Controversial: Pregnant trans man Roberto Bete and his partner Erika Fernandes, a trans woman, model for Calvin Klein underwear
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What is a woman? It’s the political question of the day, but here’s a related one for you: Can a person born with a penis give birth? 

If you know even the basics of anatomy, you’ll probably swiftly answer: ‘No.’ You may even find yourself quoting Monty Python and asking: ‘Where’s it going to gestate? In a box?’ 

No matter how determined we are to be inclusive, there are some limits to what different humans can do. And for a person with a penis, having a baby is one such limit. 

A fact you’d imagine a midwife would know better than most. But the reality, it seems, is rather different. 

So much so that a midwifery course at Edinburgh Napier University in Scotland was recently outed by whistle­blowing students for attempting to teach them how to catheterise a penis. 

Students were told their module on catheterisation — a procedure sometimes done during labour to drain the bladder — had been fully updated, because they ‘may be caring for a pregnant or birthing person who is transitioning from male to female and may still have external male genitalia’. 

Controversial: Pregnant trans man Roberto Bete and his partner Erika Fernandes, a trans woman, model for Calvin Klein underwear

Controversial: Pregnant trans man Roberto Bete and his partner Erika Fernandes, a trans woman, model for Calvin Klein underwear 

That’s right: a highly experienced midwifery lecturer with a PhD taught students that a male person could give birth. 

If you’re reading this with your face in your hands, I agree that it would be tempting to have a knee-jerk reaction and call for the teacher to be fired. 

Surely if a person doesn’t know the absolute basics of biology, they have no place teaching future healthcare providers? 

Unfortunately, though, this would not solve the problem, which goes far deeper than just one midwifery lecturer.

We need to ask why this teacher has completely lost touch with reality in this way and the answer, I firmly believe, is because midwifery has been ideologically captured by the trans lobby. 

Again and again, through my work as a writer and campaigner for women’s rights in childbirth, I have been approached with frankly dystopian stories s­howing how in thrall to trans rights midwifery has become. 

For example, at one university, I’m reliably informed a visiting lecturer has told students they must refer to ‘birthing people’ rather than ‘women’ in their essays, or face their work ‘being looked upon less favourably’. 

Other student midwives, from various courses, have told me they have been instructed to use the terms ‘childbearing individual’ or ‘pregnant people’ to be more ‘inclusive’. 

They don’t feel able to object, having fought hard for places on the course. Teachers of midwifery are also under p­ressure. 

Several have contacted me to say they feel compelled to use particular words for fear of risking their jobs.

‘Teaching midwifery now feels like walking on eggshells,’ said one. ‘I feel I have to start each class with a disclaimer on how I define “woman” and “female”.’ 

Another told of how, when teaching, she must use terms such as ‘women and birthing people’, ‘they’ instead of ‘she’, and replace words such as ‘maternity’ with ‘perinatal’, and ‘breastmilk’ with ‘human milk’. 

In spite of reservations about the changes, she feels powerless to argue. It’s all evidence of how the trans debate is becoming an area in which the unscientific beliefs of a small minority are taking precedence over basic facts. 

Indeed, last week the head of trans inclusion at campaigning group Stonewall told an i­ndustrial tribunal that ‘bodies are not inherently male or female. They are just their bodies.’

This suggests a baffling lack of biological awareness. But it’s not only lobby groups or niche communities on social media who appear to be erasing women from issues concerning their own bodies — you will also see major birth and breastfeeding organisations, and even NHS trusts, falling over themselves to write posts and even policy documents that don’t mention women at all. 

The Tavistock and Portman NHS Trust runs the UK's first gender clinic in London

The Tavistock and Portman NHS Trust runs the UK’s first gender clinic in London

From The Lancet labelling us ‘bodies with vaginas’ to the charity Sands calling mothers ‘birthing parents’ to NHS posts referring to ‘pregnant people’ to Teen Vogue describing women as ‘non-prostate owners’ and La Leche League referring to ‘­breastfeeding families’, to medical website Healthline writing an article about ‘vulva owners’ to the Royal College of Midwives talking about ‘p­ostnatal people’ — the rush to remove any reference to biological sex is at epidemic proportions.

It’s become common on I­nstagram, for example, to see posts from period pad companies or antenatal groups proclaiming that ‘men give birth’ or ‘not just women have periods’, accompanied by proud images of what appear to be men with baby bumps. 

Yet these are still biologically female people. Take the extraordinary photo of Roberto Bete, a pregnant trans man who, together with his partner Erika Fernandes, a trans woman, last week became the new face of Calvin Klein underwear. 

At Edinburgh Napier University, these misunderstandings over the binary nature of sex had clearly got the better of the midwifery lecturer, who created a new two-page section in the catheterisation module on the ‘birthing person’s’ penis. 

