'Does the patient have a penis or vagina?' The 'nonsense' new transgender form the NHS makes doctors fill out.

[Rightsraptor]

I'm just reading an article in the DT with the above headline and it's making me furious and my blood boil. Can someone do that 12ft archive thingy for me please? You all need to read this.

It's the same American Epic system that is forcing midwives to record a newborn's 'gender identity'. It is such a load of shite but, even worse, it's absolutely fucking dangerous. And it's costing £450 million. Just who are these idiots who choose and buy these ideological systems?

The DT quotes such delights as the form asking for a patient's organ inventory! It asks staff to fill in the list of the organs the patient currently has, organs present at birth, organs surgically enhanced or reconstructed and organs hormonally 'enhanced'.

There's more, but I just wanted to get this crock of shite out there so you all know about it now.

Ye Gods. What are we going to do?

Oh yeah, I can just picture the "Thanks for being an AwEsoMe ALLY!" face on sex-dysphoric /'Trans' patients when bluntly asked "So, do you have a penis or a vagina?".

So KiND!

<awaits the tsunami of tearful-cashapp-TikToks-in-cars>

It's a system from the US.

And this is how they'll be forcing compliance - computerise the world and then everyone has to obey you.

What's so irritating is that they are relying on people knowing their sex in order to answer the question.

What if you said, I don't know if I've got a vagina, how would I know?

Well do you have a hole between your legs?

I don't know, I've never looked.

They might ask about periods. What if I was pre-pubescent or didn't have them for another reason.

The entire process is completely dependent on everyone knowing everybody else's sex.

it's a massive game of let's pretend we don't know your sex, but we can't pretend we don't, unless we do.

What worries me is the next step is fixing it if the system says different to reality.

Not fixing the system, fixing the person.

It is so fucking mental I can't get my head around actual humans signing this off.

Hospitals get to choose which digital system they go for if and when they move on from paper notes - my local trust did this switch whilst I wS a trainee there. My experience was the electronic system was VASTLY better for patient care and staff experience (after bedding in). The main problem with Epic in my view is that it doesn't talk to GP systems, so there still isn't and can't be a perfect centralised record. We in GP still rely on letters (although at least now they are electronic) and remote interrogation of lab results. We can't see imaging. Similarly the hospital can't see consultation details, just coded diagnoses, allergies, medications.

Now EPIC was introduced here before the days of crazy gender stuff, so when it was formatted for our hospital, that gender page did not come through. The formatting was led by an MDT but with heavy senior doctor input, so maybe that made a difference? And most boxes/pages were not compulsory, so I'd be surprised if forced compliance to this nonsense was required. But who knows what the future holds. But I agree with whoever it was who said it's not the system thart is the problem, it's the ideology. Speaking as someone trying to balance local training so it is not entirely activist led, and struggling, I am feeling a bit hopeless about my own profession today.

We already have American forms to fill in for child development, for example. Some of the questions (culturally) don't make a lot of sense and some AE words are used.l, which can be confusing.

(This is not "America bashing")

I have two autistic sons with long hair when one is asked are they a boy or a girl he says cat or robot or refuses to speak the other looks at me in horror and gets upset because he feels someone gas made an assumption AGAIN just because he has long hair it really makes him mistrust the nhs because they should KNOW he is a boy it's on his notes! (Yes he is very very literal there is no grey area penis=boy) his last hospital stay I corrected the staff several times because they kept calling him they and he kept looking around to see who else they were talking too

The linguistic gymnastics were astounding confusing and unreal

This morning on Radio4 today they reported on a trial where all patients who attend A&E and need blood tests are automatically screened for HIV and Hepatitis.
The Dr in charge explained the benefits. They had been funded £20,000 so far and he was struggling to get more funding to roll it out.

In addition to £450K on new IT you can add £487K that has been spent by NHS England funding the Rainbow Badge Accreditation scheme. It should be noted this is the money NHSE pays to LGBTFoundation and others to administer the scheme.
It does not include £££ spent by individual hospitals to pay for rainbow lanyards, badges, road crossings, posters and other paraphernalia and the uncosted hours of management time as they engage with the scheme and rewrite all hospital policies and patient information leaflets using gender neutral language etc.

There's an excellent roundup of the scheme here:

https://open.substack.com/pub/grahamlinehan/p/so-over-the-rainbow?r=1g2e1j&utmcampaign=post&utmm_medium=email

The important question is whether the patient is transgender or not. Treatment should flow from that (where sex based), and not some guessing game

Genuine question - how will they know if the answers are accurate?

Say a man goes to his GP and is asked the questions on this system....he says "oh I had an op abroad and I now have a vagina" Does the GP just then record that on an official NHS system without checking?

I'm being a bit tongue in cheek as I assume there is an official record of anyone who has legally changed their gender. In which case, why the need for this system?

Exactly, then 99.5% of the population can say "no" and rest of appointment and treatment continues as normal.

