Oct 7, 2021Liked by Leah Libresco Sargeant

"Bodies with Vaginas" is a term men would naturally use about us, because that is what interests them. If we are going reduce women to bodies only, "Bodies with Wombs" is at least more powerful. I have often thought that our power to bring life into the world is a trigger for womb envy and therefore misogyny. Of course they would like to neutralize, or neuter, us. But I hope we do not start using physical words only for women: we are so much more than just that.

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Oct 7, 2021Liked by Leah Libresco Sargeant

I can do identify with the comment or you referenced who went to electronics camp. I think I was 15 when my mom told me “most girls don’t think like you.” What she meant was that most girls didn’t love to program computers the way I did and still do. It not only stung, but felt wrong. I later learned why. In college a professor introduced me to a PhD thesis by a former student of his. The thesis examined not only the different ways women were drawn to computing, but also the different strengths women brought to computing. That speaks to the end of what you said, that there should be a feminism that values women as women. That doesn’t have to look the same across all women-shouldn’t. Computing, hockey, electrical engineering, and military history can be feminine. So can pink and sparkles. There are many ways to be feminine. But it is still a thing.

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Oct 8, 2021Liked by Leah Libresco Sargeant

I've got to say that I feel pretty confused about the idea that we face a dichotomy between abandoning the idea of a gender binary and enforcing adherence to a gender binary via violence. I would even want to push back against the idea that we are finding a "middle" between the two, because I don't think it makes sense to frame them as a spectrum at all. There's nothing intrinsic that suggests that norms around gender must be enforced via violence if they are to be enforced at all. At best we're in some sort of two dimensional space where one axis is your beliefs about gender and another is whether/how those beliefs should be enforced.

However, I get that Martha was using this framework in part to express her frustration that many ideologies of gender and the treatment of trans people don't address the world that we're really living in right now, and how it could realistically change. I want to put forward the idea that there is plenty of room for improvement in treating trans people with dignity and love without saying things about gender that I believe are false. Taking violence and harassment against trans people extremely seriously is an obvious starting point. We could modify building codes such that many more buildings are required to have a single-occupancy, gender neutral bathroom. And that's not even to start on things that would make life easier for *everyone,* such as reducing licensing fees for therapists and allowing them to practice across state lines and remotely.

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I touched on this before, but the more I think about it, the more it bothers me how using terms like “menstruaters,” “people with vaginas,” “people with wombs,” etc., totally ignores how *these are more or less all the same people.*

It’s not like uteruses, vaginas, ovaries, etc., are disassociated traits randomly scattered throughout the population with no more relation to each other than height, brown hair, and intelligence. They *go together,* and there is one cohesive group of people in whom they go together, and that group of people has distinct needs that benefit from use of a collective noun.

It was kinda just a throwaway point to me when I first made it, a warmup for me getting to the things that really hit me in the feels (the “electronics camp” issue, as I will call it), but ugh the more I think about it the more it bothers me.

Sure, not all women (women used here to mean “adult human female”) have uteruses or ovaries or breasts, via various surgeries and whatnot. When we say “women’s health” to refer to issues surrounding childbearing etc., we are absolutely ignoring big constituencies of women, like women who have had hysterectomies, women who are lifelong celibates, women who are infertile, women who…..insert circumstance here.

Therefore, when we reduce each women’s health issue to its one most-salient body part (say, idk, appropriate research into the optimal frequency of mammograms), we divide and fracture the group that is really invested in that issue. It undermines solidarity, splinters the collective group, and reduces our social power — all while engaging in a weird doublethink effort to pretend that, again, there is no meaningful correlation among the various owners of uteruses, breasts, ovaries, and vaginas—when there is not only a correlation, there’s a deeply salient underpinning biological reality.

The fact that this weird doublethink effort seems to be led in large part by people who *don’t* have uteruses, vaginas, ovaries, etc., really makes my skin crawl. I can’t think of a single time in history when people with penises decided that the needs of people with vaginas were unimportant. Oh wait.

