Now is the Time for Detransition Diagnosis Codes
By Dr. Kurt Miceli
Dr. Kurt Miceli of Do No Harm’s letter regarding on the urgent need to create ICD-10 codes for transition and detransition
Dr. Kurt Miceli spoke about the need for medical codes for detransition at Genspect’s recent Detrans Awareness Day conference in Washington DC.
It was an honor to join Genspect’s Detrans Awareness Day on March 12. I was truly humbled by the opportunity to meet so many brave individuals who were willing to share their stories with honesty and courage. To those individuals: your willingness to speak openly—often at personal cost—continues to shape the national conversation in ways that matter. I remain deeply grateful for the kindness you extended to me and for the work you are doing to ensure that no one walks this path alone..
As I mentioned during the event, Do No Harm has been working with the Centers for Disease Control and Prevention (CDC) to develop new medical diagnosis codes—ICD-10 codes—related to gender transition and detransition. This work occurs through the CDC’s ICD-10 Coordination and Maintenance Committee. While the World Health Organization produces the ICD-10, the CDC can make clinical modifications to this diagnostic lexicon in the U.S. version, known as the ICD-10-CM.
Diagnosis codes are the backbone of clinical documentation. They allow clinicians to articulate the medical conditions impacting an individual, utilizing a clear structure and nomenclature. This ultimately supports precise documentation as well as accurate billing, while also generating data that can drive research, quality improvement, and patient safety across the entire healthcare system.
Currently, the ICD-10-CM holds approximately 70,000 diagnosis codes. This includes codes for hypertension (I10) and type 2 diabetes (E11), but also codes for walking into a lamppost (W22.02), contact with an orca (W56.2), and even a spacecraft collision injuring an occupant (V95.43). Yet, at this time, there is no code for detransition—a real, documented clinical experience affecting patients.
There is no question that these codes are urgently needed. Detransitioners in particular remain invisible to the current medical coding framework. Clinicians have no standardized way to document these visits, communicate clearly about the underlying condition, or submit claims that reflect the actual reason for care. The result is many patients whose needs are inconsistently recognized, inconsistently recorded, and too often inconsistently treated.
We hope this situation will soon come to an end.
Starting more than three years ago, before my involvement, physicians, including Drs. Carrie Mendoza and Aida Cerundolo, began the process of working with the CDC on ICD-10-CM codes for detransition. They laid the foundation by learning the ICD-10-CM process, understanding how codes are proposed and approved, and mapping out the steps required to bring detransition into the formal medical vocabulary of the United States. Their early work made it possible for us to continue pushing this effort forward today.
Last September, Do No Harm formally presented on gender transition and detransition codes to the CDC for the first time. Then, at the most recent meeting of the ICD-10 Coordination and Maintenance Committee in March, the CDC noted that one of our proposed codes, “F64.A Gender identity disorder, in remission, or gender dysphoria, in remission (desistance),” was accepted for implementation on October 1, 2026. We believe this code will help capture those who no longer experience cognitive incongruence between gender and sex.
However, more work remains to be done. That’s why we returned to the CDC in March with a revised proposal to capture different aspects of transition—social, medical (pharmacological), and surgical. With three separate codes to account for each of these states, we believe clinicians and researchers analyzing real-world data will be better able to track complications related to transitions.
More so, we also directly advocated for a code to capture detransition, or the act of stopping or reversing a gender transition. We believe this code, in particular, is essential for creating the diagnostic language to support care for individuals who have detransitioned or are in the process of detransitioning.
As to our revised proposal, we are currently within the 30-day public comment period, which ends April 17, and would certainly welcome support for these efforts. Comments can be directed to nchsicd10CM@cdc.gov and should note the proposal’s title, “Gender Identity Disorder, in remission: Transition and Detransition Codes.” Soon after the comment period, we should know whether these additional codes have been accepted for the October 2026 release.
In the meantime, we remain optimistic, knowing that these codes will help more accurately document an individual’s clinical state, support the appropriate delivery of care, provide valuable clinical information, support improvements in care, and allow researchers to collect essential real-time information. Ultimately, we aim for a medical system that will give visibility and appropriate care to those who have detransitioned.
Thank you for your support and for allowing me to share with you the current state of our work with the CDC.
Kurt Miceli, MD
Chief Medical Officer
