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.)

Okay. And? Which bit of the sky is going to fall down if anyone can learn that someone is trans? How is it a problem? How is the trans person going to be harmed by Random Receptionist knowing they are trans?

I'll be frank. Trans people are not harmed when someone knows they are trans. They are just made uncomfortable. There's a difference, a massive one, and all this talk of "harm" is getting on my trans nerves.

Someone's sex or believed gender identity is not a state secret when it comes to healthcare.
If you choose to make the risky decision to modify your body to appear to be the opposite sex, you can't expect the NHS to pretzel itself, mangling facts and data in a way that negatively affects others in order to keep your secret.

Time for transactivists to grow up and face their decisions with maturity.

This is the issue I have with the gender critical movement. It is incredibly paternalistic. Trans people are painted as incredibly vulnerable and unable to make sensible decisions, so you need to step in to guide us.

Why all the Trans Pride and even Trans Day of Visibility if it's such a secret? Why teach it in schools?

You completely ignored what I was saying. I agreed it is relevant in healthcare, but it needs to be implemented in a way that protects privacy.

What's "paternalistic" about wanting sex accurately recorded for healthcare? It was you upthread claiming that systems for accurately recording sex in the NHS is "not built for the level of privacy needed" The idea that someone's sex must be a private matter suggests a level of vulnerability / inability to function in society that's frankly off the scale.

Edited to add that this crossed with your response to me but addresses the issue.
Someone's sex is not a private matter and those who think their sex should be kept secret need therapeutic support to enable them to function in society and should be nowhere near influencing any policies in the NHS.

No, that's my point actually: trans people are NOT "incredibly vulnerable", so we need to stop treating them with kids' gloves. They can stand up as trans adults without needing to hide it. There's nothing shameful about being trans, and there's nothing secret about one's sex.

My colleagues in bone health have to know the biological sex of their patients, as there are certain treatments you can only have if you're a biological female.

If you genuinely can't understand why a trans person might consider their birth sex personal and sensitive information , I don't know what to say. For a start information about a trans person's birth sex immediately discloses that they are trans. Of course a trans person can have a legitimate interest in keeping that private and may reasonably chose to disclose it only where it is clinically necessary.

It’s gender reassignment/trans status that is private, and for a trans person this new field will disclose trans status so access needs to be minimised.

Some trans people can only focus on themselves and not see that their attempts to conceal their sex impacts on others. The person in the next bed, the HCP interpretating results, public health analysis.

They are like toddlers always craving attention - one minute its 'look at me im trans', and the next, 'my trans status is classified information'.

In an emergency situation, it may be life and death to know the patients sex. Its easy to be cavalier when typing into a forum, but its not just your life. The HCP may make disastrous decision that could lead to death, injury, wasted time and money.

'Trans status' means nothing. It could mean that they intend to transition in the future, it could mean they self prescribe a cocktail of drugs. It doesnt help the medical team alone.

They may not be in a position disclose it.

They are like toddlers always craving attention - one minute its 'look at me im trans', and the next, 'my trans status is classified information'.

Eek.

Well, if you don't know what to say, you might want to wonder if you actually HAVE something to say at all. Maybe you don't have an argument because there is NO argument in the first place?

And no, I don't see ANY reason why a trans person would want to keep the fact that they are trans out of their medical record. I really don't.

As I said: there's nothing shameful about being trans, and no harm comes from saying you're trans. So why would you want it kept out of a record where it is needed so badly that not disclosing it could end up killing you? No, I cannot think of a single reason to do that.

I also have a rule of thumb for being a responsible and ethical person. For a whole host of reasons, it often needs to be known what sex a person is, mostly for the safety and mental wellbeing of women and girls, and I believe it’s responsible and ethical for people not to lie about it, and for systems to take it into account when necessary.

Exactly. So ridiculous. It’s just dramatic hyperbole.

I think we’re going round in circles. You’re arguing that you personally can’t imagine why a trans person would want this information kept private, and treating that as evidence that there is no legitimate reason. Those aren’t the same thing.

Being trans isn’t shameful, but that doesn’t mean everyone is comfortable having their trans status disclosed, any more than someone has to be ashamed of a medical condition for it to be private and sensitive, or their ethnicity, or anything else. And nobody is arguing that clinically necessary information shouldn’t be available to clinicians when it is relevant to their care.

The point is simply that trans people can have a legitimate privacy interest in information that identifies them as trans, and that interest doesn’t disappear because you personally can’t imagine wanting that privacy. I think we’ll have to agree to disagree on that.

A person’s sex isn’t special category data.

Whether or not anyone “can imagine” why trans people want their sex kept private, it’s an unreasonable demand.

You’re entitled to think it’s an unreasonable demand, but that’s a value judgement, not an argument.

It’s an opinion, I didn’t say it wasn’t. The argument has already been made.

Talk about weaving a tangled web.

Yes I do know. But health is health. And feeling so much "distress" when other people need to know and say what sex you are in order to give you the right medical treatment, that in itself is not healthy.

There's a difference between being offensive, and being factual but uncomfortable. The trans people that you speak of seem to have decided that any and every reference to their sex profoundly distresses them and so it must be avoided at all costs. That's not a healthy or even a viable way to live. And indulging such distress only deepens it.

I don't like people drawing attention to my aging body but sometimes that's necessary for my own wellbeing. It would be unhealthy for me if I tried to limit medical professionals from doing their jobs effectively because I felt "distress" when they talked openly about my age and its physical effects.

Everyone has a right to a private life without the states interference, but that is not the same as a right to conceal their sex. That conflicts with other people rights, and in this case, the NHS ability to function.

The point is simply that trans people can have a legitimate privacy interest in information that identifies them as trans, and that interest doesn’t disappear because you personally can’t imagine wanting that privacy.

True. But in the absence of any better argument than, "They don't wanna," it does mean that their objection is noted, and can be safely discarded when creating policy.