Information is being spread that WHO has excluded the diagnosis of pedophilia from the International Classification of Diseases, 11th revision. We decided to check if this is actually true.

This decision of the organization was reported by many media: Regnum (“Transsexualism* and pedophilia are no longer pathologies? New norms in psychiatry”), TV channel “Constantinople» (“The lesson of Kostroma teaches nothing: WHO wants to legalize pedophilia in Russia?”), “Nakanune.ru» (“WHO is going to legalize pedophilia”). Journalists claim that the organization "is going to legalize pedophilia and other forms of sexual perversion as 'norms of sexual behavior'." The Tsargrad article, for example, also cites the opinion of some “smart psychiatrists” without indicating their names or professional achievements: “The approach to all forms of deviant sexual desire, in fact, repeats the path traveled by homosexuality* in 1968–1973, when several years of aggressive pressure from LGBT activists ended with a vote that excluded homosexuality from the list of mental disorders. According to ICD-11, forms of deviation such as pedophilia or bestiality are at a stage of normalization, more or less corresponding to the stage of 1973 for homosexuality.” The news also excited the Internet community - “Tsargrad” reports on a petition against the adoption of a new version of the ICD in Russia (the petition itself is no longer available, it has been preserved archival version) which was addressed to Minister of Health Mikhail Murashko. This appeal was posted on the CitizenGo portal (our colleagues from Kazakhstan had already wrotehow this site works).

The International Statistical Classification of Diseases and Related Health Problems is the leading statistical warp in health care, which is periodically revised under the guidance of WHO experts. ICD-10 was adopted in 1990. In 2007, work began on its revision, and in 2019 the 11th edition was approved.

It is extremely simple to check whether pedophilia was really in ICD-10, but not in ICD-11. It is enough to open the classification section on the WHO website. In ICD-10 the corresponding diagnosis is There is, it is coded as F65.4, that is, located in section F - “Mental and behavioral disorders”, in subsection 60–69 “Personality and behavior disorders in adulthood”. The group of diseases coded F65 is called “Disorders of Sexual Preference.” The description indicates that this group also includes paraphilias (sexual arousal from atypical objects, situations, and/or objects of arousal). The classification further lists ten pathological conditions representing various disorders. The clarifying code “.4” describes specifically pedophilia. It also defines what is meant by this diagnosis: “Sexual attraction to children (boys, girls, or both), usually of prepubertal or early puberty.”

Now let's study ICD-11. The disease classifier in it is arranged in a slightly different way: by entering paedophilia in the search, we get to a page called 6D32 Pedophilic disorder. Number 6 codes the section “Mental and behavioral disorders” (cf. “Mental and behavioral disorders” in ICD-10). The “Paraphilias” subsection (in the previous version, paraphilias were included in a subgroup, and now this is the name of the entire group of diseases) describes codes from 6D30 to 6D3Z, a total of eight pathological conditions, including “Pedophilic disorder”.

What has actually changed in the section? Fetishism and fetishistic transvestism were no longer classified as a separate disorder, but the term "paraphilic disorder involving solitary behavior or consenting individuals" appeared. Exhibitionism and voyeurism remain, sadomasochism is now called “compulsive sexual sadistic disorder.” A quick comparison of ICD-10 and ICD-11 may also suggest that the 11th revision did not include diagnoses such as bestiality and necrophilia, but in fact these disorders fell into the group “Other paraphilic disorder involving non-consenting persons.”

Also, ICD-11, unlike ICD-10, provides a more expanded description for each disease. Let's read carefully what experts write about pedophilic disorder. They do note that three things must be met to diagnose the disorder:

- a persistent, focused, and intense pattern of sexual arousal, manifested by persistent sexual thoughts, fantasies, urges, or behavior, involving prepubescent children;

- the person must act on or be noticeably distressed by these thoughts, fantasies or urges;

— the diagnosis does not cover sexual arousal and related behavior between children before or after puberty.

Separately, ICD-11 describes when it is worth drawing the line between the presence of a pedophilic disorder and its absence. In particular, without persistent sexual thoughts and fantasies, an episode of pedophilic behavior may be caused by intoxication or substance use. Also, "sexual behavior involving children that does not reflect an underlying, ongoing pattern of pedophilic sexual arousal may occur in the context of some psychiatric disorders, such as bipolar I disorder during manic or mixed episodes or dementia." Dementia in this context interpreted more broadly than senile dementia, and includes all types of decay of mental functions that occur as a result of disease or damage to the brain after the completion of its maturation (including as a concomitant pathology with prion disease, Down syndrome, alcoholism). It also states that “the diagnosis of pedophilic disorder should not be based on the sexual behavior of children before or after puberty or of adolescents with peers close in age.”

Separately, experts specified a number of cultural features. Specifically, “a scale of physical development, including primary and secondary sexual characteristics across the lifespan, may provide a more objective basis than age on which to base a determination,” and that “in some cultures, it is normative for parents to kiss their children on the lips as a sign of affection. Culturally normative behavior should not be misattributed to inappropriate sexual activity.”

As we can see, nowhere in the description is there any talk of any normalization of pedophilia. Moreover, WHO does not have the legal ability to legalize any things. In addition, different countries have different legal ages for consent or marriage. It is lowest in Yemen, Qatar and Oman. There he is amounts to only nine years old. Thus, an adult man who married a nine-year-old girl in one of these states and entered into sexual relations with her would not be legally considered a pedophile. However, if at an appointment with a doctor, guided by ICD-11, he reports that for many years he had fantasies about such interaction with a child, then the doctor will have reason to suspect that he has a pedophilic disorder.

In addition to replacing pedophilia with pedophilic disorder, ICD-11 made many other important changes. Firstly, the section “Mental and behavioral disorders” has been replenished with a number of new diagnoses - a separate code appeared for video game addiction, pathological hoarding, prolonged grief reaction. The classification also takes into account many genetic diseases that have been discovered and actively diagnosed in recent years. At the same time, transsexualism was indeed removed from the reference book. WHO Expert Dr. Lail Say motivated This is because there are no signs of disorder in this state. In order for transgender people to receive medical care, a different code is provided for them - gender nonconformity.

Thus, the journalists misinformed the audience - ICD-11 in no way legalizes pedophilia (and the WHO does not have such powers). Sexual attraction to children was not recognized as normal and was not removed from the list of mental illnesses; it was called a different term and the criteria for making a diagnosis were clarified. Law enforcement practice under Article 134 of the Criminal Code of the Russian Federation “Sexual intercourse and other actions of a sexual nature with a person under sixteen years of age” will not be affected by recommendations regarding the classification of pathological conditions.

*To convey the context, we used verbatim quotes, including incorrect and outdated words from the original source. “Verified” does not support linguistic discrimination and in materials where the editorial position is expressed, it uses neutral expressions recommended by the directory "We don't say that", in particular “transgender” and “homosexuality”.

Cover image: Public Domain Pictures