Homosexuality as a mental disorder
01
What institutions accepted
Authoritative medical classifications and state medical systems treated homosexuality as a diagnosable mental, personality or sexual disorder. The form varied: some classifications pathologized same-sex orientation itself, while later residual categories linked diagnosis to distress about orientation or a wish to change it.
02
What the evidence supports now
Homosexuality and bisexuality are normal variations in human sexuality, not mental disorders, sexual disorders or perversions. Lesbian, gay and bisexual people can experience depression, anxiety or other conditions that merit care, but stigma-related distress does not make their orientation pathological. Care should address the person's actual needs without treating a heterosexual outcome as the clinical goal; the ICD-11 therefore contains no diagnostic category based on sexual orientation.
03
Evidence for the overall belief
Open sources, locators and notes
- SupportsHistorical beliefInternational Classification of Diseases — Small code, big impactWorld Health Organization
Where in the source: Sexual health conditions section
WHO's historical overview states that ICD-6, published in 1948, classified homosexuality as a mental disorder.
- SupportsHistorical beliefCultures in psychiatric nosology: the CCMD-2-R and international classification of mental disordersCulture, Medicine and Psychiatry / PubMed
Where in the source: Abstract
The peer-reviewed review identifies homosexuality among the diagnoses deliberately retained in the widely used CCMD-2-R despite differences from ICD-10.
- DocumentsHistorical beliefParecer CFM nº 05/1985Conselho Federal de Medicina
Where in the source: pp. 1–3
The primary opinion records that Brazil's operative ICD-9 placed homosexuality at 302.0 under sexual deviations and disorders in the mental-disorders chapter.
- DocumentsHistorical beliefIran — 2017 Country Reports on Human Rights PracticesUnited States Department of State
Where in the source: Acts of Violence, Discrimination, and Other Abuses Based on Sexual Orientation and Gender Identity
The official country report states that Iranian law exempted gay men through a classification of mental disorder.
- SupportsPresent correctionProposed declassification of disease categories related to sexual orientation in the International Statistical Classification of Diseases and Related Health Problems (ICD-11)Bulletin of the World Health Organization
Where in the source: pp. 672–679
The WHO working-group review finds no clinical, public-health or research justification for diagnostic categories based on sexual orientation and recommends deleting all F66 categories from ICD-11.
- SupportsImpactInternational Classification of Diseases — Small code, big impactWorld Health Organization
Where in the source: ICD uses and sexual health conditions sections
Explains the ICD's reach across health data, clinical care, financing and administration and identifies the earlier homosexuality classification as an example of cultural assumptions unsupported by medical evidence.
04
Impact
Diagnostic classifications carry authority through clinical coding, health statistics, professional training and administration. WHO's classification gave the proposition international reach; national carriers then changed on different schedules. Brazil redirected coding in 1985, China's CCMD-3 partially normalized homosexuality while retaining an ambiguous named diagnosis, and Iran's military-exemption system still processes gay men through a medical or psychiatric route according to current government country assessments.
Context
A blanket diagnosis of homosexuality and a diagnosis tied to distress about orientation are not identical. Both appear here because the latter preserved a diagnostic rationale based specifically on sexual orientation, but the episode text distinguishes each step rather than treating partial and full depathologization as the same event.
Adoption and operational dates differ. The World Health Assembly adopted ICD-10 in May 1990 and it took effect in 1993; it adopted ICD-11 in May 2019 and that revision took effect in 2022.
A classification's availability does not establish how often a particular diagnosis was assigned. In China, a current forensic standard cites CCMD-3 as a general diagnostic reference, but the evidence assembled here does not show present-day forensic use of its homosexuality category.
Sexual orientation and gender identity are distinct. Some Iran sources discuss gay men and transgender people together because the exemption system routes both through medical categories; this entry uses those sources only for what they establish about homosexuality and does not treat transgender identity as a sexual orientation or a mental disorder.
ICD-6 classified homosexuality as a mental disorder
World Health Assembly adopted the revision that removed homosexuality itself as a diagnosis
ICD-11 was adopted and took effect without the remaining sexual-orientation-based categories
Historical totals and effects are presented as contextual evidence, not as universal causal claims.
