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The Swedes Say Crossdressing Doesn't Indicate Mental Illness

by: Autumn Sandeen

Tue Nov 18, 2008 at 11:30:00 AM EST

Sweden's The Local, which has as it's subheader Sweden's News In English, reported that Transvestism 'no longer a disease' in Sweden:

Transvestism, along with six other sexual behaviours, will be struck from Sweden's official list of medical diagnoses starting on January 1st, 2009.
Transvestism, along with six other sexual behavioursThe National Board of Health and Welfare (Socialstyrelsen) took the decision to declassify the behaviours as illnesses in order to avoid strengthening prejudices about them, said agency head Lars-Erik Holm.
"We don't want to contribute to certain sexual behaviours being thought of as diseases. These individuals' sexual preferences have nothing to do with society," he explained in the Dagens Nyheter (DN) newspaper.
In reality, Sweden's medical diagnosis system is used to gather statistics about the healthcare system. However, people have come to view the listing as a registry of accepted diseases.
The other diagnoses which will soon disappear from the disease registry include fetishism, fetishistic transvestitism, sadomasochism, gender identity disorder in youth, and multiple disorders of sexual preferences., will be struck from Sweden's official list of medical diagnoses starting on January 1st, 2009...

The first paragraphs of the Swedish version of this story translates as follows:

After the end of the year 2009 takes away Welfare diagnosis for a range of sexual expression. Among other things disappear codes for fetishism, transvestism and Sado masochism.
It could be said that we [transgender people] have come in from the exclusion now, and it is nice not to have a "disease" anymore, "said Pia-Lena Widahr that under international accounting units Lennart.
By eliminating the disease concept of Health and Welfare wants to help reduce the prejudices of certain sexual expression in the international classification system ICD (see box). Today these are sorted in under mental illnesses and behavior disorders.

There's some discussion on this -- by taking crossdressing and the other six sexual behaviors off of the list of treatable conditions, it appears that the single-payer healthcare system no longer will pay for treatment of people who engaging in any of these sexual behaviors. So if one is experiencing depression relating to one's crossdressing, will the Swedish welfare system pay for treatment for the depression, or disallow treatment because the underlying cause of the depression doesn't have a medical diagnoses? I don't know.

I have a brother who lives in Sweden, but I'm pretty sure he doesn't crossdress -- I'm guessing this bit of news isn't going to impact him directly. I'm asking him though what this means, and will report back if he answers me on this.

Autumn Sandeen :: The Swedes Say Crossdressing Doesn't Indicate Mental Illness

Tags: Transgender, Healthcare, Sweden, (All Tags)

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The Swedes Say Crossdressing Doesn't Indicate Mental Illness | 2 comments

Response from a trans activist in Sweden to concerns about negative impacts on health insurance

This was sent around via the TGEU listserv. If anyone would like to contact her about it, comment here and I'll try to put you in touch.

The demand for the exclusion of certain diagnostic criterias such as transvestitism, sado-masochism and fetishism, to mention a few from the Swedish verison of ICD-10 (KSH97) has been supported by the GLBT-community for quite a while. It's also important that the Swedish National Board of Health and Welfare will work towards an elimination of these diagnostic criterias from the ICD-10 on an international level.

As far as I can see this action will not influence how our national health insurance will fund various medical needs for the transgender community. Access to treatment is based on the diagnosis of Transsexualism F64.0 which will remain in the Swedish version of ICD-10. The law governing the right to legal gender reasignement is still in force and stems from 1972. It's at present due for revision but the new version will most likely be as restrictive as the 1972 version.

Acess to medical treatment for transgender person (surgery, hormones etc) is resticted to persons who meet with the diagnostic criteria for Transsexualism F 64.0 and are undergoing treatment in one of 6 local government run facilities. The patients have no say whatsoever in the treatment they are given and the psychiatrist in charge makes all the decisions such as if the patient should be given the opportunity to apply for a legal gender change and subsequent surgery etc.

Before you can even have your first apointment with the treating psychiatrist you would most likely have to wait a year or two. When the government body deciding in these matters lets you through this gatekeeping system and accept your application for legal gender reasignment you will be given permission to undergo SRS. The government decide which surgeon will do your SRS and you can only be reffered to one of two hospitals in Sweden.

All procedures are covered by national health insurance which is nice indeed. Still the Swedish system is very conservative in comparison with the WPATH Standards of Care.

Now to the matter of the diagnostic criteria for Gender Identity Disorder in Childhood which also will be scrapped. As this diagnostic criteria is used for treatment of children with gender issues and serve the same purpose as F64.0 Transsexualism for adults the effect of this change (that takes effect on january 1st 2009) is more difficult to predict the outcome of.

At present most children suffering from Gender Identity Disorder in Childhood are treated at The Astrid Lindgrens Childrens hospital in Stockholm. Professor Rydelius does a great job helping young patients and their families.

I know of several youngsters undergoing treatment at present, some as young as 8 years of age. At present puberty inhibators are in use. The youngest patient I've met who was put on inhibators while doing counseling work for the trans commity some years ago was 14 years old and given HRT with estrogens short of her 16th birthday.

The Swedish law restrict access to legal gender change (incluing name change) and surgery to personen over 18 years of age, regardless of parental consent.

A wide spectrum of GLBT organisation have been lobbying for the right for young transgirls and boys to at least have their name and legal gender changed as well to have early acces to SRS etc.

Somtimes transsexual youth have (with parental support) undergone SRS abroad, mainly in Thailand.

I do not think the the Swedish National Board of Health and Welfare have fully understood that the decision to remove the diagnostic criteria for gender identity disorder in childhood could have an impact on the treatment of these patients.

Hopefully it will be business as usual.

by: xckb13 @ Tue Nov 18, 2008 at 10:47:19 AM CST

I also say it is not a sign of mental illness

but that's because I live with and have had a 20+ year exclusive relationship with a man who cross-dresses.

Do I understand it? Kinda. Certainly much more now.

Is it a form of sexual deviancy? Is he a risk to anyone?NO.

Does it upset me? No- but in the past, it has.

Would I consider him mentally healthy and "normal"? YES- he is one of the most sane, rational, intelligent, caring and compassionate people I have ever met, and I am very proud to be this man's wife.

A good man, a wonderful father, neighbor and friend, husband and lover? YES.

Do I think he requires any sort of evaluation or treatment? NO

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by: Louise @ Tue Nov 18, 2008 at 11:49:11 AM CST