Sex-based language: vital for women’s rights

In January 2022, Sweden’s biggest-circulation tabloid, Aftonbladet, published a challenge to the language of gender ideology. By writer and birth activist Kristina Turner, it explains why she and other Swedish feminists are fighting to retain sex-based language in maternity and health care. With the kind permission of the writer and the newspaper, here is an edited English translation.

Gender identity must not trump women’s rights, says Kristina Turner. Removing words like ‘woman’ and ‘mother’ from the language of the maternity services excludes women.

We need an open discussion about women’s health, rights, sex and gender identity without accusations of transphobia.

Maternity services are in crisis. The decision to take gender identity or biological sex as the starting point for how maternity services are structured is critically important.

All human beings have the right to express themselves as they wish, present however they want and call themselves what they want. But it can’t be at the expense of women.

Just as with other mammals, human reproduction is based on two sexes: the female sex carries, births and suckles the baby, and the chromosomes you receive at conception affect your reproductive, physiological and relationship life.

Women’s healthcare provision is a systematically under-prioritised area. Why? Because it is founded on patriarchal structures, and pregnancy, childbirth and breastfeeding are fundamentally sexed issues that affect women’s lives and health.

Modern maternity services are based on structures where men’s needs and expectations have been taken as the norm. Obstetric violence (violence during childbirth) is a form of sex-based violence that has arisen out of these structures.

Examples of obstetric violence include a lack of informed consent to vaginal examinations, coercion to birth on your back, or being left alone against your will.

The fact that insufficient resources are allocated to maternity services is an expression of discrimination against women precisely because they are women.

When society categorises people on the basis of their gender identity rather than their biological sex, we lose the most basic tools – our language – to speak about sex-based oppression. It means we can’t talk about pregnancy as something positive specifically for women.

In Sweden, Vårdguiden (our public healthcare information service) in consultation with RFSL (Sweden’s equivalent of Stonewall) have chosen to remove the word ’woman’ from some contexts. Reason? To allow more people ‘to feel included’.

But avoiding words such as ‘woman’ and ‘mother’ – sexed words, for females – hides the power imbalance. When you no longer speak about biological sex, the physiological, psychological and rights-based differences that affect women are rendered invisible. Replacing the word ’woman’ with ’bleeder’ or ’uterus-haver’ can be experienced as dehumanising.

They replace the name of our sex with the word for a bodily function, or a body part. Maternity services are now frequently called ‘pregnancy services’ in order to avoid excluding those who don’t identify as mothers.

But without the word ‘maternity’, it’s no longer women who are centred, it’s reproduction. The newborn’s need to be part of a mother-child unit, supporting the positive aspects of breastfeeding, are affected when we write ‘the baby and parent should not be separated after birth’.

This has an entirely different meaning from ‘the baby and mother should not be separated after birth’. The language excludes women from their own woman-centred contexts. The confusion of gender identity with biological sex also generates healthcare risks.

If a woman who identifies as a man comes to healthcare services with abdominal pain it can be life threatening not to ask them if they could be pregnant.

Transwomen – men who identify as women – don’t need pregnancy tests or smears. Biological sex is medically significant and has nothing to do with gender identity.

Many women value the words ‘woman’ and ‘mother’ , especially in connection with pregnancy and motherhood.

A feminism worthy of the name must be able to support and celebrate motherhood, and our rights and needs as mothers.

We need to have an open discussion about women’s health, rights, sex and gender identity… without accusations of ‘transphobia’.

When conflicts arise with the rights of other groups you need to negotiate a joint solution—not redefine reality. That is neither democratic, equal or inclusive.

Kristina Turner, writer and birth activist