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THREAD:
What’s on your Medical Record: SEX or Gender?
This is a long thread so here’s the TLDR:
Officially, your NHS medical record is SUPPOSED to hold your SEX.
And, your gender identity *as well* IF YOU WANT.
You’ll have to read to the end to find out if it does though ;-)
What’s on your Medical Record: SEX or Gender?
This is a long thread so here’s the TLDR:
Officially, your NHS medical record is SUPPOSED to hold your SEX.
And, your gender identity *as well* IF YOU WANT.
You’ll have to read to the end to find out if it does though ;-)
1/ It’s been disturbing recently to hear a subsection of apparent medics & scientists proclaiming that sex is a spectrum, a social construct, that there’s no such thing as a female body, only a ‘female brain’.
Is this what the NHS thinks?
Is this what the NHS thinks?
2/ I did some research.
I wanted to know if the people that treat my body when I’m ill accept that my body has a sex which affects that treatment.
Here’s what I found.
After the GRA2004, the NHS, like every UK institution, legally had to record ‘gender’ for those that claim one.
I wanted to know if the people that treat my body when I’m ill accept that my body has a sex which affects that treatment.
Here’s what I found.
After the GRA2004, the NHS, like every UK institution, legally had to record ‘gender’ for those that claim one.
3/ Most institutions have OVERWRITTEN sex with gender as if they were the same thing, as if ALL of us have a compulsory gender that’s more important than our sex. If gender is different from sex, gender overrides sex; gender wins. Sex on a passport/driving licence became gender.
4/ But if the NHS do this, people will get hurt. Some will die. Anatomy, genetics, reproductive systems, drug responses, diseases…they’re sex dependent. You can’t overwrite that stuff with feelings. You can’t let ideology trump biology in medicine.
5/ So the NHS wrote a bunch of “Sex and Gender” documents to make the data architecture and systems able to capture sex AND gender. These are really detailed documents. They worked to eliminate any residual ambiguity of sex & gender terminology.
They use DEFINITIONS. <faints>
They use DEFINITIONS. <faints>
6/ Like this:
“Current Gender, as assigned by the individual to themselves”
“Sex is the phenotypic sex of the person as recorded by the Registrar on the Register of Births”
This is how these two fields look within the NHS “Data Dictionary” system
“Current Gender, as assigned by the individual to themselves”
“Sex is the phenotypic sex of the person as recorded by the Registrar on the Register of Births”
This is how these two fields look within the NHS “Data Dictionary” system
7/ It also is crystal clear that systems must never allow the two to be confused:
“The term ‘Gender’ is now considered too ambiguous to be desirable or safe”
“The term ‘Gender’ is now considered too ambiguous to be desirable or safe”
8/ “Users may confuse the terms current gender and sex, or assume that they are synonymous. Therefore, it is essential that all NHS applications display and explain current gender and sex terminology and values in a clear and consistent manner.”
9/ “NHS clinical applications should use the Current Gender and Sex format to enhance readability, ensure consistency and to cover all possible variants of Current Gender and Sex. This recommendation provides the best display format because it decreases ambiguity”
10/ Good Stuff.
There were example templates created for NHS applications showing how SEX and CURRENT GENDER should both be captured, clearly, with little pop-up (rollover) definitions, and restricted choices. So that the two would NEVER get mixed up.
Like this:
There were example templates created for NHS applications showing how SEX and CURRENT GENDER should both be captured, clearly, with little pop-up (rollover) definitions, and restricted choices. So that the two would NEVER get mixed up.
Like this:
11/ Even labelling a field with *just* the word ‘Gender’ was too ambiguous, and might be confused with sex.
The field should be labelled correctly using the “CURRENT Gender” along with its definition.
The words ‘safe’ , ‘safety’ and ‘safest’ are used in this document. A lot.
The field should be labelled correctly using the “CURRENT Gender” along with its definition.
The words ‘safe’ , ‘safety’ and ‘safest’ are used in this document. A lot.
12/ The NHS created a risk assessment/hazard document to prevent mistreatment as a result of sex v gender errors.
(It also accepts status of the patient must be entered in a ‘legally compliant’ and ‘patient-sensitive’ manner).
But it points out that clinically hurt>hurt feelings
(It also accepts status of the patient must be entered in a ‘legally compliant’ and ‘patient-sensitive’ manner).
But it points out that clinically hurt>hurt feelings
13/ Here are some of the documented risks of mixing up sex and gender:
14/ Like if administrative gender is used for clinical judgements instead of sex?
15/ Or if the user of a system (doctor, nurse, administrative person) doesn't understand the difference between sex and gender?
