Robles, RebecaKeeley, Jared W.Vega-Ramírez, HamidCruz-Islas, JeremyRodríguez-Perez, VictorSharan, PratapPurnima, ShivaniRao, RavindraRodrigues-Lobato, María InesSoll, BiancaAskevis-Leherpeux, FrancoiseRoelandt, Jean-LucCampbell, MeganGrobler, Gerhard PaulStein, Dan J.Khoury, BrigitteKhoury, Joseph ElFresan, AnaMedina-Mora, María-ElenaReed, Geoffrey M.2023-08-112023-08-112022-01Robles, R., Keeley, J.W., Vega-Ramirez, H. et al. 2022, 'Validity of categories related to gender identity in ICD-11 and DSM-5 among transgender individuals who seek gender-affirming medical procedures', International Journal of Clinical and Health Psychology, vol. 22, no. 100281, pp. 1-10, doi : 10.1016/j.ijchp.2021.100281.2174-0852 (print)1697-2600 (online)10.1016/j.ijchp.2021.100281http://hdl.handle.net/2263/91878BACKGROUND/OBJECTIVE : The most recent versions of the two main mental disorders classifications-the World Health Organization's ICD-11 and the American Psychiatric Association's DSM-5-differ substantially in their diagnostic categories related to transgender identity. ICD-11 gender incongruence (GI), in contrast to DSM-5 gender dysphoria (GD), is explicitly not a mental disorder; neither distress nor dysfunction is a required feature. The objective was compared ICD-11 and DSM-5 diagnostic requirements in terms of their sensitivity, specificity, discriminability and ability to predict the use of gender-affirming medical procedures. METHOD : A total of 649 of transgender adults in six countries completed a retrospective structured interview. RESULTS : Using ROC analysis, sensitivity of the diagnostic requirements was equivalent for both systems, but ICD-11 showed greater specificity than DSM-5. Regression analyses indicated that history of hormones and/or surgery was predicted by variables that are an intrinsic aspect of GI/GD more than by distress and dysfunction. IRT analyses showed that the ICD-11 diagnostic formulation was more parsimonious and contained more information about caseness than the DSM-5 model. CONCLUSIONS : This study supports the ICD-11 position that GI/GD is not a mental disorder; additional diagnostic requirements of distress and/or dysfunction in DSM-5 reduce the predictive power of the diagnostic model.en© 2021 Published by Elsevier España, S.L.U. on behalf of Asociación Española de Psicología Conductual. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).ICD-11DSM-5Gender incongruenceGender dysphoriaEx post facto studyCIE-11Discordancia de generoDisforia de generoEstudio ex post factoSDG-10: Reduced inequalitiesArticle