Organ donation Scotland doesn't need to know what sex their donors are !

[334bu]

mobile.twitter.com/mbmpolicy/status/1372918446099431427

Surely it is sometimes necessary to know what sex the organ donor is?

@ClimbingCancelled

So a person who has used the opt-in form and selects transgender and has an organ which is absolutely critical to saving someone's life - there's no way anyone knows what sex the donor is. Sex is critical to organ transplant. The NHS will waste hours or days trying to find out the sex of the donor - by which the recipient - quite possibly a child - will have died. Inclusivity trumps death. Good one.

Why is sex critical to the transplant process?

@SweetPetrichor

I would assume that if a person has just died, or is near death, when it comes to organ donation they’d look at the medical records for the donor. And if someone is transgender, it will be pretty obvious because I’m sure that those medical details will be recorded in medical records.

I think this is a non-issue.

Many GP surgeries and NHS record keeping allow people to create a new record under a new name and sex marker and erase all links to previous medical records.

Incidentally the GMC also allows GPs to change their sex marker on their register entry so it is possible for a GP to entirely conceal their sex from their patients (and this is happening in certain practices).

They also issue new National Insurance numbers for this group which creates a completely new record for an individual. I’m not sure what they do about existing records of NI contributions which are obviously essential for pension claim.

I previously assumed that contribution records were carried over into the new record but in the current climate we can’t assume anything sensible.

I would disagree strongly that this is a non issue. What is the reasoning or benefit behind obscuring essential information in an area where sex is absolutely essential information?

I registered when it first went online (whenever that was) and don't remember the original questions but see it's now asking for gender. (I'm in England.)

www.organdonation.nhs.uk/register-your-decision/donate/?

[quote Thelnebriati]The wrong donation can kill the recipient.

www.carterbloodcare.org/the-significance-of-being-rh-negative-or-rh-positive/[/quote]
Which is why doctors do a whole host of tests.

Zig4zag
Sex is critical for many times of medical treatment. Normal readings are often different for women and men.

''Normal range for hematocrit is different between the sexes and is approximately 45% to 52% for men and 37% to 48% for women.''
www.medicinenet.com/hematocrit/article.htm

Come on. That organ will be to be removed by a team of HCPs and there will have been a great many tests and checks. The sex of the donor won't be in doubt. I'm GC but this isn't going to leads to deaths. They don't just whip out an organ and plonk it in someone only to find out a detailed history of who it came from later.

Wasting time and resources on testing for something as basic as sex is not good practice.
Your sex should be accurately recorded on your birth certificate and medical records.

Why is sex critical to the transplant process?

Take a look at the papers here as it's an interesting area - use the boxes on the left to filter out animal studies, zero in on solid organ transplant or bone marrow etc. You might also want to distinguish living donor transplants etc. - it is truly fascinating.

pubmed.ncbi.nlm.nih.gov/?term=sex+organ+transplant

I'm not sure if sex makes a difference. The only person I know to have a lung transplant (female) knows her donor was a 19 year old male. Not everything has sex/gender relevance. Hearts etc do need to be tissue matched and to fit the cavity but the latter applies more to children

FGS they are going to get the medical bit right.

Sometimes I think these Feminist chats on Mumsnet are unhinged

@ClimbingCancelled

So a person who has used the opt-in form and selects transgender and has an organ which is absolutely critical to saving someone's life - there's no way anyone knows what sex the donor is. Sex is critical to organ transplant. The NHS will waste hours or days trying to find out the sex of the donor - by which the recipient - quite possibly a child - will have died. Inclusivity trumps death. Good one.

Ok, so say they present as male and they’ve selected transgender. They will have breaststroke of have scars from breast removal. They will have a hysterectomy scar or have a uterus and ovaries that show up on an MRI, they have labia and a vagina, or a penis and scars from the skin grafts used to create it. I’m sure that it’s very obvious to a medical professional whether an adult is male or female when presented with their naked body.

Sex (and the donor - recipient combination) can make a difference to longevity of a transplant, how well a graft takes, antigenic response etc. The clinical papers above can offer some insight.

@Thelnebriati

Wasting time and resources on testing for something as basic as sex is not good practice. Your sex should be accurately recorded on your birth certificate and medical records.

Have you actually read all the tests that have to get done before a donation can proceed? Sex will be very obvious to a medic!

Women are more likely to donate an organ and less likely to receive one.
www.bbc.com/future/article/20180730-why-more-women-donate-organs-than-men

I’m sure that it’s very obvious to a medical professional whether an adult is male or female when presented with their naked body.

