2024-05-162023/24:SoU21 · p.12SoUHealth & social services
Record-keeping, etc.
Terminology for sex/gender in patient medical records
What's at stake: Which terms are used in medical records and other care documentation can affect both the clarity of medical information and how patients feel they are treated. The issue concerns everyone who comes into contact with healthcare documentation.
Case texts and AI reasoning are AI-translated from the Swedish originals; the Swedish text is authoritative.
What the vote decides
The question is whether the government should be called on to ensure that the terms 'woman' and 'man' (and 'girl' and 'boy') are used in patient records and other healthcare documentation instead of gender-neutral alternatives, or whether terminology should continue to be handled as it is today.
Yes Yes — the committee proposal
The committee rejects the motion to regulate which terms should be used for sex/gender in patient records. It regards the issue as part of the ongoing development work on digital healthcare documentation and does not consider there to be grounds for the Riksdag to direct a formal call to the government specifically on this point.
No No — the reservations
Reservation 15 (SD)
The reservation (SD) calls for the terms 'woman' and 'man' - and, where appropriate, 'girl' and 'boy' - to be used when indicating sex/gender in patient records and other healthcare documentation, instead of terms such as 'menstruating persons', 'uterus-bearer' or 'prostate-bearer'. The government should review the matter.
Summarised from the committee report. Party labels in the summary come from the report, not from the vote.
What do the votes mean here?
Yes The committee proposal: rejecting the motions (keeping things as they are).
No Backing the counter-proposal: reservation 15 by SD.
Abstain The party marks a position of its own that is not one of the two final alternatives.
What each plan points to — and how the party voted
For each party: the vote its own election manifesto and party programme point to in this case, next to how the party actually voted. A plan can only point to Yes or No; a party can also abstain.
| Plan | Vote | Confidence | Evidence | ||
|---|---|---|---|---|---|
| V | Yes | Yes 19/0/0/5 | follows the plan | confidence: medium | not addressed |
| S | Yes | Yes 93/0/0/13 | follows the plan | confidence: low | not addressed |
| MP | Yes | Yes 13/0/0/5 | follows the plan | confidence: medium | not addressed |
| C | Yes | Yes 19/0/0/5 | follows the plan | confidence: low | not addressed |
| L | Yes | Yes 12/0/0/4 | follows the plan | confidence: medium | not addressed |
| KD | No | Yes 14/0/0/5 | departs from the plan | confidence: medium | not addressed |
| M | No | Yes 60/0/0/8 | departs from the plan | confidence: low | not addressed |
| SD | No | No 0/61/0/11 | follows the plan | confidence: medium | derived |
Committee proposal
The Riksdag rejects the motion 2023/24:386 by Michael Rubbestad et al. (SD) proposal 12.
Original (Swedish)
Riksdagen avslår motion 2023/24:386 av Michael Rubbestad m.fl. (SD) yrkande 12.
Riksdag decision: The Riksdag said no to approximately 90 proposals in motions about competence supply, e-health and preparedness that were submitted during the general motion period 2023. The motions concern, among other things, training of personnel in occupational health services, competence supply and qualifications, work environment, questions about life science, healthcare in sparsely populated areas, and health and medical services preparedness. The Riksdag refers, among other things, to ongoing work in the field.
Counter-proposals
- The counter-proposal wants to strengthen healthcare personnel's competence in recognizing early signs of mental illness and ensure primary care's access to specialist psychiatric expertise. (SD) — Reservation 15
Plan vs actual vote
Every party, in chamber order: what its own plan pointed to, how it voted, and the reasoning behind both. Highlighted rows are where the two differ — but a vote that follows the plan is a result too, so the reasoning is there for every party.
The party programme wants to strengthen LGBTQIA+ people's rights, introduce a gender recognition law based on self-determination and a third legal sex, and explicitly criticizes the binary gender norm.
Plan documents: party programme
Reasoning and quotes
The party programme wants to strengthen LGBTQIA+ people's rights, introduce a gender recognition law based on self-determination and a third legal sex, and explicitly criticizes the binary gender norm. To legislate away gender-neutral language use in care documentation and bind it solely to woman and man goes against these commitments. The plan instead wants legislation that is based on how people actually live.
Original (Swedish)
Partiprogrammet vill stärka hbtqia+-personers rättigheter, införa en könstillhörighetslag byggd på självbestämmande och ett tredje juridiskt kön, och kritiserar uttryckligen tvåkönsnormen. Att lagstifta bort ett könsneutralt språkbruk i vårddokumentationen och binda den vid enbart kvinna och man går emot dessa åtaganden. Planen vill i stället att lagstiftningen utgår från hur människor faktiskt lever.