Institutional episode 01
International — World Health Organization
Global
WHO's sixth International Classification of Diseases classified homosexuality as a mental disorder in 1948, and later revisions carried the proposition through the international classification system. The 1990 adoption of ICD-10 ended the diagnosis of homosexuality itself, although orientation-based F66 diagnoses remained. Adoption of ICD-11 in 2019 completed the classification-level correction by omitting those residual categories as well.
Institutions involved
- World Health Organization (WHO)
- World Health Assembly
Institutional context
ICD-6 placed homosexuality within the mental-disorder classification in 1948, and the ICD-9 still listed it under sexual deviations and disorders. Because WHO's ICD supplies a shared language for morbidity statistics and informs clinical and administrative systems, this was more than a statement by one professional association. On 17 May 1990 the World Health Assembly adopted ICD-10, which removed homosexuality itself and stated that sexual orientation alone was not a disorder. ICD-10 nevertheless retained F66 diagnoses, including egodystonic sexual orientation, until ICD-11 removed all categories based on sexual orientation.
Why this persisted
ClassificationWHO encoded the proposition in successive editions of the international disease classification, allowing the category to travel through national coding, clinical, statistical, educational and administrative systems.
How correction happened
Corrected1990–2019
Action: The World Health Assembly adopted ICD-10 without a diagnosis of homosexuality itself in 1990, then adopted ICD-11 without the residual sexual-orientation-based F66 diagnoses in 2019.
WHO corrected the classification in two stages. ICD-10 explicitly said that orientation alone was not a disorder but retained diagnoses defined around conflict or distress about orientation. The ICD-11 revision removed those categories after a WHO working group found no adequate clinical, public-health or research justification for them.
Consequences
- International classification of homosexuality as mental pathology
- Medical legitimacy for national and professional pathologization
- Propagation through health statistics, clinical coding, teaching and administration
- A diagnostic rationale for treatment directed at sexual orientation, retained in narrower form under ICD-10
Evidence for this episode
6 evidence linksOpen sources, locators and notes
- DocumentsInstitutional carrierInternational Classification of Diseases — Small code, big impactWorld Health Organization
Where in the source: Sexual health conditions section
Identifies WHO's ICD-6 as the international classification carrying the diagnosis in 1948.
- SupportsMechanismInternational Classification of Diseases — Small code, big impactWorld Health Organization
Where in the source: ICD uses section
Describes how ICD codes structure clinical records, statistics, financing and health-system decisions.
- SupportsConsequencesInternational Classification of Diseases — Small code, big impactWorld Health Organization
Where in the source: Sexual health conditions section
Connects the classification to an unsupported personality-disorder assumption and explains why classification changes matter across health systems.
- DocumentsContextInternational Classification of Diseases — ICD historyWorld Health Organization
Where in the source: ICD revisions under the auspices of WHO
Records the adoption and effective dates of ICD-6, ICD-9, ICD-10 and ICD-11, distinguishing Assembly action from the later dates on which revisions took effect.
- DocumentsInstitutional correctionMoving one step closer to better health and rights for transgender peopleWorld Health Organization Regional Office for Europe
Where in the source: 17 May 2019 news release
WHO identifies 17 May 1990 as the date the World Health Assembly stopped classifying homosexuality as a mental disorder.
- SupportsInstitutional correctionProposed declassification of disease categories related to sexual orientation in the International Statistical Classification of Diseases and Related Health Problems (ICD-11)Bulletin of the World Health Organization
Where in the source: pp. 674–677
Documents the residual ICD-10 F66 categories, evaluates their lack of validity and utility, and recommends their complete removal in ICD-11.
Institutional episode 02
Brazil
Latin America
Brazil used ICD-9 code 302.0, which classified homosexuality under sexual deviations and disorders. In 1985 the CFM authorized physicians to code consultations prompted by homosexuality under V62, “other psychosocial circumstances,” instead. If a separate illness was present, that underlying condition was to be coded. The opinion changed Brazilian coding practice without formally rewriting the international ICD-9 category or unequivocally resolving every medical disagreement recorded in the opinion.
Institutions involved
- Ministério da Saúde
- Conselho Federal de Medicina (CFM)
- Centro Brasileiro de Classificação de Doenças (CBCD)
Institutional context
The ICD-9, in effect from 1979, placed homosexuality at 302.0 under “sexual deviations and disorders” in the mental-disorders chapter. After Grupo Gay da Bahia asked that the diagnosis be made ineffective in Brazil, the request moved through the federal health administration. The CBCD proposed V62 for consultations whose reason was homosexuality, the Ministry of Health referred the question to the CFM, and the CFM approved that approach in 1985.
