Proposed declassification of disease categories related to sexual orientation in the International Statistical Classification of Diseases and Related Health Problems (ICD-11).
The World Health Organization is developing the 11th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-11), planned for publication in 2017. The Working Group on the Classification of Sexual Disorders and Sexual Health was charged with reviewing and making recommendations on disease categories related to sexuality in the chapter on mental and behavioural disorders in the 10th revision (ICD-10), published in 1990. This chapter includes categories for diagnoses based primarily on sexual orientation even though ICD-10 states that sexual orientation alone is not a disorder. This article reviews the scientific evidence and clinical rationale for continuing to include these categories in the ICD. A review of the evidence published since 1990 found little scientific interest in these categories. In addition, the Working Group found no evidence that they are clinically useful: they neither contribute to health service delivery or treatment selection nor provide essential information for public health surveillance. Moreover, use of these categories may create unnecessary harm by delaying accurate diagnosis and treatment. The Working Group recommends that these categories be deleted entirely from ICD-11. Health concerns related to sexual orientation can be better addressed using other ICD categories.
Department of Epidemiology, Fielding School of Public Health, 640 Charles E Young Dr S, University of California, Los Angeles, California, 90024-1772, United States of America (USA).
Susan D
SD
Cochran
New York Medical College, New York, USA .
Jack
J
Drescher
Consultant, World Health Organization, Geneva, Switzerland .
Eszter
E
Kismödi
Centre for Research in Epidemiology and Population Health, Institut de la Santé et de la Recherche Médicale INSERM), Kremlin-Bicêtre, France .
Alain
A
Giami
Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland .
Claudia
C
García-Moreno
Primary Care and Public Health Directorate, Ministry of Health, Manama, Bahrain .
Elham
E
Atalla
Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa .
Adele
A
Marais
Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil .
Elisabeth Meloni
EM
Vieira
Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland .
Geoffrey M
GM
Reed
D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D001523:Mental Disorders / Q000145:classification*; D012725:Sexual Behavior