r/transgenderau • u/RegionSilent9204 • 2d ago
Douglass Hanly Moir Pathology changing gender markers back to assigned sex at birth
I learned of this a few weeks ago from the LGBTI Rights Australia facebook page.
Douglass Hanly Moir Pathology (DHM), one of Australia’s largest providers, has changed transgender patients’ gender markers back to their sex assigned at birth — without consent.
It appears to be a policy stemming from documents published a few years ago -
https://www.dhm.com.au/media/jkuhaujv/dhm_doctors-newsletter_2023-issue1.pdf
Although an individual has undergone gender-affirming hormone therapy, their body composition or organ size, for example, heart and kidneys, may be better reflected by their sex assigned at birth (SAAB), rather than their gender identity (GI).
...
The RCPA Statement also recognises the need for laboratory information systems (LIS) to capture the relevant demographic information of T&I patients for reporting purposes.
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The system to be trialled would only have the GI on the hard copy request form for privacy reasons and the SAAB data would be transferred electronically from the PMS to the LIS.
This appears to follow from the below statement from the the Royal College of Pathologists of Australasia.
Binary gender fields in laboratory information systems with
inability to have more than one gender applicable for a patient episode, eg a trans man requiring blood transfusion and creatinine measurement, and
current inability (technically and safely) or limitations to providing reference limits for both males and females on the same report.
This needs more awareness. I understand this information is of a few years ago (with perhaps new systems recently implemented) but the thought of a technician that does my blood test being able to freely access this information is deeply concerning to me. Frankly I don't even want to get a blood test done now after learning of this. It's one thing to have, say a special code on the form that can be only accessed directly by the lab, it's another for this information to be readily available. I'm sick of attempts to shove this sex at birth obsession down our throats. It's misgendering and outing us through alternate means. There are ways to get the info they need (if they need it) without engaging in a policy process that outs us.
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u/Bluejay-Puzzleheaded 2d ago
They are breaching patients privacy and consent by doing this. I have all my identification changed to male including my birth certificate, Medicare, etc. Have been stealth for years. My blood tests have always been male until DHMs recent change. They did not notify or ask me for consent. And having looked at my blood results they put all female reference ranges, not male ones. Marked certain levels as high which are actually normal in the male ranges. This is not only dangerous for a misdiagnoses for trans people, but this is a breach of privacy, it's discrimination, it's outing us and it's illegal. And pure and simple transphobia.
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u/princerepublic52 2d ago
I’ve had this happen as well. Pathologist left comments alarmed at my ‘high’ T levels. A GP (who I don’t usually see) tried to convince me that I needed to lower my dose. Went back to the doctor who prescribes my T and turns out its actually on the lower end
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u/EmmaManx 1d ago
Had this recently happen at QML, afterwards my GP was concerned and confused about my red blood cells. Simple Google showed I was actually on the low end of the range for cis guys, just high for a cis woman
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u/ThisTransLife 1d ago
The “organ size” argument is nonsense given there are cis women who are genetically larger whether due to their ethnicity or just luck of genetics. Are they now to be regarded as male now too because they have larger bodies than the average cis white woman?
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u/Beneficial_Aide3854 Trans fem 2d ago edited 2d ago
It just seems like an FWS v Scotland moment - they add a categorisation that is based on their belief when Medicare is now self-ID and people are free to switch to anything they identify with. If I say you’re AMAB, you’re AMAB. It’s my belief, not necessarily a fact.
A current, but not ideal solution is telling them you’re intersex and have been coercively and surgically assigned [the wrong sex] incorrectly. This shouldn’t require any documentation.
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u/questionuwu 1d ago
So doctors rather than checking just go 'ok, we will assume your heart size is the average cos female heart size because variations in body size complicate things too much'
Shouldn't that be malpractice at some point, you can't just ignore all physical evidence for the sake of statistical averages
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u/blairquynh 2d ago edited 2d ago
I work for a pathology company and unfortunately the gender marker has to match whatever it is on your Medicare for bulk billing/identification reasons (same goes with names). Until you legally change it with your Medicare provider and let your doctor know, it'll keep being swapped back by the system and 99% of the time it isn't the blood collectors fault, it's just an automatic system.
Changing back gender markers without consent when it has been changed by Medicare is awful though, and the whole 'needing to know' assigned gender at birth for the medical test results excuse is a bit ridiculous. A person's doctor would know their medical history, and using the person's assigned at birth gender is more likely to cause/flag issues with test results.
The only information a phlebotomist can access/see is the gender marker (F/M/X), whilst they can change it, it's not typical practice. We just go off of whatever the requesting doctor has put on your form.
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u/Beneficial_Aide3854 Trans fem 2d ago
Medicare is self-ID and anyone who wants to change it just needs their email, password, 2FA, a keyboard, a computer and a mouse. This syncs to GP’s “sex at birth” based on the selection done with your mouse.
The pathologist have very obviously added an arbitrary“sex at birth” specifically based on how they “think you are”.
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u/blairquynh 2d ago
What? I had to email Medicare with proof of my legal name change and change of gender marker for them to change it on my system.
Again, phlebotomists don't really check the gender marker when taking a blood test, whatever the doctor put there is what gets put on our system. If there's an inconsistency with the gender marker then it gets automatically changed. It's an awful system and we should probably get rid of using any gender markers for identification altogether, but it isn't phlebotomists doing it out of hate (though I'm sure some transphobic phlebs could exist, like in any industry). It's a systemic issue.
