NHS update on recording patient sex and gender identity

Where will the information about the patient's sex be recorded then? You agree that it is important in some clinical contexts, so where will the clinician get the information from?

The wit! The cogent, convincing arguments!

The Sullivan Review recommends ending this practice:

7. The NHS should cease the practice of issuing new NHS numbers and changed ‘gender’ markers to individuals, as this means that data on sex is lost, thereby putting individuals at risk regarding clinical care, screening, and safeguarding, as well as making vital research following up individuals who have been through a gender transition across the life course impossible. In the case of children, this practice poses a particularly serious safeguarding risk, and should be suspended as a matter of urgency.

https://www.gov.uk/government/publications/independent-review-of-data-statistics-and-research-on-sex-and-gender/review-of-data-statistics-and-research-on-sex-and-gender-executive-summary

Let's imagine a patient being called through with left lower abdo pain. In which patients would you consider testicular torsion? In which patients would you consider an ectopic pregnancy? Or a GP rings renal medicine about a patient with possible renal failure - should you be using the male normal range of valies, or the female?

Every single patient, age and sex is the first vital information.

This is rubbish. The administrative data sets (not clinical notes) have only recorded gender for at least 3 decades.

If Sullivan had ever used healthcare data she'd know that a steady stream of males having gynaecological procedures and female having prostate/testes procedures exist in Hospital Episode Statistics since inception. But she hasn't so she made up her sham report on the basis of a fiction that she should is a fiction

It’s the bait and switch. “gender” isn’t actually what should be recorded, it’s sex. It’s the critical information here.

I don’t have a “gender”, I have a sex. The NHS chose to accommodate people’s false claims of being the opposite sex in a completely underhand way.

A former MNer did some excellent work uncovering this all about 6 years ago.

If Sullivan had ever used healthcare data she'd know that a steady stream of males having gynaecological procedures and female having prostate/testes procedures exist in Hospital Episode Statistics since inception. But she hasn't so she made up her sham report on the basis of a fiction that she should is a fiction

When I worked with hospital statistics, if males were recorded as having gynae procedures, or females having prostate procedures, i would flag the data as inaccurate.

Up until the late 2010s it was assumed that only a few thousand people would ever change their sex/gender, so the idea that we'd see a 'steady stream' of inappropriate procedures is rubbish.

The issue the NHS has now is that it hasn't a clue how many records have the incorrect information.

If I remember correctly, after the GRA, the NHS created a gender field in addition to the sex field, clearly stating the difference.

Somewhere along the way, the gender field was populated with sex or gender, and the sex field left blank.

Its odd that the NHS went to the trouble of designing the fields and defining them in detail, but not using them.

YY that’s how I remember it too.

Linking the piece, have just this second found it

https://medium.com/@anneharperwright/sex-gender-the-nhs-bb86b0c3ebb

Someone commented last year:

Reading this 7 years later and realising that all the concerns are justified and nothing has changed is very scary. You understood all this years ago and wrote clearly and accurately about it. Nothing changed. The Sullivan Review and the report on medical records Incoherent and Unsafe published this year (2025) say the same things as you did. Will they change anything? Will the Supreme Court ruling change anything?

Furthermore, are lots of clinical situations where birth sex is not directly relevant to clinical care.

This is silly. Who decides if a clinical situation is one where birth sex is relevant to clinical care? A HCP involved in that clinical situation. Obviously HCPs must have access to accurate information about a patient's {true, birth, biological} sex for those situations where they determine birth sex is relevant.

There is no issue with clinicians not knowing what birth sex a person is in the vast majority of cases.

But the clinicians are the ones responsible for determining if it is a case in that majority, or one in the minority of cases where not knowing what birth sex a person is, is a big issue. So clinicians need that information, in all cases, without exception.

