Democratizing Diagnoses: (Trans*)forming the DSM-5 and ICD-11

The groundwork done in the Workgroups set up to reconfigure the ‘trans*’ diagnoses in the DSM-5 and ICD-11 has taken a surprising democratized turn. Although the different Workgroups working for the American Psychiatric Association (APA) for the DSM-5 and World Health Organisation (WHO) for the ICD-11 proceed(ed) in different ways, an emphasis on widening the contributions by stakeholders and members of the public and recommendations about the changes required for the diagnoses to better reflect trans* people’s medical, economic and social lives seems to be a novel approach. This paper will examine why these changes may have occurred, what the potential problems and benefits are, and problematize who gets to choose which contributions and recommendations are ‘heard’ and included in the debate surrounding trans* diagnoses at the Workgroup level. Democratizing diagnoses seems at one level to be a progressive approach to reconfiguring the parameters of trans* diagnostics but on another level seems to be an oxymoron. The ‘recognition debate’ is implicated in this democratization of diagnoses. As such, in the latter part of the paper and utilizing ‘recognition’ scholarship, I will explore the theoretical tensions between these two seemingly contrary manifestations of diagnosing trans* people.