Health study categorising by self identified gender rather than sex!

[WifeOfTiresias]

Just entered my details on the ZOE app to take part in the much trumpeted nationwide studies of wider health issues following on from their COVID symptom study.

Lots of details to fill in regarding age, weight, prior health history etc. All as expected from a rigorous study. However, the only question to categorise us as either female or male, a pretty crucial characteristic in medical terms, was "what gender do you most identify with?" With options including non binary. No mention of biological sex whatsoever!

I'm deeply disappointed. I had great respect for the ZOE team regarding their work on COVID, but this ridiculous trans ally type approach has just rendered any data they collect pretty much useless!

I despair for the future of scientific research if this is the accepted approach now.

I had the same issue with Zoe, so I emailed them to ask about their ridiculous questions. They replied that their questions were inclusive and “scientifically accurate”

I told them that I won’t be taking part in their research because their questions mean I can’t give truthful replies. They didn’t seem to care.

They decided this ages ago, right at the start of Covid when they started asking for data. I deleted it once it became obvious that their scientific rigour was so easily abandoned in favour of a politically expedient ideology.

They will have decided most people will answer the question with their actual sex and that it will be a small enough number of people who answer with a gender identity other than their sex that it won't make enough of a difference to their data.

Wtf they're going to do with the non binary responses, though. Bin them?

Wtf they're going to do with the non binary responses, though. Bin them?

That does actually seem to be a fairly common approach.

They know they really want sex, but they feel that for political reasons they have to ask for gender, so they just bin all the "other" responses and use the "male" and "female" ones.

Wasn't that in the guidance for pay gap monitoring? Just don't include non-binaries in the figures?

Yeah, that's why I stopped using it.

Even if they bin non-binary, won't male/female also be suspect? If you can pick how you identify rather than what you are?

That is exactly what peaked me during the pandemic. Previously I hadn't thought about it, and I even had pronouns in my email.

As a data analyst, I wondered why gender identity had anything to do with the stats. And so I kept questioning and wondering.

So thank you ZOE survey & NHS covid stats for opening my eyes and making me what I am today. :D

They changed to this early on in the pandemic having been targeted by the identity brotherhood. I tried signing up to it without a belief in having a gender identity but it wasn't possible.
They just ignore anything from women.

If you want anyone to buy your "sex and gender can be different" stuff, you have to show some willingness to use sex rather than gender when appropriate.

The fact that sex is never appropriate, and it's always gender, regardless of how nonsensical, shows unserious these people are and why we shouldn't be paying any attention to them.

The problem for them is that there is no situation I can think of where we should be caring about gender rather than sex. In each situation, either we shouldn't be caring about either, or it's sex that's significant.

Gender can only be significant if you pretend it's sex, and justify it with the reasons you would use for sex. So they have to do that everywhere. If you permitted sex in one place, it would be clear that it should be used everywhere else too.

It would have made sense to ask for gender, and also a question about transgender status, and if so whether you are AFAB, AMAB or other. Other NHS database keep this information because for certain conditions it's important. It's a separate marker to gender. I am not sure the extent to which it has any bearing on COVID, but I imagine there is some correlation.

I had a sex and a gender question ?

@PoisonCrystal

That is exactly what peaked me during the pandemic. Previously I hadn't thought about it, and I even had pronouns in my email.

As a data analyst, I wondered why gender identity had anything to do with the stats. And so I kept questioning and wondering.

So thank you ZOE survey & NHS covid stats for opening my eyes and making me what I am today. :D

The effect on stain Itistics is quiet and it will probably be ignored until it is a problem. Then it will be harder to go back and unpick. I noticed there were 53 'male' full hysterectomies last year. This is fairly obviously not male patients, but where conditions are more male or female and smaller numbers are involved this data will be affected. Further more, where being trans and taking cross sex hormones affects conditions will be hidden.

I've downloaded the app and it says exactly what I hoped it would:

What sex were you assigned at birth?
Male
Female
Prefer not to say
Intersex

What gender do you most identify with?
Male
Female
Prefer not to say
Other, please specify

Just put "my sex was not assigned at birth, it was identified" and "I do not have a gender", or whatever GC stuff you want in the "Other, please specify."

Assigned in the context of including intersex seems fair to me and actually means you should not put what you feel but what you are

@DadJoke

It would have made sense to ask for gender, and also a question about transgender status, and if so whether you are AFAB, AMAB or other. Other NHS database keep this information because for certain conditions it's important. It's a separate marker to gender. I am not sure the extent to which it has any bearing on COVID, but I imagine there is some correlation.

