Hi Nikki,

I’m not entirely sure why you shared those links. I *think* that you might have been providing them as evidence that the desexing the language of maternity is relevant everywhere. I don’t think it shows that at all.  In fact I think that they illustrate another part of the problem with the export/imposition of the concept of gender identity globally. As we said in our paper, 'While people who do not conform to the social expectations of their sex are ubiquitous throughout the world, the response to such individuals is influenced by culture in which they reside. This includes in the level of acceptance or marginalization they experience, the ways in which they are accommodated and the ways in which their non-conformity is conceptualized.’ 

Some of the text in the articles you shared make the mistake of overlaying the very Western conceptualisation of gender identity onto these cultures. This is just another form of cultural imperialism. It can be difficult to sift the wheat from the chaff in this because the Western point of view is quite overpowering in terms of what is published, particularly in publications for the general public.  It is also difficult for peoples in diverse countries and cultures to explain their cultural beliefs- related to a lack of Western understanding or willingness to listen as well as it simply being very difficult to explain ideas for which there is no equivalent. There is also pressure not to clarify because of issues to do with funding for example. However, but if you go looking you can find evidence of cultural export causing difficulties. In some respects  it should be obvious, cultural beliefs developed over millennia in diverse locations cannot simply have a new philosophy overlaid on them without problems. but I’ll give you a couple of examples. Although written for a US audience (and so not as the people themselves would explain) this article shows how the spread of the concepts of gender identity and transgender have been adversely impacting traditions in Pakistan https://theworld.org/stories/2017-07-29/pakistans-traditional-third-gender-isnt-happy-trans-movement <https://theworld.org/stories/2017-07-29/pakistans-traditional-third-gender-isnt-happy-trans-movement> 

In another example, from my own backyard in the Pacific, the Fa’fafine are often cited as showing that gender identity and transgender are globally salient concepts however, this is simply not the case. Fa’fafine is a term to describe effeminate, same sex attracted males in Samoa who take on a particular role. They are respected and these individuals  are comfortable in their bodies by large it seems and do not see themselves as women. When the transgender New Zealand weight lifter Laurel Hubbard competed in the women’s competition in the Pacific Games a few years ago there was outrage in Samoa and surrounding countries. The Fa’fafine compete in men’s sporting competition, it not considered that they are other than male/men and they thought it extremely unfair that Laurel had been allowed to compete against Pacific Islander women. See comments here from the Samoan Prime Minister https://www.stuff.co.nz/sport/other-sports/114420264/samoan-pm-tuilaepa-sailele-malielegaoi-hits-out-at-laurel-hubbard <https://www.stuff.co.nz/sport/other-sports/114420264/samoan-pm-tuilaepa-sailele-malielegaoi-hits-out-at-laurel-hubbard> (the PM is a big supporter of the Fa’fafine and is a patron of their association- what he said was not controversial in Samoa). Another illustration of this difference is around sex difference, the Fa’fafine is a role for males and as far as I’ve been able to gather, the female equivalent is not a well established tradition. However, it seems there’s pressure to make it so as funders want to have sex equity in participation in programs and so those in receipt of funds have had to try to find people to fit the bill. See some discussion here 
https://www.abc.net.au/news/2019-08-31/understanding-the-pacifics-alternative-gender-expressions/11438770 <https://www.abc.net.au/news/2019-08-31/understanding-the-pacifics-alternative-gender-expressions/11438770> and also in the interviews for this podcast with Paul Vasey (there are two) https://gender-a-wider-lens.captivate.fm/

This is all just to say that the export of ideas from the US related to the concept of gender identity and transgender is causing some real problems  for many communities who are put forward as being a part of the LGBTQ umbrella. Although many of them suffered under colonialism, traditions survived, whether they will survive this neocolonialism I am not sure. 

