BMJ study: ‘Doctors risk patient safety by confusing sex and gender’

Doctors who deliberately confuse sex and gender could be putting patients at risk of being given “ineffective” or “inappropriate” treatments, a new study has indicated.

Senior medical researchers from the University of St Andrews say the significance of biological sex is being ignored by some medical practitioners, which can result in male or female-specific treatments being offered to the wrong people.

In their study, published in the British Medical Journal, the researchers explained that in cases where transgender patients have been taking cross-sex hormones for a long period, they may respond differently to treatments for medical conditions.

‘Avoidable harm’

Dr Margaret McCartney, of the University’s medical school, said: “There are many instances of sex and gender being confused by the research community and society more broadly.

“Unless we identify and count categories correctly, we will end up with errors which serve all populations poorly, including minority populations.”

Avoidable harm may result when they are conflated

Susan Bewley, an expert in women’s health at King’s College London, said: “Medical care requires an understanding of the difference between sex and gender categories; untangling them is crucial for safe, dignified, and effective healthcare of all groups.

“Avoidable harm may result when they are conflated — for example, if sex specific laboratory reference ranges are used for people whose gender is recorded but not their biological sex or hormone prescription.”

Safety risks

The warnings come as the National Institute of Health and Care Excellence (NICE) said the evidence of clinical effectiveness and safety of giving cross-sex hormones to people who wish to ‘change sex’ is of “very low” quality.

In its review, commissioned by NHS England, it said: “Any potential benefits of gender-affirming hormones must be weighed against the largely unknown long-term safety profile of these treatments in children and adolescents with gender dysphoria”.

NICE also said existing studies which support giving puberty-blocking drugs to gender-confused children are “subject to bias and confounding”.

Reviewing the impact the drugs had on gender dysphoria, mental health and quality of life, the researchers stated: “The quality of evidence for these outcomes was assessed as very low certainty.”