The thing is, they don’t really *want* that info, every time I’ve used 111 and actually said “male”, they couldn’t find me. Because what they wanted was what was on my NHS profile. So why not ask that?

I got a whole new NHS profile, so theres no link to my “biological sex”. And treating my body as identical to a cis mans is an enormous mistake anyway

Yeah literally this. They think they want birtg registered sex but most trans people already have changed sex markers which screws that assumption. The database is fucked both on data gathering and on schema for what the database labels the data as. Deliberately because of TERF fuckery.

Yeah, and we only had to do all this because their system was so shit the only way I could have “miss” as my title, was to get a whole new profile. This has been NHS fuckups the whole way

There were *years* of investment into research that led to the way the questions were asked before the Tory party forced this particular wording through via the health secretary a couple of years ago. There are ways to ask the question that get more positive responses but don't erase trans status.

Like I'm not an expert on which combination of questions gets a positive response, Ruth Pearce's Trans Health book covers a bunch of it especially around her coverage of the TransDocFail campaign that led to the NHS trying to create positive ways to engage with communications.

All I know is the dataset behind it. I've only worked on the back end with stuff like this, not the user interface.

It's not even the ui side it's the policy side as handled by public health researchers who were paid a lot of money to find out which questions to use to get accurate answers while respecting people's rights (because when you don't respect a population you get inaccurate answers, people lie)

Yes, but I'm talking about how it's stored in the DB. There's birth gender and current gender. Obviously some thought would have to go into the various categories for each.

Yeah those database fields have also been fucked with in the process of this - there used to be one field and large numbers of living trans people right now have a changed birth sex marker because of transitioning. There's no way to depend on that data either. This was done wo consulting trans ppl

(as in, huge numbers of trans people got reissued fully new NHS numbers on transition for the last 40-50 years)

Also as a side note this is a GDPR problem otherwise in Euro human rights court case law to enforce it the way it is following Hungary losing a case on a trans man asylum seeker last year around keeping a database of trans people. The insistence on just ignoring trans ppl in data gathering is bad!

TERFs argued that the questions as they were previously were ambiguous and didn't capture sex assigned at birth correctly for data, but that unfortunately decenters health needs in favour of imposing a rigid sex question on trans people that almost all of us give false or contradictory answers to.

The previous questions were aimed at behaviourally focusing on getting the most health-pertinent information in a way that is relevant to the health need in emergent and urgent care.

So typically one question bundle was "what is your sex" and sometimes additionally "is it the same as the one you were registered with at birth" with the second one acting as a flag to take the answer to the first question with caution.

They effectively removed the second question and changed the first question to be more specific to registered sex at birth, but in doing so, trans ppl start guessing which health issue they are having so they can put the one the pt thinks is comfortable and/or relevant to their current health issue.

Obviously this guessing fully undermines any"accuracy" improvements and also the removal of the second question means complications due to transition are lost in emergency/urgent care.