Stop mixing up sex and gender GPs told

[flyingbuttress43]

www.telegraph.co.uk/news/2021/04/02/doctors-must-stop-mixing-sex-gender-patients-undergoing-wrong/

Doctors have been told to stop mixing up sex and gender because it can end up with people getting the wrong treatment.

Senior medical researchers led by the University of St Andrews said there was clear evidence that biological sex and gender were both powerful risk factors for "virtually every disease and affect every organ."

The article is behind a pay wall, so here are some salient points...

Sex differences in drug metabolism were well recognised;
Gender significantly affected how a person engaged with treatment;
One GP, commenting on the article on the BMJ website said she spent hours a week ensuring the right people were called for cervical smears;
NHS systems do not allow for sex and gender to be recorded separately;
Sex and gender are not synonymous.

"Dr Margaret McCartney of the School of Medicine at St Andrews, said: "There are many instances of sex and gender being confused by the research community and society more broadly. Unless we identify and count categories correctly, we will end up with errors which serves all populations poorly."

All so obvious to us on Feminism Chat, but good to see push back
on this sex/gender mixup from the research community.

@HamsterV2

I have this problem every time I need blood tests or lab tests done at my GP surgery. They automatically put "F" in the sex box and give me weird looks when I remind them that just because I'm transitioned/post-op my sex is STILL male.

It's happened at my local hospital too. I don't care about my feelings - I care about any medical necessities being carried out PROPERLY.

The whole medical establishment has been captured by the "no hurty the gender feelz" brigade. It's infuriating.

Is it a "sex" box? Or a "gender" box?

NHS systems do not allow for sex and gender to be recorded separately;

I thought they did, I seem to recall there being provision made for precisely this - but it hasn't been used?

Chersfrozenface

That's the infuriating and worrying thing. It's a SEX box. I have actually told one Dr that I can't actually change sex and was stared at as if I'd gone mad.

‘...transitions from a male person to one who has secondary sex characteristics of a female person’ ?

Male people do not/cannot acquire female secondary sex characteristics. Female sex characteristics all have reproductive function.

That's the infuriating and worrying thing. It's a SEX box. I have actually told one Dr that I can't actually change sex and was stared at as if I'd gone mad.

HamsterV2 You'll have to save a copy of the BMJ article to show the next confused doctor!

@R0wantrees

‘...transitions from a male person to one who has secondary sex characteristics of a female person’ ?

Male people do not/cannot acquire female secondary sex characteristics. Female sex characteristics all have reproductive function.

They can have breast implants, body/facial hair removal and facial remodelling.

In that way they can acquire some of the visible secondary sexual characteristics of females.

I say "acquire" as I'm pretty sure using a verb like "mimic" would get me banned. Would I be OK with "acquire the appearance of"?

None of those are female sex characteristics.

Its cosmetic surgery.

@R0wantrees

That's the infuriating and worrying thing. It's a SEX box. I have actually told one Dr that I can't actually change sex and was stared at as if I'd gone mad.

HamsterV2 You'll have to save a copy of the BMJ article to show the next confused doctor!

I think you're right, but I shouldn't HAVE to

@R0wantrees

None of those are female sex characteristics.

Its cosmetic surgery.

To go back to @YouSetTheTone's question regarding the use / misuse of "Male To Female transition", perhaps '‘...transitions from a male person to one who has the appearance of some secondary sexual characteristics of a female person'.

Of course you shouldn't! Its completely unacceptable that patients should need to tell their doctor that they have not changed sex in order that their NHS record is accurate and in order they receive optimum healthcare.

To go back to @YouSetTheTone's question regarding the use / misuse of "Male To Female transition", perhaps '‘...transitions from a male person to one who has the appearance of some secondary sexual characteristics of a female person'.

What has transitioned? Many people have cosmetic surgery.

NHS records should allow Doctors to give appropriate medical treatment
even if the patient is unconscious

• sex
• blood type
• disease history
• surgical history

NHS records should allow Doctors to give appropriate medical treatment
even if the patient is unconscious

• sex
• blood type
• disease history
• surgical history

and current medication.

@PaleBlueMoonlight

My worry is that the words woman and man would be deemed appropriate for the gender category, with female/male for the sex category. This would consolidate the appropriation of the word woman to mean feelings/stereotypes, losing the specific words we need to describe sex as it relates to humans.

Sadly true. But I'd rather this than that proper definition of sex difference disappears altogether. Depressing isn't it.

@R0wantrees

To go back to @YouSetTheTone's question regarding the use / misuse of "Male To Female transition", perhaps '‘...transitions from a male person to one who has the appearance of some secondary sexual characteristics of a female person'.

What has transitioned? Many people have cosmetic surgery.

