Trans Gap project in Guardian

[PenguinFlipper]

Anyone seen this? https://www.theguardian.com/society/2023/may/05/nhs-treatment-algorithms-not-taking-transgender-patients-into-account

As if it were a surprise that if you misname sex as "gender" on medical records, and allow people to change it if they feel they are trans, then it's going to cause all sorts of issues around treating people appropriately.

See also routine cancer checkups not being issued to everyone of the relevant sex.

"Dr Michael Niman, a junior NHS doctor and chair of the project, said: “Currently, daily medical decisions involving gender-based scores have limited to no research for the trans community""

Perhaps if those were renamed sex based scores that might help? There is literally no point assessing a transwoman for risk of cervical cancer.

Presumably, there also needs to be research into the medical impact of people taking the wrong sex hormones for years and that factored in. Almost as if agreeing to medicate people for years with little to no evidence of the health impact is Quite A Bad Idea.

Looking at the TG project twitter, they are in the #transrightsarehumanrights camp.

Tiny bit awks that they seem to be using the discredited census numbers (see ONS statement) for trans stats: https://twitter.com/transgapproject/status/1637102204912914432

Once again, it seems crucial for the NHS to get and impose clarity on "sex" = biological sex, male or female, "gender" = whatever word salad you want with option to leave blank.

... and presumably the algorithms are going to have to take into account how "trans" a patient is, all the way from "says they are trans but no medical intervention" so just use the same algorithm appropriate for their sex, to "full on surgery/opposite sex hormones" where treatment is trickier.

This from the Teams Gap website is v interesting https://transgapproject.wordpress.com/2022/04/08/alcohol-clearance/

There are different legal allowances for alcohol for men and women to determine if you're over the limit for consent and for driving offences. They say by gender, but it's by sex obvs (and it says sex male/female in their screenshots!).

The first case shows that if a transwoman is sexually assaulted, it's possible that by male alcohol levels then they are judged to be capable of consent, but by female levels they wouldn't be. And case 2 shows a transman suspected of DUI would be over the limit on female levels but not male ones.

Anyone know what level is actually applied for trans people - actual sex or the sex they want to be? Is there any justification to use anything other than biological sex?

What do they do with non binary people?

Goodness, it's almost like sex is an important characteristic. I felt like banging my head against my desk when i read that article, it is so mind blowingly dumb.

There’s another thread going about this bonkers article, @PenguinFlipper - If only there was some way….

Take a look at the government GitHub discussion on this. This is where designers/advocates/digital staff have had this very same discussion.

There's lots of sensible answers from people citing sturdies and then there's a couple of trans people talking about hurty feelings.

Hmm.

github.com/alphagov/govuk-design-system-backlog/issues/69

It's already a complete fucking mess, and god help us if people start being allowed to register themselves as non-binary, which is on the cards if Labour get in.

As I have posted before, I have worked with quite a few trans patients and it has been fine on an individual basis. But you cannot run national screening programmes or design IT systems around feelings in people's heads.

@bingbangbongding that's a great link, thanks.

Thanks @Zeugma will go have a read.

Man oh man

I’m really not sure how to get these doofuses (doofi?) to understand that when it comes to medical treatment of your body, sex is relevant 100% of the time

gender identity is relevant 0% of the time

idiots

The website is funny.

They are a very very small group of very young doctors.

If it hadn't included trans this wouldn't have merited a paragraph in a journal, let alone front page of the Guardian.

They're idiots but clearly trans healthcare is a disaster, and I'm very supportive of anything which improves understanding and approach to this. Which would certainly include (but not be limited to) biological sex on everyone's medical records.

I read this and all I could think of was the gymnastics the author etc had to go through to avoid saying ‘it can be detrimental to someone’s health to change their sex marker on their medical records’. Coz that would be transphobic, wouldn’t it?

Really interesting thanks, and thanks to the people on that thread holding the line against the 'assigned at birth' and 'intersex' crowd.

I read that article and foamed at the mouth for a long time.

Saw that article earlier and my eyes practically rolled out of my head.

It was painful in its earnest avoidance of the colossal elephant in the room.

These are doctors, for crying out loud, apparently bemused and unable to grasp that this whole confusion is down to their dogged determination to cling on to notions of gender, when an 8 year old could tell them that a person’s sex is what will be relevant almost always, when considering appropriate medical care.

I mean, I know they must be entirely wedded to this ideology being correct at all times and in all circumstances or the world comes to an end, but really, when confronted with the problems caused by their refusal to address matters of reality, does nothing impinge on their consciousness to suggest it might be an idea to reassess?

They can’t actually be that thick, can they? Can they??

These are doctors, for crying out loud, apparently bemused and unable to grasp that this whole confusion is down to their dogged determination to cling on to notions of gender, when an 8 year old could tell them that a person’s sex is what will be relevant almost always, when considering appropriate medical care.

You're right, it's quite remarkable that they don't seem to have a grasp of the basics. Sex is massively relevant in health care.

Gender would be relevant in cases where a trans person is taking cross-sex hormones, or is suffering complications of surgery, but otherwise it's really not relevant at all.