From 2007 on, the World Health Organisation (WHO) has been revising its diagnostic manual, the International Statistical Classification of Diseases and Related Health Problems (ICD), with approval of ICD-11 due in 2018. The ICD revision has prompted debates on diagnostic classifications related to gender diversity and gender development processes, and specifically on the 'Gender incongruence of childhood' (GIC) code. These debates have taken place at a time an emergent trans depathologisation movement is becoming increasingly international, and regional and international human rights bodies are recognising gender identity as a source of discrimination. With reference to the history of diagnostic classification of gender diversity in childhood, this paper conducts a literature review of academic, activist and institutional documents related to the current discussion on the merits of retaining or abandoning the GIC code. Within this broader discussion, the paper reviews in more detail recent publications arguing for the abandonment of this diagnostic code drawing upon clinical, bioethical and human rights perspectives. The review indicates that gender diverse children engaged in exploring their gender identity and expression do not benefit from diagnosis. Instead they benefit from support from their families, their schools and from society more broadly.

In his recent report, the United Nations Independent Expert on protection against violence and discrimination based on sexual orientation and gender identity, Victor Madrigal-Borloz, examines the “process of abandoning the classification of certain forms of gender as a pathology” – “depathologization”—and elaborates on the “full scope of the duty of the State to respect and promote respect of gender recognition as a component of identity” (p. 2). The report also discusses active measures to respect gender identity and concludes with a list of recommendations. While other United Nations special procedures and agencies have addressed and condemned violence and discrimination on the grounds of gender identity and expression, this report provides a deeper analysis on its root causes. It is the first special procedures report that exclusively addresses human rights with regard to gender identity and expression, and must be considered a mile-stone in the development and enunciation of international human rights law in this regard.