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Feminism: Sex and gender discussions

GMC - sex-based registration

36 replies

NebulousHog · 13/02/2025 10:27

I'm just going to start a thread here for all the queries, questions, and concerns that have come from the Dr Upton case regarding the GMC. I'll write a little note shortly on why this has come about (abridged version), and I will also be contact Sex Matters with some queries about potential legal proceedings around same-sex care provision for women.

OP posts:
HoldTheLine · 13/02/2025 10:53

I was appalled that he would treat a female patient that had requested same sex HCP

Bunpea · 13/02/2025 11:01

Many Thanks for doing this NebulousHog!

suggest a key point is that patients need to know the sex of their care-giver and their trans status. So GMC should publish this along with their other qualifications. And doctors should accept this.

The GMC used to let the public know if a doctor was a man or a woman in the past, and before the trans issues era, it was enough that GMC published doctors’ sex (and doctors accepted this). What’s needed now is simply an updating of the GMC’s approach to keep in line with modern practices.

Also applies to other HCPs, but that’s a separate piece of work.

thanks again!

NebulousHog · 13/02/2025 11:24

I'm curious to know when the GMC changed from sex-based details on registration to gender-based details being shared, was it before DU started a medical degree, or medical training, or, afterwards?

Will have a dig.

OP posts:
illinivich · 13/02/2025 12:47

Patient hospital records changed from recording gender rather than sex in about 2009, so it wouldnt surprise me if the GMC did so at the same time.

The baroness tweeted a letter which suggests 2015, though.

AnSolas · 13/02/2025 12:57

HoldTheLine · 13/02/2025 10:53

I was appalled that he would treat a female patient that had requested same sex HCP

His employer past, current and future should be appalled that he
a) reached his level of training and did not understand the basic obligation to obtain permission thats not even without adding the informed bit.
b) he would expect other staff members to do the same and ignore training.

KnottyAuty · 14/06/2025 09:48

I hope it’s ok to revive this thread. I’ve been thinking about this a lot since February but haven’t had much time to deal with it. I did try writing to the GMC and was told that Drs don’t have to declare information related to their protected characteristics due to privacy. Which obviously interferes with my privacy and right to bodily autonomy…

The more I think about this, the more I think their blanket rule is unlawful and impractical.

I happened on this podcast by Michael Foran which touches on these matters and the law. If you want a really deep dive on the history then listen also to part 1 but it’s part 2 that’s key:

https://podcasts.apple.com/gb/podcast/knowing-ius-podcast/id1754957520?i=1000670154256

Great examples on the podcast of what is private medical information and what is not. So what is reasonable to ask for information on and what is unreasonable. Sex is almost always evident to people without asking - so in most cases people can’t legally expect privacy on that. Disability - it’s evident to anyone if they’re dealing with a wheelchair user but having to deny what you can see for yourself could mean you’re in breach of meeting legal responsibilities to that person. Then pregnancy there’s a point where no one (eg an employer or healthcare setting) don’t know by looking. There are legitimate reasons to know and there are others which aren’t. Some relate to discrimination and then others to do with accessing rights/protections - what if we weren’t allowed to acknowledge a pregnant woman was visibly pregnant for either their rights or their safety? The point at which most pregnancies become obvious to everyone- means that there’s no privacy entitlement then. They also mentioned the gap between what someone thinks themselves and what others see using the example of a wig (tupee?) which is a useful vehicle for “passing”. Also is it right if the receptionist at a medical practice doesn’t step in to prevent a criminal assault when a TW Dr offers themselves to a female patient who has requested single sex care? There are references to the Goodwin case and how there’s a difference between interaction with the state and interactions with the rights of other individuals. I’ll have to listen a few times to get a good grip on it.

However I think the GMC’s guidance on Fitness to Practice really needs to get a grip on this and be much more nuanced.

Would be interested to discuss - thanks

LadyQuackBeth · 14/06/2025 10:46

The patient doesn't need to know anything about the doctor, he just has to see a female patient requesting single sex care and keep out of the way. The hospital admin can pair the patient with a doctor of the corrext sex. Once the patient has made that request, it's really unfair to put them on the spot about an individual doctor.

