Towards depsychiatrisation of transgender identity: A French study for ICD-11

International audienceIntroduction.– As a part of the development of ICD-11, WHO recommended to remove gender identity disorders from the chapter on mental and behavioural disorders to a non psychiatrising chapter. Current classifications consider that the presence of psychological distress and impairment are necessary and sufficient to consider transgender as a mental disorder. It implies that they are universally reported and determined by gender incongruence per se. A first study, conducted in Mexico showed that they are not always present and are predicted by experiences of social rejection Objective.– The aim of this study was to replicate the Mexican study in a French context, assuming that distress and impairment will not be reported by everyone, and that they may have other determinants than gender incongruence. Method.– A total of 72 transgender adults, mostly trans-women (60%), were asked to answer a questionnaire related to their experiences of gender incongruence, distress, functional impairment, social rejection and violence, during their adolescence. Results.– As in Mexican study, most French participants reported having experienced psychological distress (88.4%) or functional impairment (85.5%). But both features were not reported by everyone. Moreover, distress was related to work and scholastic dysfunction, and participants who experienced dysfunction also reported more experiences of social rejection, particularly from schoolmate and/or coworkers. Conclusion.– Results confirmed the overall pattern observed in Mexico and support the suggestion to classify transgender incongruence outside of the category of mental disorders in future ICD-11. This could improve access to treatment, and contribute to reduce stigmatisation and victimisation