Working internationally on gender identity, gender expression and bodily issues
This year’s International Day of Action for Trans Depathologization comes with an unstoppable energy!
Just yesterday Jonas Gunnarsson, the General Rapporteur on the rights of LGBT people at the Parliamentary Assembly of the Council of Europe, declared that, “Outdated classifications of diseases at national and international levels should be removed. Transgender people’s access to medical care should be simple and stigma-free” (1) Gunnarsson’s statement reflects a growing consensus that transgender people should not be pathologized for their gender identity.
Earlier this month, the World Medical Association approved new guidelines for physicians on transgender healthcare emphasizing, that “everyone has the right to determine their own gender”.(2) In September of this year, the European Parliament adopted the Ferrara Report on fundamental rights in the European Union condemning legal recognition laws that demand transgender people be sterilized, encouraging depathologization of transgender identities in the World Health Organization’s International Classification of Diseases (ICD), and urging the Commission to prevent gender variance in childhood from becoming a new ICD diagnosis (3). This July, the WHO released its Policy Brief on Transgender People and HIV, highlighting the need to depathologize trans access to human rights (4). A similar recommendation was included in the recently released Blueprint for the Provision of Comprehensive Care for Trans People and Communities in Asia and the Pacific (5). Today, we join the new call from STP, International Campaign Stop Trans Pathologization (6).
Clearly the advocacy of activists and our allies around the world is making a real difference. The 2015 Maltese Act on Gender Identity, Gender Expression and Sexual Characteristics, as well as the legislative changes in Ireland, Mexico and Colombia, are contributing decisively to the transformation of our legal landscape and horizon by granting trans people access to legal recognition without requesting psychiatric diagnoses (7). The outcomes of the WPATH Survey on Gender Incongruence of Childhood are another sign for hope. As reported, “The survey indicated an even split among members regarding the proposed category, but non-US members were overall opposed to the proposal, and there was a strong rejection to classify a reference to trans children as a mental disorder (8).
These historic developments call the trans movement to redouble our efforts towards depathologization. We will not rest until we depathologize our identities, our right to have those identities legally recognized, and our right to make self-determined decisions about our bodies. We will not stop until we depathologize our diverse experiences, including gender diversity in infancy, childhood and, adolescence (9).
The ongoing reform of the International Classification of Diseases provides an unprecedented opportunity for trans people to stop being defined as mentally disordered just because who we are. But we must go further. The task we have ahead requires us, once and again, to stress the urgent need to identify pathologization as a specific human rights violation against trans* people, and against all of those whose gender identity or expression vary from socio-legal norms. We must continue to denounce those who consider our ways of life as pathological by definition; the unacceptable role that diagnoses are supposed to play in granting access to human rights; the subjection to conversion therapies, corrective interventions, institutionalization, and other forms of forced treatment (10); the eugenic justification of legally-coerced sterilization; the mistreatment, abuse, and other forms of institutional violence in medical settings (11).
Our image (*) for this International Day of Action for Trans Depathologization on this October 24th is an empty chair, among other empty chairs, in an empty waiting room – because no one should have to wait to be interrogated and analyzed, wait for psychological test results, or wait for a diagnostic permission just to have the right to be (12) (13).
We cannot affirm a trans person’s human right to depathologization without affirming our human right to health. Access to healthcare is a basic right; however, it is a right routinely denied to many of us in many places and in many ways – by making hospitals, schools, toilets and other sanitation services inaccessible to us; by persecuting, criminalizing and incarcerating us; by stigmatizing us and discriminating against us, especially trans sex workers, trans people living in poverty, trans youth, black trans people, trans homeless people, trans people from indigenous groups, trans people living with HIV, trans people who use drugs, trans people with disabilities and trans migrants, asylum-seekers and refugees; by bullying us, harassing us, torturing us and killing us (14).
