Law and mental health. Transgender identity: what has changed since 2018

People often speak of a “2018 law on gender dysphoria”. In fact it is not a French law but an international decision: in June 2018, the World Health Organization published the eleventh revision of its International Classification of Diseases, ICD-11. Transgender identity moved out of the chapter on mental disorders into the chapter on conditions related to sexual health, under the name “gender incongruence”. Adopted by member states in 2019, the classification came into force on 1 January 2022.

The WHO's stated aim: to reduce the stigma faced by trans people while maintaining their access to the care they may need.

The WHO no longer classifies transgender identity as a mental disorder.

In France, change in stages

France had anticipated part of this movement. In 2010, a decree removed “early gender identity disorders” from the list of long-term psychiatric conditions. In 2016, the law modernising 21st-century justice made it possible to change the sex recorded in civil status without requiring medical treatment or surgery: the procedure takes place before the court.

In January 2022, a law banned “conversion therapies”, meaning practices that claim to change a person's sexual orientation or gender identity. They are punishable by two years' imprisonment and a 30,000-euro fine, more when the victim is a minor.

The recommendations of the French National Authority for Health

On 18 July 2025, the Haute Autorité de santé (HAS) published its first recommendations on medical transition for adults. It considers that gender identity no longer needs to undergo a specific psychiatric evaluation. Care relies on a multi-professional team coordinated by the general practitioner, and hormonal or surgical treatments are only offered at the person's request, after full information and an individual assessment of benefits and risks. Psychological support is part of the care that may be offered.

These recommendations only concern adults. For minors, the HAS began specific work in 2026. The question remains debated, including in Parliament, particularly regarding age and the conditions of access to treatment.

And where does psychoanalysis fit in?

No longer considering transgender identity as an illness does not mean one may not need to talk about it. Questions, other people's views, family reactions, discrimination, the stages of a transition: a space for listening, without judgement or preconceptions, can help the person and those close to them along this path.

This article is for information only. It replaces neither a consultation nor a diagnosis, which is a doctor's role.