MONTREAL – Non-binary Montrealer Alexe Frédéric Migneault entered day six of a hunger strike on Saturday as part of a bid to pressure Quebec’s public health insurance board to add a third...
Maybe there should be two entries: the gender they identify with, and the sex assigned at birth. One would be used to address the patient, the other would be useful for medical diagnosis and treatment.
And while we are at it, a few people are born with undifferentiated sexual organs, so it could make sense even for medical purposes to include a third option beyond male and female, rare as it might be.
Medical health approaches for trans folks are actually their own separate thing because they have to take into account effects of hormone therapy. Including this could raise awareness and preparedness at medical facilities, so it’s not a bad idea at all. Either the individual on the hunger strike is on HRT and has had shit service at medical facilities where staff probably had no clue, or they’re just highly sympathetic.
edit: (I’m using “trans” here as an umbrella term including non-binary individuals, in case anyone wasn’t sure.)
I don’t know why you were downvoted, but this is a good idea. I recently read an article about how Canada is the first country to provide an option for trans and nonbinary people in the census, and Quebec could definitely do something similar.
Beginning in 2021, the precision of “at birth” was added to the sex question on the census questionnaire, and a new question on gender was included. As a result, the historical continuity of information on sex was maintained while allowing all cisgender, transgender and non-binary individuals to report their gender.
This is actually how it’s handled in a lot of electronic medical records. There is a different indicator for sex/gender assigned at birth and current gender. I’ve not seen a specific indicator for intersex, but I’ve not encountered an intersex patient so far in my career.
I have similar thoughts for a solution- just don’t have any sex or gender indicators on ID cards. Have a whole separate medical card that isn’t for identification. You keep it in your wallet in case you’re ever in an emergency, and doctors will use it to know if they should treat you like an xx or an xy or something else if it so applies. It could have a list on the back where you write any current medications, so a Dr knows what interactions your body might have to any treatments. This would be useful if, for example, you’re a female presenting biologically xy Trans person who shows up unconscious in an ambulance. Then the doctor can look at that person’s card and say “I will give this person the medical care that an XY person needs” vs saying “this person’s ID card says male but they look female, should the treatment be for a man or a woman?”
As a non medical professional I’m sure I am oversimplifying the ordeal and glossing over important points, but it’s just something I’ve thought a lot.
I’m not sure you fully understand the issue. This isn’t merely about catering to a patient’s preference to be addressed in a certain way. For some, the sex / gender assigned at birth is actually wrong, and continuing to carry that information serves no purpose but to cause harm.
What is the process for assigning gender at birth anyway? People look at the baby’s genitals and make a guess. For 99% of babies, that heuristic works. But it turns out that some people are trans or intersex, and that wrong guess causes nothing but trouble.
Don’t think that the assigned gender at birth is medically useful information, either. There are dozens of intersex conditions, and crudely categorizing people into two or three bins is too simplistic.
In short, it’s complicated. The same solution is to trust that people are whatever gender they say they are, and if they need medical services, talk to them about what they need, instead of forcing them into a life course based on a genital inspection that happened years ago.
I’m not sure you fully understand the issue. This isn’t merely about catering to a patient’s preference to be addressed in a certain way
…which is why I suggested differentiating between the way the patient would like to be addressed from their biological sex, and storing both in the health card.
What is the process for assigning gender at birth anyway? People look at the baby’s genitals and make a guess. For 99% of babies, that heuristic works. But it turns out that some people are trans or intersex, and that wrong guess causes nothing but trouble.
You appear to be conflating gender an sex. Sex is biological, while gender is a social construct. We assign sex at birth, and infer gender from that sex.
In trans people, the two do not match, which sometimes leads to disphoria. The sex assigned at birth is still accurate, but the gender that was inferred from it is not.
In intersex people, their biological sex is difficult to determine and often doesn’t fit a simple binary (e.g. XXY chromosomes or androgen insensitivity).
The same solution is to trust that people are whatever gender they say they are
There is nothing to trust about their gender, we can respect their self-identity or we don’t. As for their biological sex, it’s a significant piece of medical information. If somebody feels uncomfortable stating it clearly on their health card, they can choose not to fill it out, but for the immense majority of us it is a non-issue.
That’s the crux of the issue here: someone does feel the need to not fill out the field (i.e. filling it in with an “X”), and the health authority is forcing them to use either “M” or “F”. They are fighting for that right because they are intersex or trans, but an identity card with one or two fields is not the place to explain, because biology is complex. For medical information, you read their medical charts or talk to the patient.
They are fighting for that right because they are intersex or trans
Where did you get that? The article indicates that they are non-binary. That is neither intersex nor trans.
That’s the crux of the issue here: someone does feel the need to not fill out the field (i.e. filling it in with an “X”), and the health authority is forcing them to use either “M” or “F”
But the person in question is non-binary, which is a gender identity unrelated to their sex. It is perfectly possible that this person feels perfectly okay with a health card that indicates that their gender identity is non-binary while their sex is binary. In that case, separating gender from biological sex in their health card would address the issue at hand, particularly since nothing would prevent both fields to be left empty if they so choose.
