The Problem With “Adding More Ink”

It leads to subtracting all the women

We are all being told that in our Brave New World it is important to pretend that sex is unimportant and even perhaps, meaningless. That gender is paramount and because of its fluidity and social construction, nothing is real, permanent or true so using imprecise language so as to avoid offending anyone is vital to prevent a tsunami of suicides among those who find words alone equate to mortal violence.

Well of course that last sentence is one that I just made up; it is usually phrased something like, “because our organization values everyone, we use gender neutral language to acknowledge the diverse range of people we serve”. Or this from the UN:

“Using gender-inclusive language means speaking and writing in a way that does not discriminate against a particular sex, social gender or gender identity, and does not perpetuate gender stereotypes.”

And in the land of the unicorns where fairies cavort and everyone is always happy, this is truly a state of wonderment and awe.

But in the world that I inhabit, composed of real people, who all have the sexed body they were born with (that they didn’t get to choose from a veritable array of choices), this doesn’t really fly.

Only women give birth and breastfeed

My arena is birth, and you can’t get more “sexed” than that. Call me old fashioned, but I don’t care which of the ever increasing genders you identify as, because if you were observed to be a boy at birth, you will never need my services as a midwife or breastfeeding supporter because you ain’t never having no baby, no siree. Sex is about our reproductive capacity and gender is a social role. You cannot choose to be either an egg or a sperm producer; you can choose how you wish other people see you, which leads to the erroneous statement that “not all pregnant people are women”, except in the sexed sense where they are all indeed, women.

However, I am clearly swimming against the tide here, as more and more governments, organizations and services rush headlong in an attempt to incorporate genderless language into maternity services. Whoops, that should have been “perinatal services” (doesn’t sound nearly as “motherly”). This attempt to conflate two entirely different aspects of humanity would be humorous, if it wasn’t so damaging for women and potentially dangerous for our babies.

I don’t care what your gender is, it’s your sex that matters

Because our sexed bodies are different, depending on which (of the only two) sexes that mammals possess, there has to be some way of telling us apart. Otherwise for say mass health screening initiatives we would have to go to the expense of performing mammograms on everyone; ditto for PSA blood tests even though it would be known in advance that at least 50% were going to be negative because that sex can’t get what is being screened for. (Men can get breast cancer, but for this sex, it’s very rare and mass screening is unjustified.)

For those who remain unconvinced that sexed bodies are substantially different, I highly recommend reading the book “Invisible Women” by Caroline Criado Perez. This well researched exploration of how women are ignored by patriarchal cultures and the deleterious effects of this ignorance should convince anyone with a thinking brain that sex is in no way a social construction, but a biological reality with physiological consequences for everyone.

If you want to be understood, keep it simple

An unfortunate effect of removing clarity from written communication is the erasure of women by the use of dehumanizing language. Breaking women down to their body parts is considered to be acceptable under the aegis of “inclusivity”. Which is ironic as those body parts are not part of bodies claiming a transgender identity. This would be bad enough if it was evenly applied to both sexes, but it is not. Women already suffer in relation to health care not because we “identify as” women, but because we are women.

This video from the Queensland Health Cervical Screening Program does not mention “women” once. Apparently only “people” need to be screened for cervical cancer.

And this ad even omits any mention of humans, let alone which sex needs to be screened:

Advertisements aimed at “women and people with a cervix” are promoting a false concept: that there are two sorts of women, which is of course the entire mantra of the trans lobby, who refer to natal women as “cis” (as opposed to “trans”, which is another false reinforcer for their narrative they promote for men who claim to be women).

In direct comparison, Prostate Cancer UK advertises with an unapologetic homage to manhood and the bold statement, “Men, we are with you”. No pussyfooting around here with a coy, “men or people with a prostate”.

A recent study discovered that layperson knowledge of basic anatomy and medical terms had only improved slightly over the last 50 years, and that many people still got basic organ placement wrong around 50% of the time. Another study demonstrated that not even half of British adults knew that women “have three holes down there”.

