A few weeks ago, the supreme Court ruled that:

• A ‘woman’ is a biological woman or girl (a person born female)
• A ‘man’ is a biological man or boy (a person born male) 

Look, I’m gen X and I’m a wee bit surprised that this needed to be confirmed by a bunch of high court judges.  But I’m hoping that this means we can have respectful conversations about gender equality. Being able to have polite disagreements about sensitive topics is a skill we’ve lost at great cost to society. If we all really listened to those we think we fundamentally disagree with, both sides would almost always meet somewhere in the middle, (see my previous post, https://midwifemotherme.com/2024/05/18/somewhere-in-the-middle/) which is always vastly better than any extreme position.

Having said all that, this post might be triggering for some people, so if that’s you, please bear with me, and even if you still disagree with me by the end, remember that’s ok, we can at least respect each other’s right to hold a different view. Or stop reading. That’s also OK.

I’m a middle-aged midwife. I’ve seen a lot. More than you can imagine. And, like all professional NMC abiding midwives, I have looked after every single woman entrusted to my care with compassion and dignity and with respect to her individuality. But here’s the thing: my patients/clients are women. As JK Rowling succinctly states, “What makes a woman is the fact of being born in a body that is geared towards producing eggs as opposed to sperm, towards bearing as opposed to begetting children, and irrespective of whether she’s done either of those things, or ever wants to.” Apparently it took a high court judgment to remind us of this. When you are giving birth, you surely couldn’t be more womanly. This simply isn’t a thing a man (remember, I’m talking about someone born male) can do. It’s also something no trans women can do. Now, admittedly it’s something a trans man can do, and such a person could legitimately ask to be referred to as a birthing person. I’m OK with that.

Look, I’m OK with looking after you if you had a late termination for whatever reason (even though legally I’m allowed to opt out). It’s your body, and it’s your choice, and I can only begin to imagine what a tough decision you were faced with.

I’m OK with looking after you if it’s your 8th child and you want an eighth cesarean section – I might be very worried about you, and I might not agree with your decision to have eight kids, but if that’s what you wanted, I’m happy for you, and I’ll care for you.

I’m OK with looking after you if you smoked and drank through your pregnancy – you had your reasons, and no, you don’t have to explain, I won’t judge you.

Us midwives, we’re human, we won’t always agree with our clients’ choices, but we will endeavour never to make anyone feel unheard or disrespected. We do our best to put ourselves in the other person’s shoes and imagine how we’d want to be treated.

In my 25 years as a midwife, I’ve  come across a birthing person once, and it was probably 15 years ago. We all used the correct pronouns, even way back then. It was the right thing to do. If he wanted to be called dad by the baby he had just given birth to, that was his choice.

But does this mean that all NHS documents about pregnant women should also be about birthing people? I’m not sure about that. Are we really  being unkind and uninclusive if we just say women? I think that’s the question.

I have a daughter. If she were to become a trans man, I would support her all the way. I’m not saying I’d find it easy,  but one of the non-negotiable aspects of parenthood is that you try not to judge, you try to help. I’d probably make lots of mistakes and he’d probably get mad at me, but I hope we’d figure it out.

If I were a trans man (and I’m not, I’m well aware that I’m lucky to identify as cis gendered female), I would absolutely opt out of being the one on that labour ward bed. But I do understand that the biological urge to procreate can be overwhelming and if I were a trans man who wanted to be a parent, I’d do whatever it takes. And just because I stop taking testosterone doesn’t mean I stop identifying as a man. Doesn’t mean I stop using masculine pronouns. But I think I’d understand that physiologically, I’d have to be cared for in a manner that befits a  woman. It’d be no good expecting me to have a man’s blood pressure, or a man’s iron levels, or not check me for urine infections which a man wouldn’t be at risk of… I’d expect to have vaginal examinations to assess my labour’s progress. I wouldn’t expect to be on a male ward. Can you imagine the guys on the urology ward next to a trans man having a baby? (So sorry, guys, we thought we’d put him next to those of you who are passing a kidney stone. I’m sure you’ll understand why. And I’m sure you’ll be kind and inclusive towards him).

