Select Administrative Sex

Man, I thought I was going to get an intern under my desk or something.

Imagine my surprise.

This is from the profile interface for an online health thing.  The madness proceeds.  Literally the only truth written in every cell of your body is your sex; XY or XX.  It’s not an administrative matter, although I appreciate the nod to data sanity.  It’s the rest of the sanity we miss, and will pay for dearly.

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11 thoughts on “Select Administrative Sex”

  1. According to the CDC, a government agency, you should have SIX choices…

    Please see: https://phinvads.cdc.gov/vads/ViewValueSet.action?id=06D34BBC-617F-DD11-B38D-00188B398520

    For example, I obviously would be a type “M”, while most would interpret a sock puppet to be a type “O”.  Some might think a sock puppet might be a type “A”, many would argue this, saying maybe a “M” or a “U”. Obviously not a type “F”, (otherwise they would be pantyhose). But the most serious of thinkers might suggest a type “N”. Still I would lay my bets on sock puppets being a type “O”.

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  2. Gerry D:
    According to the CDC, a government agency, you should have SIX choices…

    That has a 2007 date.

    On the one hand, that shows how useless George W. Bush was.

    On the other hand, the limited number of choices is now likely deemed a hate crime.

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  3. Just typing “administrative sex” into a search engine opens up a pretty amusing rabbit hole.  Consider this document from the “Center for American Progress”:

    In addition to current gender identity and sex assigned at birth, it is critical to ask patients their preferred name and gender pronoun. This information should be used consistently by clinical staff in all conversations with or about the patient. Use of a name or pronoun that does not match that person’s current gender identity is stigmatizing and creates a hostile environment that can cause the patient to not return for health care in the future, or even to file a formal complaint of discrimination. Preferred pronouns are she/her/her for transgender women and he/him/his for transgender men. Some patients, especially younger patients, may identify outside of the gender binary and not identify strictly as male or female. These patients may prefer gender neutral pronouns that can include they/them/their or other, new pronouns such as ze/zir/zir.  It’s important to ask the patient what pronoun the patient wants to use and use it consistently.

    It is important to note that the HL7 codes for “administrative gender” are separate and distinct from current gender identity and assigned sex at birth. Administrative gender data should only be used as necessary, such as for insurance billing purposes (though this use is rapidly becoming obsolete as rules regarding insurance coverage for transgender individuals change), and should not be used for identifying, housing, or communicating with patients.As an example, consider a transgender woman (assigned male sex at birth, current gender identity is female).
    The relevant data in the record would be:

    • Current gender identity: SNOMED code “identifies as female gender” or “transgender woman”
    • Assigned sex at birth: SNOMED code “male”
    • “Sex”/Administrative gender: preferentially HL7 code “female”

    Regardless of the data in the administrative gender field, this individual should be referred to as “she” and “her” throughout her time in the clinical setting. Similarly, identification such as a wristband should indicate this individual’s sex as “female,” and in sex-segregated circumstances like room assignments, she should be housed according to her female gender identity.

    Note that according to this transgender women do not have a possessive pronoun.

    Here’s one from “Bioclinica”, which seems to be in the clinical trials racket business:

    Typically, clinical trials allow for a “self-reported” sociological gender. This is used for bed assignments and general grouping, but has little to do with the actual outcome of the clinical trial in most cases (unless an investigative compound causes a subject to exhibit behavioral traits of the opposite gender, which would certainly be a notable side effect).

    Analyzing Sex and Gender Data in Clinical Trials

    When it comes to analyzing data in clinical trials, it is more important to understand the clinical, chromosomal or biological sex of the subject.  This is critical when looking at lab results and comparing efficacy across groups. While this may seem like a straightforward situation, the collection of this information can be tricky.  Different standards organizations have gone about defining the collection of sex in different ways. Health Level Seven (HL 7), a global authority on standards for interoperability of health information technology, has an Administrative Sex Value that offers six choices: Ambiguous, Female, Male, Unknown, Not Applicable, Other.

    That’s a little more complicated than what we learned in middle school health class, isn’t it?

    Determining gender gets even more complex. The HL7 comments concerning their Administrative Gender Code state that: Gender is a complex physiological, genetic, and sociological concept that requires multiple observations in order to be comprehensively described. Not exactly checking a box!

    Heh—“certainly be a notable side effect”.

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  4. John Walker:
    (unless an investigative compound causes a subject to exhibit behavioral traits of the opposite gender, which would certainly be a notable side effect).

    The word “opposite” legitimizes the binary.

    Imagine, however, the horror of a modern clinical researcher confronted with some drug that turned a patient cis.

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  5. RightAngles:
    Haakon Dahl:
    Man, I thought I was going to get an intern under my desk or something.

    I’ll scratch her eyes out

    If she’s under Haakon’s desk, she likely is already blind. Or at least blindfolded.

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