Earlier today I posted a short item reporting a statement by the heads of two English Gender Identity Clinics, Professor Kevan Wylie and Dr Walter Bouman, confirming their views about how the International Classification of Disease (ICD) should be updated for gender identity diagnoses.
For background see another recent blog.
The position of these two senior clinicians was not surprising, given their involvement in the global consensus-building process led by the World Professional Association for Transgender Health (WPATH). However, this was the first time that two clinical heads had stated the position so succinctly in writing.
No sooner had this morning's blog gone out than I heard from a senior clinician at the Charing Cross Gender Identity Clinic, England's largest.
Dr Stuart Lorimer lamented that it was a shame the letter had only had two signatories. He felt sure his colleagues would want to have had the opportunity to express the same to ILGA, who were gathering the information. They'd simply not been approached.
I suggested that there was no reason they couldn't endorse the principles independently. I provided the contact details for ILGA's policy officer and the Charing Cross team went off to agree a suitable letter, to be signed by the chief clinician, Dr James Barrett.
And this is what James' message, addressed to ILGA, says:
Following the joint statement of Drs Bouman and Wylie, we would like to make our own position clear regarding gender related diagnoses in the forthcoming ICD-11. As the oldest and largest of the UK’s gender clinics, we find that dealing with the ongoing needs of our sizeable caseload (currently, around 4000 active attendees) keeps us occupied to the extent that we are often less directly involved than we would like to be in global matters such as the ICD-11 discussions in Geneva. This does not, however, mean that we are ignorant of or indifferent to those discussions.
As specialist clinicians dealing with the day-to-day realities of gender treatment, our own collective view is very similar to that of our professional colleagues. We support the renaming of the current F64.0 diagnosis, Transsexualism, to the less contentious Gender Dysphoria, Gender Incongruence or similar. Also, the diagnosis itself should, ideally, remain within the ICD-11 in a category aligned with gender identity, sexual or reproductive conditions rather than that section specifically designated mental health. This would help safeguard future provision of healthcare to gender variant people.
Again, a very clear endorsement of the direction being taken in the consensus process. And I don't doubt that the heads of the other English Gender Identity Services would agree too.