Finally some common sense*

Dr Sara Dahlen is the Sydney Selwyn Prize Winner 2019 and thus gives the keynote speech at this year’s Sydney Selwyn Lecture (much delayed by COVID-19), entitled ‘An examination of sex versus gender identity in the General Medical Council’s Trans Healthcare Ethical Guidance’. Currently she is a MSc student in Bioethics and Society at King’s College, London.

Awarded by the The Worshipful Society of Apothecaries …

… the prize is awarded to the best candidate in the Diploma in the Philosophy of Medicine examination.

Okay, so, big build-up. Big breaths. *I’m sorry but this event was mainly just common sense and if you were hoping to read about some troon fuckery please disregard this post. I’m sorry. I actually cancelled ‘Intersex Rage, biopolitical protest, and the movement for black lives’, so I can only apologise I’m bringing you this and not that. Normal service will be resumed soon.

This isn’t the first time I’ve completely misjudged things. Like the time I went to a health food day expecting to learn about massage. ‘Why are you here?’ asked the tutor in our morning pow-wow. ‘Because I want to learn how to give and receive massages’. A long silence ensued.

At the beginning of this webinar, the host got all nostalgic that we weren’t actually in their normal meeting room, listening to the tick tock of their old clocks, and sniffing musty antique carpets and furniture polish – something we can definitely thank COVID for.

Dahlen said there are two pieces of official advice the General Medical Council gives out, which essentially change the meaning of the word sex.

This is typical of the double bind that trans activism has imposed on so many frameworks – gender identity must be respected, but don’t you dare ask us about it! As was pointed out by another, this obscures the actual law as only Gender Recognition Certificate holders retain the legal right to non-disclosure.

Dahlen said one sensible factual thing after another. I know! Boor-ring. Disorders of sexual development have nothing to do with gender identity. Sex and gender identity are not interchangeable as this could, for example, result in women who had had hysterectomies being considered male. Sex is fixed and medically important! (I imagined at the corresponding moment the intersex ragers would have been saying the exact opposite and shed a little tear.)

It was disappointing that Dahlen didn’t cover the fact that cross sex hormones and surgeries cause serious medical problems, but this is very much a first step of someone actually asking probing questions, and then actually being recognised and awarded as such by a prestigious body.

It’s a sign of the times that Dahlen felt the need to explain biological sex to the audience and in even greater detail in her paper. There was a time, not too long ago, when these two categories were simply understood.

I suppose if I was going to nit pick I would point out that the case study examples in the paper are completely lame, although ones presented by the GMC itself, especially that of Angela, who alleges their GP receptionists deliberately misgendered them (would love to know how they saw down a phone line to see one receptionist turn to another). This is not, in my opinion, an example of non-maleficence (non-harming or inflicting the least harm possible to reach a beneficial outcome). Anyway we all know GP receptionists are rude – it’s traditional.

Dahlen’s conclusion was that we should record both sex and gender identity, the latter in a free text box. I would prefer records showing sex only and if the individual is on cross sex hormones that would present on their medication list. I suppose Dahlen’s suggestion is a more sensible approach than I have heard from many a trans activist but the problem simply remains that muddying of sex harms us all ultimately, and is that what we really want?

You can read Dahlen’s paper here – it’s freely available for download off t’ web.


  1. Thanks.

    FYI Bristol Uni Law School invited Mermaids and Johanna Olson Kennedy to a 2 day conference.

    Peter Dunne is the author of the paper cited in Scottish Govt GRA consultation which said a woman who’s had a mastectomy is the same as a man.


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