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https://www.psypost.org/secret-changes-to-major-u-s-health-datasets-raise-alarms/
I had to do a double take when I saw this article because I was on the exact team at the VA that did (part of) this. The reddit discussion is being hysterical about data loss but as the article reflects, the changes were purely to column headers and data element names-- or at least, that was what I heard during meetings. (I didn't actually make any of the changes, it was very much "not my job".) The bigger issue is that it sounds like the VA failed to advertise what happened to outside stakeholders. In case any of them are listening... the data tracks and has always tracked the sex at birth, and has never included the gender identity. The columns were called "gender" for the historical reason that the medical field didn't always view gender as being separate from sex.
In effect the whole change was just CYA thing-- the big bosses were making a stink about culture war stuff, and they spat out the easiest possible fix. So far as I know this had no actual impact on any healthcare measures. I can't rule out the existence of eCQM that include gender identity, and there's a (now-deprecated) FHIR extension for gender identity. but frankly I doubt we ever used it. Our data source didn't even keep track of ethnicity, which gets used as a supplement for basically every QDM measure.
Basically a waste of time, and therefore money. Being optimistic, maybe it'll be less confusing for measure developers, but it's hilarious to me that the conservative administration was basically ceding the point here by differentiating at the schema level that "sex" is different than "gender".
Yes, seems like a storm in the teapot. Anyone doing statistical analysis and worried about the effect of trans people will want more information on what the column actually tracks. Simply saying "the column name is gender, therefore it refers exactly to ..." is always precarious.
I think the steelman of the Republicans would be "there is only biological sex, and 'gender' is a word popularized by our enemies to imply that social roles associated with a sex are worth tracking separately".
But yes, that level of language policing is a bit funny. Not that the woke left has never purged Problematic terms when they were in power, but at least they had the fig leaf of 'it is not about ideology, but the bad term is hurting really people!'
"it's not about ideology, the bad (incorrect) term is polluting our data" seems pretty good -- we are talking about a medical database here, peoples' sex is actually a thing that matters; gender not so much.
(to the extent that it's a thing that actually exists, which I agree that the thrust here is that it's a 1:1 match with sex, and therefore would be redundant to track separately)
The problem is not the change per se. The wokes, the medical establishment and MAGA would agree that a column which tracks sex-assigned-at-birth should rather be labeled "sex" (with the wokes probably prefering "SAAB") than "gender". This is why this is such a non-story.
But I will not pretend that the thought process of whoever was doing the change was "oh no, if the Trump administration sees this, they will get really mad, because they really care about scientific accuracy. Remember what happened when someone confused atoms and ions in a grant application?" The thought process was more like "Trump clearly sees the word gender as the language of the political enemy, better remove it asap."
Arguably, it depends. If I want to study breast cancer, then I likely want to select "people with boobs", which might be more closely related to gender than sex-assigned-at-birth. Ideally, I would use both columns and select for cis-women (or cis-men). (If the database contains detailed info on gender related medical interventions, I guess studying trans people might be a possibility as well.)
I don't think silicone bags get cancer -- are estrogen induced breast deposits in males particularly vulnerable?
Is that really what they are saying now? I'll be polluting their data by answering "99" in the future.
(assuming that they want to know what's my favourite kind of SAAB )
Probably not, I do not hang out with a lot of wokes. or people generally. :)
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But you see the difference between:
and
right? Regardless of whether you agree with the latter.
In short, there is a difference between 'female' and 'female-identifying'. One is a reified claim about what someone is, one is a note about their beliefs.
To the degree that gender is a useful concept separate from sex, it is exactly a belief. (We could also rate passing, on a scale of 0 (always read male) to 1 (always read female), but that depends on effort, situation and so forth and is probably not worth the cost of measuring.)
Consider a column named "religion" (which is something the government sometimes tracks, e.g. to put on dog tags).
Sure, I could put in
Name: Sarah. Soul: None. Auxiliary Note: identifies as ensouled / Roman-Catholic.But that would be an asshole-atheist move. If I put in
religion: RCCinstead, then almost nobody is going to read that as "she has an eternal soul which she has pledged to the Roman-Catholic version of the Christian god and thus she will either go to RC heaven or RC hell, unlike the next guy who is Sunnite and will either go to that heaven or wherever bad Sunnites go" because nobody expects religion to work like in D&D.Or take the column "name". Nobody will claim that "Sarah" is her eternal True Name objectively etched in her very soul. Perhaps her parents named her "Karen" and she really hated that name and got it legally changed. Should we write:
Name assigned at birth: Karen. Auxiliary Note: trans-named / Sarah-identifyingThis I think is exactly the bone of contention behind the relabelling. To the trans, 'gender identity' is an innate characteristic that is often incorrectly assigned at birth and rediscovered later in life. That is very different from the conception that sees 'gender' as being a propaganda concept that is actually the exact same as sex and 'gender-identifying' as a category mistake at best and a mental illness at worth. That is what I mean by 'reifying' - the manner in which such things are recorded implicitly gestures towards an official attitude on them and is at least in part an attempt to take hold of the 'neutral' ground.
To take a more extreme example for illustration, if Sarah is an otherkin we do not say
Name: Sarah. Species: unicorn.If we note their weird beliefs at all, it would be as a note in the misc section.Finally, let's take your atheist example. Let's imagine a very, very atheist society in which 2% of people at most have a religion and it's regarded as a ridiculous peculiarity and evidence of schizophrenic delusion. Such a society would certainly not have a
Soulcolumn in their datasheets! Nor would they have a religion column because almost nobody has a religion and nobody cares about the people who do. They would, where appropriate, note the person's peculiarities in the misc section.I was amused to see 'Lord' and 'Lady' as potential titles on a questionnaire I was sent recently from Harley Street. You wouldn't get that in America, but you might get 'Mx' or various other formulations. The questions that are asked, and the way the answers are recorded, show society's implicit viewpoint and define common sense, so they are absolutely going to be a battleground in cases like this.
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