Background to the review
This independent review was commissioned in February 2024 by the Secretary of State for Science, Innovation and Technology. The aims of the review are as follows:
- Identifying obstacles to accurate data collection and research on
sex and on gender identity in public bodies and in the research system
- Setting out good practice guidance for how to collect data on sex and gender identity
All public bodies, as defined by the Cabinet Office, are in scope of the review. The review also considers research institutions and organisations from outside the public sector, where relevant to the aims of the review. The review is UK wide, respecting the devolved nature of areas of responsibility within the research and development landscape and the collection of relevant areas of data and statistics.
This report concerns data and statistics. A further report will examine barriers to research. The review is led by Professor Alice Sullivan, University College London, assisted by policy analysts Murray Blackburn Mackenzie, and Dr Kathryn Webb, University of Oxford.
Key recommendations
This section highlights 10 key recommendations before providing the full set of detailed recommendations below.
1. In line with the UK Statistics Authority (UKSA) Inclusive Data Taskforce recommendations, [footnote 4] data on ‘sex, age and ethnic group should be routinely collected and reported in all administrative data and in-service process data, including statistics collected within health and care settings and by police, courts and prisons’.
2. Data on sex should be collected by default in all research and data collection commissioned by government and quasi-governmental organisations. By default, both sexes should be included in all research, including clinical trials, and sex should be considered as a factor in analysis and reporting. As a general rule (with some obvious exceptions), a 50/50 sex ratio is desirable in studies.
3. The default target of any sex question should be sex (in other words, biological sex, natal sex, sex at birth). Questions which combine sex with gender identity, including gender identity as recognised by a Gender Recognition Certificate (GRC) have a mixed target. Sex as a biological category is constant across time and across jurisdictions, whereas the concept of ’legal sex’ subject to a GRC may be subject to change in the future and varies across jurisdictions. Using natal sex future-proofs data collection against any such change, ensuring consistency.
4. The form of the question should follow the UK Censuses (England and Wales, Northern Ireland, Scotland) question and response categories. What is your sex? Response categories: Female, Male
5. As sex and gender identity are distinct concepts, questions which combine sex and gender identity in one question should not be asked. We have observed a trend for questions which attempt to combine sex and gender diverse identities in one question. Such hybrid questions aim to solicit information on sex from the majority of respondents but on gender identity from some respondents. As such, the target of the question is muddled. Questions that mix sex and gender risk organisations being in breach of the PSED, as they do not identify either the protected characteristic of sex or the protected characteristic of gender reassignment.
6. The word ‘gender’ should be avoided in question wording, as it has multiple distinct meanings, including: a synonym for sex social structures and stereotypes associated with sex gender identity If a question targeting gender identity is worded as a question on gender, this is likely to mislead many respondents. Questions on sex have also often been labelled as ‘gender’. Change in the use of the term ‘gender’ means that it is important that questions on sex are labelled explicitly as such.
7. The NHS should cease the practice of issuing new NHS numbers and changed ‘gender’ markers to individuals, as this means that data on sex is lost, thereby putting individuals at risk regarding clinical care, screening, and safeguarding, as well as making vital research following up individuals who have been through a gender transition across the life course impossible. In the case of children, this practice poses a particularly serious safeguarding risk, and should be suspended as a matter of urgency.
8. Questions on sex and/or gender identity should not contain an additional category for people with DSD (Disorders of Sexual Developmente) conditions, sometimes also known as ‘intersex’. People with DSD have a sex, they are not a third sex or sexless category, and to imply that they are is likely to cause offence. DSD is an umbrella term without a single agreed definition, and the question of which conditions are included is contested. Under conventional definitions, people with DSD are estimated to make up 0.018% of births, i.e. fewer than 2 in 10,000. Asking for DSD status is highly intrusive, poses a risk of identifiability, and is unwarranted given the lack of analytical use for data on such a small group. Asking for this information would need to be via a distinct question, not part of a question on sex or gender identity and is likely to be justified only in the context of specialist medical studies.
9. Data providers often default to using ONS Census questions. However, the ONS 2021 Census question ‘Is the gender you identity with the same as your sex registered at birth’ has been shown to be flawed [footnote 5]. The Office for Statistics Regulation (OSR) has stated that the statistics produced by this Census variable do not comply with important quality aspects of the Code of Practice for Statistics and has de-accredited these as official statistics [footnote 6]. This question (and variants of it) should not be used.
10. As organisations increasingly seek to collect data on gender identity, the problems identified with the ONS 2021 Census question have left a user need for a simple question which can be used in data collection with the general population. Organisations wishing to collect data on gender identity will need to be clear on the target of their question. We have identified 3 distinct possible targets for such a question: The protected characteristic of gender reassignment Trans identification Identification as trans and/or gender diverse
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