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I agree that it's really important to be able to make the generalisation you're gesturing towards, when you say that "menstruators" and "people with vaginas" have a really significant and important overlap. I think in a lot of cases, we should actually be able to make that generalisation, without overtly excluding transgender people. For example, the Lancet could have written something like "Historically, medical issues primarily experienced by women have been neglected." They could then have noted in their article that of course menstruation also affects transgender men, but that its femaleness is still the main thing that led to it being neglected in the first place; if most men experienced it then this would not have happened.

"People with vaginas" is a painful descriptor in this case. The Lancet, in this particular sentence, does not want to be talking about menstruation alone; if they did, then "menstruators" might indeed suffice. They want to be talking about a variety of factors that tend to be associated with each other for biological reasons. The correct general term here should, indeed, involve the word "women," even if we want to take care not to be overly restrictive in our terminology!

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Well, and a lot of people with vaginas don't menstruate? Anyone over 45 or so, to start with. Anyone pregnant or breastfeeding. Anyone who takes the pill to not! Anyone who has had a hysterectomy!

I feel like, medically, there's value to specificity. Is the conversation about how medical issues experienced by women are neglected (where we're discussing society, the perceived role of women and how that affects medical treatment, the historic exclusion of women from medical trials and the link to unknown side effects, the exclusion of women from diagnostic criteria - for example, ADHD is incredibly underdiagnosed in women because of that - and if you're into that discussion, I HIGHLY recommend the book Invisible Women), or are we talking about menstruation or vaginas or uteruses or hormone levels (ALL of which are different, and not necessarily linked with each other!) In a medical article: figure out what exactly you're talking about, and then USE THE RIGHT WORDS. If you're talking about vaginas, that's not necessarily menstruation! De-gendering to reduce specificity doesn't help!

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Oh, when I wrote this: “ When we say “women’s health” to refer to issues surrounding childbearing etc., we are absolutely ignoring big constituencies of women, like women who have had hysterectomies, women who are lifelong celibates, women who are infertile, women who…..insert circumstance here.”

I meant to expand to say that that’s a feature, not a bug, of using collective nouns at all. Not every individual in any collective group is going to share each and every trait that is common to the group. If I join a group for, say, Christian healthcare workers, some of us will be nurses and some will be doctors and some will be Catholic and some will be Protestant, but that’s ok; we’d all be Christian healthcare workers. Occasionally there would be issues that would apply to some but not all of us: say, Catholic pharmacists wanted an accommodation not to have to dispense contraception (they want to be able to pass it to a coworker, say). The larger group could then advocate on behalf of the smaller subgroup, because religious accommodations on the job are in fact a concern of the whole group. Splintering off “Catholic pharmacists” into their own tiny group doesn’t work to include non-Catholic, non-pharmacists in the whole group; it works to cut off Catholic pharmacists from the benefits of being part of a larger group.

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Oh AND (and then I will stop replying to myself with further thoughts and go do the actual things I need to do today), to expand the analogy a bit, I see no reason not to include trans men under the “women” umbrella.

Say a Messianic Jew wanted to join my hypothetical Christian Healthcare Workers group. They identify as a Jew, but our group already had an existing document defining “Christian” as anyone who “Believes Jesus Christ to be the incarnate Son of God, Lord and Savior of the world,” or something like that.

My healthcare group could fairly straightforwardly accept the Messianic Jew into membership without changing the name of the group, which be undesirable for reasons of straightforward simplicity. “Healthcare Workers who believe Jesus Christ to be the incarnate Son of God, Lord and Savior of the world” would make an impossibly clunky acronym opaque to most outside observers, and trying to parse out the exact beliefs that are relevant in any given situation (“nurses who keep kosher,” “doctors who can’t prescribe contraception,” “X Ray technicians who need Saturdays off,” etc etc) would only cause a decrease in the utility and power of the group.

Inclusion in this context means being warm and friendly, making sure everyone has someone to sit next to during coffee hour, making sure the *material needs* of that group are met (the X Ray tech who needs Saturdays off and the nurse who keeps kosher can and should both be advocated for so that, idk, the nurse can have a separate microwave at work), but doesn’t and shouldn’t mean that the larger group needs to rework their whole vocabulary so that every tiny subgroup can connect to every word that is used.

