Join us for the 2017 ILCA Conference and Annual Meeting, Knowledge, Diversity, Equity: Global Access to Skilled Lactation Care, 19-22 July in Toronto, Canada. #ILCA17 offers opportunities to learn from leading experts around the globe (68 speakers representing 13 countries) on a wide range of topics. Aiden Farrow, IBCLC (Italy) is one of the #ILCA17 plenary speakers, and will be presenting Gender Diversity, Language, and Inclusion for Lactation Specialists. We spoke with Aiden about the role of gender-inclusive language in providing compassionate, accessible lactation support, to get a feel for what we can look forward to at #ILCA17.
Lactation Matters (LM): How can knowledge of inclusive language help International Board Certified Lactation Consultants® (IBCLCs®) improve their practice?
Aiden Farrow (AF): First, non-inclusive language is a barrier to practice.
Inclusive language can refer to many issues. My talk at the ILCA conference is about gender-inclusive language. Gender-inclusive language has become commonplace when it concerns changing male-gendered language to language that is inclusive of women. It used to be commonplace for the word “man” to mean men and women, or all people. It is no longer commonplace.
When I talk about gender-inclusive language, I am not referring to language that is inclusive of men and women. I am talking about all genders: cisgender and transgender, third gender, non-binary, agender, androgynous, gender queer, etc.
In lactation, pregnancy, and birth, until recently, language was unquestioningly female gendered and heteronormative, e.g. mothers give birth to babies and fathers support the dyad. But, not all families are composed of a mother and a father and their baby. It is now widely recognized that transgender men give birth; non-binary and agender people give birth; intersex people give birth; some men become primary caregivers without giving birth; some supporting partners are women; sometimes parents are the same sex; etc.
Mother + father + baby is no longer a formula that is inclusive of diverse family structures.
Misgendering people —for example referring to a birth father as “mum” or “mom” or referring to a female partner as “dad”—is erasing, hurtful, and disrespectful. A care provider is not doing a good job if their client or patient is uncomfortable, unable to listen to them, does not trust them, is afraid of them, is not intending to return for follow-up, is triggered, or is in any way damaged by the consultation or visit.
Transgender and gender nonconforming people have higher rates of suicide and mental illness and lower rates of health than the general population (not due to their gender, but due to society’s prejudice). This is a serious health equity issue. Knowledge of gender-inclusive language and a willingness to adopt gender-inclusive language will improve access to your care and improve the quality and appropriateness of the care you provide.
LM: What challenges do lactation consultants experience while working toward gender-inclusive language?
AF: This is very unique to the individual. Some IBCLCs do not find it particularly challenging to incorporate gender-inclusive language into their practice. I know of many IBCLCs who have updated their websites with gender-inclusive language. It may be more of an issue in unrehearsed speech.
There are some people who are strongly opposed to gender-inclusive language. I fully expect to be criticized for my talk at #ILCA17, and I am glad to be in a position to stand up and speak where other LGBTQI colleagues are perhaps not in a position where they feel safe doing so.
Some people are challenged by gender-inclusive language due to their religious beliefs, their upbringing, their ideologies, or something else. Some people were loudly outraged when the British Medical Association’s 2016 guide to inclusive language in the workplace suggested “pregnant people” in place of “expectant mothers” as inclusive of transgender men and intersex men. Some people see this as an erasure of women, but rather than proposing something that is inclusive of birthing women, men, non-binary, and transgender people, they want to maintain the current exclusive language. That is not okay. Exclusive language is not acceptable.
LM: Can you share with us one tip for introducing gender-inclusive language that you plan to share in your talk?
AF: Yes, quite simply adhere to the principle of treating your clients (and colleagues) with compassion, dignity, and respect. Change your intake forms to allow more than two genders, and ask preferred terms for parent/carer/family roles (i.e., mom/mum, dad, something else). Ask which pronouns the person uses (e.g., him, her, they, zie). Use the terms identified by your client and apologize if you get it wrong. That would be a great first step.
Aiden Farrow is an IBCLC®, writer, speaker, and infant-feeding and health-equity advocate. Based in Rome, Italy, they have spoken around the world on LGBTQI health inequities, gender diversity, gender-inclusive language, lactation support for infants born with a cleft lip and palate, and barriers to entry to the lactation profession (in particular, those experienced by non-US candidates).
Aiden participated in the 2014 Lactation Summit and the 2016 Lactation Equity Action Committee (LEAC) Global Forum, and published the groundbreaking article Lactation Support and the LGBTQI Community as part of a Journal of Human Lactation special issue on Equity. They write for the Language of Inclusion blog and the Cleft Lip and Palate Breastfeeding website, run the online support network for LGBTQI health professionals and allies Embracing Diversity in Reproductive Health, Birth and Infant Feeding, and run the Want to be an IBCLC? support groups for aspiring lactation consultants.
Aiden is currently an undergraduate student with the Open University (UK), completing a Bachelor of Science with a focus on public health and public health promotion.
You’re right! I feel very stressed just reading this article. It feels like you are angry that the entire world is not up to date on constantly changing and endless new genders identities and what they should be called. I’ve never heard some of the terms you’re using and after working in Obstetrics for over 30 years I’ve definitely never helped any type of man give birth. I’m glad that you recognize that all these new gender classifications is a bit unsettling. It seems that what has been the reality of our human existence for thousands if not millions of years is now being redefined on a daily basis. How can this not be unsettling? ( I can’t help but think the barrage of GMO food, plastics, pesticides, herbicides, and hormones in our food supply- all hormone disrupting- has a lot to do with this and many other problems such as infirtility, pcos, hormonal related cancers, etc.)
On the other hand, I want to understand what people sincerely feel and struggle with. And I want to treat everyone with the same respect and empathy. I think you will be most effective if you present your talk with understanding, humility, and a sincere sharing of what people go through that others are unaware of- In other words if you want to be effective speak heart to heart rather than demanding apologies.
Sharon, thank you for your concern, but no, I am not angry and I requested no apologies. There is nothing new about gender diversity.European colonization had a big part to play in erasure of gender diversity and that oppression is now beginning to lift, Transgender and intersex people are not a “problem” caused by GMOs, plastics, and pesticides. In your 30 years of obstetrics, you may well have met a pregnant man, and not known it. Many many transgender people are coming out later in life because of societal pressure.
THANK YOU Alice for this rational, reasonable article.
It is especially pleasing to read your comments on the use of ‘mom’ ‘mum’ ‘dad’. The terms are disrespectful and hurtful. Australian politicians love to use the phrase …..we are doing XXXX for “the mums and dads of Australia.” !!!!. GROAN ………I suspect much of my personal dislike of these terms also spring from the 70’s when I had my twins and was forever asked by male friends : “Do you work or are you just a mum?”
An additional problem I experienced was when I was awarded an Order of Australia Honour in 2006. The local paper came to my hospital (where I worked as the IBCLC) to do a story and take a photo. I had a consult that day with a lesbian couple who were both feeding their new baby. I arranged with the photographer that the whole family be in the photo and we openly discussed the reasons. It was in horror, the following week when the paper was published, to see that they edited out the second mother from the photo. So disappointing, inconsiderate and sad. Hopefully things have changed.
I am sorry I will not be in Toronto to hear your presentation.
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Can I recommend a very easy change that private practice LCs can easily make? Put a space for Pronouns on your intake forms! This normalizes that biology does not equal gender. Even if you never ever have a client who does not use she/her (you may be surprised!), it is a reminder to clinicians and clients alike.