Sexuality Policy Watch

GATE Publication: Gender is not an illness

December 15, 2017.

gate pub 

GATE released the publication Gender is not an illness. How pathologization violates human rights law. This paper was conceived and produced as a contribution to the ongoing process of depathologizing trans and gender diverse people through the reform of classification systems, legal frameworks and social attitudes. It was authored by Sheherezade Kara*, with the contribution of an international group of experts: Amets Suess-Shwend, Cianán B. Russell, Viviane Vergueiro, Eleonora Lamm, Eszter Kismodi and Mauro Cabral Grinspan.

Pathologization appears to be a new concept in the human rights field; however, it describes the lived experiences of many trans and gender diverse people around the world over the last several decades [1]. It conveys and executes a naturalized distinction between acceptable and unacceptable ways of being in the world –namely, “healthy” and “pathological”. Historically, those of us who identify ourselves in a gender different to the sex assigned to us at birth have faced stigma, discrimination and violence because being ourselves was considered to be, in itself, a pathology. Sadly, this history remains our shared present.

Pathologization has also been consistently used to deny, restrict and condition trans and gender diverse people’access to very basic rights, including legal gender recognition, gender-affirming healthcare, and its coverage  [2]. Institutionalization, “conversion” treatments, mandatory psychotherapy, coercive surgeries, invasive mental and physical examinations, sterilization, and forced divorce are intrinsic parts of the requirements imposed upon us every time and place our gender is considered to be an illness [3].

As a critical framework, depathologization was created and established by those communities and movements primarily affected by its negative effects [4 ].In spite of our visibly marginalized situation in mainstream human rights spaces and the spread of epistemic injustice associated with being defined as “pathological” subjects, trans and gender diverse activists have been able to create the language to address the norms defining, oppressing and excluding us. After years of intense trans and gender diverse organizing, that language has been adopted by official institutions [5 ].

The main goal of this paper is to highlight how pathologization sits within the international human rights framework as a specific root for human rights violations, and as set of practices and consequences that extend those violations from childhood to adulthood. Moreover, the introduction of pathologization as a key human rights concern is a necessary step to dismantle its pervasive influence and to finally make depathologization a reality for all.

​The publication can be downloaded from here​.
(*)  ​Sheherezade Kara is an human rights activist, advocate, researcher, strategist and writer working toward the development and implementation of international legal norms and standards on LGBTIQ people’s human rights and gender issues. She has worked with human rights organisations, donors, academic centres and the United Nations, including in an advisory capacity. Sheherezade was recently a member of the expert committee responsible for elaborating the Yogyakarta Principles Plus 10. She received a Master’s degree in International Law from SOAS (University of London) in 2008.
[1] Suess, A., Espineira, K. & Crego Walters, P. (2014) Depathologization, in TSQ.Transgender Studies Quarterly. Postposttranssexual. Key concepts for a Twenty-First-Century Transgender Studies, 1 (1-2): 73-77.
[2] Statement on the International Day of Action for Trans Depathologization 2017, 21 October 2017. Retrieved from: https://transactivists.org/transdepathstatement20173​] Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment (A/AHR/31/57), 5 January 2016.
[4] See, for example, the website of STP, International Campaign Stop Trans Pathologization, the Transgender Europe (TGEU) documents on Depatologisation, The Asia and the Pacific Transgender Network (APTN) compilation ​Asia and the Pacific Voices: International Day of Action for Trans Depathologization, the documents and videos produced by Iranti-org, including the toolkit (2017) Ending Pathological Practices Against Trans and Intersex Bodies in Africa. See also Vergueiro, V. (2015) Despatologizar é descolonizar, 25 October, 2015. Cabral, M., Suess, A., Ehrt, J., Seehole, T.J. & Wong, J. (2016) Removal of a gender incongruence of childhood diagnostic category: a human rights perspective. The Lancet Psychiatry 3(5), 405-406.
[5] See, for example, UN Committee on the Rights of the Child, UN independent experts, the Inter-American Commission on Human Rights, the African Commission on Human and Peoples’ Rights, the Council of Europe Commissioner for Human Rights (2016) Joint Statement on Pathologization – Being lesbian, gay, bisexual and/or trans is not an illness for International Day Against Homophobia, Transphobia and Biphobia, 17 May 2016; UN Committee on the Rights of the Child, UN Committee Against Torture, UN independent experts on extreme poverty, the right to education, sexual orientation and gender identity, the right to health, violence against women, and discrimination against women, as well as the Inter-American Commission on Human Rights, Chairperson of the Committee for the Prevention of Torture in Africa (of the African Commission on Human and Peoples’ Rights), and the Council of Europe Commissioner for Human Rights. Embrace diversity and protect trans and gender diverse children and adolescents”, Joint Statement for International Day Against Homophobia, Transphobia and Biphobia, 17 May 2017.


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