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ICD-10 Learning Lab Exit Presentation Mode

Category: F60 F61 F62 F63 F64 F65 F66 F68 F69

F66 — Psychological and behavioural disorders associated with sexual development and orientation: facilitator sheet

Teaching objective

The single most important teaching point for this category, and the reason it is included in this build with active correction rather than passive repetition, is this: distress that actually stems from discrimination, family rejection, or internalized societal stigma about one's own sexual orientation is not, by itself, evidence of an F66 disorder. A competent classification exercise should often correctly conclude that no F66 diagnosis is supported, once the actual source of the distress is identified as external rather than intrinsic to the orientation itself.

Choose material

Worked example · Case: Distress, but not from the orientation itself

Worked example

Show scenario

A young adult reports significant distress after disclosing their sexual orientation to their family, who reacted with rejection and have since become emotionally distant. The person states clearly that they are not confused or distressed about their own orientation itself — the distress they describe relates entirely to the family's reaction and their fear of further rejection from others.

(or reveal one step at a time below)
  1. Reveal step 1

    Step 1 — Check whether the orientation itself is a source of distress: the person explicitly states it is not.

  2. Reveal step 2

    Step 2 — Identify the actual source of distress: family rejection and fear of further rejection — an external, social cause.

  3. Reveal step 3

    Conclusion — No F66 classification is supported here. The distress is genuine and significant, but it is attributable to discrimination and rejection, not to the orientation itself, and this presentation is correctly classified as not meeting this category's threshold.

Comparison points

As ICD-10 frames this category, it requires distress specifically about one's own gender identity or orientation, with the orientation itself not in doubt — distress actually caused by discrimination or rejection does not meet this threshold, and often correctly resolves to 'not a disorder' here.

Discussion prompts

(or reveal one at a time below)
  1. Prompt 1

    Explain the single most important check to make before applying any F66 subtype.

  2. Prompt 2

    State why F66 does not support treating a person's orientation as something to be corrected.

  3. Prompt 3

    Explain why distress caused by family rejection does not, by itself, meet F66's threshold.

Summary

F66, as ICD-10 frames it, requires distress intrinsic to one's own orientation, not distress caused by discrimination or rejection — which often correctly resolves to 'not a disorder.'