Why this persisted
Administrative adoptionBrazil's health system applied the ICD-9 disease code until federal classification and medical authorities approved an alternative non-disease code for consultations concerning homosexuality.
How correction happened
Partially corrected1985–1999
Action: The CFM authorized V62 rather than 302.0 in 1985; in 1999 the Federal Council of Psychology barred psychologists from practices that pathologize homoerotic behavior or promise a cure.
The 1985 opinion removed compelled use of the mental-disorder code in Brazilian medical practice, but used permissive language and did not delete ICD-9's text. The psychology profession's 1999 rule supplied a clearer anti-pathologization standard, so the institutional correction developed in stages.
Consequences
- Diagnostic coding of homosexuality within the mental-disorders chapter
- Medical authority for treating homosexuality as a sexual deviation or disorder
- Institutional stigma in health care
Evidence for this episode
5 evidence linksOpen sources, locators and notes
- DocumentsInstitutional carrierParecer CFM nº 05/1985Conselho Federal de Medicina
Where in the source: pp. 1–3
Identifies the Ministry of Health referral, the CBCD recommendation and the CFM's authority to guide physicians in applying the ICD.
- DocumentsMechanismParecer CFM nº 05/1985Conselho Federal de Medicina
Where in the source: pp. 1–2
Records the operative ICD-9 code 302.0 and the administrative route by which Brazilian authorities reconsidered its use.
- DocumentsConsequencesParecer CFM nº 05/1985Conselho Federal de Medicina
Where in the source: pp. 1–3
Shows that consultations had to be coded and that 302.0 located homosexuality inside the mental-disorders chapter, including cases driven by social discrimination or a relative seeking treatment.
- DocumentsInstitutional correctionParecer CFM nº 05/1985Conselho Federal de Medicina
Where in the source: Conclusion, p. 3
Authorizes V62 for consultations concerning homosexuality and directs physicians to code any separate underlying illness rather than homosexuality itself.
- DocumentsInstitutional correctionHistórico — Resolução nº 01/1999Conselho Federal de Psicologia
Where in the source: Histórico and Homossexualidade não é doença sections
The federal psychology council identifies the 1985 medical change and explains that its 1999 resolution prohibited psychologists from pathologizing homoerotic behavior or offering a “cure.”
Institutional episode 03
China
East Asia
China's 2001 revision should not be described either as no change or as an unqualified deletion. It rejected the premise that every homosexual person was mentally ill and framed pathology around associated conflict or distress, while the manual itself retained a named homosexuality diagnosis inside a disorder chapter. CCMD-3's influence is waning as China adopts international classifications, but it remains an authorized forensic reference. That keeps the classification-level episode open while leaving actual current use of diagnosis 62.31 unproven.
Institutions involved
- Chinese Society of Psychiatry / Chinese Medical Association
- Ministry of Justice forensic-identification system
Institutional context
CCMD-2 (1989) and CCMD-2-R (published in 1995) retained homosexuality in China's psychiatric nosology. CCMD-3 made a substantive change in 2001: its accompanying explanation said same-sex sexuality was not necessarily abnormal and contemporary reporting said only cases involving serious conflict or distress should be treated as a psychosexual disorder. Yet the published classification still placed diagnoses named “homosexuality” (62.31) and “bisexuality” (62.32) under “sexual orientation disorders,” and its listed criteria did not state distress as a discrete mandatory element. China has begun moving toward ICD-11, but a Ministry of Justice standard issued in 2024 and effective in 2025 still permits forensic diagnosis under either ICD or CCMD-3.
Why this persisted
ClassificationA national professional body encoded homosexuality in successive CCMD manuals; later Justice Ministry standards incorporated CCMD-3 by reference as one of the classifications available for forensic mental-state diagnosis.
How correction happened
Partially corrected2001–present
Action: CCMD-3 stated that same-sex sexuality was not necessarily abnormal, and China later began implementing ICD-11, which contains no diagnosis based on sexual orientation.