Exactly. This really isn't something to get wound up about.

''...one study of more than 230,000 US organ donations from 1998 to 2012 showed that female-to-male kidney transplants were among the least likely to succeed.''
pubmed.ncbi.nlm.nih.gov/28596416/

''men who received a heart from a female rather than male donor, for example, had a 15% higher chance of dying within the next five years.''
pubmed.ncbi.nlm.nih.gov/19808369/

@radbadger

FGS they are going to get the medical bit right.

Sometimes I think these Feminist chats on Mumsnet are unhinged

Yes I would hope they will get that bit right but at what point in the process does that information become available to them?

How much time is wasted on the administrative processes that lead up to the point of actual medical evaluation where the team are told they have a female donor coming in and make appropriate initial arrangements and then are confronted with a male body?
Given that the accurate sex information is essential, why risk delays and wasted effort earlier in the process?

In what way is discussing the need for accurate sex information in a medical setting unhinged? The unhinged part is decision makers allowing the information to be deliberately obscured.

@Doyoumind

I’m sure that it’s very obvious to a medical professional whether an adult is male or female when presented with their naked body.

Exactly. This really isn't something to get wound up about.

I have no doubt that the relevant clinicians (those involved in the care of the donor patient, retrieval team, transplant to recipient team) know the appropriate information.

Depending on whether there is general support for persuading people to an opt-out, it might be relevant to gather some demographic information to identify whether particular groups might benefit from more nuanced information.

There are lots of interesting narrative reviews published in this area. Sex and gender (as in socialised roles) play into who donates, who receives, and who has a better record in adhering to post-operative clinical care etc.

It is important to know who is declining to donate if it's an area of substantial need for some intersecting demographics.

[quote Thelnebriati]''...one study of more than 230,000 US organ donations from 1998 to 2012 showed that female-to-male kidney transplants were among the least likely to succeed.''
pubmed.ncbi.nlm.nih.gov/28596416/

''men who received a heart from a female rather than male donor, for example, had a 15% higher chance of dying within the next five years.''
pubmed.ncbi.nlm.nih.gov/19808369/[/quote]
Presumably the doctors knew the sex of both the recipient and the donor though. It’s not a case of mistaken identity.

@gardenbird48 the vast majority of donors are already in hospital. Those who are ‘brought in’ would be through things like RTAs where they are still alive and not yet being considered as donors. If they had died at the scene, they would not be suitable for donation. Donors have to be medically alive on a ventilator in order to be used.

Even taking into account the stats around the impact of the sex of the donor, if the options are between an organ meaning potential success and no organ meaning certain death then that organ will be transplanted. My understanding is a lot goes on before the decision is made on whether the organ is suitable.

This is helpful. There is quite a process of medical records review and other evaluation before an organ donor gets as far as the physical examination.

I guess a red flag may be raised if patient records are not complete or are not available prior to a certain date and the records that are available might contain relevant information likes taking cross sex hormones but then again, if a trans patient is taking private treatment from GenderGP for example or self medicating, much of that history may not be available to NHS staff.

Given that some trans patients have prioritised obscuring their birth sex to the point of putting their own life at risk and resulting in a baby dying, I’m not convinced that everyone is responsible enough to voluntarily provide the correct information.

Keeping accurate medical records is important and no group should be allowed to obscure both for their own safety and the safety of others.

www.odt.nhs.uk/odt-structures-and-standards/organ-donation-retrieval-and-transplantation-teams/patient-potential-donor-assessment/

[quote Soontobe60]@gardenbird48 the vast majority of donors are already in hospital. Those who are ‘brought in’ would be through things like RTAs where they are still alive and not yet being considered as donors. If they had died at the scene, they would not be suitable for donation. Donors have to be medically alive on a ventilator in order to be used.[/quote]
Not living donors for things like a kidney.

If it is so unimportant why not just ask what sex are you?
Why obfuscate? What could possibly be the motive for changing sex to gender?
In a country where a court will be deciding on Tuesday whether a woman can be a male person with a female name on a gas bill, I think it is vitally important for everybody to object to the erasure of sex disaggregated data. Women die needlessly because of the lack of such data and suffer disproportionate discrimination because of it. Surely it is not too much to ask that our Medical Services get it right.

@gardenbird48
Living kidney donors are by far and large related to the recipient. I’m pretty certain if a transwoman was donating a kidney to their sister, the sister, and the doctors would know they were trans, as this type of transplant is planned well in advance and a multitude of tests are carried out beforehand.