Hospital Spaces in NHS England must now be assigned by 'biological sex'

[Tills]

Trans patients should be cared for on single-sex hospital wards or bays that align with their biological sex rather than their gender identity, according to new NHS England (NHSE) guidance.

BBC by Alison Holt, Social affairs editor and James Melley, senior social affairs producer

Trans patients should be cared for on single-sex hospital wards or bays that align with their biological sex rather than their gender identity, according to new NHS England (NHSE) guidance

It says when this is not "clinically appropriate" then alternative arrangements should be made and the dignity and safety of all patients should be maintained.

The guidance also says staff facilities should be used by people based on their biological sex, while trusts should ensure enough alternatives to single-sex facilities, such as single-occupancy toilets, are offered.

Previous NHSE guidance suggested patients and staff could be accommodated on wards or use facilities based on their gender identity.


https://www.bbc.co.uk/news/articles/cry83dyddv6no 🔗

[Tills]

Anyone in any doubt as to why I want to emigrate from the UK !!!

Imho the UK is becoming one of the worst countries in which to be us, certainly in Europe.

And this lazy attribution of terms like "trans people" and "biological sex" continues.

As I've said repeatedly, a 'trans person's' biological sex is not that which is assigned at birth. That's part of the whole point of gender incongruence and why the term 'biological' is slapped around without anyone seemingly pausing to question what it actually means in this or any other context.

Biological = connected to life or living processes

xx

[KathyLauren]

This is one reason why I decided not to get British passport, even though I am eligible for one.  If things go down the tubes here and I need to move to another country, it will not be the UK.

The term "biological sex" refers to what a field biologist can observe through binoculars when scanning a herd of wildebeest or other animals.  In other words, external genitalia.  The idea that biological sex is the same as sex assigned at birth is not one supported by biologists. 

[Devlyn ✅]

I wonder if the hallways so many people are kept in rather than rooms are single sex wards...

[Tills]

I wonder if the hallways so many people are kept in rather than rooms are single sex wards...

😂😂😂

I mean I shouldn't laugh because what you rightly refer to is appalling, but that was funny.

p.s. my sister recently had just this experience. A really nasty case of pneumonia and spent the first night being treated in a corridor.

[Devlyn ✅]

I'm sorry to hear that, Tills. The state of the NHS isn't good.

[Lori Dee ✅]

I'd like a bed in the single-sex basement next to the boiler room, please.

[Tills]

This is one reason why I decided not to get British passport, even though I am eligible for one.  If things go down the tubes here and I need to move to another country, it will not be the UK.

The term "biological sex" refers to what a field biologist can observe through binoculars when scanning a herd of wildebeest or other animals.  In other words, external genitalia.  The idea that biological sex is the same as sex assigned at birth is not one supported by biologists. 

I'm with you 100% Kathy Lauren on everything you have written.

I'm taking steps to emigrate but I ought to resume that discussion elsewhere.

xx

[Tills]

This is one reason why I decided not to get British passport, even though I am eligible for one.  If things go down the tubes here and I need to move to another country, it will not be the UK.

The term "biological sex" refers to what a field biologist can observe through binoculars when scanning a herd of wildebeest or other animals.  In other words, external genitalia.  The idea that biological sex is the same as sex assigned at birth is not one supported by biologists. 

In order to keep this part of the forum news orientated, I've developed my response to this announcement over here: https://www.susans.org/index.php?topic=250751.new#new

xx

[Sarah B ✅]

Hi Everyone

Kathy,you said:

The term "biological sex" refers to what a field biologist can observe through binoculars when scanning a herd of wildebeest or other animals.  In other words, external genitalia.  The idea that biological sex is the same as sex assigned at birth is not one supported by biologists.

I respectfully disagree with that description of biological sex.  It confuses the way sex may be observed or identified with the biological characteristics that define it.

There are a few useful definitions from major scientific and medical institutions which will help clarify the distinction.

