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To ask or not to ask (about sex)? by Micol Artom (NHS)

Talk

55 mins

How do we maintain clinical safety whilst ensuring a service responds to the needs of people with different sexes and genders? This talk explores the challenges faced in conducting in-depth user research with people who are trans, non-binary and have differences of sex development to improve a live national health service in the UK.

Date and time:

Thursday, 9 November - 13:30-14:25 GMT, 8:30-9:25 EST, 5:30-6:25 PST

Intended audience: 

Registration opens: 9 October

Register
Date and time:

Thursday, 9 November - 13:30-14:25 GMT, 8:30-9:25 EST, 5:30-6:25 PST

Register

111 online is a triage service which directs people to the best place for their symptoms. All users are asked 'What was your sex at birth?' at the beginning of their journey, and not answering prevents them from progressing further. For certain conditions, a user's biological sex may affect the clinical questions they're asked, however not all health problems will be affected by sex at birth.

The 111 online have received feedback from users indicating that they have barriers in answering the sex at birth question. Some users struggle to answer the question accurately, do not understand the reason why the question is asked and experience discomfort in having to provide this information. The question has also prevented some users from using the 111 online service entirely.

We conducted five rounds of research including with more than forty remote interviews with users who were gender diverse or had differences of sex development to better understand what barriers they face in answering questions about sex and gender, and how the way 111 online collects information about them could be improved. We completed discovery research, tested more than 15 different designs and worked with clinicians and developers to assess the feasibility of the desired changes. The key finding was that the service didn't always need to ask for sex upfront.

This talk will firstly give a brief overview of the context, methods, and findings of the research. It will then focus on the methodological and clinical challenges the researchers faced in conducting the research and developing a strategy for implementing its recommendations. The audience will take-away inclusive approaches to recruiting for, interviewing and analysing research about sex and gender. They will also learn about novel ways of communicating sensitive findings to clinicians in a way that fosters change whilst still prioritizing clinical safety.

Close-up of Micol Artom smiling with a blurred image of a city street in the background.

Senior User Researcher

Left

Senior User Researcher

Right

Left

Senior User Researcher

Middle

Right

Hostile Documentary

1h 38m | 2022

111 online is a triage service which directs people to the best place for their symptoms. All users are asked 'What was your sex at birth?' at the beginning of their journey, and not answering prevents them from progressing further. For certain conditions, a user's biological sex may affect the clinical questions they're asked, however not all health problems will be affected by sex at birth.

The 111 online have received feedback from users indicating that they have barriers in answering the sex at birth question. Some users struggle to answer the question accurately, do not understand the reason why the question is asked and experience discomfort in having to provide this information. The question has also prevented some users from using the 111 online service entirely.

We conducted five rounds of research including with more than forty remote interviews with users who were gender diverse or had differences of sex development to better understand what barriers they face in answering questions about sex and gender, and how the way 111 online collects information about them could be improved. We completed discovery research, tested more than 15 different designs and worked with clinicians and developers to assess the feasibility of the desired changes. The key finding was that the service didn't always need to ask for sex upfront.

This talk will firstly give a brief overview of the context, methods, and findings of the research. It will then focus on the methodological and clinical challenges the researchers faced in conducting the research and developing a strategy for implementing its recommendations. The audience will take-away inclusive approaches to recruiting for, interviewing and analysing research about sex and gender. They will also learn about novel ways of communicating sensitive findings to clinicians in a way that fosters change whilst still prioritizing clinical safety.

Micol Artom (she/her)

Micol Artom is a Senior User Researcher at NHS England. She manages a team of researchers for the UK-based Urgent and Emergency care service, NHS 111 online. Previously, she worked on COVID-19 Testing for 18 months focusing on their inclusive research. Her background is in academia, she completed a PhD in Health Psychology and a post-doc in digital health before transitioning into UR in the Public sector.

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