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?

I used to work in organ retrieval. This is a big fuss about nothing. Nobody donates their organs without a full medical history being available. There are multiple ways in which it will become obvious - record of any previous surgery, list of medications and top to toe physical examination are all essential pieces of information before any organs are offered. You'll also be pleased to know that the last time I checked, the forms which record all the details of the donation process ask for the sex of the donor, not the gender.

There is no way that a donor will somehow be mis-sexed. And even if that did happen (which it wouldn't), the respective sex of the donor and recipient is less important than tissue typing, blood group, size of organ and urgency of the transplant.

If the recipients medical history is unclear to staff they could lose out on an organ. I'm not seeing how this is hard to understand.

metro.co.uk/2019/05/20/pregnant-transgender-mans-baby-died-because-nurse-didnt-realize-he-was-in-labor-9613972/

[quote Thelnebriati]If the recipients medical history is unclear to staff they could lose out on an organ. I'm not seeing how this is hard to understand.

metro.co.uk/2019/05/20/pregnant-transgender-mans-baby-died-because-nurse-didnt-realize-he-was-in-labor-9613972/[/quote]
The link you provided has nothing to do with organ donation and everything to do with the fact that a transgender man did not notify medical staff that he was born female and could be pregnant. Had he done that, the outcome may have been different.
A recipient of organ donation will already have had a huge amount of tests, over a period of time, during which it would be absolutely obvious what sex they were.

@Reallybadidea

I used to work in organ retrieval. This is a big fuss about nothing. Nobody donates their organs without a full medical history being available. There are multiple ways in which it will become obvious - record of any previous surgery, list of medications and top to toe physical examination are all essential pieces of information before any organs are offered. You'll also be pleased to know that the last time I checked, the forms which record all the details of the donation process ask for the sex of the donor, not the gender.

There is no way that a donor will somehow be mis-sexed. And even if that did happen (which it wouldn't), the respective sex of the donor and recipient is less important than tissue typing, blood group, size of organ and urgency of the transplant.

Do you know which organs are sex dependent?

There are genuine concerns about the possible impact of sex and gender being used interchangeably when it comes to medical studies and the risk of individuals not being flagged up for routine screenings (prostate check or smears.) ^ This is a fuss about nothing.

I know the link was nothing to do with organ retrieval, I'm just struggling to see how anyone can be OK with forcing medical staff and the health budget to take the consequenses for an ideology.

There are consequenses, you can't forsee them all. You are minimising the risk to patients and staff.

Do you know which organs are sex dependent?

As far as I'm aware there are no organs which are only transplanted into recipients of the same sex, however size of organ may be a factor that's considered. For instance, it would be less common for a female heart to go to a man and vice versa because the difference in size can be problematic. It does happen though.

The thing is - either your sex matters for organ donation - in which case it should be known for the safety of patients - or it doesn’t - in which case it is wrong to ask people to reveal unnecessary personal data.

I don’t know enough about organ donation to know which of these is true. But either way - the question is wrong.

I'm pretty certain if you try to put the wrong size organ in a chest cavity it might make a difference. Aren't male hearts much larger?

Rule of thumb, if your heart is healthy it will be about the size of your loosely closed fist so yes they are on average bigger but not incompatible, it wouldn't work for a child though.

Also - just to add more generally, that I have been involved in a case where it was not immediately obvious to me which sex a patient was. It became clear as soon as I looked at their prescription chart because of the cross sex hormones they were on!

Are organ recipients allowed to take cross sex hormones?

@Thelnebriati

I know the link was nothing to do with organ retrieval, I'm just struggling to see how anyone can be OK with forcing medical staff and the health budget to take the consequenses for an ideology.

There are consequenses, you can't forsee them all. You are minimising the risk to patients and staff.

I don’t agree. The arguments being given on this thread for having birth sex on an opt out donation form are pointless because they are incorrect. They are saying that not having sex as an indicator could cause all sorts of medical issues with the recipient. Well it won’t because it’s an opt out form! There will be no recipient! If your argument is that anything to do with medical matters should include birth sex so that appropriate evidence is collected linked to sex which will improve services for everyone, then that’s a completely different issue. It’s also one which I agree with. If people want to campaign for change, they need to fully understand why they want change, what the implications are and then put forward their objections. Campaigning to have a sex category on a form to opt out by saying not having it will harm donor recipients is just nonsensical.

The people campaigning for change have already done the damage, women didnt get much of a say in it, not all of the repercussions will be known or understood.
OP didnt understand the form she posted, it was explained and the discussion moved on.

They are saying that not having sex as an indicator could cause all sorts of medical issues with the recipient. Well it won’t because it’s an opt out form! There will be no recipient!

The general agreement seems to be that clinicians involved in a transplant are aware of the sex of the donor or recipient in all but the most unusual edge-cases.