Why do we need to make it any more difficult than that?

Yes. Or rather, the most important question is what sex the patient is, male or female. That will affect many aspects of their care.

You could then have a field that asks whether they identify as a different gender from their biological sex. I suppose you might run into trouble depending on how many genders you offer - just male, female, non-binary? Or one of the other 100 genders the BBC claims we have.

And perhaps it needs to be recorded too whether the person just identifies as transgender or whether they have had sex reassignment surgery and/or hormones - though I expect that would be recorded elsewhere on the medical record.

Incidentally, the Epic patient record software used by hospitals has been around for years - I wonder if this is a new problem, or whether it's just being talked about now.

I've signed the petition and confirmed it, it was instant, to my surprise. I've passed the link on to my sister, my cousin and a female friend. I hope they sign, too.

I was involved in the implementation of Epic at a UK hospital. It's the hospital that decides what data items they record, not Epic. Epic provide many standard data items that you can use (some of these are not at all relevant in the UK) but you can also make your own ones (we had to do this with some NHS standard data items that were not recorded in the same way in the USA).

I use EPIC daily at work ( ophthalmology and yes in the USA) and there are definitely no parts that you HAVE to complete ( for example it asks sexually active? And one option is defer) and the system definitely lets you move on with untouched or partially completed sections - most importantly there are no parts that ask the penis/vagina organ question - BUT - I do know that you can choose your have EPIC 'built' to your own specifications so this may be an option the NHS are taking but it's not the system at fault then it's the specifications of the organization using it iyswim

What is 'transgender'?

Quite. What about trans people like Izzard, who fluctuate between girl mode and boy mode, depending on which one's most advantageous.

”are you transgender today?” 😄

It's not doing very well for signatures, just over 4,000.

I am receiving treatment in a Trust that has just adopted Epic. GPs can access which is great. I had a phone conversation with my GP days after my consultants appointment and he was able to access the Consultants letter etc. Similarly the Consultant had been about to order blood tests and I suggested the GP had already ordered a whole batch of them. She was able to see the one she wanted there and then, which added weight to her provisional diagnosis, and helped inform next steps. I too can access various stuff. The problem here, and it is a real one, is that patients need computer access and to be computer literate, but I will be able to print off my appointment letter and the relevant instructions. No more letters getting mislaid.

It has the potential to be really useful. The complaints seem to be a mix of teething problems and about how it is set up. The receptionist at the specialist clinic told me that at the moment all clinics are running late. The issue has been what you are required to complete and what you can skip. Changes were made so reception anre now only required to ask basic confirmatory questions (name, dob, address). A specialist friend was moaning about pages of diversity questions. Sex/gender did not have an impact in her field so she did not want to have to use her scarce time asking obscure questions about gender identity. Her Trust, presumably, could prioritise clinical requirements over data collection and make these optional.

Pulling records and communication together is probably a good thing. Buying a package used successfully elsewhere could be a good thing. Having NHS managers rather than doctors in departments decide what information needs collecting is probably a bad thing. My concern is the advantage it may give people like me. I got a call late Friday afternoon asking if I could attend a scan appointment first thing Monday morning. They saw I was using the system so would send the paperwork that way. It ensured that appointment was used, but I probably got it (a week earlier than the next available appointment) because I am computer literate.

Well @JudyP , it may very well be possible to adapt the EPIC system to each territory's requirements but how often will people bother with that? It's concerning that the NHS has said how much work went into choosing it blah blah but, when we start to see ideological holes in it, they say 'ooh, an oversight ... '

If they'd really been as pernickety as they've said they were they'd have spotted this right off. It's an ideologues dream..

Part of the issue is that some staff (even those in quite senior positions) are clueless and still using sex and gender as synonyms.

I got blank looks when I challenged that one of the mandatory checks before administering blood product is "gender".

Ie. you are meant to check that the patients name, DOB, hospital number and gender match the info on the blood tag before giving it.

No recognition that actually it's biological sex that's important here and that many of our patients (it's paediatrics) won't have a well established gender identity (if you even concede that such a thing exists).

And the only transgender patient I've seen the form filled in for had it completed incorrectly and said that their legal sex correlated with their gender identity. It doesn't as they are too young to have changed their legal sex. It's a fucking nightmare and could potentially exclude them from valuable health screening in the future.

That is absolutely terrible and a horrendous waste of money to boot.Cis. That fucking word, how dare they use that as the automatic for anyone who is not 'transgender' 🤬

https://m.youtube.com/watch?v=YvM1ev2JNTg

You can't just use the Epic system "off the shelf", at the hospital where I worked there was a process of configuring the screens and reports we wanted that took about 18 months before the system could go live. The content of the screens etc. was largely driven by clinical staff but of course there are some constraints (e.g. there is some data that is required by central government, the NHS uses standard definitions for a lot of data items rather than every hospital having their own version of the same piece of information, also it's unlikely to be practical to include every data item that everyone requested to put in the system).