The 2001 revision was a meaningful but internally inconsistent correction. Its explanatory text and public presentation rejected automatic pathologization, while its hierarchy and criteria retained homosexuality as a named disorder. China has not yet documented a complete replacement of CCMD-3 across the systems examined here; the 2025 forensic standard still names it alongside ICD.
Consequences
- Professional classification of homosexuality in CCMD-2 and CCMD-2-R
- Continued presence of a diagnosis named homosexuality after the partial normalization announced in 2001
- A classification rationale that could direct treatment toward changing sexual orientation
- Continued availability of CCMD-3 as a general reference in state forensic psychiatry
Evidence for this episode
8 evidence linksOpen sources, locators and notes
- SupportsInstitutional carrierCultures in psychiatric nosology: the CCMD-2-R and international classification of mental disordersCulture, Medicine and Psychiatry / PubMed
Where in the source: Abstract
Describes CCMD-2-R as a professional psychiatric classification intended for wide use in China and identifies its retention of homosexuality.
- DocumentsMechanismChinese Classification and Diagnostic Criteria of Mental Disorders, Third Edition — preserved textTrans & Gender Diverse Archive — preservation copy of CCMD-3
Where in the source: §§ 62.3, 62.31 and 62.32
Preserves the classification hierarchy and criteria that place named homosexuality and bisexuality diagnoses under sexual-orientation disorders while saying sexual behavior itself is not necessarily abnormal.
- DocumentsConsequencesChinese Classification and Diagnostic Criteria of Mental Disorders, Third Edition — preserved textTrans & Gender Diverse Archive — preservation copy of CCMD-3
Where in the source: §§ 62.3 and 62.31
Shows that the manual retained a diagnostic route tied specifically to same-sex orientation and described some people as seeking treatment to change it.
- ContextualizesContextChina redefines diagnostic standard; mental illness no longer automatically includes homosexualityChina News Service
Where in the source: 12 March 2001 report
Contemporary reporting quotes a lead drafter saying homosexual people were not mentally ill and presents serious conflict, anxiety and impairment—not orientation alone—as the intended threshold for disorder.
- DocumentsInstitutional carrierSF/T 0184-2024 — Assessment of capacity for serving a sentence in the mentally disorderedMinistry of Justice of the People's Republic of China
Where in the source: §§ 2 and 4.4
The current Ministry of Justice standard lists CCMD-3 and ICD as normative references and directs evaluators to use either for mental-state diagnosis; it does not name or demonstrate use of diagnosis 62.31.
- ContextualizesContextChina Did Not 'Remove' Homosexuality from Its Official List of Mental DisordersSuisui Wang and Darius Longarino, SSRN
Where in the source: pp. 1–14
This unreviewed legal-medical preprint compares the public declassification account with CCMD-3's hierarchy and criteria and argues for describing the 2001 change as partial normalization rather than literal removal.
- DocumentsInstitutional correctionChina redefines diagnostic standard; mental illness no longer automatically includes homosexualityChina News Service
Where in the source: 12 March 2001 report
Documents the intended 2001 break with automatic pathologization and the public claim that same-sex activity was not necessarily psychologically abnormal.
- DocumentsInstitutional correctionSF/T 0184-2024 — Assessment of capacity for serving a sentence in the mentally disorderedMinistry of Justice of the People's Republic of China
Where in the source: §§ 2 and 4.4
Demonstrates that transition away from CCMD-3 was incomplete at the classification-reference level in 2025, without establishing that the homosexuality category is used in current forensic cases.
Institutional episode 04
Iran
Middle East
Iran's military-exemption system continues to operationalize homosexuality through medical and psychiatric categories. Current assessments report that gay men may seek exemption only by submitting to medical review and that the resulting record can disclose the subsection used. Because consensual same-sex conduct is criminalized, the process can expose applicants to risks well beyond the exemption itself. Government country reporting through August 2026 documents no institutional correction.
Institutions involved
- Iranian compulsory military-service medical exemption system
- Armed Forces medical examination and exemption boards
Institutional context
U.S. and UK government country assessments report that Iran's compulsory-service system treats gay men as eligible for exemption through a mental-health or behavioral category. The translated wording quoted for the 2020 medical exemption regulations is broader than “homosexuality”: Article 33, paragraph 8 covers behavioral disorders and moral or sexual “deviancies.” Reports describe gay applicants undergoing medical examination to prove eligibility, while exemption records identify the applicable subsection. The available evidence therefore establishes the reported administrative practice, but it is not a direct publication of the full current Persian regulation.