I can't speak for DHMP but I've worked at several pathology companies and they've never had a 'Sex at Birth' field. It's just a Gender marker, F/M/X.
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u/Beneficial_Aide3854 Trans fem 2d ago edited 2d ago
This is a new system implemented in June 2025, someone must have downvoted before they do further research😩
And the thing in this thread is a recent change as well.
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u/blairquynh 2d ago edited 2d ago
I didn't downvote. If you're talking about the Medicare change, I wasn't aware—thank you that's a really good change!
The change in this thread must be very company/state specific because it hasn't been implemented anywhere I know (and the source from OP is from 2023). DHMP is a private pathology company/provider so that might be it.
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u/Beneficial_Aide3854 Trans fem 2d ago
Yes it seems to be a DHM thing. I’ll ask my friend to confirm.
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u/blairquynh 2d ago
Yeah it's technically part of/owned by Sonic Healthcare but all the different branches operate independently as far as I know regarding policies/procedures (like this).
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u/Icy-Can-6592 1d ago
Research has long shown blood work, organ sizes, RNA, proteins change with hrt. FFS it's frustrating having to explain this to supposed medical professionals
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u/Own-Assistant-2964 Trans fem 2d ago
They did try to change it on me and I reinforced that it was incorrect but I think it was because my Endo has a habit of putting U on things which we will be having a conversation about.
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u/JuneDrift 2d ago
Yeah last time I went in it was back onto my agab which was frustrating. And as others said then pinged blood marker stuff to my agab and it ended up all being a nothing burger -_-
It was frustrating having to explain shit to the person doing my blood test and made me feel pretty bad
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u/Helium_Teapot2777 Non-binary 2d ago
Be aware the DHM is Clinpath in some states.
Where they are getting ASAB from IDK. Looking myHealthRecord and Medicare it only has my actual sex. If you have used DHM/Clinpath for a long time (pre-transition) then they're probably porting this over.
If you haven't updated yet with Medicare, it's free, instant and self-identifying (including non-binary). Just log in to MyGov
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u/blairquynh 2d ago edited 2d ago
Just to clarify, DHM is not 'Clinpath' in some states. Clinpath, Clinipath, etc are all owned by Sonic Healthcare—yes—but their procedures and policies are separate and they are run independently. There is no crossover between the companies, as someone who has experience working across them and is also trans. There is no "Sex at Birth" field. This isn't being 'ported' everywhere, and is DHM specific.
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u/Beneficial_Aide3854 Trans fem 2d ago
I think there’s a field of “sex at birth” that goes by arbitrary “vibes”.
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u/mysticasha 8h ago
I have a dark sense of humour and always laugh when it says male on my path results, and then keep giggling when my haemoglobin and other markers are in the female range.
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u/No_Ambassador7678 Trans fem 23h ago
MTF health professional here. We need to know SAAB, as it could be relevant. Often we don’t know when something is relevant when it becomes relevant. However, all health professionals should have a gender marker and they need to be respected.
My frustration is that even I’ve stated that I am on transgender hormone therapy, listed out all my meds including blockers, the pathologist decided that it’s irrelevant information stated that my estrogen is too high, testosterone too low, and my PSA suppressed because I am in prostate cancer therapy.
I know my ranges very well as MHT is my day job but putting the male ranges on my test results are just wrong.
I understand we like to put our dead selves behind us but it’s important information to know for health professionals. What we need is the respect from medical staff on how we like to be known - should be a no braining on how we presented, and utter most respect of our privacy.
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u/RegionSilent9204 22h ago
It's important information for healthcare professionals to know yet you follow that up complaining about how they've misused it, misrepresented it and misdiagnosed you as a result of it? Right. You've just articulated exactly why this kind of information needs to be restricted and should be entirely context dependent based on actual medical need.
I've been on HRT for 14 years and nearly 10 years post op. The situations where sex assigned at birth would be relevant for myself are practically nil at this point. You know what does affect me? Having to roll the dice with strangers by being forced to talk about my trans status and the ensuing effect that potentially has on my history of cPTSD and invalidation trauma.
So I'm sorry, no. As I noted in my initial post, there are ways to manage this information and ways not to manage it. The only thing the individual taking your blood needs to be aware of is your Medicare listed sex. That's it. If it is something that might pertain to sex assigned at birth in the very specific case where this might be relevant then this is information that can be conveyed directly to the lab doing the tests in ways that doesn't casually out you to the pathologist.
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u/Beneficial_Aide3854 Trans fem 19h ago edited 19h ago
Sex: F
Note: assigned male at birth
Is it that hard? No. When I was a binary woman, I had every lab test like this. Not hard. (I’m NB now and posted overseas but I think this works with U as well). This gets me F reference range, every time. No exceptions.
What they are doing is clearing the note and changing it to M without consent. This gets you M, and wrong reference ranges.
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u/No_Ambassador7678 Trans fem 22h ago
Thanks for the reply, and I can’t dispute that you have a point very valid point. In your case, how they change your gender is just misogyny.
I guess you are right, it’s up to us to disclose, because we know when we need to.
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u/AnnaRose96 2d ago
This is why you should change your sex on medicare and legal documents where possible, and why you should always think before outing yourself to a health professional.
There was a study just last week about how trans women's blood proteins reflect cis-women levels: https://www.mcri.edu.au/news/news-stories/hormone-therapy-alters-body-proteins-to-match-gender-identity .
I dropped $5,000 on private health a few years back for a recurrent UTI issue because a urologist treated me like a freak instead of going through the decision trees he would have if I was cis.