[01.02.2010: Bente Steinnes] The Norwegian Directorate of Health has decided that certain diagnostic codes are now invalid in Norway, thus changing the Norwegian version of the international diagnoses register (ICD-10).
The following diagnoses are taken out: fetishism, fetishistic transvestism, sadomasochism, multiple disorders of sexual preference, and transvestism.
- In our opinion there is no basis, neither in today's societal norms nor in professional health thinking, to classify these diagnostic groups as disease, says head of the Health Directorate BjÃ¸rn-Inge Larsen (picture). By excluding the use of these codes in Norway the Directorate wishes to contribute to the weakening of a general opinion that certain sexual preferences, sexual identities and gender expressions may be seen as states of illness.
We want to avoid stigmatizing
The Directorate of Health gives considerable emphasis to the fact that several interest organizations as well as health professionals from various environments have for a long time presented knowledge that these diagnoses in and of themselves, are experienced by many people as offensive and that they contribute to stigmatizing both groups and individuals.
The diagnoses mentioned are outdated and not at the level of the scientific standards that otherwise characterizes the international diagnostic manual (ICD-10).
There have been no essential changes to these diagnoses for over one hundred years. They came into being as a result of theories based on the current knowledge and viewpoints on human sexuality in society of those long gone days. At best these diagnoses, are completely superfluous. At worst they are stigmatizing minority groups in society.
These diagnoses are not useful to the health care system
The main objective of the classification of illnesses and health problems is to enable clear and comparable statistics describing the health care assistance to patients in contact with the health care system. The diagnoses which are now deleted are very seldom reported, and are therefore of minor relevance as a basis for the contents of the Norwegian Patience Register.
The decision applies as of February 1st 2010, and the code register will be updated as soon as practically possible.
By making this revision Norway has now joined Denmark and Sweden which made similar revisions in 1995 and 2009 respectively. The World Health Organization, WHO, is currently working on a new version of the diagnostic manual: ICD-11. As all the Scandinavian countries have now abolished the diagnoses for use at the respective national levels, this will be a significant professional and health political signal to WHO in the compilation process of the ICD-11.
The diagnoses of Transsexualism remain unchanged
The diagnoses that cover transsexualism among adults and children (F64.0 and F64.2) are not affected by this revision. Concrete treatment offers are available to these groups. In 2010 the Directorate of Health shall investigate the treatment options which are available to transsexuals and transpersons, and evaluate possible improvements. In that connection it will be reasonable to evaluate the diagnostic criteria and how they are being used.
NCSF is proud to announce that 3,241 people signed the DSM Revision Petition from June 2008 to December 2009. The petition is now closed and has been sent to the American Psychiatric Association (APA) and the members of the Sexual and Gender Identity Disorders Work Group for the Diagnostic and Statistical Manual of Mental Disorders (DSM V). Thank you to everyone who participated in this historic effort!
The diagnoses in the DSM-TR-IV subject people who practice BDSM, fetishes and cross-dressing to bias, discrimination and social sanctions without any scientific basis. NCSF often sees individuals who suffer distress and impairment in their social and occupational lives (ie. interpersonal difficulties) because their desires conflict with current societal standards. These standards stem in a large part from the DSM. itself: pathologizing unusual sexual interests has led to more discrimination and discouraged individuals from seeking treatment for physical and mental health problems. This codification of "cultural aversion" was the same reason that ego-dystonic homosexuality was included in the DSM, and then removed when it was finally recognized as such by the APA.
Some of the comments made on the petition include:
#604: "BDSM is no more an illness or dysfunction than boxing, skydiving or participating in any extreme sport."
#1680: "I am all for removing these biases from legitimate psychiatry. It has ruined a friend of mine as for 8 years he has felt ashamed, depressed and self destructive because some "therapist" diagnosed him as sexually deviant and egodystonic and told him to repress his urges."
#1902: "Psychiatry should serve human wellness, not police human diversity."
#2224: "Historically, diagnoses of insanity have been used to marginalize those with unusual sexual preferences. This has to stop."
#2566: "I just had an acquaintance lose custody of her child to her now-vengeful ex due to "kink" and a bad judge. It's time to take more bias out of the DSM."
"The politicization of sexuality is common in this country," says Leigha Fleming, Board Chair of NCSF. "There is no basis in scientific fact for the categorization of BDSM and affiliated behaviors as inherently pathological or unhealthy. Social conservatives shouldn't be allowed to carry their agenda into the DSM. It wasn't appropriate when homosexuality was classified as a disorder by the APA and it's not correct now for the DSM to classify consensual adult sexual expression like BDSM, cross dressing, etc. as disorder. The DSM was never meant to be a political weapon used to marginalize sexual minorities. The overwhelming response by our constituents necessitates our involvement in this critical issue."
To see the hundreds of comments that petitioners made on the petition, click here: www.thepetitionsite.com/1/DSMrevisionpetition
To find out more about the DSM and the Paraphilias section, read the NCSF & ITCR: The Foundation for NCSF's "White Paper on the DSM Revision" at www.ncsfreedom.org
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