Not all umbrella groups can or should use language that explicitly includes all subgroups at all times. It’s not helpful. I have feelings of empathy for Messianic Jews who might not feel perfectly comfortable in a named Christian group, or trans men who might not feel perfectly comfortable in a named women’s group, but I think my responsibility is to sit next to them at coffee hour and make sure their material needs are met, not to try to fix their discomfort by trying to rework the unifying language of the group.

I think I get extra upset about this because I spent fifteen years in an originally professing Christian denomination that eventually stopped being a professing Christian denomination for exactly these reasons (wanting to use absolutely inclusive language at all times). I spent a while in leadership struggling against it, but when it became clear that the original character of the group had been irreversibly undermined (the breaking point was being asked not to quote the Gospels because they had been so extensively used by white supremacists and therefore were damaging to quote), I left.

Luckily for my life of faith I had Catholicism to return to, but unless you count this substack (maybe I do!) there is no Catholicism of Womanhood to retreat to when the original group deteriorates into meaninglessness.

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I love your contributions to this discussion, and I think this gets to the heart of the issue! Let's say you have a society of Christian Health Workers that are doing great work in the community, and, in fact, are the *only* group of health workers active in your town. But now a bunch of non-Christian folks have moved to the community, including some lovely Muslim doctors and Jewish nurses and Buddhist surgeons etc. And you want to welcome their contributions and are excited for the expertise and experience they will bring to the organization.

What do you do? Do you ask them to be comfortable working for an organization that professes to be exclusively for Christians? Do you insist they at least accept the basic tenants (become Messianic Jews if they aren't already, etc)? Do you tell them to start their own organization? Do you tell them to move to a different town where there is a healthcare organization that welcomes folks of all faiths?

Or.... do you change the name and mission statement and welcome them in with open arms?

I see the question about what terms are used in hospitals, at work, by our government to describe who gives birth, who deals with certain medical issues, etc., to be really about who is or is not a valid member of our community. Who is worth welcoming, and who is not. And even if you want to welcome trans men, insisting that they feel comfortable with the term 'woman' is rather like asking a person with other religious beliefs to become Christian.

Trans men don't want to be referred to as women. I don't see it as my place, and I don't believe I have the *power* to insist it is my place, to tell trans men otherwise.

Fundamentally, the way I see it, the whole conversation is about power. Trans men are insisting that they have the power to reject the term 'woman'. Many many others insist that they don't. And as Leah points out, that's a very very hard conflict to resolve.

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I like this translation of the issue to a less(?)/differently charged topic. I've run into a similar problem in my own life, when I hosted a variety of events at my house—one type of which (First Friday BenOp Dinners) was a specifically Christian event.

One of my friends was hurt that there would be *any* event at my house that was broadly open, but not to her. She told me she'd be willing to come "and ignore the Christian parts" and just hang out.

But that really didn't work for me! The point was to have a vibrantly Christian space, where we could talk about our spiritual lives/challenges without worrying about boring or excluding people. (This is also why I don't want people who haven't read the book to come to bookclub meetings—it dilutes what we gathered to *do*).

So, in your example, I think something real would be lost if the Christian healthcare group shifted to being only ecumenical, though they might form an ecumenical sister group to work together with the broader community, while still having an "exclusionary" core.

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Back to gender, I've seen some groups shift to more AND language "Women and Nonbinary people in Effective Altruism" "Women and Sexual Minorities in..." rather than an umbrella that means we stop talking about women as a core part of the group. And that's not without controversy, since people do feel like the AND doesn't leave everyone on an even footing or that AND only works if you then enumerate every possible category of member.

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Yes! I love the idea of you hosting events that are explicitly for Christians and the idea of a specifically Christian healthcare worker group. But! We aren't talking simply about affinity groups when we're talking about health publications or hospitals using gender neutral language. We're talking about spaces that *everyone* needs to use to be healthy. I do think the 'only healthcare group in town' scenario holds, and also demonstrates that there *is* a decision being made about who is welcome and how you value them.

I think there's a whole very fascinating conversation to be had about whether we should have gender exclusive spaces (my feelings, are, probably yes? But there's a whole history of harmful gatekeeping, decisions being made in only-men settings for instance, that makes it worthy of lengthier consideration). That isn't the discussion here though - the discussion here is about what language to use when referring to people who give birth, menstruate, etc.