- gender based on self-determinationdecisive»också se en könstillhörighetslag som baseras på självbestämmande« (party programme ↗)“also see a gender recognition law that is based on self-determination”
- third legal sex»och införa ett tredje juridiskt kön.« (party programme ↗)“and introduce a third legal sex.”
- strengthened LGBTQIA+ rights»Vi ser det som avgörande att stärka hbtqia+-personers rättigheter i en« (party programme ↗)“We consider it crucial to strengthen LGBTQIA+ people's rights in”
- legislation close to reality»Vi vill fortsätta att gå mot en lagstiftning som utgår« (party programme ↗)“We want to continue to move towards legislation that is based”
The party programme sets as a goal a society without homophobia and transphobia and counts gender identity among the power structures to be combated.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The party programme sets as a goal a society without homophobia and transphobia and counts gender identity among the power structures to be combated. Locking the concepts of gender affiliation in medical documentation in parliament decisions runs in the opposite direction from that principle. The plan does not address documentation at all, so the position is inferred from the most closely related values.
Original (Swedish)
Partiprogrammet sätter som mål ett samhälle utan homo- och transfobi och räknar könsidentitet bland de maktstrukturer som ska bekämpas. Att i riksdagsbeslut låsa vårddokumentationens begrepp för könstillhörighet går i motsatt riktning mot den principen. Planen behandlar inte journalföring alls, så ställningstagandet är härlett ur närmast liggande värdering.
- society without transphobiadecisive»klasskillnader, patriarkat, rasism eller homo- och transfobi« (party programme ↗)“class differences, patriarchy, racism or homophobia and transphobia”
- gender identity as power structure»Klass, kön, etnicitet samt könsidentitet och sexuell läggning är några av de« (party programme ↗)“Class, gender, ethnicity and gender identity and sexual orientation are some of the”
- women's right to bodily autonomy»Vi socialdemokrater står upp för alla kvinnors rätt att bestämma över sin egen kropp.« (2022 manifesto ↗)“We social democrats stand up for all women's right to decide over their own bodies.”
The election manifesto commits to strengthening transgender people's rights and introducing a third legal sex, and the party programme says that the division into either woman or man limits people who cannot clearly identify as such.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The election manifesto commits to strengthening transgender people's rights and introducing a third legal sex, and the party programme says that the division into either woman or man limits people who cannot clearly identify as such. Locking care documentation in law to the terms woman and man goes against that commitment and against the right to define oneself.
Original (Swedish)
Valmanifestet åtar sig att stärka transpersoners rättigheter och införa ett tredje juridiskt kön, och partiprogrammet säger att indelningen i antingen kvinna eller man begränsar människor som inte entydigt kan identifiera sig så. Att i lagstiftning låsa vårddokumentationen till begreppen kvinna och man går emot det åtagandet och emot rätten att definiera sig själv.
- third legal sexdecisive»stärka transpersoners rättigheter genom en ny könstillhörighetslag, och införa ett tredje juridiskt kön« (2022 manifesto ↗)“strengthen transgender people's rights through a new gender identity law, and introduce a third legal sex”
- the binary gender model limits»Indelningen i antingen kvinna eller« (party programme ↗)“The division into either woman or”
- right to define oneself»Först när alla människor erkänns för vilka de är« (party programme ↗)“First when all people are recognised for who they are”
- gender-neutral policy»anpassa familjepolitiken så att den blir könsneutral och stärka rättigheterna för stjärnfamiljer« (2022 manifesto ↗)“adapt family policy so that it becomes gender-neutral and strengthen the rights of rainbow families”
The plan says nothing about what concepts shall be used for gender identity in care documentation.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The plan says nothing about what concepts shall be used for gender identity in care documentation. The closest principle is that every individual has the right to create their own identity and that discrimination based on gender identity and gender expression shall be combated, which speaks against the Riksdag politically prescribing terminology in records. The conclusion is thus based on a derivation from the plan's freedom and equal treatment principles, not on an explicit commitment.
Original (Swedish)
Planen säger ingenting om vilka begrepp som ska användas för könstillhörighet i vårddokumentation. Närmast liggande princip är att varje individ har rätt att skapa sin egen identitet och att diskriminering på grund av könsidentitet och könsuttryck ska bekämpas, vilket talar emot att riksdagen politiskt föreskriver terminologin i journaler. Slutsatsen bygger alltså på en härledning ur planens frihets- och likabehandlingsprinciper, inte på ett uttalat åtagande.