Why this persisted
Administrative adoptionCompulsory-service authorities route gay exemption applicants through medical examination and behavioral or psychiatric provisions, then record the governing subsection in military documentation.
How correction happened
Uncorrected2017–present
Action: No institutional correction is documented through August 2026.
Recent UK assessments continue to report exemption on this basis and the associated mental-disorder label. The evidence describes some changes in which regulatory subsection is used, but no rejection of the pathological premise for gay applicants.
Consequences
- Medical or psychiatric examination connected to sexual orientation
- Military exemption through a mental-health or behavioral category
- Disclosure of the exemption subsection in military records
- Risk of employment discrimination, familial abuse, violence or arrest after involuntary outing
- State reinforcement of a pathological account of homosexuality
Evidence for this episode
6 evidence linksOpen sources, locators and notes
- DocumentsInstitutional carrierIran — 2017 Country Reports on Human Rights PracticesUnited States Department of State
Where in the source: Acts of Violence, Discrimination, and Other Abuses Based on Sexual Orientation and Gender Identity
Reports that Iran's compulsory-service law exempted gay men through a mental-disorder classification, establishing the state military system as the carrier described here.
- DocumentsMechanismIran — 2023 Country Reports on Human Rights PracticesUnited States Department of State
Where in the source: Acts of Violence, Criminalization, and Other Abuses Based on Sexual Orientation, Gender Identity or Expression, or Sex Characteristics
Reports exemption on mental-disorder grounds and states that military identity cards listed the legal subsection supporting the exemption.
- DocumentsConsequencesIran — 2023 Country Reports on Human Rights PracticesUnited States Department of State
Where in the source: Acts of Violence, Criminalization, and Other Abuses Based on Sexual Orientation, Gender Identity or Expression, or Sex Characteristics
Reports that the recorded subsection could identify gay or transgender people and expose them to abuse, discrimination and arrest.
- ContextualizesContextCountry policy and information note: sexual orientation and gender identity or expression, Iran, December 2025UK Home Office
Where in the source: § 7.8.1–7.8.5
Synthesizes the reported exemption process, quotes the broad Article 33 paragraph 8 wording, and separates what the regulation says from reports about its application to gay men.
- SupportsInstitutional correctionCountry policy and information note: sexual orientation and gender identity or expression, Iran, December 2025UK Home Office
Where in the source: § 7.8.1–7.8.5
The December 2025 assessment still reports mental-health processing of gay exemption applicants and continuing stigma and disclosure risks, with no institutional repudiation of the classification.
- SupportsInstitutional correctionCountry policy and information note: military service, Iran, August 2026UK Home Office
Where in the source: §§ 2.4 and 11.2
The August 2026 assessment continues to describe gay men as exempt from compulsory service through a mental-disorder classification, providing the latest source used to keep the episode open.
Source registryEach source is registered once and can carry several precise evidence relationships.15 sources
- 01International Classification of Diseases — Small code, big impactWorld Health Organization5 evidence links
- 02Moving one step closer to better health and rights for transgender peopleWorld Health Organization Regional Office for Europe1 evidence link
- 03International Classification of Diseases — ICD historyWorld Health Organization1 evidence link
- 04Cultures in psychiatric nosology: the CCMD-2-R and international classification of mental disordersCulture, Medicine and Psychiatry / PubMed2 evidence links
- 052 evidence links
- 06Chinese Classification and Diagnostic Criteria of Mental Disorders, Third Edition — preserved textTrans & Gender Diverse Archive — preservation copy of CCMD-32 evidence links
- 07SF/T 0184-2024 — Assessment of capacity for serving a sentence in the mentally disorderedMinistry of Justice of the People's Republic of China2 evidence links
- 08China Did Not 'Remove' Homosexuality from Its Official List of Mental DisordersSuisui Wang and Darius Longarino, SSRN1 evidence link
- 095 evidence links
- 101 evidence link
- 11Iran — 2017 Country Reports on Human Rights PracticesUnited States Department of State2 evidence links
- 12Iran — 2023 Country Reports on Human Rights PracticesUnited States Department of State2 evidence links
- 132 evidence links
- 142 evidence links
- 151 evidence link