The NHS has been instructed to put on hold any issuing of new patient records to children who have changed gender, with the health secretary citing safety reasons.
This comes as an independent Government-commissioned review concluded that the NHS should stop issuing new NHS numbers and changed ‘gender’ markers to any individuals, because losing data on sex puts people at risk.
In children, this practice poses a ‘serious safeguarding risk’ and should be halted urgently, the report concluded.
For people of all ages, a lack of information on biological sex can hinder clinical care and invitations to screening, the review by Professor Alice Sullivan, professor of sociology and head of research at the UCL Social Research Institute found.
In response to the report, health and social care secretary Wes Streeting instructed the health service to immediately suspend in-process or new applications for NHS number changes for gender change in under-18s.
The Department of Health and Social Care will also be reviewing other changes that may be needed in response to the review, he said.
Collecting ‘high quality, robust data on sex’ is critical across a wide range of fields, from health and justice to education and the economy, Professor Sullivan concluded.
The review, which applies to all public bodies, found that official UK data recording people’s biological sex and their gender identity is often unclear or conflated.
But loss of data on sex, which has been happening since the 1990s, the review said, poses particular risks within health and social care.
Such risks include not being invited for cancer screening or misinterpretation of laboratory results.
The recommendations also included that sex should be collected by default in all research, including clinical trials.
In general, forms which combine sex and gender identity in one question should not be used, the review found. And use of the word ‘gender’ should be avoided as it has multiple meanings and can be unclear to respondents.
Instead, organisations seeking to collect information on gender identify should be more specific, asking about the protected characteristic of gender reassignment, trans identification or identification as trans and/or gender diverse, the recommendations said.
Speaking on BBC Radio 4’s Today Programme, Professor Sullivan said: ‘What I’ve argued in this report is that sex is really important, we should be recording it by default – transgender and gender diverse identities can also be recorded where that’s appropriate.
‘There’s no reason to see this as a trade-off between the two. They’re two distinct variables.’
In some cases, the review found that changing data on sex held within administrative systems may have been motivated by a desire to ensure people were being addressed in the way they wanted to be.
‘Service users should of course be treated with respect and addressed by their preferred name and title,’ the review said.
But it noted it should be possible to store information on forms of address separately to information on sex and ensure that relevant people have access to this where required.
Having incomplete information will compromise care for LGBTQ patients and risk widening health inequalities, Dr Luke Gutjahr warned.
A spokesperson for the Department for Science, Innovation and Technology who commissioned the review said: ‘This government is clear that the collection of accurate and relevant data is vital in research and the operation of effective public services, particularly when it comes to sex.
‘We are grateful to Professor Sullivan for her work, which has been shared with relevant government departments and public organisations, including the ONS.’
Mr Streeting said: ‘Children’s safety must come first. It’s completely wrong that children’s NHS numbers can be changed if they change gender. And I’ve made it clear this must not happen.
‘We must deliver safe and holistic care for both adults and children when it comes to gender, and that also means accurately recording biological sex – not just for research and insight, but also for patient safety.
‘I have always made it clear that doing so does not stop us from recording, recognising and respecting people’s gender identity where these differ.
‘As we reform gender identity services across the board, we’ll take forward the serious research this review highlights.’
So it appears the terminology continues to be wrongly used: ‘issuing of new patient records to children who have changed gender’ should actually be ‘changed gender identity’; ‘NHS number changes for gender change in under-18s’ should really read ‘gender identity change in under-18s’. The significant word ‘identity’ is often missing and this of course changes the meanings and attitudes in discussions and news articles by politicians and health reporters; it is simply imprecise. Also, Mr Streeting said ‘… wrong that children’s NHS numbers can be changed if they change gender’ should, surely, be ‘…. change gender identity’. Yes, even a Health Sec., Wes Streeting, propagates the myth that you can change gender, not just gender identity, ( unless he is inadvertently misquoted, which I doubt, in this interesting item by Emma Wilkinson, of course )
It seems obvious that changing the “sex” field on medical records naturally leads to problems. Sociologists have said for years that biological sex can be distinct from gender identity so it seems overdue that public services should start to record both categories independently.
Clearly gender identity is not fixed for a lifetime.
The interesting question will be how biological sex will be defined – will it be considered fixed for a lifetime?