Then, in an email after the module was circulated, she told students: ‘Apologies for the wording being the wrong way round. This situation refers to a female who has transitioned to male. So the person has surgery to construct a penis but still has a uterus and may conceive.’ 

However, though the sex reassignment surgery industry is projected to be worth £1.2billion by 2026, the numbers of trans men giving birth are very low. In my own research I have heard of fewer than ten cases in the UK in the past five years. 

So the chance of your average midwife ever encountering a pregnant person with a surgically constructed penis are smaller than minuscule. 

Milli Hill is a freelance journalist, and the founder of the Positive Birth Movement, a global network of over 450 free to attend antenatal groups

Milli Hill is a freelance journalist, and the founder of the Positive Birth Movement, a global network of over 450 free to attend antenatal groups

An Edinburgh Napier University spokesperson said: ‘[We are] committed to upholding the p­rofessional standards required of us by the NMC [Nursing and Midwifery Council] … and wish to be inclusive of all, including those who identify within the LGBTQ+ communities.

‘The teaching materials will be updated as required.’ When you consider that all this is happening while midwifery itself is in crisis, it becomes even more baffling. 

In the aftermath of the Ockenden report — in which more than 1,800 cases revealed serious failings in maternity care at Shrewsbury and Telford Hospital NHS Trust — and maternity scandals in East Kent and Morecambe Bay, women are more scared of giving birth in an overstretched and underfunded system than ever. 

Yet huge amounts of time and energy, not to mention money, are being put into resources to teach midwives about ‘i­nclusive language’. 

None of this, sadly, surprises me. Back in November 2020, I questioned the term ‘birthing people’ in a social media post and was subjected to terrifying online attacks calling me a ‘terf’ — meaning a ‘trans exclusionary radical feminist’ — ‘toxic’ and a ‘dangerous piece of s***’. 

There were calls to destroy my books, and I was publicly ostracised by leading figures and organisations from the world of childbirth. 

Indeed, midwives, doulas, and antenatal teachers were among my most virulent critics. 

Since then, petitions and c­ampaigns have been set up to ban me from speaking at maternity conferences, and many midwives will no longer recommend my books, both bestselling guides to childbirth which have helped countless women have a better birth. 

All because I refuse to stop using the word ‘woman’. So why are the trans lobby so forensically focused on the act of childbirth, and all that a­ccompanies it?

I strongly believe it’s because childbirth, breastfeeding and menstruation are all major b­arriers that stand in the way of trans ideology’s insistence that anyone, regardless of their a­natomy, can be a woman.

The key mantra of the trans movement is that ‘trans women are women’. Some of the strongest voices in this movement are trans women in their 40s and 50s, desperate to be affirmed as female in spite of, in many cases, retaining their male anatomy.

In order for this affirmation to be complete, trans activism needs people to agree that there is no connection between female biological processes and being a woman. More than that, it needs specific people to admit this — people like me.

Birth writers, breastfeeding experts, antenatal organisations and midwifery colleges; if it can get them all to say, ‘It’s not just women who have babies’, then a citadel has truly fallen. 

It’s always amazing to me that midwives and antenatal teachers, often known for being firmly against the medicalisation of childbirth, are at the same time so captured by an ideology that supports puberty blockers, cross-sex hormones and even surgery to remove body parts in young people distressed about their relationship to their sexed bodies. 

One wonders, too, whether they are concerned for the welfare of children, many of whom they presumably helped bring into the world, who are now told they’ve been ‘born in the wrong body’.

Sajid Javid has called for an urgent inquiry into the long-term outcomes for children treated by NHS gender clinics, stating that he is particularly concerned by the findings of the Cass Review — an independent report into gender identity services for children — which found that some staff at the Tavistock and Portman NHS Foundation Trust feel ‘under pressure to adopt an unquestioning affirmative approach’. 

Modern campus buildings on the Sighthill campus of Napier University in Edinburgh

Modern campus buildings on the Sighthill campus of Napier University in Edinburgh

But this ‘unquestioning affirmative approach’ stretches far beyond the gender clinic. It’s created an environment in which people have abandoned critical thinking in favour of m­indless mantras, fuelling a culture in which a presumably intelligent and rational midwifery lecturer can suddenly find themselves teaching students that a man with a penis can become pregnant.

Ultimately, I would argue the root cause of all the current issues in maternity care is sexism. Birth is bottom of the list for investment because it’s a women’s issue.

Birth trauma is accepted as part and parcel of becoming a mother because it happens to women. 

Paternalistic language is given a free pass in the birth room just as it often is in the office or in the pub. 

We’ve not yet solved these sex-based problems, yet at the same time we’re all being called upon to deny that sex exists. And as usual, it’s women who will suffer.

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