But to come back to the core issue at hand, there is no evidence that I am aware of that any culture in the world applied desexed language to pregnant women and mothers until gender identity arose as a concept of significance in the US. This is a US cultural and policy export. The idea that sexed language should be avoided has become fairly well established in the US, it has spread to a lesser degree to other Western countries and is making its way into international policy and to other countries. I’ve been having a conversation with a woman who runs a women’s health charity in a middle-income African country after I noticed that she was using desexed language. I asked her how she came to do so and her answer was not unexpected.  She said, 'I would not say it has spread to [my country]. To the best of my knowledge, we are very few individuals, mostly activists and advocates, making this conscious effort ... I am privileged to be different because I work, mostly, with western and "woke" organizations.'

As outlined in our paper (and our collection of examples in Supplementary File 1), there are some real risks to desexing the language of female reproduction so the concern is not just cultural imperialism. When language decouples sex from reproduction, you can get all sorts of confusion. This example came across my desk today. It’s quite difficult to believe but a midwifery colleague has confirmed it.  https://reduxx.info/exclusive-midwifery-students-taught-how-to-care-for-males-giving-birth/ <https://reduxx.info/exclusive-midwifery-students-taught-how-to-care-for-males-giving-birth/> Thank you for the discussion.

Karleen Gribble
Australia
> 
> Date:    Wed, 27 Apr 2022 14:10:01 +1000
> From:    Karleen Gribble <[log in to unmask]>
> Subject: <No subject given>
> 
> Hi Nikki,
> I think that the ideas that you raise here are pretty uncontroversial. I would point out however that there's a vast difference between communicating with an individual and public health communications and communicating with an individual and data collection.  The former we emphasise the importance of in our paper, the latter is where it sexed language may be necessary for reasons of clarity, inclusivity, and accuracy and to protect the mother-infant dyad. The needs of the most vulnerable must be given particularly consideration. 
> 
> I didn’t point out previously but the newness of the idea that a word like ‘mother' is a gendered term related to gender identity deserves some interrogation. Certainly the concept of gender identity is very new, having only been developed in the 1960s but the use of gendered terms is even newer, so new for example, that ‘mother’ as a gendered term is not even included in the Oxford English Dictionary. In contrast, the meaning of ‘mother’ as applying to sex, that is meaning a female parent, is noted as the primary meaning in the OED with examples of usage  going back 1000 years provided https://www.oed.com/viewdictionaryentry/Entry/122640#:~:text=a.,a%20stepmother. 
> 
> My experience in working with the most marginalised mothers, those whose relationship is in jeopardy because of child protection concerns, incarceration, adoption or surrogacy but also in resource poor environment where maternal and infant mortality is high, is that language can be used to marginalise or support and one of the key ways of marginalising is to avoid using the term ‘mother’ or to qualify it (eg ‘birth mother’). Such is the power of the word- it holds meaning that goes way beyond what the dictionary says- that people will avoid using the term where they do not want the woman recognised as a mother or want to undermine her importance to the child (the most extreme examples are ‘surrogate,’ ‘gestational carrier,’ ‘incubator’). This is all in my mind as I just complete a submission to a government inquiry on children of prisoners! Best get back to it!
> 
> Karleen Gribble
> Australia
> 
> 
> Date:    Wed, 27 Apr 2022 09:52:48 -0400
> From:    Nikki Lee <[log in to unmask]>
> Subject: gender around the world
> 
> Dear Lactnet Friends:
> 
> After reading Karleen's post, I  searched the internet, and found these
> interesting articles:
> 
> https://juliaschwabtherapy.com/blog/cultures-with-multiple-genders/
> 
> https://www.pbs.org/independentlens/content/two-spirits_map-html/
> 
> https://screenshot-media.com/politics/lgbtqi-rights/non-binary-cultures/
> 
> Fascinating.
> 
> 
> warmly,
> --
> Nikki Lee
> RN, BSN, Mother of 2, MS, IBCLC, CCE, CIMI, ANLC, CKC, RYT500
> *@NikkiLeeHealth*
> Pronouns: she/her/hers
> *Communications are confidential and meant only for whom they are
> addressed.*
> 
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