Is being gay a mental illness?
The myth · False
「My relatives say homosexuality is a mental disorder that needs medical treatment. Is that true?」
The facts
No. Homosexuality itself is not a mental disorder; saying that CCMD-3 fully removed it from China’s disease classification in 2001 is an oversimplification, not an accurate history.
Medicine calls something a disorder when it impairs a person’s functioning, or causes distress that can’t be explained by outside pressure. Sexual orientation fails both tests. What actually hurts many LGBTQ+ people is stigma, rejection and pressure — not the orientation itself. Once you see that, the question mostly answers itself — and the answer isn’t a recent or “Western” opinion, but a conclusion the world’s psychiatric mainstream reached decades ago.
A timeline, not a single event
Depathologization wasn’t a single event; it’s a clear timeline:
- 1973: after a systematic review of the evidence, the American Psychiatric Association removed homosexuality from the DSM.
- 1990: the World Health Organization stopped classifying homosexuality itself as a mental disorder. ICD-10 did not thereby lose every orientation-related entry, and May 17 commemorates this change.
- 2019: the World Health Assembly adopted ICD-11 (in effect since 2022), which not only upheld that conclusion but also moved trans-related categories out of the mental disorders chapter entirely.
In international systems such as ICD-11 and the DSM, homosexuality itself is not a disorder. That is different from claiming that every country’s classification history changed in the same way at the same time.
In China: a classification history that needs precision
A common claim in Chinese families is that depathologization is “a foreign idea,” but the Chinese classification history cannot be reduced to a slogan. The usual account says that the 2001 third edition of China’s diagnostic standard, CCMD-3, removed homosexuality from disease classification. A 2026 analysis of the CCMD-3 text and its later use finds that it retained a “homosexuality” diagnosis under “sexual orientation disorders,” while also saying that sexual behavior itself was not necessarily abnormal. That is not the same path as the WHO’s 1990 removal of homosexuality itself. Calling a narrowing of the wording “complete depathologization” hides an important difference.
None of this changes the basic medical conclusion: homosexuality itself is not an illness to be treated. It means that a careful account of China should distinguish the classification text, how institutions used it, and current international standards instead of replacing evidence with a slogan.
If this question is causing you pain
- The pain is real — but it’s worth asking where it comes from. Is the orientation itself hurting you, or is it how people around you react to it? Medicine has nothing to cure in the first case; the second is a pressure worth naming and addressing. We unpack this idea of minority stress in our mental health explainer.
- If someone is urging “treatment” to change your orientation, read our piece on conversion practices first — that is not medicine, it is harm.
- And if things feel heavy right now, here are places you can reach out to today. You don’t need to be cured. You do deserve support.