It isn't that unusual for a doctor to say they can't treat a patient, especially in smaller towns and cities where you know a large proportion of local people. It can't be handled discretely, it doesn't have to turn into the "please validate me," show.

nothingcomestonothing · 14/06/2025 11:02

The GMC said they stopped asking for sex and started asking for 'gender' but said the regulator told them to. Would it be the PSA? I can't find the reference at the moment but I've got it somewhere

Grammarnut · 14/06/2025 11:14

nothingcomestonothing · 14/06/2025 11:02

The GMC said they stopped asking for sex and started asking for 'gender' but said the regulator told them to. Would it be the PSA? I can't find the reference at the moment but I've got it somewhere

In which case someone is either terminally insane or believes gender woo to the extent they could be termed terminally insane. Oh, that's the same, sorry.

Keeptoiletssafe · 14/06/2025 12:14

As far as dating things is concerned, there’s the government’s 2008 The Provision of Public Toilets. It mentions a gender equality duty and gender throughout though this is in terms of the polite way of saying sex. There is no mention of people of one sex going into the toilet of the other sex out of any other reason than to have sex.

I think the blurring of what gender means is important and the exploitation of its usage when the real intent was a way of avoiding ‘doing sex’. I had a form at the doctors last year that mentioned gender at the top instead of sex then started going on about sex and gender. The woman agreed to change the form, saying they had done a cut and paste job at the top so it was from an older form.

Brainworm · 14/06/2025 12:25

LadyQuackBeth · 14/06/2025 10:46

The patient doesn't need to know anything about the doctor, he just has to see a female patient requesting single sex care and keep out of the way. The hospital admin can pair the patient with a doctor of the corrext sex. Once the patient has made that request, it's really unfair to put them on the spot about an individual doctor.

It isn't that unusual for a doctor to say they can't treat a patient, especially in smaller towns and cities where you know a large proportion of local people. It can't be handled discretely, it doesn't have to turn into the "please validate me," show.

💯 And an effective policy would also protect all of these butch lesbians that TRAs have suddenly sprouted concern for. If patients know that the hospital’s procedures ensure that the person treating or caring for them is female, when this has been requested, then they are unlikely to upset all of these male looking females through the aggressive questioning that is definitely currently happening.

TheOtherRaven · 14/06/2025 12:40

Am I wrong in thinking that this was specifically referred to in the SC judgment?

The reason for purporting a male HCP to be 'equally' entitled to provide care as a biologically female HCP when one is supposed to be provided would have been under the misinterpretation of the Equalities Act.

It has been clearly confirmed that no man is a woman for the purposes of the act, whether or not he has a certificate. A man HCP cannot therefore be permitted to act as if a woman when one has been specifically requested and provided. It is the same as police strip searching.

Leaving aside the obvious severe issues for women as no one wanting men to do these things ever cares in the slightest about women, the law is clear (now) that if a specific sex based service or resource is there, then is has already passed the 'case by case' and 'proportionate' test as otherwise it would be mixed sex, and is lawful sex discrimination. It therefore must be in fact single sex with no exceptions. Otherwise it is discriminatory against all other members of the excluded sex.

northcluegc · 14/06/2025 12:44

I did try writing to the GMC and was told that Drs don’t have to declare information related to their protected characteristics due to privacy. Which obviously interferes with my privacy and right to bodily autonomy…

@KnottyAuty - you've hit the nail on the head there.

Sex is different to the other protected characteristics in that patients are (legally) allowed to discriminate based on sex, i.e. they can request a same sex doctor. Therefore, a doctor's sex shouldn't be private.

You can't legally discriminate based on the other protected characteristics, i.e. you can't request to only be treated by a white doctor or a heterosexual doctor. So sex is different to all the other protected characteristics and should be treated differently by the GMC under privacy rules.

TheOtherRaven · 14/06/2025 12:49

This is something referred to within the consultation for the EHRC guidance I believe, or perhaps the Sex Matters guidance - that it will be the case for employers to responsibly collate this data in the way that other sensitive data is collated. Medics being unwilling to be clear about this does however suppose that a man in a position of responsibility with clear knowledge of the law might seek to break the law and use his identity to access experiences in a position of trust that he would otherwise be restricted from. Which would seem a very serious offense for an HCP.

