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Databases

Transgendered Folks Encountering Document/Database ID Hassles 814

Posted by Soulskill
from the flipping-bits dept.
An anonymous reader writes "Most of us hear the equivalent of 'let me bring up your record' several times a week or month when dealing with businesses and government agencies; sometimes there's a problem, but clerks are accustomed to dealing with changes in street address, phone numbers, company affiliation, and even personal names (after marriage). But what about gender? Transgendered folks are encountering embarrassing moments when they have to explain that their gender has changed from 'M' to 'F' or vice versa. While there are many issues involved in discrimination against transgendered individuals, I have to confess that the first thing that came to my mind was the impact on database design and maintenance."
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Transgendered Folks Encountering Document/Database ID Hassles

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  • Re:Make it optional (Score:5, Informative)

    by geminidomino (614729) on Saturday June 15, 2013 @06:40PM (#44018033) Journal

    If you follow Fed guidelines in the US, it already is. "Indeterminate" and "Declined to Respond" are both required to be supported in any EHR software in order to meet "Meaningful Use" requirements.

  • Re:I call bull! (Score:5, Informative)

    by Anonymous Coward on Saturday June 15, 2013 @06:57PM (#44018139)

    So because there is one exhibitionist out there, everyone must be an exhibitionist? Does that also mean that, because you're a bigot, everyone must be a bigot?

    I'm in my mid-30s and just starting down the road of correcting my body. It is because of people like you that, despite knowing since I was 3 years old, I tried to live in denial. It is because of people like you that trans people have a suicide rate nearly 3 times higher than gay people. So you don't support us because you don't even try to understand us... that's fine. But don't belittle us.

    I didn't wake up one day and decide that I want to spend $50-100k (just facial electrolysis can cost anywhere from $5k and up and can't be done in one session, it takes months, sometimes several years, to catch all of the hair follicles during their growth phase so you can kill them), have to endure the social stigma of telling my friends and family - all while knowing that I would lose some of them in the process, etc on a whim. I've struggled to deal with who I am for my entire life and I've been suicidally depressed for most of the last ten years. My need to change stems from the fact that, if I don't, I cannot continue to live this life in the way I was forced to.

    There are lots of reasons behind gender issues ranging from genetic to in utero underexposure to hormones (or chemicals that mimic estrogen being present in our public water supply). It's amazing that, in a day where we can accept people are born gay, that it isn't a choice, that we will mock and degrade people who feel that their external sex doesn't match their internal gender.

    I hope one day, something doesn't cause you to face the same ridicule you're so happy to perpetrate on others...

  • Re:Gov. Work (Score:3, Informative)

    by quacking duck (607555) on Saturday June 15, 2013 @06:59PM (#44018177)

    You can't believe something that has only been able to be talked about in public for less than 15 years (legal homosexsual marage) wasn't in your lowest bidder made, god knows how old Government computer system?

    You got it wrong. The unbelievable part is that the lowest bidder developed software bothered to take time to add and test such a check in the first place.

    My own encounters with development houses included software that by the time it reached us for the first round of testing, still didn't have some of the most basic security checks... like don't use incremental counters as user record IDs in the URL seen by the user over the internet (fundamental design error), and for frak sake don't pull up someone else's record if they simply change the ID in the URL.

    This actually happened to a new application/renewal system Passport Canada put online, about 5-7 years ago. The glaring security hole was discovered and reported on the news soon after, and they took the system down pretty quickly after that.

  • by marauder (30027) on Saturday June 15, 2013 @07:01PM (#44018195)

    An indicator for M/F isn't recording anything much about genetic sex. If that's what you're setting out to do you'll need a much bigger box: http://en.wikipedia.org/wiki/Sex_chromosome_disorders [wikipedia.org]

    Even for people with standard-issue XX or XY sex chromosomes, the journey from that to phenotypical gender is about a six-stage process. Most people arrive at one of two endpoints, but that still leaves another 62 or so different bit-patterns for phenotypical gender, and as the article suggests the low-order bits can be flipped after birth. A write-only boolean field doesn't really do the job.

  • by Anonymous Coward on Saturday June 15, 2013 @07:01PM (#44018207)

    I imagine you're part of the "pray the gay away" crowd.

