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Is The WHO Going To Finally Declare That Being Trans Is Not A Mental Illness?

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By Riddhi Tyagi:

Up until now, the World Health Organisation puts being transgender under the category of mental illnesses. Yes, you read that right.

This will, however, change this year when the WHO revises the current edition of the International Classification of Diseases (ICD-10), a global codebook that impacts disease diagnostic manuals the world over.

The ICD-10 came into being, way back in 1990. he WHO must soon understand the importance of how far we have come as a society and how far science, in general, has evolved. Isn’t it enraging to know that being transgender currently shares space with termed mental illnesses like paedophilia.

The plan to revise the ICD has been pushed aside time and again, first in 2012, then 2015, then 2017, and to this year. Finally, the buck stops here.

Pakistani transgender march at a rally for World’s Aid Day in 2013.

Why Was It Treated As A Mental Illness?

Being trans was compared to other illnesses like Bulimia and Anorexia, because of the way body conformity and realisation works. Trans people experience anxiety about the difference between their physical body and their gender identity. This is called ‘gender dysphoria’, to be more specific.

However, gender dysphoria, unlike body dysmorphia (seen in Bulimia and Anorexia) is not an illness in itself although both terms are often confused. Being trans has been attached to a mental disorder because trans people have suffered from social anxiety and depression all these years. The distress comes with attaching a certain identity to yourself, the fear of whether people will accept your identity, and the anxiety of not having certain facilities society should allow them. It comes up when ticking the ‘gender’ box on any form, when not conforming to any of the assigned pronouns, and even when going to the washroom (the ‘He’ or ‘She’ question). Shall we then tag people being themselves as an illness just because the society is at fault?

Declassifying Transgender Identity As A Mental Disorder

A study published Tuesday in the journal Lancet Psychiatry argues and urges for the declassification from mental illnesses. “A condition is designated as a mental illness when the very fact that you have it causes distress and dysfunction”, said Geoffrey Reed, a professor of psychology at the National Autonomous University of Mexico, a consultant on ICD-11 and co-author of the study. The study clearly states that being a transgender is not a disease.

“We found distress and dysfunction were very powerfully predicted by the experiences of social rejection or violence that people had,” he said. “But they were not actually predicted by gender incongruence itself.”

According to Reed, it’s actually the external factors which play a big role and causes all distress. “The societal stigma, the violence, and the prejudices. Remove them, and all that remains is the feeling of ‘gender incongruence’,” continued Reed.

The label proposed in ICD-11 in a new chapter called “Conditions Related to Sexual Health,” is scheduled to be medically and biologically oriented.

In 2013, the Supreme Court of India had given a direction to all Indian states to improve the conditions of transgender people in India. This community has experienced discrimination in all spheres of life be it in education, at the workplace, or for their medical needs. The transgender community in India is highly vulnerable to mental and physical illness, majorly due to lack of economic opportunities, even forcing them to engage in sex work.

Despite all appreciated efforts it is hard to say that in India the stigma is absent. In fact, as Reed points out, the external factors owing to the anxiety and distress are present all over.

Homosexuality Was Scrapped The Same Way

For the longest time, homosexuality was included as a mental illness in The Diagnostic and Statistical Manual of Mental Disorders (DSM), the psychiatric disorders guidebook. The diagnosis for the same became “sexual orientation disturbance,” in 1973. In 1987 it was completely done away with as more and more gay rights advocates spoke up. If the classification of being trans as an illness is done away with (as was done with homosexuality), a huge part of the problem would be solved.

However, Reed also explains that “The risk would be if we took conditions related to gender identity out of the classification altogether, it would undermine the access to health services that transgender people have.” He added, “They wouldn’t have a diagnostic code that conveyed eligibility.”

Therefore a lot depends on how the ICD-11 language will be out in order to not stigmatize being transgender as well as classifying the anxiety of gender identity so that trans people opting for sex-reassignment surgeries can avail the benefits.

 Laxmi Narayan Tripathi, transgender rights activist, Hindi film actress and Bharatanatyam dancer. (Photo by Subrata Biswas/Hindustan Times via Getty Images)

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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

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Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

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MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

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A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

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Find out more about the campaign here.

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A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform Change.org, demanding that the Government of Assam install
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