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This is a very important point:

Trans men don't want to be referred to as women. I don't see it as my place, and I don't believe I have the *power* to insist it is my place, to tell trans men otherwise.

Fundamentally, the way I see it, the whole conversation is about power. Trans men are insisting that they have the power to reject the term 'woman'. Many many others insist that they don't. And as Leah points out, that's a very very hard conflict to resolve.

My thoughts: It's all well and good that they don't want to be called women, even though I think that perspective is sexist on their part.

But besides that, they insist they have the power to reject the term woman on behalf of all women.

How many trans men are there in relation to the overwhelming numbers of biological women who identify as such that biological women should relinquish their right to be called women?

I will always see it as sexist. Transmen who reject femaleness are undertaking male privilege to diminish women.

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To your hypothetical, if the Christian identity was central to the Christian Healthcare Workers group—say, it was central to our gatherings that we read the Gospel together, share a meal with explicitly Christian prayers, and observe Christian holidays — then I would say to the Jewish, Buddhist, and Muslim healthcare workers that we are happy to work in interfaith solidarity on common issues, but no, the Christian Healthcare Workers group is meant to be what it says on the tin.

Those who fall under our definition of terms but don’t identify as Christian would need to make a choice either to participate and work through whatever feelings of cognitive dissonance this brings up for them, or to found their own group (perhaps an interfaith group).

Those who do not at all fall under the definition of Christian (or healthcare workers; either way!) could certainly be supported in solidarity if we had some shared projects, but unless my hypothetical group didn’t really care about the Christianity part and only cared about the healthcare workers part, it wouldn’t make sense to include them.

The drive to make all groups include all people baffles me. Groups have real, specific needs and interests that may not (often don’t!) benefit from being diluted.

This does not seem cruel or exclusive to me. It seems like a basic fact of the way group character and group identity works. It’s the same reason (well, sort of; there are theological reasons as well) that Catholics have closed communion, and I am in absolute agreement with that. Catholic communion is for professing Catholics in a state of grace, and that isn’t cruel or mean or exclusive; it’s inherently necessary to the functioning of the group.

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I hear you! I think an important component here is the majority/minority dynamic and the *only group in town* dynamic. I'm not at all opposed to affinity groups, but the stakes of the gendered-language conversation are much higher than that. I'm trying to make this hypothetical sorta-equivalently high stakes.

It's definitely not a perfect analogy, but I think it's a good thought experiment to put yourself in the shoes of the first not-Christian healthcare worker who moves to this hypothetical town. And the second, and the third. How would it feel to be told that you and your compatriots are welcome in the community, but the *only* professional association in town is closed to you because of your religious beliefs? And imagine that you didn't have a choice to live in that town or not, it's the only place for you.

To carry this analogy wayyy further -

I think it's easy to imagine that eventually a different association would be formed by you and your fellow non-Christian health care workers, one that you decide is welcoming to everyone regardless of their religious beliefs. As your group becomes bigger, maybe the Christian affinity group becomes smaller - people only have so much time, after all and your group is welcoming to Christians too. You could imagine the Christian group saying you and the other newcomers have *hurt the character of the community* by creating a non denominational healthcare affinity group. Would that be fair? How would you feel?

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I’m going to challenge some premises of your expanded hypothetical.

In your expanded hypothetical, the only healthcare workers in town are all Christian, and suddenly a few new workers move in, who aren’t.

But fundamental to the premise of my original hypothetical is that Christian healthcare workers are already, maybe not a minority, but let’s say, oh, roughly 50% of the sum total of existing healthcare workers? To suggest a number drawn not at all at random. And in this town, they have long felt that their distinctive needs and concerns have never been well-addressed, hence the need for a dedicated group.

I am sure that it feels terrible and frustrating to move into down and the only professional group in the area is for people who are Not Like You.

I do not think that the correct reaction to the feelings of sadness and frustration is necessarily to change the fundamental premise of the original group.

Going to really lampshade that. Your hypothetical is kind of premised on the idea that addressing feelings of pain and frustration are necessarily the most important consideration here. You ask me how I would feel, and the answer is “awful.” But I can know that I would find the situation hard and *still not think* that the right answer is for the original group to change its ways. For instance, when I experience a romantic rejection I generally take it very much to heart and feel

devastated, the more so because I feel romantic love and attraction for a person extremely rarely, maybe once every ten to fifteen years or so. That *doesn’t actually mean* that my romantic interest is wrong for rejecting me, or that the right action for him is to accept me. My feelings, intense as they may be, and as much as I wish they might influence the decision of my romantic interest, are actually not the most salient issue in the room.

