Though pregnancy and birth are most commonly consigned to the realm of women, many people who do not identify as women are capable of getting pregnant and giving birth. In fact, nonbinary, gender fluid, genderqueer, Two-Spirit, or transgender folks do get pregnant and require prenatal, perinatal, and postnatal care.
A hospital in the U.K. has made the news lately for switching to gender-inclusive terms in the maternity ward in an effort to counter mainstream transphobia and homophobia. The hospital issued new language guidelines to help staff members with the new terminology, but of course, true to form, some members of the public showed their asses and were upset.
Some examples of the language changes include swapping out “maternity” to “perinatal” services and wards, using the phrase “woman or person” instead of just “woman,” substituting “father” with “parent,” “co-parent,” or “second biological parent,” or using “chest milk” or “human milk” or “milk from the feeding mother or parent” instead of “breastmilk.”
In the guidelines, the hospital stated gender identity could be a source of oppression and health inequality, and that women, trans and non-binary people are often disadvantaged in healthcare. “We are consciously using the words ‘women’ and ‘people’ together to make it clear that we are committed to working on addressing health inequalities for all those who use our services.”
Again, the hospital is not advocating for excising gendered terms entirely — they are merely adding additional language to include people who do not identify as women or are not in heterosexual relationships. The logic is to help normalize all different kinds of people who need perinatal care and make folks feel safe. If and when people specify the terms they prefer, the medical staff will use those terms.
To quote the kids these days, it ain’t that deep.
Why gender-inclusive terms in medicine is important
The truth of the matter is this: trans people and non-binary exist and deserve to feel safe, acknowledged, and welcomed by health care providers. And while they are by no means the majority of folks getting pregnant or giving birth, their unique needs and concerns should still be understood and met with dignity and care. Sadly, it is not the experience for many — starting even from the terms used.
A 2019 Rutgers study discovered that almost 25% of transgender people reported negative experiences with healthcare in the last year. This can partially explain why of the pregnant transgender men, about 44% do not seek prenatal care with an OB/GYN, instead seeking nurse midwives and other non-physician providers, delivering outside of the hospital setting at rates higher than women do at 17%.
According to this 2015 U.S. Transgender Survey, around 40% of the respondents reported attempting death by suicide compared to 4.6% in the U.S. population. In the year prior to completing the survey, 1 in 3 respondents reported at least one negative experience related to their being transgender (e.g.: verbal harassment, refusal of treatment) when they saw their health care provider. 1 in 4 respondents said they didn’t seek health care in the last year due to fear of mistreatment — and 1 in 3 couldn’t afford to get care so they did not seek it even when needed.
That’s super fucked up.
Changing terms isn’t going to magically solve any of the systemic bias and personal bigotry transgender and gender non-conforming folks go through. But if you can’t even go through the initial awkwardness of familiarizing yourself with terminology new to you so that other folks don’t feel like shit, can you even call yourself a good person?
As of 2019, about 1.4 million transgender folks have transitioned in the U.S. and yet still, medical providers are woefully underprepared to sensitively care for them. Because the U.S. medical system tracks transgender men who have transitioned but still have their female reproductive organs as female, there is no data on the exact number of transgender men giving birth each year.
The research suggests that of the pregnancies occurring in transgender men using hormones, approximately 30% are unplanned compared to 45% in the U.S. general population. It is thought that some of these unplanned pregnancies are because transgender men undergoing hormonal therapy to transition are incorrectly told they cannot get pregnant because of the testosterone they are taking.
People need to CTFO and be kind and inclusive
Look, the term “breastfeeding” is likely not going away — so for those of you freaking out about the death of the term, chill. No one is taking away your right to use the terms that are applicable to yourself. However, like I tell my own kids, you are not the only person on this earth.
We need to be aware that some folks who breastfeed and give birth are not women and do not identify as women. Not all partners are “fathers,” and “chest feeding” is the more appropriate term for some parents.
Many transgender folks experience heightened gender dysphoria — which is the distress a person feels when their gender does not match their outside appearance — during and after pregnancy. Gender dysphoria in transgender people is linked to increased depression, suicidal ideation, and attempted and completed death by suicide.
Pregnancy and giving birth without gender dysphoria is already a fraught time with a person’s body marinating in hormones, and physical and emotional changes. Add to that the additional stressors of possible increased gender dysphoria, negative health experiences, and other traumas — using gendered terms such as “breastfeeding,” “woman,” or “mother” can exacerbate an already difficult time.
What does it hurt you to change your language so that we can be kind? You appreciate people referring to you by the correct pronouns and language markers; other people deserve that same consideration.
You are constantly learning new language
I will be the first to admit that I am somewhat of a snob when it comes to facility with the English language. I’d blame it on the occupational hazard of being a writer, but truthfully, it’s more because I’m anal retentive and believe words have meaning and it behooves us to use them properly. I will be first in line to bemoan the colloquial misuse of “literally” when people mean “figuratively.”
I’m not proud of the fact that I have been known to wage battle over the Oxford comma; we all have lines we do not cross.
But guess what? People are more important than words. To bastardize a saying by Jesus, language was made to serve people, people were not made to serve language.
Also, you are literally (in the only way I acknowledge) learning new words all the time. Language is not static — it drifts and morphs and transforms in clever and infuriating ways. And though it takes time, we can normalize inclusive terms by using words like chestfeeding, pregnant people, or human milk in our daily lives, in our writing, and in our search terms on the internet. (Incidentally, the more you search for gender inclusive terms, the more likely articles on the internet will reflect those terms because guess what? SEO drives a lot of the terms we use because articles want to be found.)
While we might never be able to make “fetch” happen, it is my great hope that we can change our vocabulary to include gender-inclusive words around pregnancy and birth.