Our Position on Sex and Gender Data Health Innovation Kent Surrey Sussex will collect data on both sex and gender, where either data is needed, to be inclusive, maintain data integrity, mitigate against bias, and prevent exacerbating both sex and gender health, employment, and other inequalities in all its programmes of work. When referring to ‘sex’ we mean the biological sex (male or female) registered at birth and ‘gender’ refers to how somebody sees themselves, as a man, woman or neither (non-binary), in line with NHS England’s definition [1]. Biological sex and gender / gender identity are both important characteristics in their own right. They come with their own unique and intersecting risk of inequalities, and they should not be used interchangeably [2]. It is also important to note that gender and gender identity cannot lawfully replace sex as a protected characteristic [3], and both characteristics are particularly important when it comes to areas such as employment, health, crime and education, where both sex and gender outcomes and inequalities are particularly relevant [4]. In relation to Health Innovation KSS’ core business, differentiating between sex and gender is important because the evidence tells us that women’s health outcomes are disadvantaged by biomedical research which has historically been disproportionately focused on men, therefore failing to account for women’s biology in the development and implementation of health and care interventions [5]. Furthermore, recent evidence has shown that a failure to account for differences in both sex and gender can compromise data integrity in artificial intelligence (AI), leading to discriminatory and adverse algorithms and outcomes [6]. By failing to record sex as well as gender in the NHS, trans people are often left out from receiving cancer screening invitations, therefore increasing the likelihood of poor cancer outcomes and exacerbating health inequalities [7], [8]. Therefore Health Innovation KSS will now routinely collect data on both sex and gender / gender identity – where either is needed – in order to build improved, inclusive and effective data sets, better understand and mitigate against sex and gender bias; promote sex and gender equity in our organisation and work; and facilitate sex and gender health equity in our populations. ——————————————— [1] Buslón, N., Cortés, A., Catuara-Solarz, S., Cirillo, D., & Rementeria, M. J. (2023). Raising awareness of sex and gender bias in artificial intelligence and health. Frontiers in Global Women’s Health, 4. [2] https://osr.statisticsauthority.gov.uk/publication/collecting-and-reporting-data-about-sex-and-gender-identity-in-official-statistics-a-guide-for-official-statistics-producers/ [3] https://www.legislation.gov.uk/ukpga/2010/15/contents [4] Opinion: Why social scientists still need data on sex – not only gender identity | UCL News – UCL – University College London [5] Buslón, N., Cortés, A., Catuara-Solarz, S., Cirillo, D., & Rementeria, M. J. (2023). Raising awareness of sex and gender bias in artificial intelligence and health. Frontiers in Global Women’s Health, 4. [6] Cirillo, D., Catuara-Solarz, S., Morey, C. et al. Sex and gender differences and biases in artificial intelligence for biomedicine and healthcare. npj Digit. Med. 3, 81 (2020). https://doi.org/10.1038/s41746-020-0288-5 [7] Opinion: Why social scientists still need data on sex – not only gender identity | UCL News – UCL – University College London [8] Weyers, S., Garland, S. M., Cruickshank, M., Kyrgiou, M., & Arbyn, M. (2021). Cervical cancer prevention in transgender men: a review. BJOG: An International Journal of Obstetrics & Gynaecology, 128(5), 822-826. Opinion: Why social scientists still need data on sex – not only gender identity | UCL News – UCL – University College London https://www.legislation.gov.uk/ukpga/2010/15/contents