Peru Introduces Controversial Policy Labeling Transgender Identity as a Mental Health Condition
The announcement from Peru’s government that transgender identities would be treated as “mental health problems” under a new health insurance classification arrived with a level of force that many in the country were not prepared for. What began as a technical adjustment to the national insurance registry immediately grew into a national flashpoint because it reintroduced language that global health authorities rejected years ago. The decree, signed by President Dina Boluarte and published on May 10, added terms such as “transexualism,” “gender identity disorders,” and “cross-dressing” to the list of insurable mental health conditions. This move landed at a moment when international organizations, including the World Health Organization, have already made clear that gender identity is not a disease and should not be treated as one. For many Peruvians, especially those within the LGBTQ community, the shock was not simply in the policy itself but in the feeling that the country had abruptly reversed social and medical progress.
As the initial news circulated, the uncertainty quickly shifted into mobilization. Advocates pointed to the WHO’s 2019 shift that moved all gender identity related labels out of the category of mental and behavioral disorders and into a broader classification related to sexual health. The WHO stated that this change “reflects current knowledge that trans-related and gender diverse identities are not conditions of mental ill-health, and that classifying them as such can cause enormous stigma.” For many in Peru, the contradiction between this global standard and the decree was impossible to ignore. The resulting public conversation has become an intense mix of fear, anger, and determination, pulling national attention toward the deeper question of whose dignity a government is willing to protect.
A Decree That Reopened Old Wounds
When the text of the new decree became public, the language caught immediate scrutiny because it revived diagnostic labels considered outdated by global health institutions. The update was framed by officials as an expansion of coverage under the Essential Health Insurance Plan so that individuals seeking related care could access mental health services. Yet for many activists and health professionals, the issue was not the intention to increase benefits but the reappearance of terminology that has historically fueled discrimination. They questioned how a government could simultaneously assert respect for gender diversity while using labels that define transgender identity as a disorder.
In response to the rapid criticism, the Health Ministry released a statement on May 11 explaining that the update was meant to “ensure comprehensive mental health interventions” and insisting that “the ministry ratifies its position that gender and sexual diversity are not diseases.” The ministry also stressed its “rejection of the stigmatization of sexual diversity in the country.” Despite these assurances, the ministry confirmed that the decree would remain active. For many activists, this served as evidence that the clarification did not resolve the core issue because the legal classification itself carries consequences regardless of the government’s stated intentions.
The tension between these two messages created an atmosphere of confusion among the public, leaving many to question which message to believe. The decree’s language formed a legal reality while the ministry’s public statement attempted to soften the interpretation. For activists and LGBTQ individuals, the contradiction deepened their concern that the decree could lead to real harm, including reinforcing outdated stereotypes or creating openings for abusive practices. Even though the ministry reiterated that individuals “should not be subjected to treatments such as conversion therapy,” the presence of the diagnostic labels raised fears that such practices could return under different forms.
A Wave of Protest in the Capital
Within hours of the ministry’s follow-up statement, more than 60 LGBTQ organizations coordinated a protest outside the ministry headquarters in Lima. The timing was significant because it aligned with the International Day Against Homophobia, Transphobia and Biphobia on May 17, a date already dedicated to challenging discrimination and asserting the dignity of LGBTQ communities. Protesters gathered with banners, signs, and speeches that centered the message that identity is not a disorder and that Peru must not regress into outdated frameworks.
Organizations involved released a joint statement describing the decree as perpetuating “an archaic vision” that places transgender people at heightened risk of hostility and aggression. They argued that “the adoption of such a decree constitutes a serious setback in terms of our rights and in the recognition of our dignity as individuals,” and that the measure “not only reflects a lack of understanding and respect for sexual and gender diversity, but also has devastating consequences for our lives.” These statements reflected a shared fear that legal language could directly influence public perception in ways that endanger transgender individuals.
Groups such as Transformar urged the government to “adopt measures that respect and promote inclusive public policies,” framing the issue as a matter of both human rights and medical accuracy. Another organization, Collective Pride March, warned that the decree “opens the door to aberrant practices such as conversion therapies” and reaffirmed that “gender identity is not a disease, it is part of human diversity and must be respected and protected as such.” Although the Health Ministry stated that conversion therapy should not occur, activists emphasized that legal misclassification itself could embolden harmful practices. The protest made clear that the community viewed the decree not as a symbolic misstep but as a direct threat to safety and equality.
Reactions From Abroad and the Broader Political Impact
International concern quickly followed. In the United States, Representative Robert Garcia offered one of the strongest official responses. As both a gay man and the first Peruvian American to serve in Congress, he stated that he would be working with the State Department to “push back on this direct attack on LGBTQ+ Peruvians” and argued that the measure “moves Peru backward.” He added that “the decision by the Boluarte administration and the right-wing Congress to attack and label trans and intersex Peruvians as ‘mentally ill’ is discriminatory, dangerous and shameful.” His remarks framed the decree as part of a larger political pattern rather than an isolated policy choice.
The American Psychiatric Association’s long-standing terminology also came under renewed attention. Since 2013, the APA has used “gender dysphoria” instead of “gender identity disorder,” recognizing that the emotional distress some individuals experience is not caused by their identity itself but by difficulties in social acceptance or access to affirming care. This distinction further underscores how far global standards have moved from the model Peru’s decree returns to. For observers outside Peru, the decree signaled a troubling step that could influence other countries where debates about gender identity remain politically charged.
While foreign criticism cannot reverse national policy, it often signals shifts in diplomatic relationships and international expectations. The statements from abroad also provided a form of validation to Peruvian activists who felt that their concerns were being echoed beyond national borders. As the situation continues to unfold, global organizations and foreign governments may place additional pressure on Peru to revise the decree or align its health classifications with contemporary standards.
The Personal and Social Impact on Transgender Peruvians
The controversy surrounding the decree extends far beyond political statements because it directly affects how transgender people navigate public life in Peru. Many individuals already face barriers in employment, healthcare, and legal recognition. For them, the new classification reinforces a narrative that identity is abnormal or defective, making social interactions more fraught and potentially more dangerous. Activists fear that the decree could embolden discrimination in workplaces, schools, or public services where transgender individuals already report difficulties.
Social stigma also shapes mental health outcomes, and public policy plays a major role in either challenging or reinforcing that stigma. When a government labels gender identity as a mental health issue, even with the stated intention of expanding coverage, the effect can produce increased isolation or anxiety among transgender people. The renewed debate has led many to reflect on how easily progress can be undone when political decisions fail to align with scientific knowledge.
Despite the concern and frustration, many activists have also found strength in community responses. The protest became a moment of collective affirmation, reminding individuals that they are not alone and that advocacy remains a powerful force. As organizations continue to push for policy revision, the emphasis remains on dignity, scientific accuracy, and the rejection of harmful narratives.
Where Peru Stands Now
Peru’s decision to classify transgender identities as mental health conditions has reopened a difficult chapter that many hoped had already been closed. While the Health Ministry has insisted that “gender and sexual diversity are not diseases,” the persistence of the decree creates a disconnect that carries real consequences. The protests, statements from advocacy groups, and reactions from abroad all highlight how deeply the issue resonates on both personal and political levels. The situation has become a moment of reflection on how societies define health, identity, and dignity.
As the conversation continues, the responsibility now lies with policymakers to align national health classifications with established scientific understanding and to recognize the lived realities of transgender people in Peru. Communities will continue to push for change, and their persistence demonstrates a commitment not only to legal recognition but to a broader cultural shift toward respect and equality. The unfolding dialogue serves as a reminder that rights are never static and that vigilance is essential in protecting the dignity of all individuals.