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Forside Norsk Seksualpolitikk

Finland slutter seg til nordisk seksualreform

Fjerde land som fullstendig fjerner fetisj- og SM-diagnoser:
“Verken behandling, statistikk eller forskning tar skade av at diagnosene forsvinner”

 

Finland slutter seg til nordisk seksualreform

En nordisk modell for sexualreform utfordrer nå Verdens Helseorganisasjon etter at Finland fjernet fem diagnoser på seksuelle preferanser, seksuelle identiteter og kjønnsuttrykk som relaterer seg til seksuell orientering fra landets nasjonale ICD-versjon. WHO reviderer for tiden den internasjonale sykdomsklassifiseringen til en ny oppdatert ICD-11-utgave som skal være klar i 2015.

Av Svein Skeid og Odd Reiersøl

Basert på den norske modellen og det banebrytende arbeidet til Revise F65-gruppen, kunngjorde det finske nasjonale institutet för hälsa och välfärd (THL) 12. mai 2011, at landet avskaffer sykdomskodene transvestisme, fetisjisme, fetisjistisk transvestisme, sadomasochisme og multiple forstyrrelser i seksuelle objektvalg. Dette er de samme diagnosene som Revise F65 arbeider for å fjerne fra WHOs internasjonale sykdomsliste. Revise F65 er et utvalg i LLH, Landsforeningen for lesbiske, homofile, bifile og transpersoner.

Finland er det fjerde landet som foretar en slik revisjon etter at det norske Helsedirektoratet gjorde de samme diagnosekodene ugyldige 1. februar 2010. Sverige gjennomførte en lignende reform i 2009, mens Danmark fullstendig avskaffet transvestisme og sadomasochisme som diagnoser i henholdsvis 1994 og 1995.

– At fire nordiske land nå har fjernet de aktuelle diagnosene for nasjonalt bruk er et viktig faglig og helsepolitisk signal til WHO i arbeidet med utarbeidelsen av ICD-11, sier leder i LLHs Diagnoseutvalg, Svein Skeid. Den finske seksualreformen er jobbet fram av homoorganisasjonen SETA i samarbeid med eksperter fra Sexpo Foundation-gruppen. I helsemyndighetenes faglige begrunnelse fremheves det blant annet at de overnevnte diagnosene ikke er i praktisk bruk og at de fungerer stigmatiserende overfor gruppen som rammes av den.

Nordisk modell

– Vi regner med at mellom én og to millioner mennesker tilhører grupper som nå er direkte berørt av de nordiske landenes friskmeldinger basert på den veldokumenterte norske Revise F65-modellen, sier Svein Skeid. Oppdatert forskning viser at sykeliggjøring fører til vold og diskriminering mot seksuelle minoriteter og hindrer folk å søke adekvat helsehjelp. De siste to årenes utvikling viser at de nordiske landene tar seksuelle minoriteters helse på alvor. – Det ligger nå et stort ansvar på Verdens helseorganisasjon om å følge “den nordiske modellen” og fullstendig fjerne de fem fetisj, SM og trans-diagnosene i den nye ICD 11-utgaven, sier Skeid.

ICD-11 Alpha Draft

I følge ICD-11 Alpha Draft (bilde til venstre), besøkt 20. mai 2011, så er fetisjisme, fetisjistisk transvestisme, sadomasochisme og transvestisme ennå ikke fjernet fra listen over sykdommer på WHOs liste. I følge seniorrådgiver i Helsedirektoratet, Arild Johan Myrberg, ligger WHOs arbeid med å oppdatere den internasjonale diagnosemanualen ett år etter planen.

 

Seksuell orientering

I pressemeldingen på THLs offisielle nettsider, heter det at finske helsemyndigheter “har mottatt forslag om endringer i kategorier relatert til seksuell orientering.”

“Etter å ha vurdert informasjon om kategoriene terapeutisk, deres medisinske bakgrunn, synspunkter fra eksperter på diagnosenes riktighet og nødvendighet, og de nordiske landenes praksis på området, har THL, etter instruks fra generaldirektøren, besluttet at følgende kategorier skal fjernes fra den finske versjonen av ICD-10:

F64.1 Transvestisme
F65.0 Fetisjisme
F65.1 Fetisjistisk transvestisme
F65.5 Sadomasochisme
F65.6 Multiple forstyrrelser i seksuelle objektvalg”

I følge overlege ved THL, Jorma Komulainen, er disse fem diagnosene uklare og benyttes så sjelden at verken behandling, statistikk eller forskning tar skade av at de forsvinner. De siste ti årene har diagnosene blitt oppgitt som årsak til behandling mindre enn én gang i året. Det kan tolkes som at heller ikke leger anser fetisjisme, transvestisme og SM som sykdommer og at man helst ikke benytter diagnosene.