Until recently, I guess I could have gone to the Gent’s (if my menopausal bladder had decreed it was an emergency) and simply claimed to identify as a man. Fewer queues, as we all know. But I didn’t because, well, I can’t pee standing up and I wouldn’t have wanted to cause discomfort for those who can, and are doing so at the urinals. Maybe the guys wouldn’t mind. Perhaps they’d mind but wouldn’t say anything for fear of offending me. Or for fear of seeming ungracious and uninclusive. Either way, no-one would say anything so it’d be easy to conclude that no-one minded. But it wouldn’t necessarily be true.

One thing is for sure: when women transition, they don’t take up a man’s space. They won’t be in a man’s sport team, or take up a space on their podium; they won’t get paid like a cis man (according to the Human Rights Foundation, LGBTQ+ workers earn about 90 cents for every dollar that the typical worker earns), or get promoted like one; they are unlikely to take up a bed on a male ward. Cis men are unlikely to feel threatened by a trans man. Being kind and inclusive is easy when it costs you nothing.

For a women,on the other hand, being kind and inclusive:-

– Equals giving up her place on her team or on her podium. Men are stronger, fitter, faster than women. We are geared up to be pregnant and our bodies are designed to survive this in ways that tend to slow us down. It’s just a fact. We can’t compete. If my daughter were an athlete (she isn’t, that’s ok!) and she had trained intensively to be, say, in the Olympic swimming team, but didn’t make it to the Olympics because they took a trans woman (fitter, stronger, faster, no periods, don’t get me started on periods) instead, I’d be peeved. Please bear in mind that as a trans man, she wouldn’t stand a chance of being selected to represent the men.

– Equals giving up her changing room space. As reported in the Nursing Times, in August 2023, nurses in Darlington raised concerns to their trust’s human resources department over the use of a female changing room by a colleague known publicly only as “Rose”, who is a transgender woman.  26 of the nurses signed a letter which claimed that Rose had carried out behaviour that they found unsettling. They claim they were told by the trust to be more inclusive and to “broaden their mindset”. To be nice. And change elsewhere.

– Equals being cancelled and hounded out of her job for daring to express an opinion which isn’t considered kind and inclusive even though her words are nothing but respectful. Yet her opponents feel zero obligation to voice their objections (which they are legitimately allowed to express, obviously) with any such respect.  She’ll get called a TERF (trans exclusionary radical feminists). Which is a huge insult, apparently, because now we’re not just pesky feminists, we’re radical ones. Yikes! Worse, it suggests we can’t be feminists and respectful of trans people’s right to live their best life. That’s insulting. I think it’s a particularly choice insult because it implies we’re with  that man (I just can’t, I simply refuse to mame him) who unashamedly rejects equality, diversity and inclusion. You have to wonder how one could be any kind of feminist (let alone a radical one) who supports that notoriously misogynistic man and rejects EDI. It’s an oxymoronic insult.

– Equals Women having to concede that they are selfishly, unkindly, uninclusively monopolising childbirth.

– Equals lesbian women ruthlessly judged unkind for being unwilling to be with trans women. In a BBC News article by Caroline Lowbridge on 26th Oct 2021, Ani says she gets contacted on Twitter by young lesbians who do not know how to exit a relationship with a trans woman. As she puts it,
“They tried to do the right thing and they gave them a chance, and realised that they are a lesbian and they didn’t want to be with someone with a male body, and the concept of transphobia and bigotry is used as an emotional weapon, that you can’t leave because otherwise you’re a transphobe,” she said.
Like others who have voiced their concerns, Ani has received abuse online. Still, she maintains that
“A really important thing for us to do is to be able to talk these things through. Shutting down these conversations and calling them bigotry is really unhelpful, and it shouldn’t be beyond our ability to have hard conversations about some of these things.”

