“People who write obscurely are either unskilled in writing or up to mischief”

By April 12, 2023Public

This quotation from Nobel Prize Winner Sir Peter Medawar is on the pinboard above my desk. It is a daily reminder that my writing must be clear and unambiguous if it is to be understood by all my readers.

I thought of this quotation when reading in The Times that the Office for Statistics Regulation (OSR) is investigating concerns that the data behind the 2021 census figures on the transgender population in England and Wales may be flawed.

According to census data, adults with no educational qualifications are almost twice as likely as university graduates to identify as transgender. And, when the numbers are crunched, the strongest predictor of a local authority’s transgender population is the proportion of people whose main language is not English. The Office for National Statistics concedes that it is “possible” that these findings – which contradict other data – may be due to respondents misinterpreting the census question, and is working with the OSR on the issue.

Clarity and absence of ambiguity are essential to avoid misinterpretation of health information. So it’s a concern that sexed language, such as the words ‘woman’ and ‘mothers’, is disappearing from some health information, including the nhs.uk website. This has potentially serious implications, especially for women who already face barriers when accessing healthcare, such as those with low health literacy, with an intellectual disability, or whose first language is not English.

In an open letter to the NHS, the multidisciplinary Clinical Advisory Network on Sex and Gender (CAN-SG) is calling for the reinstatement of sex-based, respectful communication that meets the healthcare needs of and is inclusive to women. Several MJA members have already signed CAN-SG’s open letter. Other members who would like to add their signature can do so here: https://docs.google.com/forms/d/e/1FAIpQLSdG_4VdVBgRxL2A2deq4xxw7-xDjfUPmRvdXJvBNnmnoo8AJQ/viewform

Sue Lyon

Author Sue Lyon

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Join the discussion 3 Comments

  • Jane Symons says:

    Thanks Sue, I think this is a really important issue.
    The need for clear language and communication in health information was brought home to be some years ago, when I was doing some communications work with a large London NHS Trust.

    The challenge was how to encourage cancer patients who were practising muslims not to fast during Ramadan — an initiative which had the backing of local mosques.
    It was not simply enough to write a few clear sentences which would be translated into the various languages spoken in the area. Some of the people we were trying to reach did not read at all.

    One of the strategies we adopted was to provide USBs with audio/video messages in different languages which were handed out at community centres and mosques.
    According to the latest Census data, the area covered by this Trust now has the highest percentage of transgender residents in the UK.

    Correlation as we know, is not causation. But it seems clear that the cause of this curious statistic is the lack of clear language in the Census. Good decisions require good data, and good healthcare is based on biological reality and good information. Clear language is crucial, that’s why I have also signed this petition.

  • John Larkin says:

    If an invitation to sign the petition is being included, would it be reasonable for the article to include some instances of desexed language that could cause the problems suggested?
    Or would that leave one open to accusations of “cherry picking”?

  • Jane Symons says:

    Hi John, there are several examples of the dangers of desexed language in Sue’s post and my reply.
    The issues are also set out very well in this paper by Susan Bewley et al
    And this award-winning piece by Zaria Gorvett highlighted the risks around healthcare.

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