The Push for “Pregnant Person”: Using Gender Inclusive Language in Reproductive Rights

By Adrienne Zaya

It is often the case that advocates, policymakers and nonprofit organizations focus on cisgender women in discussing reproductive rights issues, like abortion. However, as the feminist and reproductive rights movements have evolved, so, too, has our understandings of gender, sexuality, and the reality that gender non-conforming individuals face barriers to accessing quality reproductive healthcare. As part of this process, reproductive rights and queer activists have worked to include trans/genderqueer/non-binary and other individuals. To create spaces for many who identify as such, many organizations (i.e. Planned Parenthood, Unite for Reproductive and Gender Equity (URGE), and Midwives Alliance of North America) have integrated more gender-neutral and inclusive language change into their advocacy and services. While some have objected to its use, there are a few reasons why the reproductive rights and justice movements have shifted to include more neutral language.

Note: the term gender non-binary is utilized as an umbrella term that can refer to individuals who identify as, but not limited to, genderqueer, gender fluid, or gender non-conforming.

Taking a Cue from Feminist Scholars: Social Constructions of Sex and Gender

Throughout the era of Second-wave feminism, feminist scholars began conceptualizing gender and sex beyond what many within Western societies view as a binary system of gender: male/female, men/women, and masculine/feminine. Dualistic views of gender rest on the assumptions that not only are there only two genders, but that they are divided into distinct categories intrinsically linked to both the physical body, reproductive capabilities (often referred to as the biological sex) and sexuality (namely heterosexuality). Scholars, like Judith Butler and Gayle Rubin, identified how society and policy continuously inform and reinforce these distinct gender and sex categories.[1],[2]

How we identify the physical sex and what we associate with it (i.e. uterus = reproduction = woman) is also shaped by our understandings of gender. Anne Fausto-Sterling’s work, Sexing the Body: Gender Politics and the Construction of Sexuality is an exploration of this theory. Fausto-Sterling writes,

[o]ur bodies are too complex to provide clear-cut answers about sexual difference. The more we look for a simple physical basis for ‘sex,’ the more it becomes clear that ‘sex’ is not a pure physical category. What bodily signals and functions we define as male or female come already entangled in our ideas about gender…. Choosing which criteria to use in determining sex, and choosing to make the determination at all, are social decisions for which scientists can offer no absolute guidelines.[3]

For Fausto-Sterling and other feminist scholars, our conceptions of a gender difference shape and reflect the ways we structure our social system and polity; they also shape and reflect our perception of our physical bodies. This thinking promotes the view that reproductive rights are exclusively a “women’s issue” or “women’s health issue.” As our understandings of sex and gender have evolved beyond the binary, so, too, has our language. In the end, the progressions towards more neutral language reflects the reality that reproductive rights and freedoms are things to be applied to all persons as not all people exist within the gender/sex binary.

Discrimination is Disproportionate

To map pregnancy, abortion, or other reproductive health issues onto two neatly defined categories does not capture the complexity of these issues nor the bodies on which they are debated. Individuals who may identify as “women” may not be able to get pregnant due to genetic or reproductive anomalies. Individuals who do not identify as “women” can and do get pregnant and seek reproductive health care. A prime example can be seen through the independent film, A Womb of Their Own, in which six masculine-identified people detail their experiences with pregnancy, childbirth, and raising children.

Many gender-non conforming and non-binary individuals, however, disproportionality face discrimination when attempting to access reproductive healthcare and family planning services. Research detailing the experiences of LGBTQIA+ individuals pursuing pregnancy-related or preventative sexual healthcare has found that lesbian, bisexual, and transgender men often have pregnancy-related challenges[4]. Transphobic and homophobic comments and non-gender affirming spaces have impacted patients’ desires to seek future care.[5],[6] The National Women’s Law Center reports that “[t]wenty-eight percent of transgender and gender non-conforming individuals report facing harassment in medical settings, and 19% report being refused medical care altogether due to their transgender status, with even higher numbers among communities of color.”[7]

These barriers result in increased health risks and delays in seeking care.[8] Without gender-affirming and inclusive healthcare spaces, it becomes more difficult for non-conforming or non-binary individuals to maintain their sexual and reproductive health. It also prevents healthcare practitioners from providing and ensuring patients with medically accurate and patient-centered care. Using gender-inclusive language is a simple step towards continued care for marginalized individuals creating equality in reproductive healthcare spaces that many cisgender women have experienced.

