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Cited by 469LGBTQ Health, Identity, and PolicyMental Health and PsychiatrySexual function and dysfunction studies

Disorders related to sexuality and gender identity in the ICD-11: revising the ICD-10 classification based on current scientific evidence, best clinical practices, and human rights considerations

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Reed, Geoffrey M., Drescher, Jack, Krueger, Richard B., Atalla, Elham, Cochran, Susan D., First, Michael B., Cohen‐Kettenis, Peggy T., Arango‐de Montis, Iván +4 more·2016·World Psychiatry
DOI 10.1002/wps.20354PMC PMC5032510
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Abstract

In the World Health Organization's forthcoming eleventh revision of the International Classification of Diseases and Related Health Problems (ICD‐11), substantial changes have been proposed to the ICD‐10 classification of mental and behavioural disorders related to sexuality and gender identity. These concern the following ICD‐10 disorder groupings: F52 Sexual dysfunctions, not caused by organic disorder or disease; F64 Gender identity disorders; F65 Disorders of sexual preference; and F66 Psychological and behavioural disorders associated with sexual development and orientation. Changes have been proposed based on advances in research and clinical practice, and major shifts in social attitudes and in relevant policies, laws, and human rights standards. This paper describes the main recommended changes, the rationale and evidence considered, and important differences from the DSM‐5. An integrated classification of sexual dysfunctions has been proposed for a new chapter on Conditions Related to Sexual Health, overcoming the mind/body separation that is inherent in ICD‐10. Gender identity disorders in ICD‐10 have been reconceptualized as Gender incongruence, and also proposed to be moved to the new chapter on sexual health. The proposed classification of Paraphilic disorders distinguishes between conditions that are relevant to public health and clinical psychopathology and those that merely reflect private behaviour. ICD‐10 categories related to sexual orientation have been recommended for deletion from the ICD‐11.

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  • In the ICD-11 guidelines, a deliberate attempt was made to prevent the risk of overpathologizing; distress caused by overpathologizing nonnormative sexual behavior, especially by moral judgments and disapproval, does not qualify for the diagnosis.

    “In the ICD-11 guidelines,2,20 however, a deliberate attempt was made to prevent the risk of overpathologizing. Distress caused by overpathologizing nonnormative sexual behavior, especially by moral judgments and disapproval, does not qualify for the diagnosis.”

    From Assessment and treatment of compulsive sexual behavior disorder: a sexual medicine perspective (2024) · cites this paper as [20]

  • There are significant differences between ICD-11 and DSM-5 with regard to sexual health conditions.

    “There are significant differences between the ICD-11 and DSM-5 with regard to these sexual health conditions, which have been reviewed in this journal 21 .”

    From An organization‐ and category‐level comparison of diagnostic requirements for mental disorders in <scp>ICD</scp> ‐11 and <scp>DSM</scp> ‐5 (2021) · cites this paper as [21]

  • Central to the ICD-11 diagnostic criteria for CSBD were difficulties with sexual self-control over a prolonged time that are associated with distress.

    “Central to the diagnostic criteria were difficulties with sexual self-control over a prolonged time that are associated with distress.”

    From Assessment and treatment of compulsive sexual behavior disorder: a sexual medicine perspective (2024) · cites this paper as [20]

    The section on proposed ICD-11 sexual dysfunction guidelines requires persistence and clinically significant distress, while the section on paraphilic disorders discusses sustained arousal patterns. Neither passage describes difficulties with sexual self-control as diagnostic criteria for CSBD. Searches for CSBD, compulsive sexual behaviour, and failure to control sexual impulses found no passage addressing those criteria. (LLM, conf=0.74)

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Research works printed but not linked: 3

  1. Lewis RW, Fugl-Meyer KS, Corona G et al. Definitions/epidemiology/risk factors for sexual dysfunction. J Sex Med 2010;7:1598-607.
  2. Byne W, Bradley SJ, Coleman E, et al. Report of the APA Task Force on Treatment of Gender Identity Disorder. Arch Sex Behav 2012;41:759-96.
  3. Krueger RB, Reed GM, First MB et al. Paraphilic disorders in the Interna- tional Classification of Disease and Related Health Problems, Eleventh Revision (ICD-11). Arch Sex Behav (in press).

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Authors
Reed, G. M., Drescher, J., Krueger, R. B., Atalla, E., Cochran, S. D., First, M. B., Cohen‐Kettenis, P. T., Arango‐de Montis, I., Parish, S. J., Cottler, S., Briken, P., & Saxena, S.
Affiliations
  • World Health Organization (CH)
  • New York Medical College (US)
  • NewYork–Presbyterian Hospital (US)
  • Ministry of Health (BH)
  • University of California, Los Angeles (US)
  • Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
  • Instituto Nacional de Psiquiatria Ramón de la Fuente Muñiz Mexico City Mexico
  • Department of Reproductive Health and Research World Health Organization Geneva Switzerland
  • University Medical Center Hamburg-Eppendorf (DE)
ORCID
Venue
World Psychiatry
Publisher
Wiley
Published
2016-09-22
Volume
15
Issue
3
Pages
205-221
ISSN
  • 1723-8617 (ISSN-L)
  • 2051-5545
DOI
10.1002/wps.20354
PMC
PMC5032510
OpenAlex
W2522121988
Cited by
469
References
116
Citations by year
2026: 24 · 2025: 30 · 2024: 39 · 2023: 54 · 2022: 55 · 2021: 52 · 2020: 100 · 2019: 48 · 2018: 31 · 2017: 31 · 2016: 4
FWCI
59.75
Type
journal article
Language
en
Update notices
correction (2017-05-12)
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • World Psychiatry (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
  • Pure Amsterdam UMC (submittedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
Federal Centre for Health Education, Germany
Topics
  • Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
  • Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
  • Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
Keywords
ICD-11, ICD-10, sexual dysfunction, gender dysphoria, gender incongruence, paraphilic disorders, sexual orientation, sexual health, psychiatric classification, human rights

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