The only people to whom the acronyms AFAB & AMAB apply, @DadJoke, are a subsection of the population who have DSDs (most people with DSDs simply have their sex observed & recorded like the rest of the population). The appropriation of the term is utterly inappropriate; & causes distress to people with DSDs.

The information that is needed is people’s sex - their gender identity would be relevant only if they are taking CSH, because that has the potential to create meaningful data.

Covid doesn’t care about how people choose to identify. If it did, I’m sure elderly black people would just ID as young & white. All of us on the CEV List would have been gambolling about the place like all our Freedom Days had come at once instead of waiting for our metaphorical flying Ford Anglias to come & tear the bars from our windows, too.

There is no Secret Sex Marker on NHS records. It’s not simply a change of a letter, when someone changes their “gender” in records held by the NHS a new number is issued that denotes a person is male (ends in an odd number) or female (ends in an even number). This causes failings in care unless trans people are pro-active, whether that is trans men ensuring they get smears as needed; or anyone who has transitioned ensuring HCPs who order/are analysing blood tests are aware of this because healthy ranges are different for men & women, & transitioning does not change which range is healthy for your body.

Trans healthcare can only improve if there is research into how health issues impact trans people. Wilful destruction of research in this fashion is desperately damaging.

Sarah Brown tweeted at the Zoe team that she felt that being asked what her sex was on a private app that nobody else would ever watch her using was unnecessarily distressing. This was in lockdown 1, by the way. Right at the start of it all. I despise her attitude and priorities and everything she has made it her business in life to do.

@mudgetastic

I had a sex and a gender question ?

Me too - I just answered female for Sex and "prefer not to answer " for the gender bollocks one.

Having said that... they didn't have to jump to her tune. They did, though. They clearly calculated that their data was big enough for additional useless noise around sex differences not to matter. This may not be the case in smaller studies (and nearly everything is smaller than Zoe). But what does Sarah Brown care? She gets to put her thumb in a nerve joint and push hard, and other people jump to respond, and the effect on women? Not her business.

There is a marker on NHS data, it's just not being implemented widely enough. These are “person stated gender code” and “person phenotypic sex."

AFAB and AMAB are widely used in medical contexts, and while you might prefer "identified" it's clear to everyone what it means. And, if you don't like it, put "prefer not to say" and add whatever you want in the free text box.

Making sure you include this data (as this survey does) both respects people's gender identity and allows researchers to analyse by phenotype.

Caroline Criado Perez talked about differences in adverse drug events between males and females in her newsletter this week (newsletter.carolinecriadoperez.com/issues/invisible-women-one-dose-fits-men-1050315) and how it's not related to size, but there's not a lot of research because well, who cares. No one is collecting the data on women. Zoe had that chance over covid - they could have collected all of that juicy female data, got the definitive answer to 'WTF just happened to my period' etc but no, they swapped from birth sex to self ID gender early doors.

Phenotypic sex, is that the new name for saying female human?
So we have female phenotypic sports and female phenotypic healthcare and female phenotypic segregated spaces.

Ok works for me.

All as expected from a rigorous study. However, the only question to categorise us as either female or male, a pretty crucial characteristic in medical terms, was "what gender do you most identify with?" With options including non binary. No mention of biological sex whatsoever!

Yes, I just did this this morning, and noted gthey used "gender"instead of sex, and for that awful question about "identifying with" I put "I prefer not to say". I may have to drop them a line.

Caroline Criado-Perez might be interested in this also, as the data will be muddied.

These questions are not for registering for the main ZOE app, I did this right at the beginning of the pandemic. They are for registering for the new wider health studies. Definitely no question about sex, assigned at birth or otherwise. Only a question asking you to specify the gender "you most identify with."

Is the app different on different systems as quite a few of us have clearly been asked a sex question as well as gender

I did it on apple ?

But that's what I thought I was doing ! All sorts of additional questions about health including some sex specific ones

As a transwidow I have first hand knowledge of how trans status changes the sex marker.

H found that when visiting the GP they simply had a female sex marker leading to GP asking questions about periods etc and being really confused by the situation. As far as they were concerned the records were telling them that this was a biological female sitting in front of them. Even when H said they were trans the GP thought they meant female to male so there is clearly confusion on this point amongst health professionals which must impact on the care of trans patients.

GP confirmed there is no such thing as a trans status marker so once that marker is changed all treatment, screening programmes etc go with the acquired gender. As this marker is changed as soon as the patient identifies as the opposite gender and well before any physical changes have taken place the patient gets none of the relevant screening for them. A lot of trans patients are being put at risk in this way.