NHS update on recording patient sex and gender identity

[Whatchamacallitt]

For a long time sex has been erased and replaced with gender identity. Trans-identified people actually lose out the most with this. There have been cases of trans-identified women having heart attacks, pregnancy emergencies, and kidney failure missed due to clinicians relying on normal male test ranges or presumed male sex. There have been issues for trans-identified men too but unsurprisingly it is the women who have suffered the most due to these policies.

Fortunately the NHS Core Information Standard has been updated to make 'sex at birth' a mandatory data item, with the option to record gender identity separately for patients who feel they have one.

(I don't personally believe in gender identity but recognise it is a genuinely held belief for many trans-identified people and also that it could be helpful information in the context of an altered body due to medicalisation.)

It does happen to adopted people. My daughter was given a new NHS number and one time when I’d taken her to A&E they were confused that she had no prior medical history.
I thought that was daft at the time too.
They could at least transfer key details.
Her red book was also lost before adoption so we do not have full record.

Its daft doing that to a child, but an adult shouldn’t lose their whole medical history.

Quite a few trans people claim to want to be left alone while at the same time deliberately calling attention to themselves. I guess any attention is validating, even negative attention?

There's plenty of research that has shown for many blood tests after a period on hormones reference ranges are per gender rather than natal sex, so gender would in those cases be the more relevant marker to share with the lab. Regardless, the questions of privacy, dignity, comfortability in health services remains. One issue that hasn't been discussed on this thread which is a significant concern being expressed in trans communities, is that people will feel even less comfortable and confident accessing health services which obviously has serious implications for people's health,

The right thing to share would be sex plus a list of any drugs being taken.

Knowing someone's gender doesn't convey any useful medical information. It doesn't tell you their sex and it doesn't tell you what hormones they might be taking.

Women with high testosterone, or men with low testosterone arent similar to the opposite sex in any other way. Blood test results dont make a man a woman, it means that they have unusual test results.

A woman body will process high testosterone in different ways to a mans body. The effects will be different.

Talking about male/female hormones is like talking about male/female height. A woman doesn't become a man if she is tall, a man isnt a women if hes short.

One issue that hasn't been discussed on this thread which is a significant concern being expressed in trans communities, is that people will feel even less comfortable and confident accessing health services which obviously has serious implications for people's health

This is manipulative. "If you don't do what i demand, I will harm myself."

If anyone is lurking and they are transgender or know someone who is, please know this:

• Men are 6x more likely to have an abdominal aortic aneurysm than women. This is why men are screened for it and women aren't. A ruptured AAA has an 80-90% mortality rate. The morbidity statistics aren't pretty.
• men and women experience different symptoms when having a heart attack. If you dial 999 and say you feel sick and light headed and have tummy pain with chest discomfort and you say you are aman when you are biologically female, they will not be thinking 'hmm...heart attack?' they will be thinking 'panic attack'. This could be fatal.
• Liver ademonas are always removed in men because they have a higher chance of converting to cancer. Women tend to just be monitored unless the ademona grows beyond 5cm or causes symptoms. Sex matters.

I could go on and on. Biological Men and biological Women are different. We have differences in the way we respond to medication, the way we experience disease, the way we respond to surgical treatment.

It isn't just about oestrogen and testosterone.

You describe that as "the right thing to do", but why? If it unnecessarily compromises a patient's privacy, dignity and confidentiality by outing them as trans, there should be a clear clinical benefit to justify it.

In your example, if someone is taking oestrogen, testosterone or another medication that affects laboratory values, the laboratory already interprets the result in light of the relevant information it has. It reports the measured value alongside the appropriate reference range. That doesn't require every clinician or administrator who sees the record to know the patient's sex.

Unless you're proposing an entirely new system of reference ranges specifically for people on different hormone regimens—which would itself be a substantial undertaking involving multiple categories depending on treatment—the clinically relevant variable is the person's current physiology and medication, not simply their sex recorded at birth.

So what additional clinical information does routinely displaying sex provide that cannot already be obtained from medication history and the clinical context? If there is such a benefit, it should be explained and weighed against the loss of privacy and the risk of unnecessarily outing trans patients.

Trans people take oestrogen or testosterone because of the side effects on their body, not because it makes them a different sex.

Then they claim that the definition of male and female is hormone levels.

Similarly, trans people have mastectomies and breast implants to look more like their target sex. Then claim that breasts is the definition of sex.

The same with clothes.

They use anything they can change to be the definition of sex. Whereas we know the definition of sex is our reproductive potential. And thats something they can never change.

Why would it matter if a lab technician sees the sex field when they do not have any contact with the patient?

It is just that this sample comes from a 45 year old female, or 70 year old man. Its not outing anyone's age or sex.

Clinicians who interpret the results will need to know the patients sex and medical history.

Still here banging on but still not able to answer my question as to why you are so oddly over invested in this issue? Do you have a trans relative? You claim to be female but were you born female?

I'm a retired NHS clinician which is why I am interested in ensuring accurate NHS data so what's your angle? Why do you care?

I have already answered that I was born female, but I don't think my sex, background, or personal connections are relevant to whether an argument is valid. Arguments should stand or fall on their merits, not on assumptions about the person making them.

I am happy to discuss the substantive issues. If you want to engage with the evidence, policy questions, or clinical considerations, I will respond to those. I am not going to engage in attempts to personalise the discussion or speculate about my motives.

Such a contrast on this thread. So many posts about sex differences, critical clinical issues and patient safety versus endless word salads, all aimed at persuading people that sex is a state secret and must never be recorded or acknowledged for for a very speshul group.

Good to see that the NHS has, for the first time, finally said no to them. But oh the hyperbolic whining in response.

If you want to engage with the evidence, policy questions, or clinical considerations, I will respond to those.

And yet you haven't posted any evidence to back up your wide-ranging claims eg blood reference rates. There is a LOT of subject matter expertise here, if you want a real debate.

So as I thought. Tutored by Dr Google & written by AI yet you are arguing the toss with scientists & doctors who actually know about the subject.

BTW Your posting style is familiar but I cannot for the life of me remember your previous username(s).

It’s almost as if trying to legislate a minority out of existence with lawfare is having an effect. Don’t act surprised.

Then it's just as well that we're not trying to legislate them out of existence, only prevent to over-reach.

And to protect children from having stupid dangerous things done to them.

I shared a number of pieces of research on this earlier in the thread.

Just noticed: Mash is the fourth "argumentative" poster on these threads this week to use the phrase "with lawfare" when, in many years of reading threads on FWR, I have NEVER seen a single other poster use that phrase.

Interesting... is it a new trendy phrase, or have all four of them got together and decided to use it this week?

Perhaps you can enlighten us, Mash?

My posting style is "familiar" but also apparently "Dr Google" and "written by AI"? I'm not sure how that fits together, but either way I see you are determined to focus on discrediting my person. Appeals to personal authority aren't particularly interesting, nor do they strengthen any argument.

Have you written on this subject here under a different username previously?

"Lawfare" is a term used to describe the use of legal action or legal processes as a means of pursuing political, strategic, or ideological goals.

It's a term many people are increasingly using to describe what's happening in the UK at the moment with regard to all the lawsuits / legal challenges related to trans rights being bankrolled by JKR and others.

Does it matter one way or other?

? I shared a number of articles on this

Yes, thanks for mansplaining. I understand what "lawfare" means. (Did you, before you asked your AI?)

I'm wondering why four separate posters have chosen this week to start using it, all at once. The exact same phrase. 😄

No trans right has been removed.

JKR is not a judge.