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Views And Reviews No Holds Barred

Margaret McCartney: Medicine must do better on gender

BMJ 2018; 360 doi: (Published 26 March 2018) Cite this as: BMJ 2018;360:k1312
  1. Margaret McCartney, general practitioner
  1. Glasgow
  1. margaret{at}
    Follow Margaret on Twitter at @mgtmccartney

Medicine has a shameful history when it comes to sex, gender, and identity. Attempts have been made to “fix” sex, for example, by intervening surgically to “normalise” the genital appearances of intersex people. This happened despite a lack of evidence of benefit and showed disregard for individuals’ feelings over time12—including a lack of full information about their own condition or support, especially regarding fertility. Even well intentioned medicine can do grievous harm.

In recent years terms such as “non-binary” and “gender fluid” have entered the mainstream. The Office for National Statistics may make declaration of sex voluntary in the 2021 census, out of concern that it discriminates against and offends transgender people.3 NHS IT systems don’t respond flexibly: for example, transgender men may …

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