Reading time: 4 mins

Euphemisms are part of our everyday language – just think of ‘that time of the month’ for ‘menstruation’. They relieve the force of a word that represents something traumatic, difficult to process, or taboo. Logically, everyone should avoid language that might offend or hurt others, but the real question is where we draw the line. Where is the line between politeness and hypercorrection? How does this work in medical and pharmaceutical texts?

Words matter

It was shocking to hear the term ‘incompetent cervix’ on an episode of a historical medical drama show Masters of Sex. It is not a made-up medical condition, but the term has since been replaced by the less judgemental ‘cervical insufficiency’ – a definite change for the better. A less obvious reason behind the change is the fact that similar terms like ‘heart failure’, are being replaced by ‘cardiac impairment’ or ‘cardiac insufficiency syndrome’. Dr Sally Satel suggested in her 2011 book PC, M.D. How political correctness is corrupting medicine this sensitivity can be more insulting than edifying: “You are basically sending the message that people are so fragile that they can’t tolerate reality”.

Words indeed matter, not only when speaking about medical conditions, but also – or especially – when speaking about gender and how it is represented in medical contexts. As WHO stresses, “all health professionals must have knowledge and awareness of the ways in which gender affects health, so that they may address gender issues wherever appropriate thus rendering their work more effective. The process of creating this knowledge and awareness of – and responsibility for – gender among all health professionals is called ‘gender mainstreaming’.”

The case of breastfeeding

JK Rowling sparked a series of outraged tweets in 2020 when she spoke against using the phrase ‘people who menstruate’. On a very similar note, our team recently came across a dilemma when checking the English translation of a patient information leaflet: the reference materials mentioned ‘breastfeeding people’, while the translator provided the translation of ‘breastfeeding women’. Both expressions are technically correct, so we were forced to decide which one to use. When do we use gender-neutral nouns, such as replacing ‘policewoman’ or ‘postman’ with ‘police officer’ or ‘postal worker’? Going back to the example above, who else would breastfeed if not women? Yes, men can lactate, though under the majority of circumstances, it is limited to one sex.

That is precisely the thing: breastfeeding is limited to one sex, but not to one gender. It is important to keep in mind members of the LGBTQ+ community when talking about breastfeeding. While cisgender men cannot breastfeed, transgender men can, provided their gender-affirming surgery in the form of chest restructuring (also known as top surgery) and other transitioning procedures are not preventing them to do so. In relation to transgender and nonbinary parents, the term ‘breastfeeding’ is sometimes replaced by ‘chestfeeding’ (‘chest’ seems to be the neutral term of choice), especially from 2019 onwards.

This move towards the use of gender-neutral ‘breastfeeding people’ appears also on official websites, such as the US CDC. The search results (from 13 Jan 2022) on other prominent institutions websites’ are detailed in the table below:

Website Keywords and number of search results
breastfeeding people people who are breastfeeding breastfeeding women women who are breastfeeding
EMA 0 1 215 96
ICD 0 0 20 0
BMJ 2,406 103 2,925 166
PubMed 10 0 1,565 131

 

Does that mean all mentions of ‘breastfeeding women’ need to be replaced immediately? Well, changes are rarely instant. As can be seen from the table above, the use of a gendered noun is still highly prevalent in medical literature. Some are still adapting to the facts that sex and gender are two different concepts and that breastfeeding in public is not a taboo. Many are still grappling with the notion of transgender. It may thus take some time to start speaking of ‘breastfeeding people’, but the change is definitely happening and it is important that medical language reflects this change.

How does your organisation respond to inclusive language? Do you have specific guidelines? We welcome any information on this matter, since it makes our work even more in line with your communication preferences. Let us know in the comments below or contact us at info@alamma.eu!