– Equals women crime stats taking a hit because some perpetrators are trans women. But they are being recorded as women. And then being sent to women’s prisons. Without oestrogen.

All these things affect women. Not one of them affects men. But few women speak out, even fewer men. They see what happened to JK Rowling, to Kathleen Stock, to Martina Navratilova, to Judy Murray,  and they don’t want to risk that kind of abuse. I don’t either. But I’m a middle-aged thick-skinned midwife, and I have a daughter.

Rowling got abandoned by the very young actors who shot to fame, thanks to her, in the Harry Potter films. What else could they do? They couldn’t afford to be cancelled, they still had their whole lives to live. They needed to be seen to be kind. I suspect she’ll forgive them. I can’t imagine her wanting them to endure the hideous abuse that she gets. I subscribe to a blog by Charlotte Clymer, a trans woman, and I really respect her work. She tirelessly and eloquently speaks up against that man and I’m very interested in her perspective as a trans woman. Hers can’t have been an easy life yet she’s done really well, kudos to her. But to read her blogs (which I still subscribe to because you can’t advocate listening and conversation while blocking out those you disagree with) about Rowling… well, she’s entitled to her opinion but, jeez, it’s not nice, it’s not kind, there’s zero empathy for the domestic violence that Rowling experienced as a young woman, and it’s not respectful.  Ms Clymer may have changed gender but she sure isn’t playing by the new rules when it comes to being kind. Of course, this fear of being abused and/or cancelled regardless of how respectfully a woman states her case is keeping too many people quiet. I’ve spoken to a few people about this post just to suss out the lay of the land. It would seem younger women will confess to having fewer misgivings, citing kindness and inclusion, which is lovely; whereas women my age seem to be more strongly in favour of inclusion plus common sense, but wouldn’t exactly want to go on record with that opinion. Too much at stake. But then nothing changes. Our daughters still have to toe the line, be kind, say nothing, be seen but not heard, accept the consequences like a good sport. Still, it seems to me that while only (older) women have thus far spoken up, we may finally be gaining some male allies.

The head of World Athletics, Lord Coe, who is standing to be president of the International Olympic Committee (IOC), said (in December 2024) that the female sport ‘category’ must be ‘sacrosanct’ and he was ‘uncomfortable’ watching the boxing in Paris. Look, about the boxing in Paris: I think that’s a separate issue because the women in question are affected by DSD (differences in sex development) and that can include so many different conditions with so many possible outcomes that I think you have to take each one on a case by case basis. Also, these women were designated female at birth. I’m a midwife, it’s part of my job to decide whether a baby is a girl or a boy, and obviously I have to go by what I can see. DSD is usually picked up around adolescence, through scans and genetic tests. It’s complicated and I wouldn’t know where to draw the line, but I do know I’d have had grave concerns if my daughter (who is in no way an athlete) had been competing against one of these women. Both things can be true.

And then we have the legendary feminist (and pretty awesome tennis player) Andy Murray, quoted as saying:

‘It does feel to me now as though the tide is turning. I think it’s a challenge for any woman in the public eye to speak about this and in sport it’s usually the old guard who are speaking out about it like  Navratilova. Younger female athletes, understandably, are very cautious about this because of the social media onslaught that can come with it and how it could affect sponsorship and team funding. If you’re a woman, you need to be a very strong personality now to withstand the criticism that comes with speaking out for something you believe in. It’s really sad.’

I know nothing is ever cut and dry. I know there will always be exceptions. People with DSD, for example, should be treated with care, compassion and consideration. And since we know that trans women are at high risk of domestic violence, we need to make sure they are cared for appropriately by refuges. But in both cases, common sense must be the driving factor. We must always choose to act in a way that balances the rights of trans people with those of women. The high court provided a bit more clarity which ought to help but there will always be blurry lines. And that’s ok. As long as we can have respectful conversations, we’ll all be able to live and let live.