO’s approach elsewhere. I also question whether the diagnosis can be of any value in promoting research, enhancing training, or improving services. I outline alternative approaches for enabling and documenting support provided to such children.
