[The trans depathologization perspective: a contribution to public health approaches and clinical practices in mental health? SESPAS Report 2020].

Abstract

Over the last decade, the academic-activist trans depathologization perspective has contributed to a change in the conceptualization of gender transition processes. Observing an interrelation between psychiatrization and transphobic violence, trans depathologization activist groups and allies demand the removal of the diagnostic classification of transexuality as a mental disorder. Furthermore, they have developed trans health care models and legal gender recognition processes based on depathologization and human rights perspectives. They propose changing the role of mental health professionals in trans health care, substituting the psychiatric assessment role by accompaniment and psychological support tasks. The trans depathologization perspective can be related to various approaches and topics relevant in public health and mental health, among them sociology of diagnosis, human rights based approaches to health, human rights protection in mental health, universal health coverage, review of diagnostic classifications, intersectionality perspectives, reflections on bioethical principles, models of integrated people-centered health services and approaches to research ethics. Over the last few years, informed decision-making models have been developed for trans health care in several countries and world regions. Health professionals, including mental health professionals, as well as professionals from the educational and judicial-administrative sector, can have an important role in addressing situations of discrimination and transphobic violence, contributing to the construction of a society that respects, recognizes and celebrates gender diversity.