    Just because you think it's a mental disorder, and that they are circus freaks, and that they are delusional, and that they are mutilating themselves, doesn't mean it's so. All it does is show that you are an insensitive and ignorant asshole.

  • by pesho (843750) on Saturday June 15, 2013 @07:02PM (#44018213)
    I am hermaphrodite, you insensitive clod!
  • Re::3 (Score:5, Informative)

    by Anonymous Coward on Saturday June 15, 2013 @07:15PM (#44018287)

    There are a lot of biological causes for transgenderism, the mental health issues stem from these, not the other way round. A lot of people find that just going on HRT fixes long standing anxiety and depression that nothing else has been able to touch.

  • by cold fjord (826450) on Saturday June 15, 2013 @07:23PM (#44018351)

    Supposedly this is more than made up for by the fact they can live the rest of their life how they feel they should be.

    Maybe. There are people that do regret it. If you do, there's no magic reset available. On this earth you will never fully be again what you once were.

    Are sex change operations justified? [bbc.co.uk]

    Sex changes are not effective, say researchers [guardian.co.uk]

    'I will never be able to have sex again. Ever' [theage.com.au]

    But what worries other psychiatrists is the mounting evidence that surgery may not actually improve the lives of those who feel they were born with the wrong body. A review of more than 100 international studies of post-operative transsexuals by the University of Birmingham found there was no scientific evidence that surgery was effective and, in many cases, patients were left feeling more distressed. Baltimore's Johns Hopkins University — which housed one of the pioneer gender clinics — no longer performs sex-change surgery due to such concerns.

    A recent British review found suicide rates of up to 18 per cent among people who had undergone gender reassignment surgery. Doctors from London's Portman Clinic say they see many patients who feel trapped in "no-man's land" after surgery, finding themselves with a body which is no longer recognisable as male or female. Psychotherapy, the experts believe, may have saved them from such a fate but few gender clinics offer it. -- more [theage.com.au]

    Long-term follow-up of transsexual persons undergoing sex reassignment surgery [nih.gov]

    It's a difficult issue for all concerned.

  • by Oligonicella (659917) on Saturday June 15, 2013 @07:24PM (#44018365)
    To the biologically illiterate AC:

    47,XXX
    48, XXXX
    49 XXXXY syndrome
    49, XXXXX
    Klinefelter's syndrome
    Turner syndrome
    XX gonadal dysgenesis
    XX male syndrome
    XXYY syndrome
    XYY syndrome
  • Re::3 (Score:4, Informative)

    by KGIII (973947) on Saturday June 15, 2013 @07:48PM (#44018525) Journal

    That is true in some cases. There are others who have no biological issues at all but simply feel they were born into the wrong body (I've spoken to a few of these who've gone ahead with the gender re-assignment) and it's a difficult position for them to be in. While your statement is true for some it certainly isn't true for all.

  • by Your.Master (1088569) on Saturday June 15, 2013 @08:33PM (#44018785)

    Unless you're expecting to perform a genetic test on people rather than comparing against their driver's license photo, "genetic sex" is irrelevant.

    The article is specifically about somebody being called male at birth, but being visibly female when she did a test drive, so they didn't understand the license. The "genetic sex" was actively counterproductive in this case.

  • Re:Medical databases (Score:5, Informative)

    by scrib (1277042) on Saturday June 15, 2013 @08:53PM (#44018891)

    I write software for a blood center and birth sex is critically important for proper handling of donated blood. I had no idea that male and female blood had to be handled differently, but it largely boils down to how a pregnancy (even one that spontaneously aborted and a woman might not even realize she had) can affect blood antibodies. An F->M transgender should report that fact.

    As a starting point of research for the curious, check out TRALI [wikipedia.org].

    Even though the plasma from female donors is used for manufacturing (as is ALL plasma collected at places that pay for it), I still encourage women to donate, especially platelets! (Technically, the plasma from AB+ females can be used.)

  • Re:Sex versus Gender (Score:4, Informative)

    by KGIII (973947) on Saturday June 15, 2013 @09:03PM (#44018941) Journal

    That is how jails do it. No matter how far along you are in gender reassignment - if you have a penis you're going to a men's facility.