KnottyAuty · 14/06/2025 13:00

TheOtherRaven · 14/06/2025 12:49

This is something referred to within the consultation for the EHRC guidance I believe, or perhaps the Sex Matters guidance - that it will be the case for employers to responsibly collate this data in the way that other sensitive data is collated. Medics being unwilling to be clear about this does however suppose that a man in a position of responsibility with clear knowledge of the law might seek to break the law and use his identity to access experiences in a position of trust that he would otherwise be restricted from. Which would seem a very serious offense for an HCP.

This is the exact situation - let’s call it the “Upton Problem”. A trans identifying male Dr believes TWAW and therefore offer themselves as a woman physician when someone has asked for a female. In theory there is criminal assault if the Dr goes ahead gaining consent by deception.

On the other hand the Dr’s employers or colleagues fear being accused of disciplinary action on discrimination/harassment or criminal prosecution about revealing of GRC details if they try to intervene to prevent the assault. There’s a clear problem with the law here which the regulators need to get a grip on.

Yes they need to protect their members’ privacy but they also have a duty to avoid their trans members from criminalising themselves. Plus a duty to patients to protect them from assault.

The GMC needs to update their professional guidance to help Drs and the public navigate this developing field… the no debate/nuance isn’t helping anyone

KnottyAuty · 14/06/2025 13:32

I wonder if we could crowd fund legal advice to be sent to the regulator of regulators? It’s not just the GMC that needs to develop their guidance to balance need and promote good relations between groups

nothingcomestonothing · 14/06/2025 14:46

This isn't the reference I was looking for but still relevant:

https://www.sexnotgender.info/the-gendered-medical-council-2/

KnottyAuty · 14/06/2025 21:06

here’s how to complain but the question is what should a complaint be about?
https://www.gmc-uk.org/about/get-involved/complaints-and-feedback-about-our-service/how-to-raise-complaint

BundleBoogie · 14/06/2025 21:30

LadyQuackBeth · 14/06/2025 10:46

The patient doesn't need to know anything about the doctor, he just has to see a female patient requesting single sex care and keep out of the way. The hospital admin can pair the patient with a doctor of the corrext sex. Once the patient has made that request, it's really unfair to put them on the spot about an individual doctor.

It isn't that unusual for a doctor to say they can't treat a patient, especially in smaller towns and cities where you know a large proportion of local people. It can't be handled discretely, it doesn't have to turn into the "please validate me," show.

That would assume that the doctor has an ounce of integrity and respect for women and would actually agree to step aside and not see a female patient.

The male doctor who practised in London while identifying as a woman certainly wouldn’t step back - he was delighted that female Muslim patients under the false impression that he was a woman agreed to sexual assault intimate procedures they wouldn’t have otherwise agreed to.

He was so proud of himself that he was interviewed boasting about his in a magazine. Given the determined attitude of Dr Upton and nurse ‘Rose’ in current court cases to be present with undressed women, he is clearly not alone.

The GMC appears to be living in an issue of Viz.

POWNewcastleEastWallsend · 15/06/2025 03:39

However, the patient does need to know the sex of the GP, nurse or HCP when the practice uses an online booking system that gives patients the choice of booking to see a male or female practitioner.

If the practice lists male Dr Blokey-MacWomanface as female and the falsified GMC Registration also says female then neither patient nor Dr are protected.

There is a relevant FOIR here:

Same Sex Care in NHS

GMC reply, 7 April 2025:

We do not have any policies about what to do if a patient requests care
from a doctor of a particular gender or sex.

We recognise that some patients may have reasons for wanting to see a
doctor of the same sex – for instance, because they want to discuss a
sensitive topic or need an intimate examination. It’s our understanding
that patients who want to receive care from a doctor of a particular sex
or gender are likely to seek, and be able to obtain this, from their local
healthcare provider. The healthcare provider will be best placed to advise
on whether the request can be accommodated, taking account of factors such
as the nature and urgency of the treatment needed and availability of
staff.

It’s important to note that nowhere in our professional standards do we
require doctors to declare their gender history nor their sex – or any
other protected characteristics – to patients. This guidance is in line
with the law.

Background

Our standards promote an approach where a doctor and patient together
consider the patient’s medical history and clinical needs, explore how the
patient’s wishes and preferences may affect aspects of their care, and
work to reach a shared understanding and agreed way forward. They do not
set out a definitive list of issues that doctors must raise with every
patient. They take account of what stakeholders (including patients) told
us they see as important factors for doctors to give thought to, when they
have a discussion with a patient, and the different weight that should
attach to these considerations (as reflected in the ‘must’ and ‘should’
duties in the guidance).

