Acclaimed Canadian novelist Margaret Atwood recently caused an online furore for sharing an article entitled ‘Why can’t we say the word ‘woman’ anymore?’
The article in question, authored by Star columnist Rosie DiManno, argued that:
“Woman” is in danger of becoming a dirty word … struck from the lexicon of officialdom, eradicated from medical vocabulary and expunged from conversation.
Which is a bitchy thing to do to half the world’s population.
Critics were quick to label the article “transphobic”, sending “shockwaves through the trans community”, arguing that Atwood’s “choice of sharing this piece is simply one of many that threatens the group’s livelihood – serving as a dog whistle for anti-trans legislation and sentiment”.
One of Atwood’s novels, ‘The Handmaid’s Tale’, imagines a world where women become ‘invisible’, ‘reduced to the sum total of their biological parts’. So she is completly on-message when she complains about the new requirements of ‘inclusive’ language that replaces sex-specific concepts like ‘woman’ and ‘mothers’ with ‘gender-neutral language’, such as ‘people who menstruate’, ‘uterus owners’, ‘bodies with vaginas’, ‘pregnant people’ and ‘chest feeders’.
Predictably, attempts to reclaim language that is specific to women as female are met with charges of transphobia, violence, and hate speech.
A new article, authored by ten prominent women’s health researchers from around the world has directly challenged this global trend to desex language, highlighting some of the real life concerns and practical consequences of removing sex and sex specific references from language, especially when it comes to issues of pregnancy, birth, lactation, breastfeeding and newborn care.
Attributing honourable motives to those promoting the new desexed language, the authors nevertheless argue that “this kindness has delivered unintended consequences that have serious implications for women and children”. They identify numerous issues that arise as a result, of which three stand out: 1) a decrease of overall inclusivity; 2) the dehumanising of women by reducing them to body parts or biological processes; and 3) the introduction of inaccuracy to health communication, which precludes precision and creates confusion.
It decreases overall inclusivity
The authors point out that using imprecise or vague language creates barriers to communication that particularly disadvantages marginalised groups:
“Avoiding sexed terminology in relation to female reproduction works against the plain language principle of health communication and risks reducing inclusivity for vulnerable groups by making communications more difficult to understand. Those who are young, with low literacy or education, with an intellectual disability, from conservative religious backgrounds, or being communicated to in their non-native language are at increased risk of misunderstanding desexed language.”
Secondly, the authors argue that desexed language dehumanises women by using terms that refer to body parts or physiological processes:
“Referring to individuals in this reduced, mechanistic way is commonly perceived as ‘othering’ and dehumanizing. For example, the term ‘pregnant woman’ identifies the subject as a person experiencing a physiological state, whereas ‘gestational carrier’ or ‘birther’ marginalizes their humanity. Efforts to eliminate dehumanizing language in medical care are longstanding, including in relation to women during pregnancy, birth and new motherhood. Using language that respects childbearing women is imperative given the prevalence of obstetric violence. Considering women in relation to males as ‘non-men’ or ‘non-males’ treats the male body as standard and harkens back to the sexist Aristotelian conceptualization of women as failed men.”
Introduces inaccuracy and precludes precision
Thirdly, desexing language introduces inaccuracy, precludes precision and creates confusion:
“Replacing a word with another of different meaning as if they are synonymous makes communications inaccurate or confusing. For example, in a growing number of papers, the severity of Covid-19 disease in pregnant women is being misrepresented by comparing ‘pregnant people’ to ‘non-pregnant people’ when the comparator in the research in question is ‘non-pregnant females’. Given the greater severity of covid-19 disease in males, this misrepresentation means readers may under-estimate disease severity in pregnant women.”
“In the Australian Department of Health case, the mistake appeared when a previously published document was updated and a seemingly simple and innocuous ‘find and replace’ undertaken with the word ‘women’ switched with ‘people’. This change made the statistics on disease severity incorrect.”
Why does all this matter? The issue is fundamentally important because of the potentially serious impacts it can have on the delivery of health outcomes to pregnant women and their infants, who have unique vulnerabilities and health needs based on their sex.
The authors note the sobering statistics related to maternal and infant health around the world:
“Each day, an estimated 810 women die during pregnancy, birth and afterwards, with the majority of deaths in low and middle income countries. More women across low, middle and high income countries suffer life threatening pregnancy and birth complications with short and long term consequences. Maltreatment and obstetric violence occurs everywhere and significantly contributes to birth trauma. Puerperal psychosis affects 1-2 in every 1,000 mothers often in the first few days after birth and is a leading cause of maternal death through suicide, as well as infanticide… Globally, 3.9 million infants die each year, over 800,000 of these deaths are attributable to premature cessation of exclusive or any breastfeeding.”
Jenny Gamble, former President of the Australian College of Midwives, and one of the co-authors of the article, argues that:
“Confusing the idea of gender identity and the reality of sex risks adverse health consequences and deeper and more insidious discrimination against women… Sex [a reproductive category], gender [a societal role], and gender identity [an inner sense of self] are not synonymous but are being treated as if they are.”
The authors make the point that a good practice going forward should be that medical records note both sex and gender identity (where relevant), making the point that “there is a dearth of knowledge about how to support the health needs of transgender individuals, particularly regarding the long-term health effects of hormonal treatments. Further research is urgently needed and in this research, data on sex remains vital”.
The health and wellbeing of pregnant women and their babies is one area where precision in language is critical. The authors push back against the argument that “objections to desexing the language of female reproduction can only be rooted in prejudice or resistance to change”. They argue that “there are significant implications to desexing language when referring to inherently sexed processes and states. These implications need to be openly discussed and thoughtfully considered”.