NHS update on recording patient sex and gender identity

Booking and reception - how the patient is called from the waiting room, correspondence, and respectful communication.

Mental health services - social role, lived experience, and gender identity may be highly relevant to assessment and therapeutic rapport.

Breast screening - trans women who have undergone years of oestrogen therapy may require breast assessment.

Bone health - this is affected by hormone balances

Endocrinology - hormone results are affected by hormone therapies.

Laboratory interpretation of blood results - for some patients on long term hormone therapy reference ranges may be according to gender rather than birth sex.

Furthermore, there are all kinds of clinical contexts where birth sex is not relevant at all, and more important is treating the patient in a manner that is compatible with their dignity, safety and privacy, e.g dermatology, orthpaedics etc, etc etc.

This whole thread was started with the OP declaring what was in the best interests of trans people, and I waded in to object to that for reasons clearly outlined in my initial posts.
There are two trans people on this thread: one who would like a birth sex marker on his medical record and the other who would not. Both should be free to make those decisions for themselves as adults with legal capacity who have a right to make decisions about disclosure and access to personal information and decisions about their own healthcare.

Fortunately this is what is stated in the implementation guidance:

• Gender identity should ONLY be recorded if a person has a gender identity and wants it recorded in their healthcare record and a clinician decides it is appropriate to record it.
• Information about gender identity should ONLY be recorded if a person has a gender identity and wants additional information about it recorded in their healthcare record and a clinician decides it is appropriate to record it.
• Pronouns should ONLY be recorded if a person wants their pronouns recorded in their healthcare record and a clinician decides it is appropriate to record them.

As such, I think that's a fair compromise.

Fortunately this is what is stated in the implementation guidance:

• Gender identity should ONLY be recorded if a person has a gender identity and wants it recorded in their healthcare record and a clinician decides it is appropriate to record it.
• Information about gender identity should ONLY be recorded if a person has a gender identity and wants additional information about it recorded in their healthcare record and a clinician decides it is appropriate to record it.
• Pronouns should ONLY be recorded if a person wants their pronouns recorded in their healthcare record and a clinician decides it is appropriate to record them.

As such, I think that's a fair compromise.

Booking and reception - how the patient is called from the waiting room, correspondence, and respectful communication.

Mental health services - social role, lived experience, and gender identity may be highly relevant to assessment and therapeutic rapport.

Breast screening - trans women who have undergone years of oestrogen therapy may require breast assessment.

Bone health - this is affected by hormone balances

Endocrinology - hormone results are affected by hormone therapies.

Laboratory interpretation of blood results - for some patients on long term hormone therapy reference ranges may be according to gender rather than birth sex.

Furthermore, there are all kinds of clinical contexts where birth sex is not relevant at all, and more important is treating the patient in a manner that is compatible with their dignity, safety and privacy, e.g dermatology, orthpaedics etc, etc etc.

I don’t have a gender and will only accept a gender field if there’s a ‘none’ or ‘not applicable’ option, the same as with the religions question. Like you, I will not accept some sexist person deciding to allocate a gender to my record anymore than I would accept having religious belief ascribed by someone who believes in gods.

Booking and reception - how the patient is called from the waiting room, correspondence, and respectful communication.

Mental health services - social role, lived experience, and gender identity may be highly relevant to assessment and therapeutic rapport.

Breast screening - trans women who have undergone years of oestrogen therapy may require breast assessment.

Bone health - this is affected by hormone balances

Endocrinology - hormone results are affected by hormone therapies.

Laboratory interpretation of blood results - for some patients on long term hormone therapy reference ranges may be according to gender rather than birth sex.

Furthermore, there are all kinds of clinical contexts where birth sex is not relevant at all, and more important is treating the patient in a manner that is compatible with their dignity, safety and privacy, e.g dermatology, orthpaedics etc, etc etc.

Booking and reception - how the patient is called from the waiting room, correspondence, and respectful communication.

Mental health services - social role, lived experience, and gender identity may be highly relevant to assessment and therapeutic rapport.

Breast screening - trans women who have undergone years of oestrogen therapy may require breast assessment.

Bone health - this is affected by hormone balances

Endocrinology - hormone results are affected by hormone therapies.

Laboratory interpretation of blood results - for some patients on long term hormone therapy reference ranges may be according to gender rather than birth sex.

Furthermore, there are all kinds of clinical contexts where birth sex is not relevant at all, and more important is treating the patient in a manner that is compatible with their dignity, safety and privacy, e.g dermatology, orthpaedics etc, etc etc.

Its as bonkers as me not wanting everyone to know im menopausal, so demand that I can decide who needs to know my date of birth and when.

Everyone else can record their true date of birth, but i can have a false one or have it blank depending on my mood.

In many healthcare interactions, a person's gender is the more relevant demographic characteristic

Can you give some examples, and would this be gender in addition to sex or instead of sex?

You are conflating a lot of different things here.

No one is arguing that clinicians should be misled or that patients should receive treatment based on false information. The question is whether there should be a mandate for birth sex to be routinely and universally displayed across all clinical encounters - whether that is proportionate, justified and the impact of such a rule on the privacy of trans patients.

Nor does recording a person's gender necessarily amount to "false information". In many healthcare interactions, a person's gender is the more relevant demographic characteristic, while birth sex is a separate piece of clinical information that may or may not be relevant depending on the context.

The debate is about how healthcare systems should record and disclose different types of information—not about whether clinicians should be deceived.

I do not have a gender, I reject gender. Gender is sexist stereotypes - obviously anyone who looks at me and is sexist will assume a gender for me because my sex is obvious, but non-sexist people will not and won't need to as gender is irrelevant, they will merely perceive my sex and get on with their day. I want my NHS records to have my sex clearly and visibly indicated to anyone who sees my records because they need to know whether to compare the levels of various things being detected in my blood samples etc against male or female averages to know what is elevated/insufficient. I want any "gender" box to be blank and always blank and never automatically filled in with the gender that a sexist person would expect from my body type, because there is no need for anyone who is treating me to know anything about the extent to which sexist stereotypes (ie gender) apply to me.

The idea that sex should be something private is very silly and it would be irresponsible and unprofessional for anyone working in healthcare to aid anyone in keeping it a secret, it would be openly encouraging malpractice failures with someone being given the wrong treatment for their body type. A female who has had drastic cosmetic surgery and takes huge testosterone doses is not the same as a male and needs to be treated by a clinical team who know them to be a female who has had drastic cosmetic surgery and takes huge testosterone doses. A male who has had drastic cosmetic surgery and takes huge oestrogen doses is not the same as a female and needs to be treated by a clinical team who know them to be a male who has had drastic cosmetic surgery and takes huge oestrogen doses. The NHS clearly knows this, and isn't afraid to say so any more.

Why is my investment any stranger than yours? This is a matter of public policy and we have opposing opinions on the matter.
I am concerned about a huge range of human rights and social justice issues.

You seem oddly over invested in this issue. Do you have a trans relative?

You are conflating a lot of different things here.

No one is arguing that clinicians should be misled or that patients should receive treatment based on false information. The question is whether there should be a mandate for birth sex to be routinely and universally displayed across all clinical encounters - whether that is proportionate, justified and the impact of such a rule on the privacy of trans patients.

Nor does recording a person's gender necessarily amount to "false information". In many healthcare interactions, a person's gender is the more relevant demographic characteristic, while birth sex is a separate piece of clinical information that may or may not be relevant depending on the context.

The debate is about how healthcare systems should record and disclose different types of information—not about whether clinicians should be deceived.