- right to own identitydecisive»Varje individ har rätt att skapa sin egen identitet.« (party programme ↗)“Every individual has the right to create their own identity.”
- ban on discrimination»kön, ålder, sexuell läggning, könsidentitet, könsuttryck, funktionsnedsättning,« (party programme ↗)“sex, age, sexual orientation, gender identity, gender expression, disability,”
- protect minorities' rights»inskränka kvinnors, minoriteters och HBTQI-personers rättigheter« (2022 manifesto ↗)“restrict women's, minorities' and LGBTQ people's rights”
The plan commits to strengthening LGBTQI competence in healthcare and ensuring that every person can live in freedom and security regardless of gender, which argues against the Riksdag fixing what gender concepts healthcare documentation may use.
Plan documents: 2022 manifesto
Reasoning and quotes
The plan commits to strengthening LGBTQI competence in healthcare and ensuring that every person can live in freedom and security regardless of gender, which argues against the Riksdag fixing what gender concepts healthcare documentation may use. The plan additionally wants political detailed governance of healthcare activities to decrease. The counter-proposal's demand is therefore rejected.
Original (Swedish)
Planen åtar sig att stärka hbtqi-kompetensen i vården och att varje människa ska kunna leva i frihet och trygghet oavsett kön, vilket talar mot att riksdagen låser fast vilka könsbegrepp vårddokumentationen får använda. Planen vill dessutom att den politiska detaljstyrningen av vårdens verksamheter ska minska. Motförslagets krav avvisas därför.
- strengthened LGBTQI competence in healthcaredecisive»Hbtqi-kompetensen i vård, skola och omsorg ska stärkas och ett lagskydd mot omvändelseterapi ska införas.« (2022 manifesto ↗)“LGBTQI competence in healthcare, education, and care shall be strengthened and legal protection against conversion therapy shall be introduced.”
- freedom regardless of gender and sexual orientation»Men det handlar också om varje människas rätt att leva sitt liv i frihet och trygghet, oavsett kön eller sexuell läggning.« (2022 manifesto ↗)“But it is also about every person's right to live their life in freedom and security, regardless of gender or sexual orientation.”
- less political detailed governance»Samtidigt ska detaljstyrningen och byråkratin minska i verksamheterna.« (2022 manifesto ↗)“At the same time, detailed governance and bureaucracy in operations shall decrease.”
The party programme establishes that women and men can have different symptoms and different healthcare needs and that healthcare must consciously take these differences into account; documentation that records gender as woman or man is a prerequisite for this.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The party programme establishes that women and men can have different symptoms and different healthcare needs and that healthcare must consciously take these differences into account; documentation that records gender as woman or man is a prerequisite for this. The election manifesto also wants national standards for all digital healthcare information. The counter-proposal's requirement is thereby in line with the plan.
Original (Swedish)
Principprogrammet slår fast att kvinnor och män kan ha olika symtom och olika vårdbehov och att vården medvetet måste beakta dessa skillnader; en dokumentation som anger kön som kvinna eller man är en förutsättning för det. Valmanifestet vill dessutom ha nationella standarder för all digital vårdinformation. Motförslagets krav ligger därmed i linje med planen.
- gender has medical significancedecisive»Kvinnor och män kan ha olika symptom och olika vårdbehov« (party programme ↗)“Women and men can have different symptoms and different healthcare needs”
- national standards for healthcare information»Trygg patientsäkerheten med nationella standarder och tekniska specifikationer för all digital vårdinformation.« (2022 manifesto ↗)“Secure patient safety with national standards and technical specifications for all digital healthcare information.”
- research on both genders»inriktas på både kvinnor och män.« (party programme ↗)“be directed at both women and men.”
The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.
The plan says nothing about terminology in patient records.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The plan says nothing about terminology in patient records. Closest lies the party programme's explicit opposition to identity politics' collectivism and the election manifesto's prioritization of women's diseases and earlier diagnoses, which presupposes that sex is clearly stated in medical documentation. Based on these principles the plan speaks for the counter-proposal's requirement, but the evidence is thin.
Original (Swedish)
Planen säger inget om terminologin i patientjournaler. Närmast ligger idéprogrammets uttryckliga motstånd mot identitetspolitikens kollektivism och valmanifestets prioritering av kvinnors sjukdomar och tidigare diagnoser, vilket förutsätter att kön anges tydligt i vårddokumentationen. Utifrån dessa principer talar planen för motförslagets krav, men underlaget är tunt.
