The Sección Diversidad Sexual of the Centro Nacional de Educación Sexual in Havana, Cuba, has recently issued the following statement:
STATEMENT ON DESPATHOLOGIZATION OF TRANSSEXUALISM
Cuban Multidisciplinary Society for Sexuality Studies
5th Cuban Congress of Sexual Education, Orientation and Therapy
The Sexual Diversity section of the Cuban Multidisciplinary Society for the Study of Sexuality (SOCUMES) proposed the adoption of the following Declaration in its General Assembly of Members on 18 January 2010 in Havana, based on a proposal made by the National Commission for Comprehensive Care of Transsexual People, of the National Center for Sexual Education (CENESEX).
Recalling the current inclusion of transsexuality as a mental disorder in the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) published by American Psychiatric Association (APA) and the International Classification of Diseases (ICD-10) of the World Health Organization (WHO);
Recalling also that the Standards of Care adopted in Cuba by the National Commission for Comprehensive Care of Transsexual People rely on those published by the World Professional Association for Transgender Health (WPATH), which also includes the classification of the Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases E-10;
Considering that the American Psychiatric Association will publish in 2012 the fifth version of the above mentioned manual and that the chief and other specialists of the working group responsible for the review have recently proposed the non-removal of this category, as well as the application of corrective psychological therapy to children, to the sex assigned at birth;
Taking into account the concern expressed by individuals and human rights groups at the international level regarding this issue,
Considering that all transgender people -including transsexuality, transvestites and intersex people- may be vulnerable to marginalization, discrimination and stigma, based on the socially regulated binary approach that recognizes only two gender identities: male and female;
Considering also that the above classifications perpetuate and deepen social discrimination against these groups, causing irreversible physical and psychological damage that can lead these people to commit suicide;
Considering in addition that transsexuality and other transgender expressions are not an option for a lifestyle and that the modifications to their bodies have no cosmetic intentions. It is a right and an inner need to live with the gender identity which the person feels to belong;
Recalling the Yogyakarta Principles on the application of international human rights law in relation to sexual orientation and gender identity, especially Principle 18 on “Protection from Medical Abuses” which, among other things, make States and governments responsible to “ensure that any medical or psychological treatment or counseling does not, explicitly or implicitly, treat sexual orientation and gender identity as medical conditions to be treated, cured or suppressed”;
Considering that the right to public health and universal free access to its services are guaranteed by the Cuban government for all, but still requires additional laws to fully protect the rights of transgender people;
Recalling Resolution 126 of Public Health Ministry, of 4 June 2008, which regulates the procedures involved in health care for transsexuals;
Recognizing that multidisciplinary care provided by the National Commission for Comprehensive Care of Transsexual People, since its foundation in 1979 until today, has led to a remarkable improvement in the quality of life of transsexual people and their families.
Express our support for the removal of transsexuality from the international classification of mental disorder, especially in the DSM-V update to be published in 2010.
Reject the application of psychological therapies for transgender people, in order to reverse their gender identity, as well as sex reassignment surgeries performed to those under 18 years old.
Reaffirm that transsexuality and other transgender identities are expressions of sexual diversity, to which it must be ensured all psychological, medical and surgical treatments required to alleviate alterations to the mental health of these individuals, as a result of stigma and discrimination.
Also reaffirm that the implementation of these procedures respects sexual rights of each person, and are consistent with bio-ethical principles of autonomy, nonmaleficence, beneficence and justice.
Reaffirm in addition that transgender care should be comprehensive, beyond just medical and psychological care, to ensure recognition and respect for their individual rights.
Reiterate the need to consider all necessary legislations to ensure recognition of these rights, especially the Gender Identity Bill, which includes the identity change regardless sex reassignment surgery performance.
Call for a broader implementation of educational strategies regarding sexual orientation and gender identity at all levels of education and to the general population, as stated in the National Program for Sexual Education.
Reaffirm the need to include the attention to transgendered people in comprehensive social policies of the State and Government of Cuba, in correspondence with the “Declaration of the General Assembly of the United Nations, condemning the violation of human rights based on sexual orientation and identity gender “, supported by Cuba on 18 December 2008.
Havana, 22 January 2010
Sección Diversidad Sexual
Centro Nacional de Educación Sexual
Although it may be tempting to say that Cuba now joins France in regarding transsexualism as not being a mental disorder at all, there is some dispute about the reality of the French Health Ministry’s announcement in May 2009.
There has been some fairly lively discussion between various trans support groups in Europe, and there is a view that the French Health Ministry’s announcement was only about principles of reimbursement, and not about the moral obligations of the medical profession. Apparently, the French HAS (Health High Authority), which is run directly by the Ministry of Health, is currently promoting more pyschiatric control of trans people. It seems that the HAS report explicitly recommends that the French Social Security’s “official teams” (ie. those who are charged with pathologising and psychiatrising French trans people) be extended to the whole country.
Additionally the report also says that “psychiatric assessment will still be needed” for trans people to access their civil and human rights, no matter what is decided by the Health Ministry regarding reimbursement and classification.
The inference is that France is not working towards “depsychiatrizing” trans people and is therefore not fully committed to depathologisation.
Cross-posted at Questioning Transphobia