 

Referanser:

THL (2011). ICD-10-tautiluokitusta päivitetään 2011. Kunngjøring 12.5.2011 fra Det finske nasjonale institutet för hälsa och välfärd (THL). Hentet 12. mai 2011 fra http://www.thl.fi/doc/fi/25489

Revise F65 (2010). SM, fetisjisme og transvestisme ikke lenger sykt i Norge. Hentet 12. mai 2011 frahttp://www.revisef65.org/friskmelding.html

Socialstyrelsen (2008). Pressemelding fra den svenske Socialstyrelsen 17.11.2008. Hentet 12. mai 2011 fra http://www.revisef65.org/socialstyrelsen.html

Revise F65 (1995). Danmark fjerner SM som diagnose. Hentet 12. mai 2011 frahttp://www.revisef65.org/danmark.html

Revise F65 (2009). Faglig grunnlag for å fjerne norske fetisj- og SM-diagnoser. Hentet 12. mai 2011 fra http://www.revisef65.org/notat.html

Wright, S. (2008). Second National Survey of Violence & Discrimination Against Sexual Minorities. NCSF. Hentet 12. mai 2011 frahttp://www.ncsfreedom.org/images/stories/pdfs/BDSM_Survey/2008_bdsm_survey_analysis_final.pdf

Wright S. (2010). Depathologizing Consensual Sexual Sadism, Sexual Masochism, Transvestic Fetishism, and Fetishism. Archives of sexual behavior. Volume 39, Number 6, 1229-1230.

Categories
English Seksualpolitikk

Finland joins Nordic sexual reform

Finland joins Nordic sexual reform

 

Finland joins Nordic sexual reform

Fourth country to completely remove fetish and SM diagnoses:
“Neither care, statistics nor research are harmed by abolition of the diagnoses”

A Nordic sexual rights reform model now challenges the World Health Organization since Finland removed five diagnoses of sexual preferences, sexual identities and gender expressions related to sexual orientation from their national ICD version. WHO is currently revising the International Classification of Diseases to an updated ICD-11 edition within 2015.

By Svein Skeid and Odd Reiersøl

Based on the Norwegian model and the groundbreaking work of the Revise F65 group, the Finnish National Institute for Health and Welfare (THL) announced May 12, 2011, that Finland next year will remove the diagnoses of Fetishism, Fetishistic transvestism, Sadomasochism, Multiple disorders of sexual preference and dual-role transvestism from the Finnish ICD edition (THL, 2011).

These are exactly the same five diagnoses that Norway repealed more than one year ago, and the same diagnoses that Revise F65 has worked a decade to delete from the International Classification of Diseases published by The World Health Organization, WHO (Revise F65, 2010). Sweden removed six diagnoses of sexual behaviours in 2009, among them the same classifications as Norway and Finland now have deleted (The Local, 2008). Denmark withdrew the diagnoses of dual-role transvestism and sadomasochism in 1994 and 1995, respectively (Revise F65, 1995).

– The Nordic sexual rights reform movement is putting pressure on The World Health Organization to follow suit, says Svein Skeid, leader of the Revise F65 group. Revise F65 is a subdivision of LLH, The Norwegian LGBT Association. Currently four Nordic countries have repealed fetish- and SM diagnoses from their national ICD-versions.

– I am happy to inform you that the proposition to revise the ICD-10 classification concerning sadomasochism, fetishism and transvestism has passed in Finland, says Tommi Paalanen, Chairman of the Sexpo Foundation, the Finnish Foundation for Sex Education and Therapy. The proposition was made by SETA, The National LGBT rights organization in Finland and the Sexpo Foundation with a group of experts from many different fields.

Sexual orientation

In their official press release, The Finnish National Institute for Health and Welfare writes that “Changes in the categories related to sexual orientation in the Finnish version of ICD-10 have been proposed to THL.” The press release continues:

“After having evaluated information on the use of the categories in question therapeutically, their medical grounds, opinions of experts on the correctness and the necessity of the classification and general practices in Nordic countries, THL has, by the decision of the Director General, ended up removing the following categories from the Finnish version of ICD-10:

* F64.1 Dual-role transvestism
* F65.0 Fetishism
* F65.1 Fetishistic transvestism
* F65.5 Sadomasochism
* F65.6 Multiple disorders of sexual preference”

The Nordic Revise F65 model

– To date, we estimate that one to two million people in the Nordic countries belong to groups that primarily benefit from the sexual rights reform based on the well-documented Revise F65 model, says Svein Skeid. The Finnish decision strengthens Revise F65’s strategy to motivate more countries to remove their national versions of the ICD SM/fetish diagnoses.

