"We are both of the opinion that the diagnosis of transsexualism (F64.0) should be removed from the mental health chapter of the forthcoming ICD-11 and that the terminology which describes this condition should be changed to gender dypshoria or gender incongruence, or another more neutral term. "
That is the clear policy position being expressed by the clinical heads of two of England's Gender Identity Clinics, Kevan Wylie and Walter Bouman.
Professor Wylie heads the Porterbrook Clinic gender identity clinic in Sheffield and Dr Bouman heads the Nottingham service.
Their words come in a letter to a policy officer at the International Gay and Lesbian Assocation (ILGA), Sophie Aujean, who is gathering views from european clinical leaders on the revision of the International Classification of Diseases.
They add, "In order to ensure access to treatment and appropriate healthcare for trans people we support inclusion of this condition within the ICD-11, preferably in a separate chapter of sexual-related, gender identity-related and reproductive-related conditions."
This statement does not come as a surprise, since both Kevan Wylie and Walter Bouman have been closely involved with the consensus process being conducted by the World Professional Association for Transgender Health. However, it is the first time any clinicians in England have committed their positions to paper quite so unequivocally.
This will add to expectations of a more than cosmetic change to the underlying precepts in the revised clinical protocols to be determined by the Gender Identity Services Clinical Reference Group, which will begin work shortly. If a broadening clinical consensus agrees with stakeholders that transgender experiences don't belong within mental health classification then it becomes really difficult to continue advocating ways of working which impose unusual conditions on patients seeking hormonal and surgical support to realise their identities.