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Writer's pictureLa Petite Sirène

ESCAP statement onthecare forchildren andadolescents withgender dysphoria : anurgent need forsafeguarding clinical, scientific, andethical standards


According to the DSM-5-TR [1] gender dysphoria refers to “…the distress that may accompany the incongruence between one’s experienced or expressed gender and one’s assigned gender”, requiring also the presence of “…clinically significant distress or impairment in social, school, or other important areas of functioning”; the DSM-5-TR lists  gender dysphoria among mental disorders. In contrast, the latest ICD-11 [2] describes gender incongruence as a condition “…characterized by a marked and persistent incongruence between an individual’s experienced gender and the assigned sex”. In order to avoid the stigma connected to mental disordes and the “double stigmatisation” of this historically highly stigmatised population, the ICD-11 decided to remove the gender identity-related diagnoses from the section on mental disorders and include it in the section “Conditions Related to Sexual Health” [3]. As such, gender dysphoria is not a mental health disorder according to WHO definitions, but psychiatrists and other mental health professionals may be asked to be involved to address co-occurring mental health problems [4]. Even though not all people with gender incongruence experience distress or dysfunction, the condition can be accompanied by significant suffering and have a major psychosocial impact on the individual and the family, sometimes requiring medical and psychosocial interventions.


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