The ICD-11 classification of gender incongruence of adolescence and adulthood: adequacy among transgender people in Lebanon

Abstract

The aim of this study was to evaluate the adequacy of the then proposed International Classification of Diseases version 11 (ICD-11) diagnostic guidelines for Gender Incongruence of Adolescence and Adulthood in a sample of transgender people accessing multi-disciplinary health care services at specialised organisations in Lebanon. The cross-sectional study reported here was part of the ICD-11 field test studies that took place in several countries. Twenty-eight Arab transgender adults residing in Lebanon were recruited after giving consent to participate in a structured interview with a mental health professional. The questions asked of them consisted of the following: socio-demographic data; medical history related to gender identity; experiences of gender incongruence; psychological distress; rejection; violence; and functional impairment. Results showed that Arab transgender individuals living in Lebanon report being the victims of violence, abuse, discrimination and rejection from family, peers and society in general. As a result, they develop psychological distress that is better explained by the social context in which they live, rather than by their transgender identity. Reformulating ICD-10 Transsexualism as Gender Incongruence of Adolescence and Adulthood in ICD-11 and moving this diagnosis out of the chapter on mental disorders chapter would be favourable to the Lebanese sample.

Keywords:

• Gender incongruence
• transgender
• Lebanon
• distress
• ICD – 11

Acknowledgements

BK, JK, GR and RR are affiliated with the ICD-11 Mental and Behavioural Disorders Field Studies Coordination Group and the World Health Organization (WHO) Department of Mental Health and Substance Abuse. The views expressed in this article are those of the authors alone and, unless specifically stated, do not reflect the official policies or views of WHO.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 These centres included the (1) Arab Foundation for Freedoms and Equality (AFE-MENA), (2) the Middle East and North African Organization for Services, Advocacy, Integration & Capacity building (MOSAIC), (3) Helem (the Arabic acronym for the Lebanese Protection for Lesbians, Gays, Bisexuals and Transgenders and also the Arabic word for ‘dream’) and (4) Marsa, a sexual health clinic.

Additional information

Funding

This work was funded by the World Health Organization (WHO).