WAS statement about the WHO / ICD 11

The World Health Organization (WHO) has just announced the official publication of a new version of the International Classification of Diseases (ICD-11). This new version marks the culmination of a long process which lasted about ten years and which benefited from a large number of contributions by and comments from professional specialists and patient organization advocates.

The new ICD includes for the first time a chapter on Conditions Related to Sexual Health which brings together conditions that were previously categorized in other ways and mostly under the category of mental disorders.

The proposed changes in the ICD-11 embody a more integrated approach to sexual health. This reorganization reflects the WHO’s definition of sexual health as “a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity” (WHO, 2006). The new chapter on Conditions Related to Sexual Health includes sexual dysfunctions, sexual pain disorders, paraphilic disorders, gender incongruence, adrenogenital disorders, sexual transmitted infections, changes in female and male genital anatomy, sexual assault and childhood sexual abuse, and contraceptive management. Most importantly, the proposed new classification bridges the mind/body divide, which has long been a prominent feature of medical care related to sexual dysfunction. Moreover, eliminating the outdated mind/body split and removing many disorders from the mental and behavioral disorders sections, allows practitioners to address these issues more holistically, in a less stigmatizing and less myopic way. By using a sexual health approach, these guidelines will improve the way that public health practitioners approach, record, and report diagnoses, moving away from a persistent emphasis on negative outcomes toward an approach based in integrated, holistic care.

The new classification also eliminated past guidelines that impose a normative standard for sexuality and removed all categorizations that selectively target people with same-sex orientation or gender nonconformity, with no clear public health justification. In addition, the new classification removed transsexualism and gender identity disorder from mental and behavioral disorders and moved them to a new chapter, thus destigmatizing individuals with gender incongruence and providing a foundation for better access to both biomedical and psychological treatments.

The World Association of Sexual Health (WAS) actively participated in all stages of the ICD revision process, by participating in a number of committees and working groups.

WHO is opening a new chapter in the management of sexual health problems. And WAS, as an international organization with more than one hundred member organizations across the globe, will continue to promote and advocate for sexual health and sexual rights throughout the lifespan and across the world by advancing sexuality research, comprehensive sexuality education, and clinical care and services for everyone. This includes research and advocacy to foster and develop better approaches to all aspects of sexual health, including sexual disorders and dysfunctions, paraphilia, genital pain, and problems in the context of reproductive health.