Back to the town of 50% Christians. Similarly to the Christian Healthcare Workers, if the only church in the 50% atheist town is a Catholic church, and a protestant or two moves in (or a Protestant, a Jew, and a Muslim move in, or if a Protestant, a Buddhist, and a Hindu walk into a bar) it does not even remotely follow that the Catholic church must open its membership to the Protestants, no matter how devastated the Protestants are that there is not a place for them in the new town to

practice their faith.

Now. The Christian Healthcare Workers (CHW because I am tired of typing that) and the Catholics certainly have a duty of kindness and aid towards the newcomers who have just moved in. Perhaps, depending on circumstances, the established group should help the new group get started up, maybe lend time and money and other resources. Maybe the CHWs include the newcomers in their mutual aid society, or lend the newcomers their meeting space. Maybe the Catholics help host a fundraiser for the new Protestant church down the street.

And sure, maybe as the Interfaith Healthcare Workers or the Protestants grow, the original group shrinks a little. And that’s ok, and no the OG group should not nastily blame the new group.

But none of this is a justification for undermining the original purpose and character of the original group.

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I was with you in your own comment, till I got to "Being able (at least in theory) to have a baby is also a big part of how I understand who I am as a woman." I felt some jabs of pain for the women who find they're infertile, and for all women who live long enough to experience the loss of this potential -- through a needed hysterectomy, an abortion or other surgery gone bad, or simply through inevitable menopause. It's extremely important to value women as mothers and potential mothers -- and also extremely important to value women simply as women -- whether or not we ever bear children. It's really painful to me to think of non-mothers been seen as less womanly or less valuable.

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This is why I included (at least in theory!). Infertility is very hard for both men and women, but I think the kind of pain it is is different for both. My husband and I have lost six children before our daughter Beatrice made it to birth, and we both mourned together, but differently.

There is a big gap in *how* we experienced miscarriage in that it was *our* child we were losing but *my* body that was physically holding and then relinquishing the baby.

This is why I think the capacity is a big part of being a woman—women who don't or can't have children aren't *less* women but the experience of having or not having a baby isn't a gender-neutral one. Grief, loss, even frustration with other people's expectations is profoundly shaped by being a woman, specifically.

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You certainly may be right about this. I think it's almost impossible, though, to generalize, even about men in our culture, when it comes to losing a child - through miscarriage, abortion, or death after birth. And men mature, so a man's attitude and feeling-experience is apt to change accordingly -- even to the memory of such a loss.

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I don't think it's lesser, but I do think it's different.

(Different != lesser is a big theme of this substack!)

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I don't think of it as a jab.

Before a woman discovers she is infertile or before she has had some other loss of a child, she likely became aware of her potential to become a mother from the moment she learned sex education and understood menstruation.

Whether motherhood ever comes to fruition is a different story, but most women begin in the same place in that they know the potential that comes with their female biology.

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Both are true: Mothers are women who do or who have had children; There are some women who have never had children, myself included. It does not make us less of a woman, but it does mean we are not (biological) mothers. Need it be said that there are other ways of mothering? Of course there are, including spiritual motherhood. Nevertheless, physical motherhood is a possibility for and only for the female of the species.

The male gives life through his seed. The female gives birth to the child who is fruit of their union.

A comparison: It is not because some people are born without sight that we should say that seeing is not essential to what it is - and to what it means - to be human. It is, which is why we rightly deem being blind a tragedy; and we expect medical science to do all it can to overcome this limitation where it is found. To do medicine in any sphere requires a norm to which one works.

We have to get back to being able to talk about things objectively, not always through the lens of real or potential offence however painful that is in individual cases.

We are becoming increasingly ‘green’. This is because we are acutely aware of the ‘eco balance’ throughout the entire universe. Touching one aspect of this complex structure ANYWHERE upsets that balance EVERYWHERE.

We know this now.