– As four of the Nordic countries have now abolished the diagnoses for use at the respective national levels, this will be a significant professional and political signal to the World Health Organization in the revision process of the ICD-11. We strongly encourage WHO to follow the Nordic Revise F65 model and completely remove the five fetish, SM and trans-diagnoses in the forthcoming updated ICD 11-edition, Svein Skeid concludes.

ICD-11 Alpha Draft

According to the current ICD-11 Alpha Draft (picture left) retrieved May 20, 2011, Fetishism, Fetishistic transvestism, Sadomasochism and dual-role transvestism are not yet taken off the list of disorders of psychological development and gender identity. According to Senior Adviser Arild Johan Myrberg at the Norwegian Directorate of Health, WHO’s ICD revision process isdelayed by a year.

 

The diagnoses are so seldom in use, that neither care, statistics nor research are harmed by their abolition.

”We studied all cases over a period of ten years and found only occasional ones”, reports Dr. Jorma Komulainen, the chief physician at THL.

”These are not rare behavioural patterns, but only seldom is there any reason to seek medical treatment”, Komulainen notes. In fact, so seldom that the abolition of the categories will have no effect on statistics whatsoever. – More harm has been inflicted on people who have felt that they have been labelled by such diagnoses, he says.

During the last decade, the diagnoses in question have been used for therapeutic reasons less frequent that once a year. This can be understood as though neither physicians consider SM, fetishism and transvestism to be diseases, and that they reluctantly use the diagnoses.

”A year and a half ago, we made a decision to attempt at abolishing this category”, reports Minna-Maaria Lax, the chair of DreamWear Club, which is an association representing Finnish transvestites. ”The major problem is that when examining himself or herself, a transvestite may have noticed that he or she has a mental disorder, thereafter starting to regard himself or herself ill”, Lax notes. In conflict situations, for example during a divorce, the classification may have given a weapon to the other party. When it comes to social thinking, the use of these categories is likely to raise public disapproval of transvestites.

Stigmatizing diagnoses

The official reasons for the Finnish removal, are:

1) The medical criteria for the removed classifications are not clear.

2) The use of the categories in treatment records is rare, and their removal does not significantly influence the practice of health care statistics.

3) The use of these categories may cause harm to persons classified according to them.”

The Finnish arguments are similar to the documentation that Revise F65 has sent to The World Health Organization. Revise F65 argues that “the ICD diagnoses of Fetishism, Transvestic fetishism and Sadomasochism are superfluous, outdated, non scientific and stigmatizing” (Revise F65, 2009).

An internet-based survey carried out by the National Coalition for Sexual Freedom (NCSF) with 3,058 respondents, showed that 37.5% of the participants indicated that they had experienced some form of discrimination, harassment or violence due to the social stigma attached to their fetish/BDSM orientation or behavior. The study included respondents from 41 countries, including Europe, in addition to the United States (83,4%). The survey concluded that “pathologizing unusual sexual interests has led to increased discrimination and discouraged individuals from seeking treatment for physical and mental health problems.” (Wright, 2008, 2010).

 

References:

THL (2011). ICD-10-tautiluokitusta päivitetään 2011. Announcement by THL, the National Institute for Health and Welfare in Finland. Retrieved May 12, 2011, from http://www.thl.fi/doc/fi/25489

Revise F65 (2010). Fetish and SM no longer diseases in Norway. Retrieved May 12, 2011, fromhttp://www.revisef65.org/friskmelding_eng.html

The Local (2008). Transvestism ‘no longer a disease’ in Sweden. Retrieved May 12, 2011, fromhttp://www.thelocal.se/15728/20081117/

Revise F65 (1995). Denmark withdraws SM from Diagnosis-list. Retrieved May 12, 2011, fromhttp://www.revisef65.org/denmark.html

Revise F65 (2009). ICD Revision White Paper. Retrieved May 12, 2011, fromhttp://www.revisef65.org/icd_whitepaper.html

Wright, S. (2008). Second National Survey of Violence & Discrimination Against Sexual Minorities. NCSF. Retrieved May 12, 2011, from http://www.ncsfreedom.org/images/stories/pdfs/BDSM_Survey/2008_bdsm_survey_analysis_final.pdf

Wright S. (2010). Depathologizing Consensual Sexual Sadism, Sexual Masochism, Transvestic Fetishism, and Fetishism. Archives of sexual behavior. Volume 39, Number 6, 1229-1230.