Rhetoric Matters

As activists, we often function as primary voices for others when engaging with policymakers and the general public. How we frame reproductive rights issues and who we include in those discussions will often translate directly into future legislation and advocacy efforts. Rhetoric has tangible impacts on public discourse, individual experiences, and the application of certain rights or legal protections. Should we define reproductive rights and freedoms solely for cisgender women or only for those who fit a societal mold of “womanhood,” we reproduce the erasure of marginalized individuals, like trans men, within reproductive rights spaces as well as cisgender women who cannot get pregnant or never wish to be pregnant. Speaking about numerous reproductive rights issues exclusively in terms of women ultimately ignores the need for current or future laws to protect rights of all child-bearing peoples.

Objections to the use of gender-inclusive language note that the use of female or women-centered language is intentional and needed as cisgender women have and continue to struggle to have their identities of issues seen as important. Arguably, much of the anti-reproductive rights rhetoric is based on patriarchal, misogynistic, and sexist notions of women’s social position. This context is important to consider and describing abortion or other reproductive rights issues as women’s rights issues serves as a reminder of the decades of progressive activism by those within the women’s rights and feminist movements to establish and maintain their rights. It is, therefore, important to acknowledge the advances women have made in this space. However, utilizing gender-inclusive language is not antithetical to this history. Movements in the LGBTQIA+ spaces have historically been linked to reproductive rights issues and the women’s rights movement. Quite often, both share the same adversaries.

The use of gender-neutral and inclusive language simply seeks to expand the application of reproductive rights to all persons. With a resurgence of political activity throughout the United States around reproductive autonomy, and attempts to roll back reproductive rights and other anti-discrimination policies on a federal level, it is essential that individuals active within reproductive rights spaces take note of how the discourses and language they use, as well as the rhetoric delivered by the state, shape who is guaranteed reproductive rights and who may be left behind. The establishment of reproductive freedom and equality cannot be achieved if some are left out of the equation.

[1] Butler, J. (1988, December) Performative Acts and Gender Constitution: An Essay in Phenomenology and Feminist Theory. Theatre Journal. 40(4). p. 519–531

[2] Rubin, Gayle. (1975) “The Traffic in Women: Notes on the ‘Political Economy’ of Sex.” In Toward an Anthropology of Women, Ed. by Rayna R. Reiter. New York: Monthly Review Press. p. 157–210.

[3] Fausto-Sterling, A. (2000) Sexing the Body: Gender Politics and the Construction of Sexuality. 1st Ed. Basic Books. p.3–5

[4] Wingo, E. et al. (2018, July). Reproductive Health Care Priorities and Barriers to Effective Care for LGBTQ People Assigned Female at Birth: A Qualitative Study. Women’s Health Issues. 28(4). p. 350–357

[5] Obedin-Maliver, J.& Makadon, H. J. (2016) Transgender men and pregnancy. Obstetic Medicine. 9(1) p. 4–8

[6] Macapagal, K., Bhatia, R., & Greene, G. J. (2016). Differences in Healthcare Access, Use, and Experiences Within a Community Sample of Racially Diverse Lesbian, Gay, Bisexual, Transgender, and Questioning Emerging Adults. LGBT health, 3(6), 434–442

[7] National Women’s Law Center. (2015, September). If You Really Care About Reproductive Justice, You Should Care About Transgender Rights! https://nwlc.org/wp-content/uploads/2015/08/rj_and_transgender_fact_sheet.pdf

[8] M. Agénor, M., et al. (2017) Sexual orientation and sexual health services utilization among women in the United States. Preventive Medicine, 95., pp. 74–81

NARAL Pro-Choice MD

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The political leader of the pro-choice movement in Maryland.

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