And yet, we are prepared to deny and to manipulate the most fundamental building blocks of human ecology: namely, the necessary complementarity so finely rooted in the sameness and the differences inherent in being male (a man) and female (a woman). The lived experience of these binomials is kaleidoscopic. But the existential foundations of all those experiences lie in every single cell of the human body. Nothing can alter this fact, and we deny or manipulate this universal truth at our peril….

Question: Would anyone suggest that we deny sexual differences in every other - or indeed ANY other - living species?

Answer: No. So why are we trying to do so with our own?

Because the human mind (and only the human mind) is capable of taking something objectively true and making it mean something else, even its opposite. But that cannot change reality: a rose by any other name is still a rose.

The painful experience of a minority of human beings who are ill-at ease in their bodies should be both acknowledged and respected.

But it should not and ought not lead us to deny the reality of the flesh in all bodies. Again, the fact that some people are blind cannot be a reason to take ‘sight’ out of our vocabulary.

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One of my favourite pieces of writing about embracing femininity as a positive thing was written by Julia Serano. You can read it here:


(Subsequent website changes have erased the formatting of the headers, so that they blend with the text, but it should still be readable).

Serano is transgender, and her view of femininity is from the perspective of someone who wasn't socialised into it -- who was, in fact, quite strenuously socialised out of it, as a child -- but who chose to embrace it anyway. Reading the above piece of writing was a bit of a turning point, for me, as I realised that I, too, have ways in which I actively choose and identify with womanhood and femininity -- not as compulsory behaviours but simply as positive traits that feel natural to me.

Serano also has some insightful writing on the notion of what sex and gender are, and on how to delineate them. In her book "Excluded," she advocates for a holistic understanding of gender as a complex trait that involves biological, psychological and cultural factors acting in concert. Because they are complex, and involve a wide variety of factors that are not the same for everybody and cannot really be controlled, we see a wide variety of ways in which gender is experienced and expressed by different people, in real life. As someone who is still trying to figure out how to include important biological variations between men and women into my feminism -- biological variations that may not be absolute, but that nevertheless exist in the aggregate -- I really appreciate her efforts to create a framework in which we can appreciate the role of biology in creating gender differences without falling into the trap of thinking that gender works in the same way for everyone.

Some people feel like they are "cisgender by default" -- they don't really care about their gender, they just take the one they're given. Some people feel like they've been shaped by the gender they were given in ways that they like, even if they might not have intrinsically chosen it. They're glad of the confinement provided by the notion, because "a cage is also a frame," and being given structure can be an essential element of growing an identity for many people. And some people actively embrace a gender identity, be it cisgender or transgender or nonbinary, and find that they identify with it in a way that feels at least partially intrinsic to them, even as it can also be shaped by societal forces.

Gender is experienced by different people in such different ways. Societal forces are an important part of that, which cannot be erased. So we face a situation in which the collective institutions of society play a pivotal role in creating and maintaining identity factors that are nevertheless intensely personal. We cannot simply default to an individual and atomised view of these things, but nor am I willing to accept a society that callously leaves people behind when they don't fit in.

On a broad level, I feel like "gender should exist, but be optional and flexible" is a reasonable compromise. But this still leaves a great many details unwritten. On the whole, I hope we can find compromises that allow society to give us all the support we need.

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Other Feminisms is one of the few spaces that allows for an engaging and not-terrible cross-ideology dialogue on this topic. Thank you!

I *love* the call out of the lancet for a) not being consistent and b) using "bodies with vaginas" when talking about menstruation instead of, say, people with uteruses or as Laurie points out, wombs. Folks who have had a vaginoplasty surgery don't menstruate!

That said, I do find it hard to imagine a not-violent murky middle on this subject, although I'd love to hear more thoughts on what that would include. Like I mentioned in the thread with Magdalen, one option could be to take violence against trans folk (in addition to physical violence, withholding employment, deadnaming, using wrong pronouns, etc) a *lot* more seriously than we do now. If women and men were used as broad terms in situations where they aren't inclusive of trans men or trans women's biology *but* trans women and trans men were given legal and social protections and not treated as a less-than-human minority, the choice of words could be a significantly smaller issue. I think I'd still be in favor, but a lot less wedded to the idea than I am.

