Gender Self-Identification Could Be Muddling Monkeypox Surveillance Data in UK

Test tubes labelled "Monkeypox virus positive and negative" are seen in this illustration taken May 23, 2022. (Dado Ruvic/Reuters)

The nature of the monkeypox outbreak might be muddled by gender self-identification, according to experts, as it emerged that the one percent of infected female individuals in the UK could in fact be biologically male.

An Infectious Disease Behaviorist told The Epoch Times that while it's true for accuracy that data on both sex and gender is important, focusing on how someone identifies in society is pandering to politics and risks "weakening public health surveillance systems."

The UK has the highest current recorded levels of the tropical disease in the current outbreak which is spreading predominantly amongst and affecting gay or bisexual men. The number of confirmed cases is 793 as of June 22.

Self-Identified Gender in Health Records

For confirmed cases in the UK, where gender information was available, 758 (99 percent) confirmed cases were male, with 5 confirmed female cases. The median age of confirmed cases in the UK was 37 years (interquartile range 31–43).

A spokesperson for the UK Health Security Agency (UKHSA) told The Epoch Times by email that patients are asked how they would describe their gender, so "the data shows gender identity rather than just gender at birth."

Unlike the UKHSA, the WHO records both sex ("sex at birth") and gender via their Monkeypox Case investigation form which can allow researchers to conduct in-depth epidemiological investigations into the disease. The CDC also has a similar process (pdf), asking "what sex were you assigned at birth, on your original birth certificate?"

France detected 277 cases of monkeypox, health authorities said on Tuesday, including the first case in the country of a woman contracting the virus. The Epoch Times has not been able to verify if French authorities collect data by gender identity.

The data on sex could be seen as paramount as it has recently been reported that fragments of the monkeypox virus have been detected in semen in a handful of patients in Italy, raising questions over whether sexual transmission of the disease is a possibility, scientists said on Monday, according to Reuters.

"However having an infectious virus in semen is a factor that tips the balance strongly in favour of the hypothesis that sexual transmission is one of the ways in which this virus is transmitted," said Francesco Vaia, the institute's general director, though there is a lack of formal evidence to prove this.

'Need Consistent and Accurate Data on Sex'

Data and health experts told The Epoch Times that they expressed concern about the way that the data was collected.

Alice Sullivan is a professor of Sociology and Head of Research at University College London's Social Research Institute who recently gave testimony on the importance of separating gender and sex in Scotland.

The Scottish Parliament is currently considering draft legislation, the Gender Recognition Reform (Scotland) Bill, which will allow individuals to change the sex recorded on their birth certificate by simply making a statutory declaration.

She told the Committee on June 21 that "we need consistent and accurate data on sex, to make comparisons over time and between countries, and to evaluate the effect of policy interventions. Sex is not the same thing as gender identity. We need data on both of these variables."

Sullivan told The Epoch Times by email that "health data always needs to include information on sex, because sex is a systematic variable which affects every dimension of health. And when it comes to conditions where men who have sex with men may be particularly at risk, this relates to their male sex, not their identity."

'Weakening Public Health Surveillance'

U.S.-based Infectious Disease Behaviorist Sean G. Kaufman told The Epoch Times that the stigma was real when it came to HIV in the 80s, noting the parallels with Monkeypox.

However, Kaufman said that when it comes to gender self-identification, important details from disease investigation could be overlooked: "we're pandering to, in my opinion, a sense of political correctness."

"If you start allowing people to identify as something that they're not biologically, when you look at surveillance of chronic disease, or even acute infectious disease, what it causes is confusion," he said.

But he said that the reality is that when you're trying to solve a problem, the more data you have is key, and having data on both sex and gender is important, as is looking at social-economic trends and health literacy when identifying chronic disease outbreaks.

But Kaufman added that if you cannot include biological sex and you have to include how someone chooses to identify "what you're doing is you're pandering to politics."

"You are weakening your public health surveillance systems because you cannot get the scientific information you need to be able to track and prepare and prevent disease transmission or even chronic disease development," he added.

Lily Zhou contributed to this report.