Question to the Department of Health and Social Care:

To ask His Majesty's Government, with regard to the service specification for NHS children and young people's gender services, published on 1 April, whether the NHS and relevant service providers plan to use the ICF-11 definition of gender incongruence instead of the DSM-5 diagnosis of gender dysphoria.

NHS England's consultation report on the proposed changes to the service specification for specialist gender services for children and young people, published on 1 April 2026, describes that the open caseload within the children and young people’s gender service is defined by the International Classification of Diseases 11th Revision (ICD-11) as all children referred into the service will have a marked incongruence between their experienced/expressed gender and their natal sex.

For the purpose of diagnostic assessment, the holistic assessment framework that is described in the service specification refers to ‘gender dysphoria’ as defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) and references the Cass Review’s observation that “there is no clear consensus across international guidelines as to whether DSM-5 diagnosis of gender dysphoria or ICD 11 diagnosis of gender incongruence is preferred. However, in clinical practice the DSM-5 diagnosis of gender dysphoria is more widely used, this also applies to research publications”.