How did the GMC come to record the ‘gender’ of doctors and not their sex?
The General Medical Council (GMC) is the statutory regulator of medical doctors in the UK. Doctors who practise medicine in the UK must hold a registration with a licence to practise.
The medical register allows members of the public to search for a doctor by their name or registration number to check that her/his licence is valid. When a doctor dies, retires or otherwise relinquishes registration, this is noted in their register entry but records are not deleted.
For every doctor, information on their fitness to practice history, qualifications, whether they are on the GP register, etc is shown for all to see and verify.
As is their ‘gender’.
‘Gender’ is only ever a binary female or male in their register, so do they mean sex, not ‘gender’?
But why, of all organisations, does the GMC use the term ‘gender’?
This is a typical entry (Dr Adrian Anthony Harrop):
Just ask any woman in need of intimate medical care: it matters a lot for reasons of dignity, modesty, privacy, well-being, religion, past abuse and safety.
As Maya Forstater puts it:
It is a basic matter of consent that patients can choose to be seen (at least for primary care) by a doctor or nurse of a particular sex. No justification is needed, but obvious reasons include feeling more comfortable, religious codes of modesty or a history of abuse or trauma. Intimate examinations in particular can be embarrassing or distressing, and it is common that girls and women prefer to be seen by a female healthcare professional for these procedures.
It should go without saying, but when someone is putting their fingers inside your vagina, consent matters.
But if the GMC records the ‘gender’ of doctors, how is anyone supposed to know the sex of their doctor?
First, how did the GMC come to record ‘gender’?
To try to understand how the GMC came to use the term ‘gender’ instead of sex, I submitted a request under the Freedom of Information Act 2000. The GMC were very helpful and provided what information they had.
I note your website has a copy of The General Medical Council (Form and Content of the Register) Regulations 2015. This supersedes The General Medical Council (Form and Content of the Registers) Regulations No 2 2010 of which I also have a copy. This, in turn, superseded The General Medical Council (Form and Content of the Register) Regulations 2010. I am also aware of the 2007 issue of these regulations but I don’t know if there were any intervening issues but I assume there were earlier issues of this regulation.
Paragraph 5 of the 2015 regulations states:
Under the Freedom of Information Act 2000, please provide copies of the 2010 regulations and copies of all earlier superseded regulations that define the entries in the register of medical practitioners as required by Section 2 of the Medical Act 1983.
It would also be helpful if you could provide copies of any equivalent regulation or other statement that defines what details were entered in the medical register before the Medical Act 1983 and by any of the GMC’s predecessors.
As you know the issue prior to the current (2015) FCR was in 2010 when two versions were issued, superseding the 2007 issue. I have conducted searches of archives to locate historical issues, and collated all that we hold in the attached bundles. One bundle is for FCR [Form and Content of the Register] deriving from the Medical Act 1983 as the primary legislation, and the second bundle contains older issues of equivalent rules. The older versions of the information are contained in Council Committee minutes, or form part of broader Medical Practitioners Registration Regulations. We believe there was also a 1996 Regulation (in addition to the 1996 regulation for Limited Registration in the bundle) but we do not hold a copy.
So, the entries in the GMC’s medical register are prescribed in regulations the Council makes in exercise of powers conferred by section 31 (1) and (2) of the Medical Act 1983 (as amended), and these regulations have changed over the years.
Working back in time (click on the year to read the details):
The current regulations.
The GMC labelled this as post the 1983 Act.
The GMC labelled this as pre the 1983 Act.
In summary, the regulations required the medical register to record:
So, accepting that there may be omissions from all this, ‘gender’ was in use in 2006, it was man and woman before that (with an option for women to add Miss or Mrs), and before that, the default was a doctor was a man, and a woman was identified by Miss or Mrs (or by her title if it was clear that was a female title, perhaps such as Lady or Baroness).
However, given the number of new versions of these regulations produced this century, the gap between 1996 (where it said man or woman) and 2006 (where it said ‘gender’) is odd, but maybe it really didn’t change that much in those pre-digital days, particularly since the earlier regulations mandated the use of individual card records stored in locked metal filing cabinets:
The different changes are interesting and no doubt some of the earlier — somewhat awkward — constructions reflect a desire to at least try to shake off an old-fashioned patriarchal image — although it is interesting they unashamedly used the word sex in 1969.
However, it looks like that at least as far back as 2006, they used the word ‘gender’ and in those more innocent times, they probably were just trying to be polite but did actually mean sex. However, this was shortly after the Gender Recognition Act of 2004, so it could be they thought they were being ‘progressive’ in using the term ‘gender’.
Note also the change in personal pronouns, starting out with just ‘his’ (in 1969), moving to ‘his and hers’ (in 1969) and then onto ‘their’ (in 2010)! I assume the latter change was in response to calls for ‘gender-neutral’ drafting.
A change to the term they use for the sex of doctors would require a formal change to those Form and Content of the Register regulations by the Council.
Perhaps pressure should be brought to bear on the GMC to bring their regulations up to date so that patients can be clear about the sex of their doctor, allowing them to make informed decisions about their medical care?
But before that can be done, there is the issue that even this binary ‘gender’ entry in the register cannot be relied upon to give the sex of a doctor.
Part 2 will look at how the GMC creates a duplicate entry in its medical register for a doctor who requests a change to their ‘gender’ with no public traceability or accountability.