  • by mysidia (191772) on Saturday June 15, 2013 @09:35PM (#44019115)

    There will be certain cases - a lot of medical data, for example - where gender truly is important.

    For medical records, they should be gathering not just a simple "gender", but:

    • Genetic Gender: Male / Female / Other / Unknown -- Regardless of physical appearance -- are your chromosomes X, XY, or something strange? This would likely be a 2 or 3-dimensional scale, rather than a simple M/F.
    • Endocrine Gender: Male / Female / Other / Unknown -- Does your body hormonally act like a Male or Female? E.g. Does your body chemically have a female monthly cycle or something else? Again, this would be a 2-dimensional scale.
    • Physical Gender: Male / Female / miXed / None -- (E.g. Some genetic females, might for whatever reason, have some male physical bits; some males might for whatever reason, have some female physical bits)
    • Self-Identity Gender: Male / Female / Both / None -- What gender the person views themselves as, this may be influenced by their culture.
    • Sexual Gender: Male / Female / Other / None -- What gender the person determines them to be sexually. E.g. There may be people who are physically Female, and identify themselves as female, but sexually speaking -- they may be Male, as in, they will prefer to have a Woman as their sexual partner, even though they are physically a Woman.

    There are potentially a few more things, that should be there.

    The point is a simple "What gender?" question was a wrong question to begin with; based on a cultural sterotype that there are two kinds of people -- Boys and Girls.

    Reality is much more complex; with all those medical "conditions"; which aren't really diseases per se, where you have androgynous people.

  • by tverbeek (457094) on Saturday June 15, 2013 @10:22PM (#44019347) Homepage
    Gender is not determined (solely) by genetics.

    First, despite what you learned in 7th grade Biology class, sex is not a simple matter of X and Y genes. A person's sex genes may be altered, or due to environmental factors, don't express normally. A surprising ratio of babies are born with ambiguous genitalia, which the attending medical staff will respond to by either guessing how the child will develop, or suggesting surgery to select one or the other gender. Parents will sometimes leave the child's physical features as they are, but (for obvious reasons) pick on gender or the other and raise the child accordingly, which may work OK for a while, but by the time of puberty the fact that their child isn't simply "male" or simply "female" becomes more problematic.
  • by realityimpaired (1668397) on Saturday June 15, 2013 @10:38PM (#44019407)

    I was curious about whether you tried testosterone therapy and it didn't work? I can't tell if that's what you're saying or if you feel like you were abused by yourself for producing testosterone.

    Most of the transwomen that I know view the body's natural production of testosterone to be the body slowly poisoning itself, in a circumstance where they have a hard time convincing a doctor to give them a treatment which can stop it. This is one of the major reasons why transgendered people have a very high suicide rate among those who haven't had treatment.

    I'm curious about this statement too.. you're saying your heart may tell you you're a woman. What does that mean? Is there some feeling that all women have that men aren't supposed to feel?

    Self identification. You think of yourself as a man (I assume). The GP identifies herself as a woman. The difference is that you (assuming you're male) have the dangly bits to go with it, so there's no discord between your identified gender and your physical sex. For a transgendered person, their physical sex does not match their identified gender, and that clash can cause serious body image issues, severe depression, and suicidal behaviour. Usually, the only effective treatment for somebody in that situation is to start living as their perceived gender, and almost universally, once a transperson starts their real life experience (long before they get any kind of surgery), the depression and other mental issues disappear very quickly.

    I know it's difficult to wrap your head around... usually the only way to understand it is to go through such a change yourself or (in some cases) to know people before/after their transition and see for yourself the positive difference it makes in their life, but there is a distinction between a person's physical sex and their gender identity. These are two distinct and separate variables that go into the definition of "you", and when the two do not have the same value, it causes problems. Since there isn't really a way to change one (gender), the only effective treatment is to look at the other.

  • Re:WTF (Score:5, Informative)

    by mwvdlee (775178) on Sunday June 16, 2013 @12:45AM (#44020017) Homepage

    Any half-decent database system already DOES have the ability to change both gender and race.

    Not so much to support transgender or theoretical "transrace" people, but simply because users sometimes make mistakes and systems must allow such mistakes to be corrected.

The tree of research must from time to time be refreshed with the blood of bean counters. -- Alan Kay

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