NIH, Office of Research on Women's Health: "Sex is a biological classification that is encoded in every individual's DNA.  It is defined by the genetic complement of sex chromosomes, with males having XY sex chromosomes and females having XX sex chromosomes" [1].

Endocrine Society: "The classical biological definition of the 2 sexes is that females have ovaries and make larger female gametes (eggs), whereas males have testes and make smaller male gametes (sperm); the 2 gametes fertilize to form the zygote, which has the potential to become a new individual" [2].

National Academies of Sciences, Engineering and Medicine: "Sex is a multidimensional construct based on a cluster of anatomical and physiological traits that include external genitalia, secondary sex characteristics, gonads, chromosomes and hormones" [3].

Taken together those definitions give us a clearer picture.

Biological sex in humans and other mammals is reflected in a correlated suite of reproductive traits including chromosomes, gonads, hormones and reproductive anatomy.  Sex recorded at birth is usually inferred from external genital anatomy because that anatomy ordinarily corresponds with the other sex characteristics.  In approximately 98% of cases external genitalia accurately identify biological sex.  In atypical or intersex cases further investigation may be required.

So external genitalia are evidence of biological sex.  They are not the definition of biological sex.

That is also why a doctor or nurse can normally record a newborn as male or female simply by examining the external genitalia.  If something is ambiguous or atypical then further investigation may be necessary.

Tills, you said:

As I've said repeatedly, a 'trans person's' biological sex is not that which is assigned at birth.  That's part of the whole point of gender incongruence and why the term 'biological' is slapped around without anyone seemingly pausing to question what it actually means in this or any other context.

There is a distinction worth making here.

Gender incongruence refers to a person's gender identity or gender expression differing from the sex recorded at birth.  It does not mean that the person's biological sex was incorrectly identified at birth.

Medical transition can subsequently alter some sex characteristics such as hormone levels, secondary sex characteristics or anatomy.  That is a separate question from whether the sex recorded at birth accurately reflected the person's biological sex at the time [2].

So two different concepts are being mixed together here.  Biological sex describes biological characteristics.  Gender incongruence describes the relationship between a person's gender identity or expression and the sex recorded at birth.

References:
[1] Office of Research on Women's Health.  (n.d.).  Sex as a biological variable (SABV) primer course: Instructor guide.  National Institutes of Health.  https://orwh.od.nih.gov/sites/orwh/files/docs/InstructorGuideSABVPrimer_final_508.pdf 🔗

[2] Bhargava, A., Arnold, A.  P., Bangasser, D.  A., Denton, K.  M., Gupta, A., Hilliard Krause, L.  M., Mayer, E.  A., McCarthy, M., Miller, W.  L., Raznahan, A.  & Verma, R.  (2021).  Considering sex as a biological variable in basic and clinical studies: An Endocrine Society scientific statement.  Endocrine Reviews, 42(3), 219–258.  https://doi.org/10.1210/endrev/bnaa034 🔗

[3] National Academies of Sciences, Engineering and Medicine.  (2022).  Measuring sex, gender identity and sexual orientation.  The National Academies Press.  https://doi.org/10.17226/26424 🔗

Best Wishes Always
Sarah B
Global Moderator
@Tills @KathyLauren

[Tills]

I'm sorry @Sarah B but this is part of the problem.

You have taken one set of biological markers and excluded so many others. We already know that there are intersex states, which you haven't mentioned despite some members on here having been born intersex. Intersex is one illustration of why you cannot slap binary assignation on individuals without understanding the complexities involved.

There are also a huge range of other "Biological sex" markers that are deliberately ignored as part of a trans exclusionary agenda.

These include, but are not limited to, chromosome variations, alleles, receptors, aromatase, neurons and neural plasticity, hydroxylation, astrocytes, hormone ranges and hormone endocrines (which are never tested at birth), brain signals and receptors including the pituitary gland and the hypothalamus, mental congruence and incongruence etc. etc. the list is almost endless and complex, never tested at birth for variance and (of course) some of this variation develops later into what some people delineate as gender incongruence. But gender incongruence rarely occurs in a vacuum. It can have environmental triggers (nurture) but even these are almost always rooted in antecedent biological markers (nature) which are every bit as much a part of biological sex .