What is your suggestion, then, for a replacement for the term "Male to Female transition" / "Female to Male transition"?

Because it's used a lot.

What is your suggestion, then, for a replacement for the term "Male to Female transition" / "Female to Male transition"?

My suggestion is that such misleading terminology is not used by the medical profession. Its completely contrary to good practise to use such inaccurate terminology, especially if the consequences compromise patient care.

@R0wantrees

What is your suggestion, then, for a replacement for the term "Male to Female transition" / "Female to Male transition"?

My suggestion is that such misleading terminology is not used by the medical profession. Its completely contrary to good practise to use such inaccurate terminology, especially if the consequences compromise patient care.

Nor by the BBC? I ask this on the basis of your earlier comment "Indeed, doctors and the BBC have a responsibility to those people who believe that sex change is possible. It is not."

And by extension, not by any other media either?

As it happens, I agree.

What is your suggestion, then, for a replacement for the term "Male to Female transition" / "Female to Male transition"?

Wouldn't having an accurate record of surgery and medication be better? There are many different variations on what 'male to female transition' (sic) can encompass. hamster might be best placed to comment on what would work in practice, I guess.

Nor by the BBC? I ask this on the basis of your earlier comment "Indeed, doctors and the BBC have a responsibility to those people who believe that sex change is possible. It is not."

And by extension, not by any other media either?

The BBC by dint of its unique status has obligations beyond that of other media.
Of course all media should report more responsibly. The responsibility for change will have to start within public sector rather than private though. Regulatory capture is widespread.

relevant thread:
www.mumsnet.com/Talk/womens_rights/3541908-Regulatory-capture

@HamsterV2

Chersfrozenface

That's the infuriating and worrying thing. It's a SEX box. I have actually told one Dr that I can't actually change sex and was stared at as if I'd gone mad.

That's insane! And terrifying.

Hamster how do you think it should be done ?

The person I know has always been utterly open about their history.
I know their birth name even though I met them 25 years after their surgery.
So although I always call the person by their female name and refer to them as "her" in real life conversations
as we all get older I am more and more aware that biological reality
trumps feelings.

Its a shame that so many of the young woke folks say that I need to be "educated" and tell me about clown fish.
Their intolerance is endangering lives.

@Anovaneway

Patient confidentiality needs protecting though. Eg receptionists don’t need to know people’s birth sex. It could lead to misgendering (or dodgy furtive glances) which would put some people off from seeking care.

In situations where it really matters then yes a consultant for example might need to know in which case a note that the patient is transsexual m2f or f2m can be included in the referral (which I believe many doctors discretely do) or perhaps there could be different levels of access to records based on position and a need to know basis.

Clerical staff in doctors offices and hospitals see patient records, that's really just a reality. They file them, send things off to consultants, etc. Back when I was a student working in a GPs office, there were discrete yellow stickers on some patient files - to alert us that we couldn't put those patients to wait alone in an exam room as they were likely to pinch needles.

Being able to be confidential about that stuff is just part of the job.

I will say, most medical people I know realise this. The problem is more with systems.

I think we should get rid of all these ridiculous trans umbrella terms that Stonewall et al have lumped together to be inclusive and go back to basics.

ie Transsexual or Transsexuality - the old DSM categorisation. Medical professionals knew what it was. Sex observed at birth should remain on all medical records permanently, and a diagnosis of gender dysphoria that is MEDICALLY treated with a full ADULT pathway should be noted as a lifelong condition (unless detransitioning of course). Obviously each step of that pathway should be fully documented.

Obviously changes to a person's legal name are a moot point as anyone can change their name on any documentation, but I think that a gender marker should be added as clarification to at least provide dignity to the transsexual patient.

Coming up with convoluted or various "in transition" terms is just denying reality, and as we all know a large proportion of trans patients (especially mtf) don't go through with a full surgical outcome.

Perhaps a pre-op or post-op marker might be helpful. (Thinking aloud as I haven't fully thought it through)

Trans(sexual) people have specific healthcare needs that are different to men or women not on a trans-medical pathway (namely endocrine issues, regular liver/kidney testing, increased risk of DVT, heart issues, strokes etc due to treatment). Hiding or denying those needs is only going to put the patient at risk, even before other "non-trans" health conditions that may arise... Clinicians need to know the biological sex of ANY trans patient.

TLDR:

Keep biological (sex observed at birth) marker.
Reference patient's transsexuality as an ongoing condition (just as one would reference kidney disease or IBS)
Place gender marker for dignity reasons.

Perhaps a pre-op or post-op marker might be helpful. (Thinking aloud as I haven't fully thought it through)

Details of specific operations should be on a patient's records regardless eg a lot of women will have had mastectomies and hysterectomies.