A non pathologizing approach in the assessment of gender incongruence and gender affirming treatment (Part 1 & 2)

Content and aim: With the publication of ICD-11, transgender identity has been officially recognized as a non-pathological condition and, therefore, as a standard variant of human identity and lived experience. The placement of gender incongruence – removed from the “Mental and behavioral disorders” chapter and included in the new “Conditions related to sexual health” chapter of ICD-11 – was the first decisive step towards shifting the paradigm of how to provide assessment and gender-affirming treatment to transgender persons. Denmark was a pioneer country in this process by removing the F.64 diagnoses in chapter V of ICD-10, “Classification of Mental and Behavioral Disorders” in January 2017 and replacing them with non-pathologizing diagnoses. Thus, gender incongruence has since then been interpreted as neither a somatic nor a psychiatric disorder.

What are the clinical implications of this, and how can it be done in practice? Using the Danish example and looking at recent research on transgender identity, the speaker will describe a modern approach to these conditions.

Examples form clinical cases will be used to illustrate the process from how to assess the transgender person´s treatment needs to how to fulfill them.
Learning Objectives:

1. To describe and understand the development of transgender identity in a non-pathological frame;
2. To understand the possible clinical presentations of gender incongruence in adults;
3. To describe the assessment of gender incongruence and related needs for gender-affirming treatment;
4. To describe the possible pathways of psychiatric morbidity and the relevance it can have for the gender-affirming treatment;
5. To describe the role of the mental health professional according to this new paradigm of assessment and treatment.

Produced in 2021