Global Action for Trans Depathologization 2017

Michel Riquelme

Michel Riquelme

Non-binary Trans Activist, Director of OTD Chile "Organizando Trans Diversidades."
Michel became an activist in 2005, when they started coordinating social projects in LGBTI groups, with an emphasis on community development and transgender health issues. Has received Fundación EPES Grant, Rainbow Leaders RFSL Fellowship, and was awarded the Andrés Bello University Acción Joven Award. Self-identified as transfeminist, Michel is also editor at Le Trans magazine.
Michel Riquelme

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In 2009 when first I heard about the Campaign to “Stop Trans Pathologization (STP) -2012”, many violent situations that I had lived for being transgender began to have a clearer explanation for me.

Why must we as transgender people have to go to a psychiatrist to validate who we are? Why is it that whatever a stranger has to say about who I am holds more credibility than my own definition of myself?

The way that western culture has faced the existence of transgender people is overwhelmingly burdened by prejudice, violence and discrimination. Gender diversity that has always existed in different cultures has been relegated to a corner of social marginality, with medicine and psychology being direct accomplices of it all. Different examples give account of this situation. The Trans Rights Europe Map & Index 2017 of Transgender Europe reflects that 36 countries in Europe still maintain the requirement of a mental health diagnosis to legally recognize the gender identity of a person. Some of these countries do not even allow such recognition. In the case of South America, only five countries have enacted regulations for the recognition of gender identity, however, some of these regulations maintain the requirement of psychological certifications.

The imposition by the states to oblige transgender people to undergo psychological or psychiatric evaluations is a form of coercion that violates the human right to identity. This imposition also violates the 18th principle of the Yogyakarta Principles, which says that “No person shall be forced to undergo any form of treatment, procedure, medical or psychological examinations, nor to remain confined in a medical center, on account of their sexual orientation or gender identity. Regardless of any classification to the contrary, sexual orientation and gender identity of a person are not, in themselves, medical conditions and should not be treated, cured or suppressed”.

Another human right that is often violated due to the pathologization of trans people, is the right to health care. The PATHOLOGIZATION has become a form of arbitrary discrimination against the transgender population, due to the fact that, in order to be able to access a particular provision of health (hormone therapy and/or surgery) we are forced to submit to psychiatric or psychological examinations, unlike the rest of the population who is not forced to such examinations to gain access to the same health care. An example of this is that millions of cisgender women (women who are identified with the sex and gender that were assigned to them at birth) in the world consume sex hormones as a form of contraceptive method, and there are countries where these medications can be prescribed even by non-medical professionals. No clinical protocol requires that women get diagnosed by a psychiatrist as having “pregnancy dysphoria” or some mental pathology before allowing them access to sex hormones. However, when it is about transgender people, the clinical protocols immediately impose psychiatric certifications to access the same sex hormones.

This discriminatory treatment related to the access to health care is perfectly punishable by the laws against discrimination that consider gender identity as an explicit category. As stated in the Inter-American Convention against All Forms of Discrimination and Intolerance, “Discrimination may be based on the grounds of nationality, age, sex, sexual orientation, gender identity and expression, language, religion, cultural identity, political opinions or of any other nature, social origin, socio-economic status, level of education, immigration status, refugee status, repatriated, stateless, or internally displaced person, disability, genetic feature, mental or physical health condition, including infectious, mental disabling or any other condition”.

The negative impact of the pathologization of trans people also has its adverse effects on the way in which society generally perceives the existence of transgender people. According to the results of the first survey about transgender and non-conforming gender population in Chile, called the T Survey, the main violence that transgender people face is the denial of our identity, which in essence means the denial of our existence. The 96% of the people surveyed said that their identity was challenged in the health centers, the 27% expressed that their health demands were ignored, and the 15% said they have been burdened by verbal discrimination in health centers. Prejudice and discrimination are also evident in the fields of education and the family.

The pathologization of the difference generates hate speech that is built around a particular social group. The argument that a certain difference is the product of a disease or disorder, is reiterative in hate speech and hate crimes against LGBTI people.

This is why from a Human Rights perspective the pathologization of transgender people has no justification whatsoever, as well as the constant postponement of the complete depathologization of the gender transition in the DSM manuals (Diagnostic and statistical manual of mental disorders) and ICD (International Statistical Classification of Diseases). This postponement keeps us in the social marginality where we are humiliated and even murdered, and it has been the breeding ground of prejudices, discrimination and hate speech against transgender people around the world.

The International Campaign to Stop Trans Pathologization, makes a calling every year in the month of October to hold demonstrations around the world demanding the withdrawal of the classification of the processes of transition between gender equality as a mental disorder (DSM diagnostic manuals of the American Psychiatric Association and the World Health Organization), as well as it requests for a trans-specific public health care policy. It  calls to change the model of health care for transgender people, discarding the model of compulsory psychiatric and psychological assessments toward a model of informed consent where each person can decide about their health care. The STP campaign also calls for the legal recognition of gender without medical requirements, for the depathologization of gender diversity in childhood, as well as for the protection against transphobia.

STP campaign is a pioneer on an international level in these lawsuits and reminds us every year that no manual of mental disorders, no doctors, no parliamentary scrutiny, nor any State is above human rights.

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