If doctors follow our approach, and a patient expresses concern about who
would provide intimate care or carry out an intimate examination, then our
guidance on [1]Intimate examinations and chaperones would be relevant and
helpful. It sets out requirements on doctors to explain what an intimate
examination will involve, why it is being recommended, what the patient
may experience during the process, and the right to request a chaperone as
well as having a friend or partner present. In addition, we highlight ways
in which a doctor may work with a patient to meet their needs, for
example, by rearranging the examination to another date and time when a
chaperone can be present. We explain the responsibilities of chaperones,
to make sure that the doctor respects the privacy and dignity of the
patient and does not act in a way that exploits the patient’s
vulnerability.

https://www.whatdotheyknow.com/request/same_sex_care_in_nhs#incoming-2978231

The NHS Constitution did not get updated as promised and the outcome of the Consultation run under the previous Conservative Government is not going to be published by the current Government,

NHS Constitution plans to strengthen privacy, dignity and safety
Proposed updates to NHS Constitution for England will reflect biological needs of patients and empower people to request same-sex wards and care.
30 April 2024
https://www.gov.uk/government/news/nhs-constitution-plans-to-strengthen-privacy-dignity-and-safety

Consultation outcome
NHS Constitution: 10 year review
Published 30 April 2024
Last updated 3 March 2025

We recognise the timing of the general election disrupted the consultation and people’s ability to respond. We also appreciate more could have been done to ensure the accessibility and inclusivity of the consultation so that it could reach a wider audience.

For these reasons, this 10-year review is now closed.

For those who spent their time responding to the consultation, be assured that we will consider your feedback and take into account all relevant factors as part of our 10 Year Health Plan.

We will be developing the next consultation on the NHS Constitution to align with the 10 Year Health Plan’s ambitions. Exact timings for this will be set out in due course.

Original consultation
Summary
Consultation seeking views on proposed changes to the NHS Constitution.
This consultation ran from
9am on 30 April 2024 to 11:59pm on 25 June 2024
https://www.gov.uk/government/consultations/nhs-constitution-10-year-review

Guidance
NHS Constitution for England
The principles and values of the NHS in England, and information on how to make a complaint about NHS services
Published 8 March 2012
Last updated 17 August 2023

(not updated following the Consultation above)
https://www.gov.uk/government/publications/the-nhs-constitution-for-england

Guidance
Handbook to the NHS Constitution for England
Updated 24 January 2025
https://www.gov.uk/government/publications/supplements-to-the-nhs-constitution-for-england/the-handbook-to-the-nhs-constitution-for-england#patients-and-the-public-your-rights-and-the-nhs-pledges-to-you

This includes:

Rights and pledges covering respect, consent and confidentiality

Right: “You have the right to be treated with dignity and respect, in accordance with your human rights.”
The right to dignity includes a right not to be subjected to inhuman or degrading treatment. The right to respect includes the right to respect for private and family life.

This right has broad meaning, but for the NHS your care, where possible, should be provided in a way that enables you to be treated with dignity and respect.

Where appropriate your health professional must also follow the standards set by their own professional body and/or regulator.

Source of the right
The right to be treated with dignity and respect is derived from the rights conferred by the European Convention on Human Rights (ECHR) as given effect in UK law by the Human Rights Act 1998. The ECHR is designed to protect human rights and fundamental freedoms.

It is unlawful for a public body to act incompatibly with those ECHR rights (section 6 of the Human Rights Act).

Individual health professionals are also governed by the standards set under the professional regulatory regime that applies to their profession.

Right: “You have the right to be protected from abuse and neglect, and care and treatment that is degrading.”
People who use services must be protected from suffering any abuse or improper treatment, including degrading treatment or treatment which significantly disregards their needs. Abuse includes sexual offences, physical or psychological ill-treatment, neglect, theft, misuse or misappropriation of money or property. Care or treatment must not include unnecessary restraint, or be provided in a way that discriminates on grounds of age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex, and sexual orientation.

To achieve this all providers must have, and implement, robust systems and processes that make sure that people are protected. Staff should be aware of their individual responsibilities to prevent, identify and report abuse when providing care and treatment.

