"How inclusive language can help to reduce birth trauma"

I found this thread very interesting. It is a young trans-identified female who takes testosterone, has had a mastectomy and intends to get genital surgery. So hardly someone that TRAs could claim is bigoted and hateful to trans-identified people. Whilst I have many concerns about some of the poster’s experiences and views, she makes her feelings on this matter completely clear.

She made a few posts laying out how uncomfortable she is with inclusive language but this comment is particularly telling:
I hate terms like 'front hole', or the even worse 'bonus hole', to my core. I think they are utterly degrading. A vagina is not just a 'hole', any more than an anus or the oral cavity is. They are complex organs with a variety of functions. I don't like the fact that I have a vagina, but when needing to have health care discussions I would much rather it be called the correct term, than one that treats it as if it exists purely for the purpose of PIV intercourse.

She is exclusively attracted to women, has no desire to have receptive vaginal sex, and is a victim of rape. In light of all that, TRAs referring to her vagina as a bonus hole is particularly abusive, cruel and degrading in my opinion. This disgusting sexualised language is an attack on all women. Sadly, some trans-identifying women have been sufficiently gaslit to accept it, but her example highlights the clear universal truth of that fact.

I really don’t think that the constant demands to use this language is being done for the benefit of people like her. It is all about erasing the female sex to support the demands of men who want access to out private spaces. I believe that is why we don’t see men referred to as penis-havers, impregnators, or their penises called bonus dildos. Because trans-identified men would be very unhappy being referred to like that and it would undermine their efforts to invade our space. Clearly they don’t care one iota about how their advocacy harms women, trans-identified or not. Their priority is always for the feelings of men.

You also noted how the statistic about LGBTQ women is being abused to imply that trans-identification is the main issue faced by this group. Of course, the vast majority of those women are not trans-identified. My wife and I had our children before same sex parenting was fully understood or accepted. We definitely faced some prejudice and when I went into labour with our first child they tried to prevent her from staying with me.

We successfully challenged that but it was hurtful and distressing without a doubt. But that doesn’t compare to my previous experience of going through a fraught and prolonged labour without adequate pain relief and suffering a fourth degree tear as a child victim of sexual abuse. That was completely avoidable, should have been at the forefront of their mind in an underdeveloped 12 year old, and left me with long term pain.

Birth trauma is the physical and psychological trauma inflicted on women during labour - whether through unnecessary interventions like routine episiotomies or failure to notice or care when women are at high risk of an adverse outcome like I was. Hurt feelings and offence are not birth trauma.

Why does "inclusive" invariably seem to end up meaning "pandering to the delusional and the fetishists, preferably while reinforcing systemic misogyny"?

When I'm giving birth I want to be referred to as 'a pregnant woman, the Mother'. I don't want my most female of experiences in life fucked up by stupid diversity ticking. No thank you. If John in the suite next door is also having a vagina birth but wants to use opposite sex language about themselves so be it. Doesn't need to affect my experience.

@TicklishLemur I absolutely agree with you on specialist health messaging for transpeople. As you say, those who've taken hormonal or surgical steps to transition may have different needs to others of their sex, and it means that plain english can be used for the clearest messaging for the general population.

If you are pregnant and upset to the point of trauma by the wrong pronouns, I would suggest that social services and the mental health team would be a good bet due to the relationship between women and girls who identify as trans a history of trauma / sexual abuse in the past.

Maybe address this appropriately rather than being ridiculous and blame staff for using the correct pronouns for you.

Male people don't get pregnant. Only women.

If you are in this level of denial then there should be a whole bunch of concerns about your new child.

I detest the violently misogynistic and degrading terminology such as calling us baby carriers or referring to our front holes. I am also disgusted by the move to erase women and girls from information about female conditions. Finally I agree with others here who have pointed out how insulting it is to use birth trauma as an excuse to push for a movement that undermines and disrespects women.

However, one of the suggestions I think make sense - providing literature that is specific to trans-identified or detrans women where there is a need. It’s not a matter of agreeing on an ideological basis, but I don’t want anyone to be left without vital health care knowledge. Although the article constantly bangs on about inclusive language (which I can also assume means the erasure and degradation of women) it is far more important that they are accurately and clearly informed about their healthcare needs.

For example, in a lot of women testosterone use causes vaginal atrophy which can make cervical screening painful. If they and their health care providers are aware of this issue then there are things that can be done to make screening more comfortable.

I suffer from the same condition, but being post-menopausal it was something the nurse was already thinking about and so after examining me she prescribed an oestrogen pessary and rearranged to a later date when it had taken effect. I don’t imagine that would be at the front of your mind when caring for a young woman. It important that both she and her nurse are aware, because a painful and unpleasant experience could decrease future uptake rates.

I mentioned cervical screening because that is an issue that affects a lot more trans-identifying women than pregnancy, but the same is true in relation to pregnancy and contraception. A lot of trans-identified women falsely believe that testosterone use protects them from pregnancy when it does not. They also need to be informed that using testosterone whilst pregnant can cause birth defects in the developing foetus.

None of this is about accepting or supporting the use of drugs or surgery in trans-identified people, but on a practical level people do these things whether we think it is the correct way to manage their psychological issue or not. They and their doctor need to have an awareness of the medical consequences, and guidance specifically designed for these groups can provide that without degrading and erasing women and girls. Nor does that literature itself have to use misogynistic language; in fact I have seen several trans-identified women who are uncomfortable with this language too.

