and cultures but are broadly such as serve approved social and biological purposes." The description of homosexuality also included the line, "Code homosexuality here whether or not it is considered as a mental disorder," which acknowledged the lack of professional consensus on homosexuality as a mental disorder. After ego-dystonic homosexuality was removed from the DSM-III-R, the American Psychological Association passed a policy statement, drafted by the Committee on Gay, Lesbian, and Bisexual Issues, that urged its members to not use the diagnoses of homosexuality or ego-dystonic homosexuality listed in the ICD-9, DSM-III, or future editions of either manual. It specifically noted: "the next revision of the ICD is not anticipated to be completed until 1992 and may, according to current proposals, then contain the 'ego-dystonic homosexuality' diagnosis which APA also opposes." In the process of developing the ICD-10 (which was adopted by the WHO in 1990), the authors decided to delete the category of homosexuality. They initially considered replacing it with three diagnoses: "ego-dystonic sexual orientation associated with heterosexuality," "ego-dystonic sexual orientation associated with homosexuality," and "ego-dystonic sexual orientation associated with bisexuality." Eventually the decision was made to simplify these into one category, "ego-dystonic sexual orientation," which was defined in the ICD-10 as: The diagnosis was located within section F66, "psychological and behavioural disorders associated with sexual development and orientation," and the following note was included in that section: "Sexual orientation by itself is not to be regarded as a disorder." Removal from the ICD The World Health Organization was increasingly called on to remove ego-dystonic sexual orientation from the ICD, including by the American Psychological Association, which recommended removing the section of categories related to sexual orientation (part F66), noting that they were "historically rooted in and support continuing unscientific stigmatization of homosexuality by health professions." As part of the development of the ICD-11, the WHO appointed a Working Group on the Classification of Sexual Disorders and Sexual Health to make recommendations on part F66. In 2014 the working group recommended deletion of part F66 due to a lack of clinical utility, a lack of usefulness in public health data, and the potential for negative consequences, including the risk of these categories lending support to "ineffective and unethical treatment" such as conversion therapy. In reference to ego-dystonic sexual orientation, the working group noted that although the description of the category includes gender identity and also could theoretically be applied