As for why it makes sense to specify the biological sex in their health card, it is a medically useful piece of information that 99% of the patients would have no problem recording. Don’t forget that patients are not always able to communicate at the time they are in need to health care. So, again, if it is useful and non-controversial for 99% of the patients there’s no reason to remove it, just provide a way for patients to opt out of a simple M/F choice if they wish to.
Maybe there should be two entries: the gender they identify with, and the sex assigned at birth. One would be used to address the patient, the other would be useful for medical diagnosis and treatment.
And while we are at it, a few people are born with undifferentiated sexual organs, so it could make sense even for medical purposes to include a third option beyond male and female, rare as it might be.
Medical health approaches for trans folks are actually their own separate thing because they have to take into account effects of hormone therapy. Including this could raise awareness and preparedness at medical facilities, so it’s not a bad idea at all. Either the individual on the hunger strike is on HRT and has had shit service at medical facilities where staff probably had no clue, or they’re just highly sympathetic.
edit: (I’m using “trans” here as an umbrella term including non-binary individuals, in case anyone wasn’t sure.)
I don’t know why you were downvoted, but this is a good idea. I recently read an article about how Canada is the first country to provide an option for trans and nonbinary people in the census, and Quebec could definitely do something similar.
https://www150.statcan.gc.ca/n1/daily-quotidien/220427/dq220427b-eng.htm
This is actually how it’s handled in a lot of electronic medical records. There is a different indicator for sex/gender assigned at birth and current gender. I’ve not seen a specific indicator for intersex, but I’ve not encountered an intersex patient so far in my career.
I work in medical IT and see pronouns for patients listed with the patient info (UC Davis). So we are logging that information too.
I have similar thoughts for a solution- just don’t have any sex or gender indicators on ID cards. Have a whole separate medical card that isn’t for identification. You keep it in your wallet in case you’re ever in an emergency, and doctors will use it to know if they should treat you like an xx or an xy or something else if it so applies. It could have a list on the back where you write any current medications, so a Dr knows what interactions your body might have to any treatments. This would be useful if, for example, you’re a female presenting biologically xy Trans person who shows up unconscious in an ambulance. Then the doctor can look at that person’s card and say “I will give this person the medical care that an XY person needs” vs saying “this person’s ID card says male but they look female, should the treatment be for a man or a woman?”
As a non medical professional I’m sure I am oversimplifying the ordeal and glossing over important points, but it’s just something I’ve thought a lot.
I’m not sure you fully understand the issue. This isn’t merely about catering to a patient’s preference to be addressed in a certain way. For some, the sex / gender assigned at birth is actually wrong, and continuing to carry that information serves no purpose but to cause harm.
What is the process for assigning gender at birth anyway? People look at the baby’s genitals and make a guess. For 99% of babies, that heuristic works. But it turns out that some people are trans or intersex, and that wrong guess causes nothing but trouble.
Don’t think that the assigned gender at birth is medically useful information, either. There are dozens of intersex conditions, and crudely categorizing people into two or three bins is too simplistic.
In short, it’s complicated. The same solution is to trust that people are whatever gender they say they are, and if they need medical services, talk to them about what they need, instead of forcing them into a life course based on a genital inspection that happened years ago.
…which is why I suggested differentiating between the way the patient would like to be addressed from their biological sex, and storing both in the health card.
You appear to be conflating gender an sex. Sex is biological, while gender is a social construct. We assign sex at birth, and infer gender from that sex.
In trans people, the two do not match, which sometimes leads to disphoria. The sex assigned at birth is still accurate, but the gender that was inferred from it is not.
In intersex people, their biological sex is difficult to determine and often doesn’t fit a simple binary (e.g. XXY chromosomes or androgen insensitivity).
There is nothing to trust about their gender, we can respect their self-identity or we don’t. As for their biological sex, it’s a significant piece of medical information. If somebody feels uncomfortable stating it clearly on their health card, they can choose not to fill it out, but for the immense majority of us it is a non-issue.
That’s the crux of the issue here: someone does feel the need to not fill out the field (i.e. filling it in with an “X”), and the health authority is forcing them to use either “M” or “F”. They are fighting for that right because they are intersex or trans, but an identity card with one or two fields is not the place to explain, because biology is complex. For medical information, you read their medical charts or talk to the patient.
Where did you get that? The article indicates that they are non-binary. That is neither intersex nor trans.
But the person in question is non-binary, which is a gender identity unrelated to their sex. It is perfectly possible that this person feels perfectly okay with a health card that indicates that their gender identity is non-binary while their sex is binary. In that case, separating gender from biological sex in their health card would address the issue at hand, particularly since nothing would prevent both fields to be left empty if they so choose.
As for why it makes sense to specify the biological sex in their health card, it is a medically useful piece of information that 99% of the patients would have no problem recording. Don’t forget that patients are not always able to communicate at the time they are in need to health care. So, again, if it is useful and non-controversial for 99% of the patients there’s no reason to remove it, just provide a way for patients to opt out of a simple M/F choice if they wish to.