In the lead-up to Intersex Awareness Day, GATE has shared a technical submission to the World Health Organization on reform of intersex issues in the International Classification of Diseases (ICD):
A new version of the ICD, called ICD-11, is expected to be completed in 2018.
Our concerns with the proposed ICD-11 draft include the unnecessary pathologisation of often benign physical variations, including through new terminology, and proposed unlawful medical interventions.
In particular, procedures are explicitly defined for the following diagnostic codes that are unlawful in at least one jurisdiction, of international concern to community organisations, and of international concern to human rights institutions:
- 5-alpha-reductase 2 deficiency
- 17-beta-hydroxysteroid dehydrogenase 3 deficiency
- congenital adrenal hyperplasia
Those interventions have been criticised for their weak evidence, and irreversible physical and mental health consequences, in the WHO report on Sexual health, human rights and the law; therefore, it is contradictory and inappropriate for the proposed ICD revision to require them. They should be removed. Additional codes contain language that is used to justify similar interventions, and this should also be removed.
The proposed ICD-11 draft introduces the category of “disorders of sex development” as the diagnostic umbrella term for intersex variations. We propose to replace it with “congenital variations of sex characteristics”, and other additional systemic changes.
The submission was coordinated by Morgan Carpenter and produced in consultation with intersex activists from all around the world.