Erasing women from cervical screening advertising means that women will die from not realizing they needed to be screened.

Apparently “mother” is not inclusive

Did you realize that the words “female”, “women” and “mother” are now considered “harmful” and “offensive”? And that in the UK, NHS staff have been advised to treat all patients as “gender neutral” until their preferred gender has been confirmed?  I would have thought that in regard to medical care, far more important than your gender would be your sex. Because your sex is encoded in every single cell of your body, cannot be altered, responds differently to treatment and drug protocols and doesn’t have a ideological viewpoint.

Oxfam International is a charity that operates globally. Its stated aims are to fight inequality to end poverty and injustice; hence it has a large presence in less developed countries. It recently published a new “Inclusive Language Guide” for its employees and volunteers.

And what are some now forbidden words that must be erased? Not surprisingly, “mother” has been replaced by “parent” and "people who become pregnant" is preferable to "expectant mothers".

In the total lacuna of irony that is a hallmark of “inclusive” language, English is discouraged as it is a “colonialist language”. There is no recognition of the colonialist imposition of the Western philosophy known as queer theory that is being forced on everyone. And if English is verboten (um, even between native English-speaking entities?), how is communication to be fostered; hieroglyphics anyone?

Among other bits of reality-denying rubbish, the lie of “assigned at birth” trope is pushed:

It is bad enough when general purpose organizations buy into the compelled speech required by the trans lobby, but when groups founded with the aim of supporting women through birth and breastfeeding, it becomes appalling.

I thought that midwife meant “with woman”?

The Midwives Alliance of North America (MANA) was founded in 1982 for the purpose of countering the overwhelming influence of the male dominated medical profession in the obstetrical care of women in the USA. It was unapologetically women centered until September 2015 when their “Position Statement on Gender Inclusive Language” was published.

In what is a fairly long statement, there are very few “women” and no “mothers”; they have been replaced by “people”, “humans” and “pregnant and birthing folks”.

In an astonishing display of ignorance, readers are told that, “Biologic sex is defined as male and female; despite this apparent binary, biology is rarely a simple dichotomy and sex is no exception.” Quick, someone alert the world’s fertility clinics to let them know they can branch out from their dichotomous use of eggs and sperm in baby making!

This article in the British Medical Journal discusses the use of additive language in women’s health care and points out that language formulated to include trans “men” may leave women feeling excluded. And wonders how this may affect the overwhelming majority of women needing to access care tailored to them. This stunning research paper spells out exactly what happens when obfuscating, desexed language is used in maternity care.

This can also be seen during the height of the Covid-19 pandemic, when NICU visiting conditions were radically altered. If visiting was allowed at all, it was restricted to one “parent” at a time. When it comes to new babies, parents are not interchangeable Lego blocks. Yes, dads are important, but not nearly as important as mothers whose bodies are expecting to have constant contact with a new baby to establish a breast milk supply that is crucial for a baby’s lifelong optimal health. Being denied access to their babies (or feeling pressured to give up their time to the other parent) was highly stressful for mothers.

Disrupted maternal-infant bonding during this critical period has such profound effects that can lead to lifelong dysregulation in the mother/child relationship. This does not apply to “parents”, but to mothers.

Dr Nils Bergman who is a world-renowned physician specializing in newborn health has done research showing the mother’s body is the newborn’s natural “habitat” – with mother’s warmth and mother’s milk being essential to the optimal survival and regulation of the newborn. He is crystal clear on the importance of mothers (not generic parents) for infant wellbeing and survival.

Using “a variety of terms” to replace a word that everyone already understands

La Leche League International (LLLI) has happily jumped on board the trans express by changing its official policy to use “a variety of terms” in place of mother and by supporting “everyone” to breastfeed despite its Mission Statement:

Our Mission is to help mothers worldwide to breastfeed through mother-to-mother support, encouragement, information, and education, and to promote a better understanding of breastfeeding as an important element in the healthy development of the baby and mother.

