NHS Blood donating form saying 'gender' not 'sex'

VicSynix

Brilliant work!

We apologise, we are aware that the form does not appropriately capture the information necessary by asking for gender instead of sex. We are in the process of updating the forms. Unfortunately the incorrect terminology has been used.

Blimey

Excellent job Vic

Indeed mixed sex toilets is a yes - individual cubicle toilets i.e. one door straight into the loo works for gender neutral and the door symbols are quite interesting - you have the circle with the male and female symbols branching off - to be equitable to those who don't know or recognise that symbol, there's also the 'figures' - the traditional male, female and a figure made up of half of both - you then have to make that sign inclusive for accessible toilets and or baby changing as well - so, in the worse scenario you have five symbols (male, female, trans, baby and wheelchair) plus the text underneath that the toilet can be used by any gender ..... what will be more interesting is if we are ever expected to make multi cubicle toilets accessed from one door, also gender neutral i.e. walk through the main door, to find three cubicles all gender neutral - designers and planners will have a nightmare meeting any compliance or guidance standards - it could be the end of the urinal as we know it if you retro amend access to toilets and making them gender neutral. Think of all those shopping centres needing to be changed and re-designed for the future.

Well done!

You'd think the NHS would be sensible about this but hey ho.

Working in a healthcare organisation we are now changing signs on toilet doors to gender neutral with mixed symbols and logo's

So mixed sex?
I do wonder how accessible the language and signs are in such cases.

I'm not sure I personally have an issue about the wording for my donor form. I gave blood irregularly until I got into a good routine (with an obliging employer) that ended up with me as a platelet and plasma donor for the last 4 years (now at my 98th donation plasma/platelet wise). Working in a healthcare organisation we are now changing signs on toilet doors to gender neutral with mixed symbols and logo's. It is a mine field to say the least. I know that whether it be my blood, platelets or plasma, the people who need it, (whatever gender or sex) will get it. We've ham strung our public bodies with all these challenges or gender neutrality and correctness - don't shoot the messenger as it's not the staff who need to be questioned on these decisions but the senior decision makers please.

Yes, it is official guidelines. As explained on the webchat.
Also, if you self identify as a women you would not be able to donate as frequently as per the female guidelines because periods.

It's crazy.

As ItsAllGoingToBeFine said

Haemaglobin levels are set for both males and females; there is a legal requirement that these must be met before a donation can be given. Donors who identify themselves as male will be assessed using the male haemoglobin levels and similarly donors identifying as female must have sufficiently high haemaglobin levels to meet the female levels

I have given blood many times but failed (as a male) a couple to times to reach the male threshold for haemoglobin. I asked the nurse if I self-identified as female would they take my donation they said yes.

Don’t know if this is the official guidance.

Why would they have a higher level for males if it's not a risk? The female cut-off (125g/L) is below the normal adult male range (130-180g/L)

www.royalwolverhampton.nhs.uk/services/service-directory-a-z/pathology-services/departments/haematology/haematology-normal-adult-reference-ranges/

So a tw could meet the level for women but not the level for men and be allowed to give blood even though their haemoglobin is very low for a male.
I don't think that means extra risk for a TW, as they would exceed the required level for a woman, but wouldn't have the same risk factors (periods) that a woman has - and in England would go down to 3 times per year.
So the extra risk is with TM, if and when they still have periods and are requested to donate 4 times (that latter risk is negligible, I think, many more countries are 4 times standard). You can always skip, obviously. The Hb measurement is an issue when still menstruating, though.

PencilsInSpace I think men have naturally higher levels.

They do, yes. From the FOI:

Haemaglobin levels are set for both males and females; there is a legal requirement that these must be met before a donation can be given. Donors who identify themselves as male will be assessed using the male haemoglobin levels and similarly donors identifying as female must have sufficiently high haemaglobin levels to meet the female levels

2) The haemoglobin level at which we accept a donor is defined in law (Blood Safety and Quality Regulations 2005, and an EU Directive) as 125g/L for women and 135g/L for men. This is for the safety of donors to prevent anaemia developing.

So a tw could meet the level for women but not the level for men and be allowed to give blood even though their haemoglobin is very low for a male.

I use a Sharpie on any forms that solely ask your "gender" rather than "sex".

However, I feel it is even more important to be aware of this in a medical/healthcare setting. I recently was given a form at hospital which asked "is your gender the same as the one assigned to you at birth?" This was for a pre-op assessment - what the fuck does your desire to confirm to social stereotyping (or not) have to do with your medical care?! Before we even start with the assigned at birth bollocks.

I discussed it with the surgeon who agreed with me and seemed very GC. Interestingly he said "you just can't say things like that in public these days, to your employers or to your teenage children" (the latter bit did make me smile albeit ruefully )

Obviously I leafleted the FPFW leaflet everywhere I could and made my feelings clear on the questionnaire and patient feedback.

(I'm not allowed to give blood so haven't seen those forms but agree it is ridiculous).

MilkGoatee

YY
In the article linked above, the male non-binary blood donor is put onto female protocol:

(extract)
So I wrote back to NHS Blood and Transplant – they must love me! I said I’d rather register as female – but I raised my query. They replied:

Your paperwork and your record will show your gender as female, we will test your blood using the female cut-off level for haemoglobin testing and the crucial bit now is you should not donate more than 3 times a year.

