A new lexicon for midwives downgrades words involving “women” and “female”

February 11, 2021 • 11:45 am

The policing of language continues apace. This article was originally printed in the Torygraph, but that’s paywalled. Fortunately (?), it was reprinted in Yahoo! News, and you can read it by clicking on the screenshot below:


What has happened is that medical services directed at biological women are changing their lexicon, apparently—though this is not made very clear—because some biological women who identify as men still require the services of gynecologists and obstetricians. Therefore, because transgender men consider themselves men in all respects, any word that implies that these services are directed towards “women” must be changed.

According to the article, the changes, designed to be “gender inclusive”, are limited to Brighton and Sussex University Hospitals (BSUH) NHS Trust, but believe me, they will spread widely and rapidly. Here are some of the changes (quotes from the article are indented):

First, the Maternity Services Department of Brightton and Sussex has been changed “perinatal services.”


Staff have been told to avoid using the word “mothers” on its own and have been given a list of alternative terms to use when addressing patients including “mothers or birthing parents”, “breast/chestfeeding” and “maternal and parental”.

Instead of saying “breastmilk”, they can choose from “human milk” or “breast/chestmilk” or “milk from the feeding mother or parent”.

I don’t get this at all. Even transmen who use maternity services are likely to have breasts, even if they’ve been reduced by surgery to nipples alone. And if they have no breasts because of removal, then (as far as I know), they couldn’t lactate much anyway, and “chestmilk” becomes superfluous. Or do transmen with breasts object to the simple use of the word “breasts”? I don’t get the “chestmilk” at all, even as an attempt to be more inclusive.

. . . . Other changes include replacing the use of the word “woman” with the phrase “woman or person”, and the term “father” with “parent”, “co-parent” or “second biological parent”, depending on the circumstances.

But women are persons, so why not just say “person”?

If people want to be called “fathers” if they’re transmen who have given birth, I have no objection and would be glad to accommodate them. I don’t know how I feel about those terms being incorporated into the literature, though, so that in every reference to “mother”, they have to say “mothers and fathers”.

The real question is whether an entire grammar should be changed to take care of a very small number of transsexual men who get women’s health care, for apparently about 1% of British adults identify as “transgender or non-binary”. But  I’d suspect that the percentage of transmen seeking ob-gyn services is substantially smaller, since most of the 1% would identify as “non-binary”.   Should the entire lexicon of a hospital be changed to accommodate the <1%? This is a different issue from calling people whatever they want to be called, something I’m in favor of.  It’s an issue of making everyone adhere to a terminology that might offend fewer than 1% of the population. And remember, language changes of this type are far less oppressive than actually discriminating against transsexual people.

There’s also this:

The guidance from BHSU follows a 2017 dictate from the British Medical Association which said pregnant women should not be called “expectant mothers” but “pregnant people” as it could offend intersex and transgender men.

But can’t expectant “mothers” be men, or when you become a transsexual man do you automatically must get offended if you give birth and are called a “mother”? To me, a “mother” is someone who gives birth, but that may not be a general view.

The ethical question here is what percentage of a population has to be offended (and I doubt that all transsexual men would be offended at the present language), before you change the language for everyone. Suppose only 0.1% of British adults were transgender or nonbinary. Would that be sufficient? How about only five or six people?

Clearly, some people like J. K. Rowling are already disturbed at language changes, while at the same time advocating equal rights and respectful use of pronouns for transgender people. From the article:

Telegraph columnist Suzanne Moore – who resigned from The Guardian last year after colleagues criticised the newspaper for publishing “transphobic content” following an article she wrote about sex being a biological classification “not a feeling” – said: “I’m worried that women will lose the capacity or ability to even name our own body parts or our own biology.

“Why must this language be applied to all women who clearly do have breasts and are mothers? Why must the average woman suddenly not be able to call herself a woman or call her breasts breasts? These are biological facts.