- rejected identity politicsdecisive»Denna identitetspolitikens kollektivism strider mot« (party programme ↗)“This identity politics' collectivism contradicts”
- women's diseases are prioritized»Stärka forskningen gällande sjukdomar som drabbar kvinnor« (2022 manifesto ↗)“Strengthen research regarding diseases that strike women”
- accurate diagnosis»Förbättra möjligheterna att ställa tidigare diagnoser, bland annat med hjälp av digitala beslutsstöd och strukturerade arbetssätt med till exempel riskprofilering« (2022 manifesto ↗)“Improve opportunities to make earlier diagnoses, among other things with the help of digital decision support and structured working methods such as risk profiling”
The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.
The plan explicitly opposes questioning the human biological sex and against translating gender theories into practice in public activities.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan explicitly opposes questioning the human biological sex and against translating gender theories into practice in public activities. The party programme states that there are biological differences between women and men. Using the terms woman and man in medical records instead of circumlocutions follows directly from that stance.
Original (Swedish)
Planen vänder sig uttryckligen mot att människans biologiska kön ifrågasätts och mot att genusteorier omsätts i praktiken i offentlig verksamhet. Partiprogrammet slår fast att det finns biologiska skillnader mellan kvinnor och män. Att journalföringen använder begreppen kvinna och man i stället för omskrivningar följer direkt av den hållningen.
- biological sex recognizeddecisive»Människans biologiska kön ifrågasätts och barns naturliga utveckling och intressen har problematiserats.« (2022 manifesto ↗)“The human biological sex is questioned and children's natural development and interests have been problematized.”
- against gender theories»Vi tror på vetenskap och inser att förvirrande genusteorier får förödande konsekvenser när de omsätts i praktiken.« (2022 manifesto ↗)“We believe in science and realize that confusing gender theories have devastating consequences when put into practice.”
- biological sex differences»På kollektiv nivå finns det biologiska skillnader mellan kvinnor och män« (party programme ↗)“At the collective level there are biological differences between women and men”
- national health documentation»Införa ett nationellt patientjournalsystem« (2022 manifesto ↗)“Introduce a national patient record system”
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Sources and documents
- The committee report on riksdagen.se (2023/24:SoU21)
- Committee report full text (HB01SoU21)
- Per-MP voting data (API)
- Case status (API)
Documents under consideration
- Motion 2023/24:1002 — Rätt till tolk inom hälso- och sjukvården av Helén Pettersson och Åsa Karlsson (båda S)
- Motion 2023/24:1041 — Digital vård av Carina Ödebrink m.fl. (S)
- Motion 2023/24:1084 — Bemötande av våldsutsatta kvinnor av Azra Muranovic m.fl. (S)
- Motion 2023/24:1092 — Svenskar i utlandet av Markus Wiechel m.fl. (SD)
- Motion 2023/24:1127 — En sömlös vård av Helena Storckenfeldt och Lars Püss (båda M)
- Motion 2023/24:1172 — Integritetsskydd vid Ivo-anmälningar av Markus Wiechel (SD)
- Motion 2023/24:1191 — Internationellt kris- och hälsosamarbete av Markus Wiechel (SD)
- Motion 2023/24:1208 — Nationella beredskapslager av Ann-Christine Frohm Utterstedt och Eric Westroth (båda SD)
- Motion 2023/24:1239 — Delegationer i sjukvården av Martina Johansson (C)
- Motion 2023/24:128 — Betalningsansvar för outnyttjade tolktjänster av Eric Palmqvist (SD)
- Motion 2023/24:1348 — Begränsning av bemanningsföretagen i vården av Peder Björk m.fl. (S)
- Motion 2023/24:1393 — Gemensamt it-system i vården av Peter Ollén (M)
- Motion 2023/24:1538 — Marknadsföring av nätläkare av Johan Löfstrand m.fl. (S)
- Motion 2023/24:1584 — Legitimation eller skyddad yrkestitel för ortoptister av Ulrik Nilsson (M)
- Motion 2023/24:1682 — Anonymisering av sjukvårdspersonal i patientjournaler av Eric Westroth (SD)
- Motion 2023/24:1812 — Osteopati av Elisabeth Thand Ringqvist (C)
- Motion 2023/24:19 — Insyn i barns läkemedelslista av Ann-Christine From Utterstedt (SD)
- Motion 2023/24:1929 — En nationell digital infrastruktur för sjukvård och äldreomsorg av Gunilla Carlsson och Amalia Rud Pedersen (båda S)
- Motion 2023/24:2069 — En stärkt psykisk hälsa i hela landet av Carina Ståhl Herrstedt m.fl. (SD)
- Motion 2023/24:2072 — Folkhälsan i fokus av Carina Ståhl Herrstedt m.fl. (SD)
Source: The Swedish Parliament