It Doesn't Exclude Women to Acknowledge Everyone Who Can Get Pregnant

Dorothy Poucher

To say that abortion bans, like those recently passed in Texas, are part of a war on women is true. But to say they are a war on women alone is to erase the harm experienced by the transgender, intersex, nonbinary and gender expansive individuals whose lives are also deeply impacted by access to abortion and reproductive healthcare.

Even though US District Judge Robert Pitman noted in his short-lived stay of the Texas ban, “The court recognizes that not all pregnant people identify as women,” very few major media outlets have made any change in how they discuss abortion. A New York Times article (10/6/21) that focused on Pitman’s decision and language overlooked the footnote, as did subsequent reporting on the ruling in the Times and the Washington Post, where most articles on abortion used exclusively gendered language like "pregnant women."

'Political purity test'

Framing an issue as a "culture war" (Atlantic, 9/17/21) takes the focus off the people actually affected.

Other journalists have tried to minimize the importance of the issue. Emma Green argued in the Atlantic (9/17/21) that “only niche groups" seem to care about how we talk about gender and pregnancy. (The ACLU has a “niche” Twitter following of 2 million people, while Planned Parenthood has a “niche” audience of 987,000 on Facebook.)

Green spent much of her interview with Louise Melling, the ACLU's deputy legal director, raising questions about whether "there’s something lost in trying to create a more inclusive vision of pregnancy." In one question, Green argued that "aspects of these terms are also exclusionary. Talking about ‘birthing people’ means you are not talking about ‘women giving birth’ or ‘birth moms.’” To which Melling accurately responded:

Talking about birthing and gender discrimination is still something that women can do. We just also simultaneously want to talk about the ways in which we’re not recognizing trans men as parents. If we’re doing this right, we’re creating more, not less, conversation, because we’re talking about the many different ways in which gender expectations are playing out on who we are.

The Atlantic also featured Helen Lewis (10/26/21)—whose transphobic statements made her a controversial hire for the outlet two years ago—defiantly headlined, "Why I'll Keep Saying 'Pregnant Women.'" Lewis argued that people shouldn't be forced to use gender-neutral language like “pregnant people,” which "progressives" have supposedly "turned...into a political purity test." This is “an etiquette code set by the rich and well-educated,” she wrote, that ultimately obscures "the social dynamics at work in laws surrounding contraception, abortion and maternal health.” Her argument here not only minimizes the impact of language change on the lives of non-cisgender people, including those who are not rich or "well-educated," but also falsely claims that including more than just cisgender women in this discussion erases the discrimination that women face.

Lewis even went so far as to paint “pregnant people'' as the analog to “all lives matter." But, of course, "all lives matter" erases the racism that "Black lives matter" highlights by decentering those most vulnerable, whereas saying "pregnant people" does the opposite. “Pregnant people” underlines the sexism and heteropatriarchy that abortion rights advocates work to highlight, by including another group of people equally or even more marginalized by those systems.

The pervasive current and historical reliance on the phrase "pregnant women" demonstrates how deeply embedded in our cultural conceptions is the assumption that pregnancy is inextricably linked to femaleness. Using the phrase "pregnant people" will not erase this connection to women, or suddenly suggest that cisgender men might be included under this umbrella.

A focus on the vulnerable

Politico (9/10/21) reported that some who reject inclusive language are "fearful of alienating potential supporters and provoking an even bigger backlash from the right."

Nicole Huberfeld, professor of health law, ethics and human rights at Boston University, says that abortion and healthcare discussions often lose sight of those most affected: “The thing that often gets lost in these discussions is the real-world implications, especially for already vulnerable populations.”

A focus on the theoretical argument, rather than the people affected, results in discussions of sexual and reproductive health that are neither full nor accurate. Writers trying to bring awareness to the problematic nature of abortion bans are missing their responsibility to foreground the lack of access and adequate care for those who are not cisgender.

Talking about inclusive language and the Texas ban, Sen. Barbara Boxer (D-Calif.) said (Politico, 9/10/21): “‘Whether you say A, B, C or D—get rid of the law.... That’s the most important thing.’” The implication is that getting rid of the Texas law will fix abortion care for everyone, so the language doesn’t make much of a difference. While such a move would absolutely help, the reality is reproductive rights and access are not currently equitable, and they haven’t ever been (CounterSpin, 9/10/21).

Using inclusive language does not minimize the reality that abortion bans affect cisgender women, but simply reflects the reality that transgender men and intersex, nonbinary and gender expansive individuals are also affected, and are especially vulnerable.

Consequences of exclusion

Ms. (3/11/21): "Transgender and nonbinary people access reproductive health services, including abortion, every day."

Excluding them from the discussion, on the other hand, has dire material effects. BU Today (9/11/21) explains that “women-specific gendered language” in health conversations and settings can often

manifest in extreme discomfort—for example, feeling like one doesn’t belong in a medical center. Consequences of this harm include individuals not seeking regular, preventive healthcare.

Ivy Gibson-Hill, part of The Campaign for Southern Equality, says in an interview with Blue Ridge Public Radio’s Lilly Knoepp (5/17/19) that each time a non-cisgender person goes to the doctor, they

are having to think, "Am I in a stable enough mental place, to be able to put up with this, and to have my identity called into question and be disrespected in the doctor’s office, or have my pronouns laughed off—which is an experience that I have almost every time that I go to the doctor.”

Misgendering in healthcare can also lead to inaccurate or false diagnoses. According to an article in Ms. (3/11/21) by Sachiko Ragosta:

In clinic settings, language that conflates gender and sex assigned at birth can lead to inadequate or inappropriate screening and treatment for certain outcomes, including organ-dependent cancers, resulting in higher rates of cancer among TGE [transgender and gender expansive] people.

The effects are physically, mentally and emotionally damaging.

Words have impact

Language changes, then, are important at all levels—in politics and healthcare settings, in workplaces and everyday conversations—including in news media. This would mean incorporation of phrases like “pregnant people" and “birthing persons,” using “people” instead of specifying gender, using "they/them" pronouns when speaking about those affected, and noting that those affected include transgender men and nonbinary, intersex and gender expansive people.

This language change is not everything, but it is a basic first step. And it is a reminder to not just mention but to also take into account the experiences of these individuals and communities, and to advocate for them. Appropriate language on the impact of abortion bans wouldn't stop at gender expansive, transgender, nonbinary and intersex individuals, but would also include unhoused, low-income, and Black and brown people, who are likewise especially vulnerable in their quest for adequate health- and abortion care.

Our words have an impact. It’s time journalists use them wisely.