Now this is a fracas I don’t know about, but if Moore was really ostracized for saying that sex was a real biological classification—which it is—and not just a “feeling,” then that ostracism is reprehensible. Any biologist with experience of mammals knows that sex is indeed a real biological classification, and is used regularly in those who work with animals. It’s based on a binary of gamete size (it’s not just bimodal or a continuum, for there are no gametes in humans  intermediate between sperm and eggs). All of us need to push back against the idea that “sex” (as opposed to gender) is a biological construct. Gender, yes; sex, no.

As for how we react to expurgated and altered language like “chestmilk,” well, I just don’t know, and I’m not just saying that. It seems to me to depend on what percentage of a population has to be catered to linguistically because they might get offended. Weigh in below.


h/t: Ginger K.

44 thoughts on “A new lexicon for midwives downgrades words involving “women” and “female”

  1. As John McWhorter would point out, you’re not supposed to understand it, you’re supposed to comply with it. This is religious observance.

      1. I am sceptical of that number. It’s a bit like the old “10% of people are gay” number. When the ONS did a proper survey, they found the true number was more like 1% to 2%. I’d like to see the actual survey and find out what the question was that was actually asked.

        I think it is true that Brighton has a higher than average gay population though. I don’t know that it would necessarily follow that it also has a higher than average transsexual population.

  2. Le sigh.

    LORETTA: It’s every man’s right to have babies if he wants them.

    REG: But… you can’t have babies.

    LORETTA: Don’t you oppress me.

    REG: I’m not oppressing you, Stan. You haven’t got a womb! Where’s the foetus going to gestate?! You going to keep it in a box?!

    LORETTA: crying

    JUDITH: Here! I– I’ve got an idea. Suppose you agree that he can’t actually have babies, not having a womb, which is nobody’s fault, not even the Romans’, but that he can have the right to have babies.

    FRANCIS: Good idea, Judith. We shall fight the oppressors for your right to have babies, brother. Sister. Sorry.

    REG: What’s the point?

    FRANCIS: What?

    REG: What’s the point of fighting for his right to have babies when he can’t have babies?!

    FRANCIS: It is symbolic of our struggle against oppression.

    REG: Symbolic of his struggle against reality.

  3. I was just thinking the other day, as a joke to myself, that the day may come when word editing software will start to autocorrect what we write. So I can write: “A woman was being driven crazy by her irresponsible boyfriend”, and it would appear as: “A menstrator was being driven differently-abled by hxr irresponsible penis-bearer friend”.
    I’ve probably not translated this correctly, but you get the general idea.

    1. It will probably start editing stuff retrospectively, too… Still, at least you won’t have to worry about being cancelled when the “correct” lexicon changes (again!) at some point in the future.

  4. Once upon a time, a few biologists (including, unfortunately, our host’s otherwise brilliant PhD advisor) issued overheated warnings about what they chose to call “biological determinism”. These warnings were misconstrued by a generation of ignorami, and mistakenly taken to mean that nothing is biologically determined—the ultimate in the blank slate view of life. The
    first step in this confection is that the X and Y chromosomes don’t determine
    anything. The next step will be (or is already being reached for) a doctrine that all the other chromosomes don’t determine anything either, and therefore one should be as free to choose one’s species as one’s pronouns.

  5. The opposition to the use of the world breast is ridiculous. Everybody is born with breasts, men including. Men don’t have fully developed breasts, but they are there anyway. Only if someone have their breasts fully removed could we say they don’t have breasts. But of course if someone is lactating, the breasts are there.

  6. Given that ‘breast’ refers to the lactating organ (on a human), anyone lactating almost tautologically has breasts, regardless of whether they identify as a man or a woman.

    Still, in the spirit of accommodation, we could all start using “mammary gland.” That eliminates the need to make up a new word and is scientifically accurate.

    1. I had better tell the local supermarket meat section their skinless chicken chests are labelled incorrectly. A wokester’s work is never done.

  7. I guess I’m just too old. It’s like learning a new language of some sort that I just don’t have an interest in putting energy into. I keep getting confused with the pronoun They, when referring to one person. Someone said to me, “They went to the market.” I didn’t understand who else went besides the person I was asking about. I think They might have been insulted when I asked who else went.