This is silly. Who decides if a clinical situation is one where birth sex is relevant to clinical care? A HCP involved in that clinical situation. Obviously HCPs must have access to accurate information about a patient's {true, birth, biological} sex for those situations where they determine birth sex is relevant

Far from silly- We routinely limit the collection and sharing of sensitive personal data in healthcare contexts, while still ensuring clinicians can access relevant information when needed. Several examples have already been provided on this thread - hiv status, mental health issues, sexual orientation.

You’re conflating two separate questions: (1) whether clinicians should have accurate information when it’s clinically relevant, and (2) whether it should be mandatory for administrative bodies to routinely record and share birth sex for every patient regardless of patient consent and privacy concerns. The first does not logically entail the second.

Its been said here many times, sex is not sensitive personal data.

Individuals being sensitive about their sex is not the same as it being sensitive data.

It isn't practical to make decisions moment by moment about whether to hide or reveal birth sex.

Clinicians on the ground are going to observe the natal sex of the patient because the vast majority of trans individuals do not pass, no matter how much they think they do. But the lab scientist won't know that Lucy is really a man so they should be reporting against male reference ranges. Equally, a doctor looking at a patient's notes without the patient in front of them might not know that they should be thinking about male disease patterns.

Patients can't possibly know whether sex is relevant to clinical decision making. As I stated before, as an example, propofol is fat based, so men and women absorb and process it differently. Most patients wouldn't know that.

This.
What we're seeing played out on this thread and elsewhere is a desperate attempt to undermine the SC judgment and all the related cases by insisting that birth sex is such a shameful secret it must be kept confidential. If you can't identify someone's sex then you can't enable all the legal single sex spaces, services and requirements and we're back to men claiming to be women being able to invade ss spaces and to violate women with impunity.

The fact that the NHS has finally been forced to recognise the importance of accurate recording of sex is an important development in returning to accurate data capture in medicine.

Hence the desperation evident from those used to being prioritised over the rights and needs of everybody else.

Sex does not matter

You seem to be completely illiterate (in spite of posts above to inform you) about how chromosomes (not just hormones, the actual chromosomes) affect health and the treatment of health issues.

It is precisely because patients come first that it's essential that sex is known in treating patients.

Worth repeating!

So the fact that information may legitimately form part of someone’s medical record when clinically relevant doesn’t establish that it should therefore be a mandatory demographic field for every patient. That is precisely the distinction I’m making about sex at birth.

I'm a retired A&E consultant. You don't understand the issue because you are not an HCP & have your own agenda. Birth sex of any patient is always clinically relevant just like age, weight & other demographics that relate to a patient's physical body. In terms of medical care it doesn't matter a damn that you believe you have a gender identity any more than if you believe you have a soul. It's the physical characteristics of the body that matter not what's going on inside your mind.

Birth sex isn't by any means always the most helpful indicator for labs on what reference ranges they should use. There are numerous studies that show that after a period of around 6-12 months on hormone therapy many values shift towards those typical of gender interpreting results using birth-sex reference ranges can become misleading.

“Always” is doing a lot of work for you there.

Birth sex is clearly relevant in many clinical situations—for example, pregnancy, prostate disease, cervical screening, reproductive medicine, and some diagnostic pathways where anatomy or physiology matters.

But it is plainly not always relevant. It isn’t necessary to know a patient’s birth sex to treat a simple laceration, manage an ankle sprain, remove ear wax, treat many minor infections, or assess an isolated finger injury.

Clinical relevance is context-dependent. That’s a basic principle of medical practice.

Suggesting that I “have my own agenda” doesn’t really add anything to the discussion. It would be more productive to keep the conversation focused on the arguments rather than making assumptions about each other’s background or motives

Lol - now arguing with a retired A & E consultant 😅

We know you think birth sex should be a massive secret. Fortunately the rest of the world and finally the NHS disagrees with your "belief" and understands that it's a medically relevant fact.
Suggesting that medics pretzel systems to keep this massive secret of birth sex for a tiny % of the population while ensuring the rest of society gets accurate data informed medicine isn't going to work.