Why Gender and Hormones Matter in Medical Care

The Sullivan Review: A Transphobic Attack Disguised as Research

The UK government-commissioned Sullivan Review is not a neutral study, it is a politically motivated, gender-critical assault on trans rights, driven by the far-right and weaponised by the Labour Party for political gain. It is a calculated effort to force a rigid, binary classification of ‘immutable biological sex’—a transphobic dog whistle—into medical data, disregarding established science to push a bigoted agenda. This review, led by Professor Alice Sullivan—an advisor to the anti-trans hate group Sex Matters—was never about improving healthcare. It was designed to erase trans people from medical records and enshrine harmful, outdated practices that put lives at risk.

One of the most alarming aspects of the Sullivan Review is its refusal to acknowledge that hormone therapy plays a crucial role in shaping a person’s health profile. Instead, it clings to the falsehood that sex is an unchangeable biological constant. This is not just inaccurate, it’s dangerous. A person’s dominant hormone profile is often the most decisive factor in determining health risks, treatment responses, and medical needs. By forcing a sex-at-birth model onto medical records, the Sullivan Review is advocating for a system that will lead to misdiagnoses, inadequate treatment, and worse health outcomes for trans people and others with hormone-related conditions.

The Myth of ‘Biological Sex’ as a Medical Standard

Medical records have long relied on ‘biological sex’ as a baseline for diagnosis, but this is an outdated and scientifically lazy approach. Health risks are not dictated by chromosomes, they are driven by hormonal and physiological factors that evolve over a person’s lifetime.

For transgender people, this is particularly critical. A trans woman on oestrogen does not share the same cardiovascular risk profile as a cisgender man, just as a trans man on testosterone will experience changes in bone density, muscle mass, and blood composition that align with cisgender men, not women. Treating patients based on their assigned sex at birth instead of their actual physiology is not just bad medicine, it’s malpractice.

Hormones Define Health Risks, Not Sex

Sex-based assumptions in medicine have long been flawed, but for trans people, they are actively harmful. Consider the following:

• Heart Disease: Oestrogen lowers heart disease risk, meaning trans women on HRT have risk factors more aligned with cis women. Trans men on testosterone, however, develop a cardiovascular profile similar to cis men. Misclassifying patients can lead to inappropriate treatment and misdiagnosis.
• Bone Health: Oestrogen is vital for maintaining bone density. Trans men not receiving adequate monitoring for osteoporosis or trans women being overlooked for bone health concerns, face serious long-term risks.
• Cancer Screening: A sex-based approach to cancer screening is flawed, yes trans women still need prostate exams but they also may need breast screenings, and trans men may still need breast and cervical screenings. Ignoring gender identity in medical data leads to gaps in care that put lives at risk.

Medical Records Must Reflect Reality, Not Gender-Critical Ideology

Doctors relying on ‘biological sex’ alone are more likely to miss key health risks, especially for trans patients. If a trans woman arrives at A&E with chest pain and her records list her as ‘male,’ she may not receive appropriate cardiovascular assessments due to outdated assumptions about male heart attack symptoms. A trans man on testosterone experiencing gynaecological issues may struggle to be taken seriously if his medical records erase the reality of his current physiology.

To fix this, healthcare systems must:

• Overhaul Medical Records: Gender identity, current hormone levels, and relevant medical history must replace the default binary sex marker.
• Train Healthcare Providers: Doctors need education on trans healthcare to prevent medical negligence rooted in ignorance.
• Invest in Research: Decades of biased, sex-based medical studies must be corrected with trans-inclusive research that accounts for the realities of hormone therapy and gender identity.

The Sullivan Review is a Political Weapon, Not Science

The Sullivan Review is not just misguided—it is a deliberate effort to erase trans people from medical data, forcing outdated binary classifications that have no place in modern medicine. This review ignores decades of endocrinological research and dismisses the lived realities of trans patients and their healthcare providers. By entrenching a sex-at-birth framework, it actively endangers lives.

This is not about ‘scientific accuracy’, it is about forcing a gender-critical ideology into medical policy. The review was commissioned by the Conservative Party, but it has now been seized upon by Labour politicians like Keir Starmer and Wes Streeting, who are shamelessly capitalising on the relentless anti-trans media campaign to score political points. Rather than standing up for trans rights, Labour has chosen to weaponise this review, betraying the very people they claim to represent.

The Sullivan Review is not about improving healthcare. It is a tool of oppression. It seeks to strip away the legal and medical recognition of trans people, undermining their rights under the Equality Act 2010, the Gender Recognition Act 2004, and the Human Rights Act 1998. It is a manufactured crisis designed to justify discrimination and roll back trans rights under the guise of ‘data collection.’

The Fight for Better, Safer Healthcare

The Sullivan Review must be rejected in full. The UK government must commit to evidence-based medical practices that prioritise gender identity and hormonal reality over ideological dogma. Anything less is a betrayal of trans people’s right to safe, effective healthcare.

Relying on ‘biological sex’ is not just outdated, it is dangerous. Medicine must catch up with reality, and that means treating trans patients based on who they are now, not the outdated labels forced onto them at birth. Lives depend on it. Trans people will die from this—and for those behind it, that’s not a flaw, it’s the goal.