Using Inclusive Language Isn’t Enough

Celeste Orr and Erin Leigh Courtice respond to criticisms of the British Medical Associations’ guide on inclusive language which aims to ensure that trans, intersex, genderqueer, and non-binary people are not subjected to discriminatory language.


Since January 2017, Hayden Cross has garnered a lot of media attention. He is the first publicly-known pregnant trans man in Britain. In response to the media attention, there has been considerable criticism of the 2016 British Medical Association’s “A guide to effective communication.” The guide recognizes that some trans men and intersex men may become pregnant and it calls for the use of more inclusive language. The guide recommends that medical professionals use the phrase “pregnant people” instead of “expectant mothers.”

While the guide was published in 2016, before Cross’ pregnancy, a connection between Cross and the guide persists. Many of the articles and people criticizing the guide assume or suggest that it was published since Cross’ pregnancy. In this way, Cross is being blamed for the apparently “Orwellian” instructions, which undoubtedly intensifies the cissexist violence being aimed at him.

According to Philip Davies, British Conservative MP, the guide is “completely ridiculous.” Laura Perrins, of The Conservative Woman, describes the recommendations as “anti-science, anti-women and anti-mother.” Similarly, Sarah Vine claims the guide is “an insult to mothers.”

These recent criticisms are deeply problematic. For example, Perrins’ claim that the guide is anti-science is not only ironic, but false. Her claim reproduces the scientifically unsubstantiated essentialist theory that bodies are innately sexed and gendered, as observable by various bodily characteristics and capabilities. Though we have been taught to see bodies in the categories of female, male, or “disordered,” bodies aren’t inherently sexed or gendered. Ideas about sex, like ideas about gender, are (re)created in, through, and by culture. In other words, dominant socio-political ideas about gender precede or influence how sex is (re)defined, imposed, and understood. As such, pregnancy is not inherently feminine. Cross’ pregnancy doesn’t undermine or negate his masculinity, or render him innately female.

Importantly, the inclusion of intersex men in the document highlights the fact that bodies aren’t dichotomous. Typically, it is assumed that people are either male or female, signaled by genitalia, chromosomes, hormones, and so on. However, the science of sex has, for some years now, recognized that sexual characteristics exist on a spectrum.” Recognizing the “inherent messiness” of bodies—the beautiful array of morphologies and capabilities—and the inability to divide them into a sex or gender dichotomy is pro-science.

Claiming that the guidelines are “anti-mother” is also misguided. Not all pregnant people who are women necessarily conceptualize themselves as mothers. For example, some women may plan to put the child up for adoption or they may be surrogates, and do not view themselves as mothers. Other women who are pregnant and will raise the child may plan to use a term other than “mother.” For instance, lesbian couples often choose different terminology, and families with more than two parents might use different labels.

Not all pregnant people are mothers, but all mothers are people. Hence, using the term “people” widens the discursive space, allowing those who don’t ascribe to motherhood discourses to feel less threatened and unrepresented in medical(izing) spaces.

Many articles claim that the guide is meant to avoid offending or upsetting people. But it’s not simply about upsetting people. If trans men, intersex men, and genderqueer and non-binary people aren’t reflected in the language used—if they’re erased and deemed women—they’re dehumanized. They’re (once again) denied authority over their bodies, identities, experiences, and narratives.

The guide aims to combat the ways in which cissexism, interphobia, queerphobia, and heteronormativity are embedded in everyday language. We commend the guide for emphasizing that pregnancy isn’t fundamentally a woman or feminine experience. Nevertheless, adopting the proposed language isn’t enough.

Trans, intersex, genderqueer, and non-binary people continue to struggle to access adequate, nondiscriminatory, and/or non-mutilating healthcare, including reproductive healthcare. Further action is needed to ensure trans, intersex, genderqueer, and non-binary people are protected and provided with nondiscriminatory (reproductive) healthcare. Such actions include outlawing intersex genital mutilation and sterilization practices, removing legislation that prevents or discourages trans people from accessing reproductive healthcare, and instituting more policies and practices that ensure people’s self-determination and bodily autonomy are preserved. Without such changes, the guidelines merely gesture at inclusivity.


Celeste Orr is a Ph.D. Candidate at the University of Ottawa in the Institute of Feminist and Gender Studies.

Erin Leigh Courtice is a Ph.D. Student studying psychology and sexuality at the University of Ottawa.

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