The text of the article: Midwifery students are being taught how to help men give birth in a textbook that experts have warned is rife with anatomical fiction.
Edinburgh Napier University told training midwives that they may be caring for a “birthing person” who has male genitalia and a prostate gland, in a bid to support transgender people.
A module guide on how to provide safe care in childbirth told students: “It is important to note that while most times the birthing person will have female genitalia, you may be caring for a pregnant or birthing person who is transitioning from male to female and may still have external male genitalia.
“You need to be familiar with the catheterisation procedure for both female and male anatomy. For this reason, where appropriate, this book refers to the birthing person.”
The guide, obtained by The Telegraph, explained the “male anatomy catheterisation” procedure during birth, commonly used during caesarean section to drain excess fluids, along with diagrams on “ensuring the scrotal area is covered”.
Midwifery students were advised that “male persons should be warned of discomfort as the deflated balloon passes through the prostate gland”, a part of anatomy that is only found in biological males.
This prompted a backlash from students at the university, one of only three Scottish institutions recognised by the Nursing and Midwifery Council for undergraduate midwifery courses, as it is impossible for men to get pregnant or give birth.
On Thursday night, experts criticised the guide as “inclusive to the point of nonsense” and warned that the simplification of procedures risked dangerous practices.
'Inclusive to the point of nonsense'
Prof Geraldine Walters, the executive director of professional practice at the Nursing and Midwifery Council, the regulator, told The Telegraph: “This workbook includes some clear inaccuracies in its current form. We’d expect the university to review and correct this.”
Kat Barber, the co-founder of the Sex Not Gender Nurses and Midwives group, added: “Women can’t have prostates, that's quite straight forward, so this policy reads to me as though it is inclusive to the point of nonsense."
The registered nurse told The Telegraph: “Someone who has written the policy has aimed to include differing genders which is fine, but in absence of real knowledge on how to care for those people which is dangerous.
“What's more concerning is that the students have had to take to journalism to ask questions about it, which tells me a lot about the state that our nursing and midwifery institutions are in, who should be able to ask questions.”
A student backlash when the guide was released late last month led to course leaders apologising for “wording being the wrong way round”. They said they were referring to a trans man who “has surgery to construct a penis, but still has a uterus and may conceive”.
However, The Telegraph understands that the wording of the guide has not been changed and the university on Thursday stood by it.
Elaine Miller, a fellow of the Chartered Society for Physiotherapy, raised concern about scientific accuracy even for female-to-male transitioners, given the lack of evidence on those who undergo a phalloplasty to create a penis and wish to give birth.
She told Reduxx, the feminist website which first reported the guide: “A [female] with a gender difference can become pregnant but will not have male genitalia.
“Most [females] who use testosterone, at the doses used for ‘transition,’ will develop vaginal atrophy. The fragile tissue of an atrophied vagina may be unable to stretch to accommodate a baby’s head,” warning of “new types of birth injury” which have not been studied.
'Language is the issue'
Female-to-male transgender people can still get pregnant if they have not had a hysterectomy or taken certain hormone-blocking drugs, such as Freddy McConnell, a trans man who gave birth but remained “mother” on the birth certificate after a High Court battle.
But this is not the case for trans women who are born male, as eggs must be made by biological females and scientists have not yet achieved a breakthrough through methods such as IVF.
A growing number of British universities are using terms such as “birthing people” on midwifery courses to be trans-inclusive.
And last year, Brighton and Sussex University Hospitals NHS Trust became the first in the country to formally implement a gender inclusive language policy for maternity services, including words such as "chestfeeding".
Debbie Hayton, a teacher who is a transgender woman, added: “Somebody needs to wake up - this is crazy. I think language is the issue - people who should know better are signing this off because they don’t want to upset people.”
Edinburgh Napier University said it was “committed to upholding the professional standards required of us” by the Nursing and Midwifery Council.
A spokesman added it “wish[es] to be inclusive of all people, including those who identify within the LGBTQ+ communities. The teaching materials will be updated as required.”