There's plenty of evidence that hormone differences, for example, can be incongruent with external genitalia just as brain function can be incongruent with the bodily presentation. That's not just a lesser 'gender'. It's bound up with biological sex. You cannot separate them without descending into reductionism, which is never a good thing. You cannot separate out one part of the bodily function from others and say, in true reductionist fashion, that this is the defining characteristic. It's this sort of casual acceptance which, for example, leads people to assume that mental ill-health is somehow not related to physicality. That somehow the brain exists in a vat.

@KathyLauren is correct and, with respect, our community has made a mistake in letting this lazy adoption of the term 'biological sex' (mostly by non-medics by the way) to be stamped without greater understanding of the complexities of sex and gender. This is an age where nuance is sacrificed to understanding. Don't let this place go that way too.

Throughout my childhood my mother used to joke that she thought my chromosomes must have been mixed up. As it happens over 50 years later during some blood testing they discovered that I do, indeed, have a chromosome mutation (they prefer the term 'variance' now). That chromosome mutation was never tested at my birth, so the body with which I was assigned was incongruent. That's biological ...

Not gender. Sex. Wrongly labelled. Because like most binary thinking, and most labelling, it's simplistic. And simplistically wrong.

xx

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[Tills]

So I think you're wrong in your narrowly conceived and reductionist definition @Sarah B both from a biologically gender and sex perspective. But I'll leave it there as I don't generally find the internet a helpful place and I come on this forum for a supportive space. And this thread was really meant to be posting a news item rather than a wider discussion.

xx

[Finally Anna]

Disclaimer: Just my tuppence, and I am not defending those rules, absolutely not.

What the lawmakers are after is not really based on the definition, if there even is a universal one, of biological sex etc.

I think they want mainly two things: One is to appear "correct" in the eyes of the public, one is to define rules that ensure safety for all (read: cis women). Meaning to avoid any backlash from whatever things that could happen. "We have rules. Those have not been followed. It is not our (politicians) fault".

The problem is that it is not possible to define a rule, or several rules, that covers all aspects of this so called "problem". There is a rather wide spectrum here, and to then put down rules that define who goes where will be a fail regardless of how those rules are written. For a system that works best, there needs to be a case-by-case decision and that can only be handled by the staff doing the work and in cooperation with the patients.

[Tills]

I think another way of putting it is that those lawmakers are:

Pandering to a bigoted populace
Pandering for votes
Pandering to a powerful elite who run the media and outlets

Based on morality, ethics, or integrity it is not.

xx

[Tills]

And it's not just us. It's going on across the board.

Rulers and their majorities love to discriminate. Scapegoating is essential to this and sits within prejudice theory. All societies use it as a means of control. Set up a scapegoat, vilify them, then cast them out into the desert = the scapegoat.

As per René Girard:


Key Mechanisms

• Frustration-Aggression: When people face economic depression, social instability, or personal failure, their frustration builds up and looks for an outlet.
• Selection of Targets: The chosen scapegoat is usually a minority, an immigrant group, or someone with low power who cannot easily fight back.
• Catharsis and Cohesion: Uniting against a common enemy gives the dominant group a false sense of relief, moral clarity, or temporary social peace.


René Girard's Mimetic Scapegoat Theory

• Mimetic Desire: French theorist René Girard argued that humans naturally imitate each other's desires, which inevitably turns friends and neighbors into rivals.
• The Scapegoat Mechanism: As rivalry and social tension peak, a community projects all its collective violence onto a single arbitrary victim.
• Restoring Order: Eliminating or banishing the victim purges the community's pent-up aggression and temporarily restores order.

[Petunia]

I can't argue one way or the other.

But what does it really matter what definition of assigned at birth matters in the case of hospital admissions?

This is a non binary issue made into a pollictcal football rather than looking at the real issue of not enough beds and not enough medical staff