  8. Where these language regulators go wrong is in the conflation of word and meaning, as if the meaning of a word is somehow permanently affixed to that word. The existing meanings and the attendant connotations that they seek to escape will soon enough apply to the neologism. The word doesn’t determine the meaning. The whole project is doomed to fail as language evolves.

  9. Not to mention the fact that breastfeeding is stigmatized enough as it is (in Western cultures, anyway – I can’t speak for non-Western cultures). I don’t see how further bowdlerizing the term, like we’re back in Victorian England, is going to improve things.

  10. “Chestmilk” sounds too much like some horrible euphemism for …SOMETHING, I don’t know what. And it is a fact that males do have breast tissue and can even–albeit rarely–develop breast cancer. There’s nothing transphobic about referring to breasts and breast milk.

    As for the “mother being the one who gives birth” comment via PCC(E), though I basically agree, it IS something that’s less clear to me. I know that male sea horses, in a sense, bear their young and “deliver” them. Are those considered or referred to as mothers? Does it matter? Words are all invented, after all, but common usage is what gives them their meaning. I’m confused.

  11. So do pre-op transwomen go to gynecologists? Do the gynecologists do prostate checks or is it a pretend cervical exam so as not to hurt the patient’s feelings?

  12. “Any biologist with experience of mammals knows that sex is indeed a real biological classification, and is used regularly in those who work with animals. It’s based on a binary of gamete size…” – J. Coyne

    Yes, but biological reality is still more complex, as Paul Griffiths explains in his interesting article “Sex is real: Yes, there are just two biological sexes. No, this doesn’t mean every living thing is either one or the other”:


    1. Yes, there are hermaphrodites and intersexes in humans, the species we’re talking about, but they are developmental anomalies and are vanishingly rare. Let me ask you this: suppose that there were NEVER any rare intermediates? Would this suddenly change the misguided contention that biological sex isn’t real but a social construct. And yes, there are sterile males and females, but that is not an exception to the binary nature of sex.

      If you don’t think I now about intersexes or similar situations, then you must not think I know my biology. I stand by my statement.

      1. Your statement isn’t false. By saying that “biological reality is still more complex,” I didn’t mean to say that sex—defined in terms of “the ability to do one thing: to make eggs or to make sperm” (Griffiths)—is non-binary, but merely that “different species, though, manifest the two sexes in different ways” (Griffiths). Griffiths affirms (and so do I) that “in species that make two different kinds of gamete – and where one gamete of each kind is needed to make a new organism – there are two sexes,” and that “[b]ecause they produce two kinds of gametes, hermaphroditic species still have two biological sexes – they simply combine them in one organism.”

  13. Enough of this madness! If transsexuals are offended by medically accurate terms, then let the fools keep on being offended.

      1. I concur. It’s very important that we be polite with our transphobia, we wouldn’t want the mask to come completely off.

        1. Ah, so any annoyance with immaturity is a “phobia”, eh? You do realize, don’t you, that slinging the term “phobia” around is a blatant political tactic? Let’s see, there’s “transphobia”, “homophobia”, “xenophobia”… oh, and my favorite: “Islamophobia” — all meant to demonize any opposition for any reason, since “phobia” technically means “an *irrational* fear”. There is nothing irrational about having a healthy fear of political movements, which often really are dangerous. This “transsexual revolution”, for example, is dangerous to the integrity of science, as we’ve just seen.

          Hmmm, is there such a word as “adultophobia”? If so, I could throw it back at you. Is there a word for worshipping one’s own feelings to the point of denying reality? I’d call it “infantilism” or even “delusion”, but these don’t end in “phobia”.

      2. It *is* damned foolish to expect the whole medical, biological, and scientific field of knowledge to change its lexicon because somebody’s delicate feelings somewhere might be “offended”. Or maybe the proper term is “infantile”; Nature is not affected by your precious feelings, and nobody above the age of 5 should expect it to be.

