The ICD-11 reformulated sexual health-related conditions by creating a new chapter called 'Conditions Related to Sexual Health,' overcoming the artificial distinction between 'organic' and 'non-organic' conditions, reclassifying Gender Incongruence outside of mental disorders, removing sexual orientation-related diagnostic categories, and significantly modifying paraphilic disorder classifications.
Key Findings
Background
ICD-11 created a new chapter called 'Conditions Related to Sexual Health,' consolidating sexual dysfunctions previously split between 'Mental and Behavioral Disorders' and 'Disorders of Genitourinary System' in ICD-10.
The reorganization was described as 'overcoming the artificial, yet historical, distinction between organic and non-organic conditions'
The new unified chapter is intended to 'reflect and provide guidance for more integrative clinical approaches'
This change aligns classification with clinical practice, where an integrative approach 'has been consistently recommended' but was not previously reflected in diagnostic classification
Results
Sexual dysfunctions in ICD-11 are defined using a non-normative but individual-based threshold and categorized according to stages of the sexual response cycle.
The categorization by stages of the sexual response cycle is 'similar to ICD-10 and Diagnostic and Statistical Manual of Mental Disorders 5th version (DSM-5)'
ICD-11 also considered 'similarities and distinctions in the clinical presentation of the dysfunction in men and women,' resulting in differences from the DSM-5 approach
The individual-based threshold represents a shift away from purely normative definitions of dysfunction
Results
Gender Incongruence was reclassified from mental disorders in ICD-10 to the new 'Conditions Related to Sexual Health' chapter in ICD-11.
This reclassification reflects 'the current non-pathologizing understanding of gender diversity'
The criteria for Gender Incongruence were revised 'to embrace the variability in the experience of gender identity'
The move out of the mental disorders chapter represents a significant conceptual shift in how gender diversity is understood in international classification
Results
ICD-11 removed the residual diagnostic categories related to sexual orientation that had persisted in ICD-10.
The paper states that 'residuals of sexual orientation-related diagnostic categories were removed'
This removal reflects an evolution in the understanding that sexual orientation variations are not pathological conditions requiring diagnosis
This change is presented alongside the de-pathologization of gender diversity as part of a broader human rights-informed revision
Results
Paraphilic disorders in ICD-11 replaced 'Disorders of sexual preference' from ICD-10 with significant modifications in conceptualization and classification.
The paper notes 'significant modifications in conceptualization and classification' without specifying all details in the abstract
The renaming from 'Disorders of sexual preference' to 'Paraphilic disorders' reflects a conceptual shift in how these conditions are framed
The ICD-11 revision was described as following 'current evidence, best practice, and taking human rights into consideration'
What This Means
This research summarizes major changes made in the World Health Organization's ICD-11 (International Classification of Diseases, 11th revision) related to sexual health, sexual dysfunction, and related conditions. One of the most significant structural changes is the creation of a new chapter called 'Conditions Related to Sexual Health,' which brings together conditions that were previously scattered across separate chapters dealing with mental disorders and physical (genitourinary) disorders. This reflects long-standing clinical recommendations to treat sexual health in an integrated way rather than artificially separating psychological and physical causes.
The ICD-11 also made important changes regarding gender and sexual orientation. Gender Incongruence — the experience of one's gender differing from the sex assigned at birth — was moved out of the mental disorders chapter entirely, reflecting a current scientific and human rights-based understanding that gender diversity is not a mental illness. Additionally, leftover diagnostic categories that had pathologized sexual orientation were fully removed. The criteria for Gender Incongruence were also broadened to better capture the diversity of how people experience gender identity. For sexual dysfunctions, ICD-11 maintained a structure based on stages of the sexual response cycle but introduced individual-based (rather than purely statistical) thresholds for defining dysfunction, and acknowledged differences in how dysfunctions present in men versus women.
This research suggests these changes will have meaningful implications for clinical practice, encouraging more holistic, non-stigmatizing approaches to sexual health assessment and treatment. By removing pathologizing language around gender diversity and sexual orientation while refining how sexual dysfunctions are defined and categorized, ICD-11 aims to better align international diagnostic standards with both current scientific evidence and human rights principles.
Başar K. (2025). The Changes in ICD-11 Related to Sexual Health and Dysfunction and Their Implication for Clinical Practice.. Turk psikiyatri dergisi = Turkish journal of psychiatry. https://doi.org/10.5080/u27559