IMPORTANCE OF SEXED LANGUAGE – Effective communication about pregnancy, birth, lactation, breastfeeding and newborn care: the importance of sexed language

by Karleen D Gribble, Susan Bewley, Melissa C Bartick, Roger T Mathisen, Shawn Walker, Jenny Gamble, Nils J Bergman, Arun Gupta, Jennifer J Hocking, Hannah G Dahlen

Frontiers in Global Women’s Health, Section on Maternal Health. 7 February 2022, Volume 3.

“On 24 September 2021, the Lancet medical journal highlighted an article on its cover with a single sentence in large text; “Historically, the anatomy and physiology of bodies with vaginas have been neglected.” This statement, in which the words “women’s bodies” were replaced with the phrase “bodies with vaginas,” is part of a trend to remove sexed terms such as “women” and “mothers” from discussions of female reproduction. The good and important intention behind these changes is sensitivity to, and acknowledgment of, the needs of people who are biologically female and yet do not consider themselves to be women because of their gender identity. However, these changes are often not deliberated regarding their impact on accuracy or potential for other unintended consequences. In this paper we present some background to this issue, describe various observed impacts, consider a number of potentially deleterious consequences, and suggest a way forward.”

“Sex (a reproductive category), gender (a societal role), and gender identity (an inner sense of self) are not synonymous. Sex is salient to reproduction, as there are only two gametes and pubertal pathways to adulthood and gamete production, and only one gamete producing body type that becomes pregnant. As a general principle of communication, it is well established that the sex of individuals should be made visible when it is relevant and should not be invoked when it is not. This facilitates avoidance of sex stereotyping while ensuring that sex-based needs and issues are not overlooked. In communication related to female reproduction, sexed language including the words “women” and “mothers” has therefore predominated. Yet, this usage has been challenged in response to rising numbers and visibility of people who have a gender identity which means they do not wish to be referred to as such. As described below, we should address individuals as they wish, but more broadly there are risks to desexing language when describing female reproduction.”

“The discussion here is presented with an explicitly global audience in mind. While people who do not conform to the social expectations of their sex are ubiquitous throughout the world, the response to such individuals is influenced by the culture in which they reside. This includes in the level of acceptance or marginalization they experience, the ways in which they are accommodated and the ways in which their non-conformity is conceptualized. It should be recognized that the penalty for non-conformity with gender roles can be high. Where the concept of gender identity is salient, desexing the language of female reproduction has emerged as an accommodation to remedy marginalization. However, it needs to be kept in mind that pregnant and birthing women and new mothers and their infants have unique vulnerabilities and also require protection.”

The paper goes on to define and discuss “the concept of gender identity and Queer Theory, the twin propositions that both sex and gender are socially constructed and that gender is the more important of the two…. The number of children, adolescents, and adults, reporting gender identities in conflict with their sex (described as being “transgender”) has grown dramatically in recent years. Alongside this increase, the idea that not everyone who gives birth is a woman has gained prominence.”

“Crucially, words such as “woman,” and “mother” can have both sexed and gendered meanings….”

“In response to Queer Theory-derived concerns, many organizations and individuals are changing the language they use to describe women so as to prioritize gendered understandings and avoid sexed terminology. These language changes are intended to avoid distress, are described as inclusive, and are encouraged by diversity, equity, and inclusion initiatives. Desexed language is most common in the English-speaking West, but it is increasingly being applied internationally. However, there appears to have been little consideration of the ethics of these changes, including the principles of avoiding harm and health maximization, or how they may impact on women and children’s rights.”

It continues by looking at what the consequences of these language changes are and argues that they decrease overall inclusivity, dehumanise women and mothers, and include people who should be excluded, as well as creating confusion and disembodying and undermining breastfeeding. It then discusses the significance of the word “mother” as perhaps the oldest word in every language. It then raises broader issues for policy, advocacy and research. For example, it says: 

“It has long been recognized that language plays a role in advocacy. For this reason, feminist linguistic activism of the 1970-80s sought to remove sexist language from public life. Women used to be invisible when “he” or “men” were used as the default contributing to the disregard of women in research, policy, and public life. In the midst of the current move to desex language, we argue that if women and mothers are not named, it makes it more difficult to effectively advocate for them; “women” disappear into “people” and “mothers” disappear into “parents.””

The authors then go on to discuss ways forward, taking account of the origins of and purpose of gendered language and the continuing need for sexed language. They conclude by offering a list of questions that authors should ask themselves when they are writing about these matters.