This is the restriction being applied to female donors as in the general population females have less iron than males. As you may be aware testosterone has some influence on your body’s uptake of iron.

If you stick to 3 times a year donation frequency (average 16 weeks) and you continue your healthy lifestyle, you are at low risk of developing anaemia even if you start hormone replacement therapy and testosterone blockers. Hope this reassures you.

Kindly let me know your donor ID and I will update your record so the nurse on session is aware of our discussion.

Which all makes sense – but it didn’t really answer my question about being registered female before starting HRT. I note that I can also only donate three times a year as female as opposed to four times as male. Anyway, I left it there – and then forgot about the whole thing. Until today – donation day." (continues)

PencilsInSpace I think men have naturally higher levels.

Is it that women need higher levels in order to be allowed to donate? As they need more time to replenish with periods and all that. That would mean that TW are less likely to donate than TM.

But TM are at risk, if they still have periods, if they require lower levels to be allowed to donate.

May 2017 Beyond the Binary article by Andie Pas de Deux
'Giving blood as a non-binary transgender person'

Confirms UK description of blood donation which allows donors to declare their 'preferred gender' rather than biological sex.

In this article the male blood donor 'chooses' to donate blood as 'female' and describes correspondance with the UK Blood Donor Service.
beyondthebinary.co.uk/giving-blood-as-a-non-binary-transgender-person/

What seems lost to the author is any consideration to the impact on the blood transfusion service of their demands for validation and most importantly the possible impact on ensuring safe blood products for intended recipients.

Current context being the long awaited contaminated blood hearing:
www.theguardian.com/uk-news/2019/apr/30/what-is-the-contaminated-blood-scandal

Independent 2017
www.independent.co.uk/news/uk/home-news/gay-men-donate-blood-rules-three-months-after-having-sex-12-government-policy-freedomtodonate-a7854811.html

There was discussion about this with regards a complaint by a transgender person North America last year.
www.mumsnet.com/Talk/womens_rights/3372218-Identifying-as-female-to-sell-blood

The last few vaccination forms for my DDs have had Gender on them, I crossed it out and wrote 'Sex - Female'.

The two articles posted by @OldCrone are DEFINITELY worth reading for anyone in the UK

Sex, Gender & the NHS Part 1: The “Single-Sex Hospital Wards” that have always been a lie
medium.com/@anneharperwright/sex-gender-the-nhs-1e8f4e6363a6

Sex, Gender & the NHS Part 2: Your Medical Record and your Ladybrain
medium.com/@anneharperwright/sex-gender-the-nhs-bb86b0c3ebb

I worked in the NHS and fed back my experience of the sex vs gender issue to the author so I won't repeat it all here (life is too short!)

The only thing I would like to point out is that the forms are normally designed or approved by Medical Records Dept - not clinical staff. Most of the gender/sex mix-ups across the NHS seem to be due to clerical/admin staff in Medical Records and IT Depts being responsible for implementing relevant directives from the NHS and Dept of Health - and not understanding them, eg. a widespread misreading of a directive (around about 2007 I think, might be a little earlier) about an additional requirement to record gender.

I know for a fact that this was misinterpreted in some NHS trusts as an instruction to re-label the data field "sex" as "gender" rather than add a new field for "gender". This is because "sex" and "gender" are, or at least were, used interchangeably in common parlance. I challenged it in my Trust but was told, basically, "computer says No".

I was also told that on every occasion we saw a patient, even if we were seeing them every week, that we had to ask them if they had "changed sex" since they were last seen! I told Medical Records that I did not intend having my patients think that I had gone stark staring mad and refused to do it. (In a previous post I worked with transsexuals but I was completely unaware of the "Transgender" issue until a few months ago.)

Image attached of the relevant part of the Out Patient Form from where I worked, after we had been told to replace "Sex" with "Gender". This was in use from, I am pretty sure, no earlier than 2007.

I’d always assumed the blood would be tested to determine/double check it’s, um... provenance (surely not too difficult?), along with testing for safety.

Is that not the case?

Anyone like to FOI for the Equality Assessment then? Good point re the TW iron levels.

Do you think they’ve confused it - so when they say ‘transgender women’ they mean women identifying as men? Then it makes sense

I wondered that, because the language is so confusing. But I think the answer is no.

8: The criteria by which a transgender woman will be considered by NHSBT to be a woman for the purposes of the MSM deferral. If a donor states that they are a woman we accept that and do not enquire about their birth gender. As stated earlier in this response, donors who identify themselves as male will be assessed using the male haemoglobin levels and similarly donors identifying as female must have sufficiently high haemaglobin levels to meet the female levels.

There is additional risk to tw because they will only have to meet the required haemoglobin levels for women. These are lower than for men which means tw who give blood may be at risk of anaemia.

Am I right in thinking all policy (changes) by a government department must undergo an equality assessment before implementation?

This seems to be introducing higher risk into the blood system, but I am not sure that it is higher risk to any particular group? Possibly higher risk to men as they could receive blood from a transman who has been pregnant?