Providers must act as soon as they are alerted to suspected, alleged or actual abuse, or the risk of abuse.

If a patient makes allegations of abuse, they must receive the support they need and where allegations of abuse are substantiated, providers must act to redress the abuse and take the necessary steps to ensure the abuse is not repeated.

Source of the right
This right is based on the fundamental standard requiring providers registered with CQC to protect people from abuse and improper treatment set out in regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (as amended from time to time). The fundamental standards are legal requirements that NHS trusts, NHS foundation trusts, GP practices, ambulance services and other providers of NHS services must meet. Patients should always be treated in line with the fundamental standards. If this is not happening, then the organisation is not meeting its legal duties, and CQC can take action against the provider.

Right: “You have the right to accept or refuse treatment that is offered to you, and not to be given any physical examination or treatment unless you have given valid consent. If you do not have the capacity to do so, consent must be obtained from a person legally able to act on your behalf, or the treatment must be in your best interest.”
If you are detained in hospital or you are in the community - for example, on a community treatment order under the Mental Health Act 1983 - different rules may apply to treatment for your mental disorder. These rules will be explained to you at the time. They may mean that you can be given treatment for your mental disorder even though you do not consent.

Except in the limited circumstances explained here, no one can carry out any physical examination or give you treatment unless you have given your valid consent. Although clinicians will have good reasons for examination or treatment, which they should be able to explain to you, you can accept or refuse the examination or treatment if you wish.

If you lack capacity to consent and have given a person legal authority to make the treatment decision for you (under a health and welfare lasting power of attorney), then they can consent to or refuse treatment on your behalf where this would be in your best interests. A health and welfare deputy appointed by the Court of Protection can also usually make these decisions.

If you lack capacity to consent and there is no such person, then someone else - for example, a doctor - will have to act in your best interest. Doctors and all other health professionals must follow the Mental Capacity Act 2005 when they make decisions in your best interests. They must, for example, where practicable and appropriate, consult certain people, including those who care for you, such as family members and other people interested in your welfare. For serious medical treatment decisions, if there is no family member or friend who can be consulted, an independent mental capacity advocate must be appointed, who will represent you. In some difficult cases the courts will be asked to decide what is in a person’s best interests.

Source of the right
The law relating to battery and assault makes it generally unlawful for a person to be given a physical examination or treatment unless they have given valid consent. Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 also requires that care and treatment must only be provided with consent.

If, even with support to make the decision, a person does not have the capacity to consent - for example, because of their mental state - or does not have competence to consent because they are a child with insufficient understanding to give consent, treatment may take place without the consent of the individual concerned. In such cases, treatment may be consented to by another individual - for example, the parent of a child, or a health and welfare attorney or deputy, who has authority to make such decisions by making a best interests decision under the Mental Capacity Act 2005. In other cases, treatment may be given where a doctor, for example, determines it is in your best interests. In some cases, the NHS must apply to the court for a declaration that a particular treatment is in a person’s best interests.

Further detail about mental capacity and what happens when you cannot give consent yourself can be found in the Mental Capacity Act 2005 and its associated code of practice. For children who are unable to consent to or refuse treatment because they lack sufficient understanding (that is, they are not Gillick competent) parents may consent or refuse treatment where this would be in the child’s best interests. Again, in some difficult cases the courts will be asked to determine what is in a child’s best interests.

If a person does not have the relevant capacity or competence to consent to their treatment arrangements and those arrangements amount to a deprivation of liberty, then proper legal authority is required in line with the person’s rights under Article 5 of the ECHR. In many cases this is done under the Deprivation of Liberty Safeguards, and by the Court of Protection. The Mental Capacity (Amendment) Act 2019 provides for the replacement of the Deprivation of Liberty Safeguards with the Liberty Protection Safeguards (LPS). The timing for the implementation of LPS is to be determined.

Individual health professionals are also governed by the standards set under the professional regulatory regime that applies to their profession.

Rights and pledges covering informed choice

Right: “You have the right to express a preference for using a particular doctor within your GP practice, and for the practice to try to comply.”
Within your GP practice, you have the right to say which particular GP you would like to see. Your GP practice will try to accommodate your choice wherever possible although there may be reasons it cannot do so.

