Medical Examiner

How to Think About the Debate Over the Phrase “Pregnant People”

Gender inclusive language has important implications for health care.

A pregnant person with a white long-sleeve shirt and their hands on their belly.
Photo by Anastasiia Chepinska on Unsplash

“Anyone with a uterus.” “Pregnant person.” “People who menstruate.” As Slate’s science editor, I’ve been using phrases like these a lot in the pieces I publish, to accurately describe who will be affected by the fall of Roe v. Wade.

But this kind of inclusive language has also been a renewed focal point of several pieces and arguments from people who say it erases “women” in problematic ways. Notable voices as of late have been Pamela Paul, of the New York Times, and Bette Midler; but these kinds of arguments have persisted for a while.

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This conversation is somewhat absurd from the get-go—in the past few weeks, I have also published the word women plenty of times. One thing that informed my perspective on this issue—that it’s useful to deploy inclusive language, but also fine to still talk about how women as a group are affected—is a Waves episode from November, featuring a conversation between Susan Matthews, Slate’s executive editor, and Evan Urquhart, Slate’s community manager. If you’re wondering what the “debate” is about, or how to think about it, I think you’ll find their perspectives useful. We’ve transcribed and lightly edited part of their discussion here. (For the full episode, listen here.)

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Evan Urquhart: I think we really need to dispense with the idea that trans activists, or, literally, anyone else in the world, wants women to stop referring to themselves as women. Women should be calling themselves women, they should be calling themselves mothers, they should be using any language that is comfortable for them.

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To the extent that people say that anyone has a problem with that in the trans community, that’s an actual lie. So, I think it’s important to call out when something is really not true. The times when it might be appropriate to use “pregnant people” is when you were talking about the universe of people who can get pregnant, some of whom are actually men, trans men like me, and some of whom are non-binary people who don’t identify as men or women.

Susan Matthews: In the articles that say, “I’m reclaiming ‘pregnant women’”, or, “I’m allowed to call myself whatever I want,” there’s a really interesting tension there, just about the fact that a lot of these writers are writing from feminist perspectives, but are very much claiming language that defines them by their reproductive potential.

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Evan Urquhart: I think sometimes people are saying, “Hey, I don’t want to be identified by my biology. I don’t want to be called a person with a vagina,” and that’s where they’re missing that, yeah, you are a person with a vagina, you call yourself a woman. I am also a person with a vagina, and sometimes someone might want to include me in the conversation.

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Susan Matthews: That’s really the impetus for the entire conversation: how we can make certain spaces more inclusive and more welcoming to anybody who could be having a health care need that they would need information on, or access to, or that is being infringed upon.

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Evan Urquhart: There’s some social science research that says that trans men are actually more likely to avoid getting needed health care than other trans people, than trans women and non-binary people.

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Just speaking personally, a couple years ago, I was referred for counseling to a place called The Women’s Initiative. And this is a wonderful old-school women’s feminist charity, and their website talks about women, all over it.  And I looked everywhere on this website to see just the little line that said, “Oh, also trans people are included,” and I couldn’t find it.

I didn’t know whether this was an actually transphobic organization that was making a point or whether this was a website that hadn’t been updated for a while, which turned out to be the case, whether my referral was an error, whether I was eligible to receive counseling. So, I, as a journalist, reached out, and I was pretty polite, but I said, “Hey, I’m a trans man. I was referred here. Should I let the person who referred me know that this isn’t appropriate for me, or are you going to update some of the language on your website?”

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They said, “Oh, we’re so sorry. We’re trans-inclusive,” and I was able to get services. But as a trans man, if I am going for services that say, “woman, woman, woman” everywhere, I may reasonably think that I’m not eligible.

Susan Matthews: I think that some people who end up writing these op-eds are reclaiming the idea that they have the right to say “pregnant women”. The more useful thing could be to maybe be a bit more curious about that and to report out and think about why it actually matters.

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While I understand the emotional reaction and the feelings around wanting to say the word “woman” without worrying about it, what matters is, which feelings do we act on? Do we prioritize privileged people’s slight feeling of awkwardness or discomfort, or do we think about the actual more material effects that some of these words have, and try to remedy that? To me, prioritizing the ways that I could feel awkward just feels much less important than prioritizing the actual material things that you experience.

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Evan Urquhart: I see three separate things happening with the use of “woman” vs. more inclusive language. So, one is actual trans men needing to practically access health care and how we reach out to them and make sure that people in my community are getting the health care that we need.

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Then there are times when being drawn into a discussion of trans issues is going to be politically counterproductive, when it’s really important to be spotlighting sexism and not allowing bad faith conservatives to drag you off into defending trans issues. I think that is a legitimate fear that people have that needs to be factored into things at times.

Then, I think there’s also what you’re talking about, which is like an irritation, “Well, I shouldn’t have to worry about trans men.” And I don’t have a lot of sympathy for that as a trans man. If you’re tired of worrying that I exist, you’re just going to have to get over that as far as I’m concerned. I’m not going to go out of my way to worry about the fact that you’re a bit irritated that you have been reminded that I exist.

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Susan Matthews: I called up a law professor at Georgetown, and I talked to her about the fact that she had just recently finished a law review article that was specifically for an issue that took on women’s rights. And she had used the phrasing of “pregnant women” and gendered language throughout the whole piece, but she also put in a footnote to just say, “Women are not the only people who can become pregnant, and this is just to acknowledge that.”

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I thought that was a smart way to handle it, but I was curious to hear what you thought about if that is sufficient, and what the right way is to use “pregnant people” versus “women.”

Evan Urquhart: When we’re trying to have these political debates about what’s traditionally been known as women’s issues, and we’re asking like, “Oh, is this time to go back, rewrite everything, and call it ‘people’s issues’?” Probably not. That’s going to be super unspecific. We’re definitely not going to know what we’re talking about. Sometimes, for clarity, you don’t want to go into a big digression about how trans men get pregnant too.

But for the guys in Texas who are trying to restrict access to healthcare, as far as they are concerned, I’m a woman. So, their sexism is not going to be really careful about my gender identity. I want my political allies to be aware of that, and the fact that I need feminism too and other trans men need these things too, it’s important that we’re recognized in the language.

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