Some of the alternative terms for mother now found in LLLI materials include “breastfeeding families”, “lactating parent” and “chestfeeding”. Taking this even further, a new goal is to substitute “human milk feeding” for breastfeeding and to not refer to breast milk at all. Anyone can feed a baby human milk (as long as they can find a “lactating parent” to supply it). It seems you don’t actually need a mother at all.

Personally, I think that mother is a perfectly adequate word to describe the role of women caring for children.

Every language in the world uses a word for mother to accommodate the early vocalizations of babies. Because m, p and b are the easiest sounds to form, every culture has a word for mother that makes it the norm for this to be one of the first understandable words that babies say. After all that hard work for the first months of caring for a new baby, we deserve this reward!

Used with the permission of the artist.

Erasing women endangers babies’ lives

Some of this unnecessary adding of language is merely annoying, but as in the case of skipped screening (because the message is not clear that it is for women), some attempts to include “everyone” in global health messaging is dangerous. There is no situation that better demonstrates this, than when you are supporting HIV+ women who are pregnant and wanting to breastfeed their babies. Mixed signals caused by sloppy and imprecise communication here can literally be deadly for babies and no amount of gender woo can change this fact.

For a comprehensive overview of what women need to do to safely breastfeed with HIV, this book will tell you everything you need to know and so much more. In brief, if a woman is taking her anti-HIV medication as prescribed and if she exclusively breastfeeds her baby, the risk of her baby becoming infected with HIV is negligible.

If she is unable or unwilling to meet either of these two conditions, to keep her baby from becoming infected she must formula feed her baby as this totally prevents her baby from contracting HIV from her milk. Of course, then her baby loses all the protection from every other disease and condition that formula fed babies are prone to, but women must weigh up the competing risks. Mixed feeding is never an option for an HIV+ mother.

It is only women who give birth and breastfeed. Vertical transmission of HIV to the baby can only be passed from mother to baby through pregnancy, birth or breastfeeding. Many women living with HIV live in countries in which the penalties for homosexuality or coming out as a transgender man or woman are severe. Thus “adding more ink” serves no purpose here other than virtue signaling and pandering to the feelings of a minuscule minority of women identifying as men who, if they have had “chest masculinizing surgery” (elective mastectomy), will not be able to produce milk in any case, so they will not need any breastfeeding guidance as they will be formula feeding their babies.

Health literacy is correlated with health outcomes. And in countries where HIV rates are higher, literacy rates are often lower. Simpler is better; additional words are more often confusing, rather than explanatory. Given these facts, why are all these extra words needed?

The British HIV Association Safer Triangle Booklet, which was updated in January 2023 and is meant for patient education uses these phrases:

Only breast/chestfeed if your breasts/chest and nipples are healthy

healthy breasts/chest

breast/chest injury or infection

discard your milk regularly from both breasts/sides of the chest

The British HIV Association Interim Statement on HIV and Mixed Infant Feeding, December 2022 contains these terms:

breast/chestfeeding

women/birthing parents

mother or birthing parent

expressed breast/chest milk

breast/chestfeeding mother or birthing parent

Who is this being written for? Mothers with real health challenges or an audience poised to criticize any lack of “inclusivity”?

Additive language sends the wrong message

There are not two types of women. A mother is a mother. Every language in the world has words for these that are universally understood by its speakers. A very few people are born with only one foot, but there is no global movement to protest selling socks in pairs as not inclusive of them. Global health messaging should be aimed at the widest possible audience, not directed at 1% of the population. Specific health needs can be tailored towards those that need them. Sex is the most important factor in determining how we live our lives; what opportunities are open (and closed) to us and what our life course will be. Keeping communication simple keeps it understandable and useful and obfuscating facts can be harmful.