Source of the right
The right is set out in the regulations made under the NHS Act 2006, which underpin the contractual arrangements for the providers of GP services - in particular paragraph 22 of schedule 3 to the National Health Service (General Medical Services Contracts) Regulations 2015 and paragraph 21 of schedule 2 to the National Health Service (Personal Medical Services Agreements) Regulations 2015.

(Note: says nothing about the sex of the GP though.)

Right: “You have the right to be involved, directly or through representatives, in the planning of healthcare services commissioned by NHS bodies, the development and consideration of proposals for changes, in the way those services are provided, and in decisions to be made affecting the operation of those services.”
You have the right to have your say in person or through a representative:

  • in the planning of healthcare services commissioned by NHS England and ICBs
  • on the proposals for any changes in the way in which those services are provided
  • on decisions which may affect the operation of those services

This right applies if implementation of a proposal or decision would have an impact on:

  • the manner in which services are delivered to you or other people
  • the range of health services available to you or other people

Source of the right
NHS bodies have duties to make arrangements with a view to securing such public involvement in relation to the services for which they are responsible under sections 13Q, 14Z45 and 242 of the NHS Act 2006.

(Presumably applies to such things as the outcome of the Consultation on the NHS Constitution, which the Government does not intend to publish!)

TakingMyChancesWithTheRabbits · 15/06/2025 05:52

It’s important to note that nowhere in our professional standards do we
require doctors to declare their gender history nor their sex – or any
other protected characteristics – to patients. This guidance is in line
with the law.

But do they require them to declare their sex to their employer? If not, how can the "healthcare provider .... advise on whether the request [for a doctor of the same sex] can be accommodated" if they don't have accurate information about this?

nothingcomestonothing · 15/06/2025 08:45

TakingMyChancesWithTheRabbits · 15/06/2025 05:52

It’s important to note that nowhere in our professional standards do we
require doctors to declare their gender history nor their sex – or any
other protected characteristics – to patients. This guidance is in line
with the law.

But do they require them to declare their sex to their employer? If not, how can the "healthcare provider .... advise on whether the request [for a doctor of the same sex] can be accommodated" if they don't have accurate information about this?

At an organisational level, their employer isn't likely to know a HCPs sex. Obviously at a departmental level people know colleagues' sex because they have eyes and ears, but the organisation won't because they don't ask.

My Trust uses ESR for staff records. I can change my 'gender' on it whenever I like, but no where does it record my sex.

KnottyAuty · 15/06/2025 09:12

TakingMyChancesWithTheRabbits · 15/06/2025 05:52

It’s important to note that nowhere in our professional standards do we
require doctors to declare their gender history nor their sex – or any
other protected characteristics – to patients. This guidance is in line
with the law.

But do they require them to declare their sex to their employer? If not, how can the "healthcare provider .... advise on whether the request [for a doctor of the same sex] can be accommodated" if they don't have accurate information about this?

This paragraph was the text included in a GMC email to me. It’s really unsatisfactory as a response. I also reviewed the intimate examination guide and that’s also inadequate.

This guidance is within the law
What utter piffle - I bet they couldn’t quote which law if they were asked!?

In most cases the Dr doesn’t need to declare what we can see with the evidence of our own eyes!

The GMC is potentially enabling criminal assault (treatment without proper consent) or leaving members open to carrying out assault by issuing vague guidance. Helps neither the members nor the patients.

KnottyAuty · 15/06/2025 09:15

nothingcomestonothing · 15/06/2025 08:45

At an organisational level, their employer isn't likely to know a HCPs sex. Obviously at a departmental level people know colleagues' sex because they have eyes and ears, but the organisation won't because they don't ask.

My Trust uses ESR for staff records. I can change my 'gender' on it whenever I like, but no where does it record my sex.

Does it ask about any other protected characteristics?

nothingcomestonothing · 15/06/2025 09:26

KnottyAuty · 15/06/2025 09:15

Does it ask about any other protected characteristics?

I've just checked, the sections under 'my equality and diversity' are Ethnic Origin, Country Of Birth, Sexual Orientation, Religious Belief, Marital Status, Disability Details. You have to fill those in and you have to update or verify there are correct every year. Under basic information (name, address NI number etc) it records my 'gender'. Nowhere does it record my sex.