This week (Nov 12-19) is Transgender Awareness Week in the United States. Transgender Awareness Week helps raise the visibility of transgender and gender non-conforming people and address the issues this community faces. According to Fenway Health’s glossary, a transgender person is "an umbrella term for people whose gender identity and/or gender expression differs from their assigned sex at birth (i.e., the sex listed on their birth certificates). Some groups define the term more broadly (e.g., by including intersex people) while other people define it more narrowly (e.g., by excluding “true transsexuals”)."  A person who is transgender may have a uterus but identify and express their gender as male. This person may choose to become pregnant and birth a child. They need respectful and evidence-based childbirth classes just like other pregnant people.

As childbirth educators and birth professionals, we can do a small but important part to make all of the people in our classes feel comfortable and welcome. One of the first steps is to recognize that not all people with uteruses identify as female. Sometimes pregnant people may identify as female, sometimes as male and sometimes as neither or both at the same time. This may be confusing to some readers.  A great resource for learning more about the spectrum of gender expression is found on the Genderbread Person website. The important thing to remember is that the pregnant person gets to determine how they identify and how they want to be addressed.  Our role is to create a welcoming space for all families. It is important to recognize that not every gender-diverse person is comfortable in sharing about themselves. For the educator, it is good to assume that each and every class may have gender-diverse participants and operate from a place of inclusion right from the start.

Here are some suggestions on how to do this in your childbirth classes:

• On your website and registration material, consider using gender-neutral language. (More on suggested terms below.)
• On registration and intake forms, ask your participants what their pronouns are. (He/him, she/her or they/them.)
• Don't assume that every pregnant person has a husband, a male partner, or is even partnered at all.  Consider referring to the non-pregnant person who is attending as the support person.
• Introduce yourself at the beginning of class with your own pronouns, so others may feel comfortable following suit if they wish. If this feels awkward at first, that is normal.  Practice a few times in front of a mirror, just like we prepare for teaching a new curriculum, and soon it will flow easily and naturally. If you happen to slip up and refer to someone with the wrong pronoun, quickly apologize and move on.  There is no reason to make it about you. Everyone knows it might happen from time to time.
  • Example: "Hi, my name is Sharon Muza, and I use she/her pronouns."
• During class, when you are referring to the people who are giving birth, consider using the following nouns: "pregnant people” instead of “pregnant women”.  Other options include laboring people, birthing people, birthing person, laboring person, gestational parent, postpartum parent, pregnant person, lactating person, lactating parent, nursing parent/person, breast/chestfeeding parent.
  • Example: "When the laboring person arrives at the hospital, they may first go to triage for assessment."
  • "The breast or chestfeeding parent may find it helpful to meet with a lactation consultant."
• To refer to the pregnant person and their support, some options might be “parents,” “families,” “class members” and “students” more often instead of focusing only on “mom” or "couples."
  • Example: "The new family may enjoy having meals brought to their home by friends and families after the baby comes."
• When using pronouns, use “they” rather than “she” or “he” and “them” rather than “her” or “him."  They can refer to a single person as well as a group. (We do it all the time in English. "Has the teacher arrived?  No, they have not.")
  • Example: "They may want to change into a hospital gown or prefer to wear their own clothes in labor."
• To refer to the non-pregnant person, consider terms such as support person, family member, non-gestational parent, and birth team.
  • Example: The support person can massage the laboring person's back to help with back pain."
• Review your handouts to make sure that they are consistent and use the same language as above.
• Examine your videos and A/V items to be as inclusive as possible, and are representative of a very diverse group of family structures.
• Ensure that there is a gender-neutral bathroom available for class members to use. Very pregnant men would not be comfortable or feel safe using a female bathroom.

Lamaze has an inclusivity statement that can help guide educators:

The journey through pregnancy and parenthood is unique for everyone. Lamaze welcomes and respects all individuals and families on this journey from every corner of the world. Regardless of who you are, where you live, who you love or what language you speak, we want to be with you on your path from pregnancy to parenthood. We believe that birth is transformative for every family and that everyone deserves a safe and healthy birth experience. Our goal is simple; we want all parents to feel confident, supported and powerful as they ask questions, make decisions and navigate their individual path through birth and parenthood.

You can learn more about Transgender Awareness Week from the GLAAD website. Recognizing that transgender and gender-diverse people are creating families just like everyone else is the first step in creating a welcoming classroom. Childbirth educators can welcome these families with a few simple changes to their vocabulary and course material so that no one is excluded.  Have you already shifted your classroom to this more inclusive language? Can you share how that process went in the comments below? I personally shifted my language (verbal and written) several years ago but feel like it really took about two years of constant use before it flowed naturally and easily from my lips or fingers when typing. Give yourself grace if you are making the shift.  It takes time. What matters is that you are working on it. Comments and discussion are welcome, remember to please share your thoughts respectfully.

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