16/ That previous post is interesting because we learn:
a. Records might be accidentally altered - eek
b. Screwing up SEX is worse than screwing up gender
(Gender is an administrative courtesy but SEX is essential for clinical care)
a. Records might be accidentally altered - eek
b. Screwing up SEX is worse than screwing up gender
(Gender is an administrative courtesy but SEX is essential for clinical care)
17/ c. ‘rollovers’ on the field labels — these are pop-up descriptions on forms that appear when you hover over a label to make absolutely sure you know what the accurate description is
d. National Health Screening programmes are SUPPOSED TO BE BASED ON SEX, NOT GENDER VALUES.
d. National Health Screening programmes are SUPPOSED TO BE BASED ON SEX, NOT GENDER VALUES.
18/ So, if you’re like me, at this point you are massively relieved. Sanity has prevailed, our medical records are keeping our sex on them, gender is there for those who want it but the NHS isn’t stupid and won’t stuff this up.
Let me ruin that for you.
Let me ruin that for you.
19/ I submitted a Subject Access Request to my local hospital to take a look at my own medical record.
Here’s what I received.
That’s right.
I’ve got a ladybrain on my medical record.
And my sex is ‘unpopulated’.
This hospital cared for me with two pregnancies and births.
Here’s what I received.
That’s right.
I’ve got a ladybrain on my medical record.
And my sex is ‘unpopulated’.
This hospital cared for me with two pregnancies and births.
20/ I probably should have seen this coming. But I didn’t.
What I expected was that I’d possibly find an assigned (and unwanted) ‘current gender’ *in addition to* my sex.
I had an inkling that national screening programmes were being run off ‘gender’ data instead of sex data.
What I expected was that I’d possibly find an assigned (and unwanted) ‘current gender’ *in addition to* my sex.
I had an inkling that national screening programmes were being run off ‘gender’ data instead of sex data.
21/ https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/623309/Transgender_cross_programme_screening_leaflet.pdf
This leaflet confirms that National Health Screening programmes are using 'gender' not sex.
This leaflet confirms that National Health Screening programmes are using 'gender' not sex.
22/ There’s plenty of evidence the system is currently malfunctioning.
Not only are we now calling trans people for the wrong screening, not only might they have the wrong treatment, but ALL of us are at risk.
Datasets for health outcomes are now muddled with both sexes.
Not only are we now calling trans people for the wrong screening, not only might they have the wrong treatment, but ALL of us are at risk.
Datasets for health outcomes are now muddled with both sexes.
23/ Disease incident risks will be wrong. Blood & transplant donors/recipients may match ‘gender’ but not sex.These are real outcomes.
Last year a transman lost vital time getting a kidney transplant.They were assessed using male kidney function ranges. This was a 5’1’’ female.
Last year a transman lost vital time getting a kidney transplant.They were assessed using male kidney function ranges. This was a 5’1’’ female.
24/ http://clinchem.aaccjnls.org/content/63/11/1680
That was in the USA. But of course it could happen here. Not to mention that if a female gets a transplant from a male donor it’s more likely to fail. Sex matters.
That was in the USA. But of course it could happen here. Not to mention that if a female gets a transplant from a male donor it’s more likely to fail. Sex matters.
25/ I was anticipating a campaign pointing out that forgotten sex data is right there, NHS, Look! Use SEX to call women for cervical smears!
Now I’m thinking that perhaps the NHS don’t hold sex data on any of us.
Maybe they’ve completely, utterly screwed this whole thing up.
Now I’m thinking that perhaps the NHS don’t hold sex data on any of us.
Maybe they’ve completely, utterly screwed this whole thing up.
26/ I can’t tell you what is actually on your own medical record, but you can submit a SAR like I did to find out.
What you SHOULD find, is your SEX is accurately captured in the PHENOTYPIC SEX field & your CURRENT GENDER should be default ‘Not Known’ unless specified otherwise.
What you SHOULD find, is your SEX is accurately captured in the PHENOTYPIC SEX field & your CURRENT GENDER should be default ‘Not Known’ unless specified otherwise.
27/ But you may find that your sex has vanished, and your ladybrain/manbrain has been assigned & is being used for a great many purposes.Maybe, when we look at the computer systems that hold our records, maybe NONE of them are actually following the NHS SEX and GENDER Standards.
28/ Maybe this is a much bigger muckup than I initially presumed.
https://medium.com/@anneharperwright/sex-gender-the-nhs-bb86b0c3ebb
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https://medium.com/@anneharperwright/sex-gender-the-nhs-bb86b0c3ebb
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