Diagnoses and treatment guidelines
Trans and non-binary people often face discrimination in the health care system as well. To this day, trans people in Germany are still diagnosed with “transsexualism” and “gender identity disorder”.
Fortunately, this outdated and pathologizing diagnosis could soon become a matter of the past: the diagnostic classification system, called ICD, has already been revised to this end. With the release of ICD-11 (the 11th version of the WHO's International Statistical Classification of Diseases and Health Problems) in January 2022, long overdue updates have been made: the pathologizing classifications were replaced by the diagnosis of ”Gender Incongruence” (i.e. the permanent lack of congruence between assigned sex and gender identity).
Correspondingly, the diagnosis for children and adolescents in ICD-11 has also been updated to “Gender incongruence of childhood”.
However, there is still a long way to go before the ICD-11 is introduced in Germany. A concrete date has not yet been set.3 Nevertheless, these new developments are another important step towards destigmatisation of trans and non-binary people.
An important document for the enforcement of a proper and fair treatment of trans and non-binary patients in childhood and adolescence is the so-called S3 guideline Gender Dysphoria in Childhood and Adolescence, Diagnosis and Treatment of the Association of the Scientific Medical Societies (AWMF).4 It contains, for example, recommendations for the treatment of trans-specific health issues.
Adult trans people can refer to the S3 guideline Gender Incongruence, Gender Dysphoria and Trans Health.6. The German Trans Association (BVT*) has created a guide (German only) for everyone seeking treatment.
On the one hand, the guidelines are an orientation for health care personnel and, on the other hand, a tool in the hands of patients and their families for asserting claims and demands from the health insurance. The guideline for children and adolescents is currently being revised.