The National Health Service (NHS) has allegedly removed the words pertaining to the gendered term ‘women’ from a number of its web pages, as first reported by The Times. Some of the online medical guidance affected by this change includes those on ovarian, womb and cervical cancers—conditions that are typically suffered by those born with the female sex biology.
The NHS’ goal behind the move was to ‘desex’ its jargon to become more gender-neutral and inclusive of those with female biological anatomy who do not identity as women, like non-binary or transgender individuals.
The Daily Mail made note of some of these changes. According to the publication’s testimony, one informational page on the NHS site used to read: “Cancer of the womb (uterine or endometrial cancer) is a common cancer that affects the female reproductive system. It’s more common in women who have been through the menopause.” Instead, it now reads: “Most womb cancer usually starts in the lining of the womb (endometrium), this is also known as endometrial cancer.”
Another example cited by The Times stated that ovarian cancer is “one of the most common types of cancer in women.” Now it explains: “Anyone with ovaries can get ovarian cancer, but it mostly affects those over 50.” However, the words have not been entirely removed, with the word ‘women’ or ‘woman’ still being referenced in sub-sections of the pages, the outlet noted.
A spokesperson for NHS Digital—the body responsible for the updating of online NHS guidance—told the publication that allegations the words had been entirely removed were unfounded: “It is not correct to say that there is no mention of women on the ovarian, womb and cervical cancer pages. We have updated the pages as part of our routine review of web pages to keep them in line with the best clinical evidence, and make them as helpful as possible to everyone who needs them.”
Despite this, reactions to the changes have led to criticism from experts as well as people online. A nurse who represents the campaign group Sex Not Gender Nurses and Midwives, Kat Barber, spoke to The Times and suggested that desexing language could actually create another issue when it comes to language barriers. Though Barber welcomed the efforts to be more inclusionary, she also noted that the NHS cannot operate under the assumption that medical names for female anatomy are widely known—especially when evidence suggests that is indeed the case.
“Whilst we welcome efforts to include, inclusion should consider all communities and should never trump safety,” she continued.
Another expert, Doctor Karleen Gribble of Western Sydney University (and lead author on a paper about why sexed language in birth and childcare is vital) shared the same sentiments, telling The Times: “I think that the changes to desex language are well intentioned, but we are seeing that they are making communications less clear and when it comes to critical health issues that has great potential to place the health and wellbeing of individuals at risk.”
While the subject is nuanced and requires mutual understanding, the above reports have subsequently resulted in an online backlash that has permeated through Twitter—a backlash not similar to those of the experts but one motivated largely by what may be seen as an ‘anti-woke’ brigade. “This is madness: Men don’t have wombs, ovaries, a cervix or other female reproductive organs and that’s a scientific fact,” broadcaster Niall Boylan wrote.
Another said: “ONLY WOMEN have womb cancer. STOP THIS MADNESS!! NHS should become (N)ational (H)ateWomen (S)ervice,” while a third read, “The NHS should do the job properly and not concern themselves with minority causes.” A fourth user doubled down on their attack on the health service, “This nonsense is why the NHS is not fit for purpose, they are too busy being WOKE than treating the sick. These cancers ONLY affect biological women,” capitalising “biological women” in the tweet.
While there are, of course, valid concerns on such a change and a healthy discussion is warranted, such introductions often become an opportunity for many to unabashedly display their outdated understandings of gender and offer an excuse to be transphobic. And no one has time for that.
Artificial intelligence (AI) is continuously making grounds in a multitude of industries, one being the medical world. First used to diagnose early onset dementia, it will now aim to tackle racial inequalities in medicine as part of Sajid Javid’s—the UK’s health secretary—plan to “level up” the country’s health service. A new report by The Guardian details the projects behind this new governmental initiative.
Javid described his reasons behind the AI initiative to the publication, “As the first health and social care secretary from an ethnic minority background, I care deeply about tackling the disparities which exist within the healthcare system. As we recover from the pandemic we have an opportunity for change, to level up, and ensure our NHS is meeting the needs of everyone.”
The past 18 months have only continued to shed a light on the ever-present widespread issue of racial inequality in many pillars of society—one being the medical field. Structural racism in healthcare leads only to poorer health conditions for those from black, Asian and ethnic minority backgrounds. A 2020 Sky News report on such matters found that black women are five times more likely to die in childbirth than white women in the UK. Structural racism impacts even medical equipment, with a recent review carried out by the NHS Race and Health Observatory finding that pulse oxygen monitors may be less accurate on darker skin.
These problems have been present for decades, and the COVID-19 pandemic has only exacerbated them. Speaking on this particular inequality, Javid stated, “It is unacceptable that black women in England are five times more likely to die from complications during childbirth than their white counterparts. AI could help us better understand why this is the case and ensure black mothers have an equal chance for a healthy life with their newborn.”
The above issue is behind one of the projects put forward as part of this initiative; the project will employ computer algorithms to study and examine the causes behind such maternity issues for black mothers. The findings from such research will then be implemented as part of updated training for nurses and midwives.
This AI effort to clamp down on racism in health care, titled the AI Ethics Initiative, will be fronted by NHSX—a governmental department that focuses on improving NHS policy, data and technology. Other potential projects include the creation of an AI-powered chatbot tasked with aiding the screening of sexually-transmitted infections (STIs) and HIV among ethnic minority groups. Another AI screening project in this drive aims to better identify and diagnose diabetic retinopathy in such communities.
Head of AI research and ethics at NHSX, Brhmie Balaram, told The Guardian, “Artificial intelligence has the potential to revolutionise care for patients, and we are committed to ensuring that this potential is realised for all patients by accounting for the healthy needs of diverse communities.” One of the most critical AI projects in this new goal is the updating of UK health data that would more accurately represent the country’s population. Currently, there seems to be a great divide in data which should be more inclusive.
For Javid, this is the first most important and integral part of the drive, “If we only train our AI using mostly data from white patients it cannot help our population as a whole. We need to make sure the data we collect is representative of our nation. This new funding will support the development of a much-needed set of standards to make sure datasets for training and testing AI systems are diverse and inclusive so no one is disadvantaged because of their race.”
While entrusting AI comes with its own issues—take Facebook’s AI algorithm labelling black men as ‘primates’—he continued by highlighting the positives of such technology, “Technology, particularly AI, can be an incredible force for good. It can save valuable clinician time and help provide faster, more accurate diagnosis, so patients can access the care they need as quickly as possible. It can also help us better understand racial differences so we can train our workforce to look for different symptoms or complicating factors, diagnose faster, and tailor treatments.”
As we hopefully await potential improvements coming from these projects, we can’t help but wonder if it’s too good to be true. With claims of voter suppression, an attack on immigrants, a war on Black Lives Matter and still legal revirginisation surgery—to name a few—the UK has a long way to go in the battle for equality.