  14. Once you start denying medical terms like “breast”, there’s no logical endpoint. Why not let men have benefits and time off work to cover fertility treatments even in the absence of a “uterus”, because that’s a gendered term? And if the obvious answer is “because a baby has to have a uterus to grow in”, well, doesn’t milk need to come from a mammary gland? Once you toss basic empirical distinctions at the level of physical reality out the window, you don’t really have a leg to stand on when it comes to defining where to stop. Why not let a man off of rape charges because he claims his genitalia is actually female, via his own self identification, and therefore incapable of penetration in the way that the accuser describes?

    The sad thing is, a year or two ago, if I would have read my own words above, I would have waved them off as a “hysterical slippery slope” argument. But I have to say, when it comes to the slippery slope of Wokeness, I got that one wrong. I said it was only a fringe thing that would never become mainstream because people have common sense. Others said that logic matters and language matters, and if you let people toy with language and logical principles, it only makes sense that this will be followed to its logical conclusion. So now I am much warier, and open to the possibility that logic and language will be followed to their logical conclusions once a given premise / set of axioms is set in place.

  15. The Suzanne Moore story is sadly true. She did write such an article, and then over 300 of her colleagues wrote a letter to the editor criticising her, with one even saying they felt uncomfortable being in the same room as here. They names were secret to begin with, but we’re soon leaked. Eventually it became too much for her. Unherd has an interview with, and an article by, her on this story.

  16. We might as well throw the baby out with the bathwater and do away with related parts of our lexicon and anatomy like nipple and areola…let’s go with “bumpy chest bits” with the understanding that we may need to revise these terms in the near future and will conduct annual vocabulary reviews henceforth. I’m sorry but adjective morphing is not empathy and has devolved into a silly game.

    I wouldn’t characterize this as an ethical dilemma either because I don’t think changing words does much to solve prejudice against tiny populations of people who differ slightly from the rest. For the same reason, I don’t think the facile move of tearing down statues or renaming buildings does much to assuage racism.

    By analogy, there are 2.7 million wheelchair users in the US so 0.8% of the US population. By law, they must be accomodated by having ramps built everywhere to provide them access. That’s a good and compassionate national policy but what we don’t do is provide them ramps but allow them to ban stairs which is what these vocabulary games essentially do.

  17. ” It’s based on a binary of gamete size (it’s not just bimodal or a continuum, for there are no gametes in humans intermediate between sperm and eggs).”

    This is something I didn’t know about. I thought there was some internal difference between male and female gametes. Is it really just based on the size difference between an ovum and a sperm? Or did I miss something important?

    1. Of course there are other differences, the most obvious being the chromosomes. The point is that all gametes fall into one of two groups, which are easily distinguished on the basis of size, and there is nothing in-between.

    2. No, gametes are haploid cells (containing a single chromosome) with different structures, cellular mechanics, and chemical reactions. Ovum and sperm are very distinctly different.

  18. If a trans man gets pregnant, then they’ve already accepted – out of biological necessity – that they are playing the role of a female in this aspect of life. I suspect, if you ask them, not a single one would have a problem with “breast milk”. They probably also wouldn’t have a problem with the term “mother”, at least during pregnancy and birth.

  19. It would be really great for a journalist or reporter to conduct an interview with a leading trans activist and inquire as to why we must change our entire language to meet the preferences of less than 1% of the population, but we’re supposed to ignore the 99% of the population that is likely very offended that their entire language and identities are being altered by this “spell check” on language.

  20. So, a woman who considers herself to be a man —or at least doesn’t consider herself to be a woman — is horribly triggered if people refer to her using female terms. They don’t want to be associated with their feminine anatomy. But they’re apparently okay with getting pregnant and giving birth. This seems more than a little inconsistent.

    It doesn’t look like the point is for them to avoid thinking about their underlying anatomy. It looks more like the point has to do with controlling other people. So I don’t think it’s a matter of numbers and proportions. If they’re not cringing at doing what only women can do, then they have no right to cringe at the descriptive vocabulary.

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