Stop conflating sex and gender, NHS told by watchdog

Yahoo

28-01-2025

The NHS has been told by a watchdog to stop confusing the terms 'sex' and 'gender' in official data.
NHS England was accused of conflating the two terms in its staff survey, which asked about 'gender discrimination' and whether a person's gender had an impact on career progression, rather than their sex.
The complaint by the Sex Equality and Equity Network for NHS employees (SEEN in Health) said it had been 'inundated with concerns from employees' about the data being collected from the health service's 1.5 million staff.
Some staff are understood to have boycotted the data collection because of concerns about its accuracy.
The tangling of sex and gender throughout means 'analysts will be unable to determine progress made to reduce sexual harassment towards women', SEEN in Health said.
The UK Government defines sex as 'referring to the biological aspects of an individual' while gender is 'where an individual may see themselves as a man, a woman, as having no gender, or as having a nonbinary gender'.
The Office for Statistics Regulation (ORS), the stats watchdog, has agreed that the NHS must improve the clarity in its survey for 2025, in a letter seen by The Telegraph.
Ed Humpherson, the director general for regulation at the ORS, wrote: 'We consider that NHS England should look to provide clearer guidance and definitions to both survey respondents and data users in future surveys.'
In one question, NHS staff were asked: 'Does your organisation act fairly with regard to career progression/promotion, regardless of ethnic background, gender, religion, sexual orientation, disability or age?'
But it failed to list all protected characteristics under the Equality Act, which includes sex or gender reassignment, despite 'previous staff surveys indicating high rates of sexual harassment of women', SEEN in Health said.
The network also said it failed to 'ask the respondent if they have experienced sex discrimination, despite the NHS introducing the Sexual Safety in Healthcare charter [last] year'.
'As with the previous question 'gender' has no legal basis and the NHS cannot assume that all respondents will understand that gender, in this instance, presumably refers to sex,' it said.
The next question asked about staff's 'experiences of unwanted behaviour of a sexual nature', but the group argued the previous conflation and errors in use of the terms meant it would not give an accurate picture of 'progress made to reduce sexual harassment towards women'.
Further questions ask staff for information on the gender that best describes them, with the critics saying 'the survey also compels, by way of not including an option to state 'do not have a gender identity' in 27a, respondents to acknowledge a belief they may not have'.
The NHS uses the data collections to inform its internal activity including recruitment and communications, such as through the establishment and promotion of equality, diversity and inclusion teams and their work.
Mr Humpherson said while the official statistics could not be 'declassified' because they had not been accredited and that it was not within the OSR remit to determine their legality, the concerns could be escalated to the Equality and Human Rights Commission.
He said the OSR 'agree that there is scope for NHS England to be clearer about which concept the survey is aiming to collect and that a lack of clarity could result in the distinct concepts of sex and gender identity being conflated'.
The OSR last year set out its own updated guidance on the collection of gender identity data.
The results from the 2024 edition of the NHS questionnaire, which reveals insights into staff morale, workload, and pressure, as well as issues such as bullying, discrimination and harassment, are yet to be published.
The OSR said NHS England had agreed to review the terminology it would use in its 2025 survey.
Fiona McAnena, director of campaigns at human-rights charity Sex Matters, said: 'Yet again we see people who should know better describing this as 'a complex and evolving area'. The simple reality is that everyone is either male or female, no matter what they feel or say about their 'identity'.
'Everyone knows what sex they are, and when data about sex is needed, it's perfectly reasonable to ask a straight question and expect an honest answer.
'This is the approach that all public authorities should take in order to restore accuracy and robustness to official statistics across the board.
NHS England was asked for comment.
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