However, if the sex information is being collected to assess willingness to be a donor (whether to give consent or to opt out) then it might be relevant to identify any demographic information that might be used to fund support and education programmes. Eg, if men sign up to opt out then that might be interesting. If the default is now that everyone has opted in in Scotland and men don't opt out then that probably tells some researchers something about inertia rather than actual objection to transplantation.

Accuracy and relevance are two of the most important things in data collection and in a medical context even more so as people could be harmed if they get it wrong.

@Soontobe60

I think you’re making a mountain out of a molehill. If a patient is being considered for organ donation they are most likely already in hospital, probably in ICU on a ventilator. The hospital has an extensive list of tests they have to do in order to assess suitably. They will also gave access to their medical records. These tests will clearly show what sex the donor is, regardless of how they identify.

What tests do they do that show the sex? And will they specifically check for sex or will they go with whatever 'gender' or sex is in docs like birth certificate?

Also thanks for the reminder to opt out.

I have done so already but am suspicious that the Scotgov will use any excuse to slip people back on the yes list without telling us.

In my view this is a gross breach of bodily autonomy. I object in the strongest terms to the presumed opt in and I find the manipulative and coercive way the choice is presented as patronising and offensive.

I have just opted in specifying which organs I am happy to donate. The 'gender' question was compulsory and had 5 options.
Male, Female, Other, Transgender or Prefer not to Say.

So either they are asking about sex and believe there are more than two, or they are actually asking for gender identity which is surely completely irrelevent for organ donation. Either way it didn't sit right with me on a form from a medical organisation.

@334bu

Accuracy and relevance are two of the most important things in data collection and in a medical context even more so as people could be harmed if they get it wrong.

Exactly.

As a slight aside, my family member is a GP. Their practice allows patients to change their sex marker and unlink with previous medical records (I don’t know if they actually get erased but they become disassociated with that patients name).

The GPs feel that it is unsafe to do this and means that they are potentially making treatment decisions on a patient with a blindfold and one hand tied behind their back so to speak (apart being massively limited for time and resources).

The way the GPs mitigate the risk that they see is to put a secret birth sex marker on the patients records. The patient isn’t aware of it but the doctors can see it and act accordingly.

I’m not sure how they attempt to mitigate the lack of previous medical records- I guess they just have to hope that the patient tells them what they need to know (not guaranteed given the lengths to which people will go to obscure their birth decision and a lack of medical knowledge means that they don’t necessarily know what information is important in a given scenario).

This does leave the doctors at risk of legal action for incorrect treatment of a patient died or was seriously injured as a result which is a concern.

The point of this whole issue is that obscuring a persons birth sex can lead to all sorts of unintended consequences.

Agreed - it's about opting-out not opting-in.

Agreed - it's about opting-out not opting-in.

So the sex of those opting out doesn't matter but their gender identity does? Why??

@Thelnebriati

If sex on your birth certificate is by self ID, how will they know a donors sex?

Presumably they do tissue typing so they probably don't need to rely on recorded sex.

No idea why 'gender would need to be recorded though, except maybe for working out who to target campaigns at.

@334bu

Agreed - it's about opting-out not opting-in.

So the sex of those opting out doesn't matter but their gender identity does? Why??

It isn’t asking for gender identity. If you look at for example the census form, it asks for sex, which is not an optional question, then if asks for gender identity which is optional. The ONS knows that sex and gender identity are two different things. The donation opt out form only asks for gender. It is incorrectly conflating sex with gender and that is where the issue arises. Many people know that sex and gender do not mean the same thing, but whoever put together this form thinks it’s the same thing. Data is only useful if the people inputting that data are being honest. Some trans people will answer the question by indicating what ‘gender’ they see themselves as whilst others will answer ‘transgender’. Others will choose ‘do not wish to say’. So in reality, the form is useless as a means of collecting data on the demographic make up of who chooses to opt out of organ donation in Scotland. In other words, it’s not worth the paper it’s written on. @gardenbird48 if what you are saying is correct, then why would a medic be at risk of legal action if the patient had chosen for their medical records to be changed to indicate female but the patient was born male? Who’s going to sue them? The patient who didn’t tell them their birth sex? Can you see how implausible that would be? @ArabellaScott I think you are too suspicious. Do you see everything as a conspiracy? Fine, you don’t believe in organ donation, that’s your choice. But does that work both ways? Would you want yourself or your children (assuming you have them) to be recipients should the need arise? Or would you be relieved that the number of organ donors has risen significantly since the introduction of an opt out rather than opt in system therefore increasing the chances of getting a donor should you be in that situation? Bodily autonomy is meaningless if you’re dead.

No idea why 'gender would need to be recorded though, except maybe for working out who to target campaigns at

Agreed but in that case why would they ignore sex. The discrepancy between male and female opt in in the past must surely be the biggest target for any campaign to ensure widespread awareness of new regulations.

Surely they either need the information (in which case collect it) or they don't (in which case new laws mean they can't collect it) .....

So going to reinforce why are they asking

ps of course it needs to be sex or nothing - Gender has to be totally irrelevant???? no relation to anything with regard to organ transplant I would have thought