Being trans is no longer an illness

On 10 February 2010, an inconspicuous decree with a big impact appeared in France's official gazette. France removed "early disorders of gender identity" from the list of long-term psychiatric illnesses. Being trans was thus officially no longer considered a mental illness. No other country in the world had dared to take this step before.

Health Minister Roselyne Bachelot had announced it in May of the previous year, shortly before the International Day Against Homophobia and Transphobia. Trans organisations had long fought for it. For them, being classified as a psychiatric case was a constant humiliation. Anyone who wanted to transition had to be listed as mentally ill so that health insurance would pay.

Medicine did not disappear from the picture entirely, however. From then on, treatments were billed under a different category of long-term illness, so that full reimbursement was maintained. And anyone wanting to change their legal gender still needed surgery and medical reports. Louis-Georges Tin, the initiator of the International Day Against Homophobia, therefore spoke of a symbolic victory.

But symbols can open doors. In 2016, France abolished the medical requirements for changing legal gender. The World Health Organization followed in 2019. In its new classification of diseases, it moved gender incongruence out of the chapter on mental disorders and into the one on sexual health.

In retrospect, the decree was not an end point but a beginning. For the first time, a state had put in black and white what trans people had always known: they are not ill.