I’ve been writing a long piece on midlife and menopause hormone changes and updating my women/female health series of courses. In all honesty, I’ve been struggling with the language. I feel reasonably skilled in using neutral and inclusive language in this case. Does it mean avoiding the word ‘woman/lady’ and using ‘people’ instead?. With me so far?
Ageing and menopause are heavily associated with negativity in western cultures. The mainstream UK media and education spaces are very white-focused, *cis-gendered, and heterosexual; the resulting conversations and resources often exclude the experience of people who are not – white, cis or hetero.—swerving ‘lady’ is easy because, for me as a UK born citizen, “lady” can be perceived as outdated and feel like the older version of ‘girl.’ It notions a style of femininity, where women are inherently timid ‘good’ and silent.
However, I am struggling with the prospect of omitting the word woman from conversations about menopause or anchoring it to ‘people’. As we know, it [menopause] primarily happens to *cis-gendered women, a person whose sense of personal identity and gender corresponds with their assigned birth or biological sex. But, importantly, I appreciate menopause also occurs in the LGBTQ+ community, trans men, non-binary and intersex folks, who are a growing and vulnerable communities that I do not want to omit or ignore from this conversation or space.
Many organisations haven’t used “inclusivity policies” equally. For example, the NHS relabelled the cervical smear test to “screening for women and people with a cervix”. Yet no one seems to campaign for prostate and testicular screening to be re-titled “screening for men and everyone with a prostate or testes.”
Those on hormone treatments may need to stop and start for several reasons. Including during medical or surgical procedures. Did you know the entire medical transition process can take up to seven years? I know from “doing the work”, as my US cousins would say (I genuinely have an American family), that not every trans or non-binary person takes hormones, nor do all want body reassignment procedures. A person can change their gender expression with no medical intervention by publicly declaring their gender. So LGBTQ+ people may experience menopausal symptoms in midlife, perhaps following on from dealing with unwanted menstrual bleeding and all that entails.
The shift to the term period products was a valuable, inclusive neutral language revision welcomed by most. Yet, I struggle with this change (no pun intended); my personal and professional experience informs me it can be othering and deeply damaging when people don’t use inclusive language, making the folks affected feel ignored or invalidated.
However, maintaining the concept “female” and “women” is crucial to understanding the particular lived experience in medical and academic specialities of an already significantly under-investigated group – cis-gendered women- the biological female who identifies as a woman.
It’s essential to understand the distinct challenges of females, girls and women and their increased vulnerability to violence, sexual harassment, domestic abuse, sexual assault, rape. Specific health conditions; self-harm, cancers, dementia, osteoporosis, chronic pain, and there is more. While I am fully aware of the massive and significant risk of abuse and violence in LGBTQ+ communities, if self-declared trans folks are included in these statistics, knowledge, understanding and data will be thwarted.
A male’s self-identification into the category of “woman” doesn’t automatically bring on susceptibility to these concerns, nor does a female’s self-identification out of those categories lessen it. Sadly, women and females continue to live in a sexist world, so we need reliable data. We need the same level of data about LGBTQ+ folks, but shouldn’t this be separated for all concerned’s health and wellbeing; am I wrong? Or have I missed something?
I know this is an area of much discussion in feminist spaces and within LGBT+ research. To date, no clear answer has emerged. I write and offer training about medical conditions and wellbeing in public, corporate and health spaces; it’s crucial to state prevalence by biological sex instead of gender. Unfortunately, it’s not an issue I have found a straightforward way to address without offending someone, and I know I am not the only person who’s being challenged with this well-known area of contention.
The discussion is further complicated as most people don’t refer to themselves by their biological sex, for example, “female”, because it’s a scientific term that refers to the sex of any species capable of producing children. In contrast, “woman” refers to human beings.
Moreover, the word female can reduce a woman’s reproductive parts and abilities when used outside of science or research space. Some will find this offensive, dehumanising and exclusionary. Importantly, it’s not how we speak in person well, not in English.
From speaking with colleagues, most (not all) agree it is essential to maintain a link to the usage of ‘woman’ for the reasons I have already raised. Some have mentioned that women are too often still sidelined, labelled hysterical, depressed or just awkward for too long. There is the beginning of open, genuine discussions around women’s needs and uniqueness. Still, some fear these discussions being diluted or hijacked or if the female/women experience isn’t valued, supported, and celebrated.
For ease, and I fess up, it feels like a swerve; I’ve decided for the time being to use women/female/people interchangeably when talking about female sex-specific concerns such as menopause. It makes the reading clunky, and some end users have raised objections and concerns about the loss of women safe spaces, including “our” language.
I’ve now changed the title of my pelvic floor to “Pelvic floor demystified for those with female anatomy.” The dance of how best to use language to be truly inclusive in an evolving landscape of words continues.
What say you? Happy to hear any helpful comments.