ICD-11

ICD-11 is the eleventh revision of the World Health Organization’s International Classification of Diseases, adopted by the World Health Assembly in May 2019 and in force since January 1, 2022. As the world’s shared standard for coding and health statistics, it is what member states — China included — use to update their national systems.

For LGBTQ+ people, ICD-11 made two key changes. First, it finished the cleanup on sexual orientation: homosexuality itself had already been removed in the ICD-10 approved in 1990, but ICD-10 still carried leftover entries such as “ego-dystonic sexual orientation.” ICD-11 deleted them all — orientation is no longer a diagnostic object in any sense. Second, it renamed the trans-related entries “gender incongruence” and moved them out of the mental disorders chapter into a chapter on conditions related to sexual health. The design is deliberate: it states clearly that being transgender is not a mental illness, while keeping a pathway to gender-affirming care such as hormones. For more, see Trans 101.

Register note: an academic and clinical term. Keep the two years straight: 2019 is when it was adopted, 2022 when it entered into force.

Common misreading: “ICD-11 finally removed homosexuality from the disease list.” The depathologization milestone for homosexuality was 1990; what ICD-11 completed was clearing legacy categories and re-homing the trans entries. For China’s domestic counterpart revision, see CCMD-3.