Medical Journal: Birth Certificate Sex Designations ‘Harmful’ for Transgender People

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The New England Journal of Medicine (NEJM) embraced “woke” culture in a recent article asserting sex designations on birth certificates “offer no clinical utility” and can even “be harmful for intersex and transgender people.”

The authors of the article, titled “Failed Assignments – Rethinking Sex Designations on Birth Certificates,” state, “We believe that it is now time to update the practice of designating sex on birth certificates, given the particularly harmful effects of such designations on intersex and transgender people.”

Vadim M. Shteyler, M.D., Jessica A. Clarke, J.D., and Eli Y. Adashi, M.D., wrote the piece in which they argue:

Recognizing that the birth certificate has been an evolving document, with revisions reflecting social change, public interest, and privacy requirements, we believe it is time for another update: sex designations should move below the line of demarcation.

Biological sex, the authors say, should join “race and parents’ marital status” and those designations that are no longer “useful” pieces of “public health information.”

They explain:

Designating sex as male or female on birth certificates suggests that sex is simple and binary when, biologically, it is not. Sex is a function of multiple biologic processes with many resultant combinations. About 1 in 5000 people have intersex variations. As many as 1 in 100 people exhibit chimerism, mosaicism, or micromosaicism, conditions in which a person’s cells may contain varying sex chromosomes, often unbeknownst to them. The biologic processes responsible for sex are incompletely defined, and there is no universally accepted test for determining sex.

“Assigning sex at birth also doesn’t capture the diversity of people’s experiences,” the authors continue. “About 6 in 1000 people identify as transgender, meaning that their gender identity doesn’t match the sex they were assigned at birth.”

“Others are nonbinary, meaning they don’t exclusively identify as a man or a woman, or gender nonconforming, meaning their behavior or appearance doesn’t align with social expectations for their assigned sex,” they add.

“Now that the U.S. Supreme Court has held, in Obergefell v. Hodges, that bans on same-sex marriage are unconstitutional, only a few legal contexts relying on sex designations remain,” the authors further argue.

Others in the medical community and elsewhere, however, took to Twitter to disagree.

According to his bio, Shteyler, a clinical assistant professor of medicine at Brown University, “writes on the intersections of gender theory and medicine,” while Clark’s bio notes she is a professor of law at Vanderbilt Law School where her research “focuses on American equality law.”

A professor of medical science, Adashi is a member of the National Academy of Medicine and a former advisor to the World Health Organization, the World Bank, the Rockefeller Foundation, and the Bill and Melinda Gates Foundation, his bio at Brown University states.

The authors argue the medical community must no longer simply report scientific medical news.

“Today, the medical community has a duty to ensure that policymakers don’t misinterpret the science regarding sex and that medical evaluations aren’t being misused in legal contexts,” they conclude.


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