The World Health Organization (WHO) intends to update its manual “Gender mainstreaming for health managers: a practical approach” stating “that sex is not limited to male or female”.

From the WHO they explain that they are modernizing their manual, published in 2011 and that they are going to update it with “new scientific evidence and conceptual progress on gender, health and development”.

They will also go “beyond binary approaches to gender and health to recognize gender and sexual diversity, or the concepts that gender identity exists on a continuum and that sex is not limited to male or female.”

Several scientists have spoken out against these assertions, precisely because they lack any scientific basis, in contrast to what the WHO affirms.

One of them is Jenny Gamble, Professor of midwifery at Coventry University, who has already written a scientific article in response to another published in The Lancet in which the term woman was replaced by “bodies with vaginas”.

Speaking to MailOnline she described the WHO change as “problematic”. “It is a dismissal of basic biology and mistake” she said. “Biology is a key determinant of health and illness.” “Not being clear about basic biology opens the door to a range of problems, including very poor health communication but also distorted data,” Gamble concluded.

Likewise, Dr. Karleen Gribble, Professor at the Western Sydney University School of Nursing and Midwifery, stated that “‘The wording regarding there being more than male and female sexes is concerning.” According to the WHO, the manual is being updated “in the light of new scientific evidence and conceptual progress on gender, health and development.” “‘However, there is no new scientific evidence suggesting there are more than two sexes.” “‘Rather, the idea that there are more than two sexes, is a postmodern, unscientific understanding that should not be supported by the WHO.”

Bioethical assessment

As we have previously published in our Observatory, the sex of a person is a defining characteristic of the individual, determined from the moment of conception by the genome, which will promote integral development differentiated as male or female, that is, binary, affecting the neurological, psychological, anatomical, endocrine, immunological and biochemical characteristics.

The concept of “gender”, although directly conditioned by this previous biological reality, refers rather to traits of masculine or feminine behavior and their social interaction. It includes the self-concept of one’s own sexual identity, which, unlike sex, can be influenced by external or internal factors, which can cause the immutable biological reality of sex to diverge from its associated perception and behavior, gender.

Confusing this with the existence of more than two sexes is a serious mistake, all the more serious because it comes from an international organization of the importance of the WHO.


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