The struggle for depathologizing our lives while ensuring full access to human rights – including healthcare and legal gender recognition – is being carried out by trans* activists worldwide. We are involved in different initiatives at different levels. We are following and informing the ICD revision and reform process, promoting legal reforms, training health providers, monitoring the implementation of public policies on health, conducting research, writing guidelines and papers, challenging insurance companies, demanding governments change their laws and policies, reporting to human rights institutions, organizing resistance, demonstrating in the streets, and celebrating a new Day of Action for Trans Depathologization. All around the world there are trans* activists with the skills, the expertise, and the commitment to transform the reality we do our best to survive in. Most of us face one of the most enduring and negative consequences of trans pathologization: we are very rarely recognized as true knowledge-makers, and given formal opportunities to be agents of those changes we all want to see in the world.
* The World Health Organization to continue and deepen the process of depathologizing trans people, and to avoid the introduction of the proposed category of “Gender Incongruence of Childhood”.
* States to reform their legal systems to allow universal access to recognition and transition-related healthcare under human rights standards.
* National, regional and international human rights institutions to introduce pathologization as a ground for human rights violations.
* Medical, Psy*, Bioethical associations and health providers to embrace human rights principles.
* Donors and allies to support trans activists’ work on depathologization.
* Trans* activists to make every day a Day of Action for Trans* Depathologization: together, we are unstoppable!
Mauro Cabral and Masen Davis, Co-Directors.
(1) It’s time to stop treating transgender people as diseased, says Pace rapporteur. Available at: http://assembly.coe.int/nw/xml/News/News-View-en.asp?newsid=5845&lang=2
(2) WMA Statement on Transgender People. Available at: http://www.wma.net/en/30publications/10policies/t13/
(3) European Parliament resolution of 8 September on the situation of fundamental rights in the European Union (2013-2014). Available at: http://www.europarl.europa.eu/sides/getDoc.do?type=TA&reference=P8-TA-2015-0286&language=EN&ring=A8-2015-0230
(4) Transgender People and HIV. WHO. Available at: http://www.who.int/hiv/pub/transgender/transgender-hiv-policy/en/
(5) Blueprint for the Provision of Comprehensive Care for Trans People and Trans Communities in Asia and the Pacific. Available at: http://www.searo.who.int/entity/hiv/documents/blueprint/en/
(6) STP launches the Call to Action for the International Day of Action for Trans Depathologization 2015. Available at: http://www.stp2012.info/old/en/news#call_to_action2015
(7) Making Depathologization a Matter of Law. A comment from GATE on the Maltese Act on Gender Identity, Gender Expression and Sex Characteristics. Available at: http://wp.me/p1djE5-9K
(8) Results of Member Survey on Gender Incongruence of Childhood (GIC) Diagnosis for ICD-11. WPATH. Available at: http://www.wpath.org/site_page.cfm?pk_association_webpage_menu=1635&pk_association_webpage=6638
(9)Critique and Alternative Proposal to the “Gender Incongruence of Childhood” Category in ICD-11. Available at: http://wp.me/a1djE5-4u
(10) Interview with Dainius Püras, UN Special Rapporteur on the Highest on the right of everyone the highest attainable standard of health. Available at: http://wp.me/a1djE5-aq
(11) Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment and punishment, Juan E. Méndez. 1 February 2013 -A/HRC/22/53 Available at: http://www.ohchr.org/Documents/HRBodies/HRCouncil/RegularSession/Session22/A.HRC.22.53_English.pdf
(12) License to Be Yourself. Laws and Advocacy for Legal Gender Recognition for Trans People. Open Society Foundations. Available at: https://www.opensocietyfoundations.org/reports/license-be-yourself
(13) Watch: 34 Countries in Europe Make This Nightmare a Reality. Available at: http://tgeu.org/nightmare/
(14) New Interactive maps depict situation for Trans persons worldwide. TRANS RESPECT VERSUS TRANSPHOBIA, TGEU. Available at: http://transrespect.org/en/new-interactive-maps-depict-situation-for-trans-persons-worldwide/