I can’t agree with those suggesting that the NHS shouldn’t spend the money, which frankly wouldn’t be very much, on producing this kind of guidance or suggesting it is wasteful. We all deserve health care that considers the individual needs and risk factors we have, and I can’t support the notion that any group is less entitled to this. Whether I agree with someone’s choices or beliefs has no impact on that.

Sorry if I’ve gone off on a bit of a tangent. I know the true issue most of us have is with the degrading language and treatment of women and girls, and I expect everyone here agrees about the need for complete transparency regarding the consequences of experimental hormonal and surgical interventions.

However, I wanted to raise the examples because I think the difference between these two approaches is sometimes overlooked, and I do believe that there are ways we can protect the health of trans-identifying people without promoting harmful and dangerous ideology.

I have little doubt that a pregnant woman would feel much more comfortable challenging well-meaning clumsy speech than challenging politicised speech being used about her and around her to control her thinking.

But a very loud drop in the ocean. Middle class, educated, demanding, influential. Especially compared to all those women who don't speak good English.

Fair enough. I should have said 'who don't identify as women'

It's still going to be a drop in the ocean.

I doubt most of them identify as men. But I bet there are a lot of "non-binary" women who resent being called "women".

As I said on another thread, I'd love to know what percentage of women (not LGBTQ+etc women but all those of the female sex however they identify):

Identify as a man
AND get pregnant
AND mind being referred to as a woman themselves
AND think this should trump all other women's rights and that all references to women, mother etc should be removed from medical and health literature.

It will be down in the tiny fractions of a percent, given that less than 1% of women identify as trans anyway.

I really object to the statistical
weaselling in that article, trying to imply that 28% (ooh, big number) of LGBTQ etc women are having traumatic births because of.... misgendering?

It makes it sound at a glance like 28% of women. This is why we need to know exactly who we are taking about, and the numbers not just percentages involved.

And using 'LGBTQ+' in this context is useless - no one giving birth is 'G'. Most of the 'L' probably want to be called women because that's what they are. Its ridiculous forced teaming to prioritise the T+ over everyone else.

Edit for typo

Stella O'Malley describes talking through the negative effects of taking male hormones with an autistic teenage girl who wanted to transition and her mother during therapy. The girl said very seriously "that would happen to you Stella because you're a woman not to me because I am a man". (My paraphrase)

We really do need to use sexed language to spot the people who are deeply and dangerously confused. It's not kind to pretend.

Or to please the pedant above, perhaps substitute 'lowest in the world' for 'zero' as yes, technically that would be impossible 🙄

We tell our socially inept kids that liberal use of the word 'technically' will not make you any friends!

Absolutely this 👏

I'd say inclusive language comes a long way below appropriate pain relief, paying attention to the signs that something is going wrong and intervening earlier, and enabling the labouring mum to feel like she's retaining a degree of control over what's happening, if you want to prevent both physical and emotional trauma.

I'm pretty sure it's because they want to become mothers, while at the same time they equate being treated as a fully human person with being treated as a man. Being (treated as / referred to as) a woman is shameful.
If I wasn't so sleep deprived I'd throw in a wonderful Mary Daly quote. Internalised mysogyny, that'll do.

Jaysus the entitlement. What is it that makes people so desperate to identify into oppression?

DEI initiatives in childbirth should be trying to address the truly horrific race-based gulf in maternal mortality. The fact in 2023 maternal mortality for Black women was almost four times higher than for White women (in the UK) is scandalous. The figure is the same for the USA (in some States it’s 7 times higher); & in Australia Aboriginal and St Torres Islander women are more than 3 x more likely to die than white women.

Improving access to & quality of maternity services for disabled women would be nice too. Just as one of those crazy radical thoughts.
BMJ Open

Of course, this means actual work - including addressing racism that many people refuse to accept &/or acknowledge exists - not doing find + replace in a range of documents & being smug about how wonderfully inclusive & progressive you are.

I wouldn’t have minded what they’d called me if they’d managed to empty my catheter after chopping through my bladder during my c section.

It’s such bullshit. I’m on a breastfeeding group on fb that’s riddled with chest feeding and the blue haired brigade. I’ll never understand how you can be so detached from your sexed body you’ll be offended by biologically accurate language but you’ll do something so wedded to your sexed body like get pregnant or breastfeed. No one’s ever explained it and I doubt they ever will.

Well, they would not. It is impossible to reduce infant and maternal mortality to zero.

Harumph. Person centred care is about the person being cared for. Not the person caring for them or telling Twitter how inclusive they are not.

Anyone else recall Ciara Curran's heart wrenching testimony about the impact of NHS erasure of terms like mother?

https://www.mumsnet.com/talk/womens_rights/5012863-the-reality-of-losing-sex-based-language?

https://www.dailymail.co.uk/health/article-13108207/Grieving-mother-gripping-teddy-memory-late-daughter-slams-dehumanising-NHS-erasure-terms-like-mother.html

It's not clear how this works. Women have been having traumatic births for many decades. Even now only a very small proportion of those who give birth, possibly less than 1%, identify as trans. So it's hard to see how inclusive language could have any impact beyond making it more difficult for women not fluent in English to understand official communication.

No, they can’t waste spend money on this bullshit. The NHS has a million other things to spend taxpayers’ money on.

Let's compromise: If a hospital or practice has a year long streak of a zero mortality rate for women and children in childbirth, they can spend their time on money on this kind of stuff.
Till the mortality rate for childbirth is zero, I kind of think we should focus on that. The actual lives involved.

I find it unconscionable in the context of the Birth Trauma report that detailed physical trauma to mothers that the word has been co-opted for this navel gazing twaddle