But, in our current reality, I wonder what the murky middle really looks like? 50% of trans men have attempted suicide according to at least one survey. We know that using inclusive language reduces suicidal ideation: the language we use can save lives! And yet in most debates on the topic 90%+ of the discussion is about vague possible futures, most of which maintain the status quo idea that being trans is unnatural or an affront to truth. I truly don't see how anyone could create a non violent or less violent world where that idea persists?

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We have some fundamental truth-disagreements.

I have a lot of thoughts about the causes of suicide. I’m a lifelong depressive and have had several major bouts of suicidal ideation. I have spent *a lot* of time thinking about what causes suicidality, what can prevent it, and how best to think about it.

In general, I think it is more or less totally false to ever point up an extrinsic “reason” that someone kills themselves, with limited exceptions I will outline below.

Wanting to kill yourself is almost universally an outgrowth of deep underlying mental health issues. Reducing it to simplistic external reasons papers over the actual problem and the actual need.

People who are suicidal also almost universally try to rationalize this desire with constructs that are equally almost universally untrue.

During times that I have wanted to die or was considering ways to die, I came up with *all sorts* of rationales for that course of action, all of them products of my mental illness even if and when they were rooted in reality. For instance, experiencing abuse can certainly drive suicidality—it drove much of mine—but also I had untreated depression, independent of any abuse. The abuse was one thing; me incorrectly internalizing that the abuse proved my worthlessness was another thing.

There is also a sort of a spectrum along which the external behaviors of others can be more or less implicated in someone’s suicidality. Outright abuse is on one end of the spectrum; part of the solution there certainly has to be the end of the abuse, probably via removing the victim from the situation. Then moving down the spectrum, one encounters behaviors that are perfectly reasonable on the part of the external party: a breakup, say, or a firing, can absolutely trigger someone’s suicidality, but it isn’t at all straightforward to say “the breakup CAUSED her suicide,” or “being fired MADE her kill herself,” and it’s even less straightforward to argue that the solution to suicides in people who have been dumped is for their partners to take them back (or for their bosses to rehire them). The solution is intensive mental health care, with a combination of meds and therapy and possibly hospitalization.

(I think it is important to note here, too, that when people say they want to die because of a breakup or being fired, they’re *not lying.* They’re telling the truth as best they can. That’s how it feels when you are suicidal. I have been there. I know. Depressed brains tell all sorts of lying stories. And we can compassionately listen to the story of someone who wanted to die after a painful divorce or breakup without making a straightforward connection to that event and the suicidality.)

Then there are socially conditioned suicides—the exception to the “most suicides can’t be straightforwardly attributed to outside influences.” Maybe the least fraught example of this could be ritual suicides in cultures where that is called for—say, the captain going down with the ship, perhaps unnecessarily, because *that’s what you do.* There are and have been times and places where suicide, in certain circumstances (or at least a gesture towards it) is culturally conditioned. Leaving aside the honor culture of the captain going down with the ship, I think of the absolute epidemic of cutting that ripped through my high school. Cutting is one way that depression plays out, and it is socially conditioned.

In the case of people with severe gender dysphoria, we *know* that that strongly tracks with severe depression. I haven’t seen any studies that pull this out and control for it to my satisfaction, nor studies in which I am convinced that “hearing inclusive language” isn’t largely coterminous with “having access to decent mental health care,” nor studies that relied on much more than self-reporting on the reasons for suicidality, which for reasons I outlined at length above, I don’t think much of.

In general, I think the much better solution to the problem of suicidal ideation in people with severe gender dysphoria is excellent mental health care, including both meds and also probably CBT which is pretty well studied in depression, and hospitalization as needed. When people tell me “trans kids commit suicide because of misgendering,” I hear it as something equivalent to “teenagers commit suicide because of breakups.”

Okay, maybe kinda sorta true, but in both cases it papers over the obvious deep mental health issues, and also suggests entirely the wrong solution. Neither an end to breakups nor an end to misgendering is, in my mind, a reasonable response to this problem.

This leads me to a final concern. I was as I mentioned elsewhere pretty gender non-conforming throughout my entire adolescence and early adulthood. Of the girls and young women in my friendship groups, pretty much all were GNC to some

extent. I think I must have been personal friends with every single other girl in my high school of 1600 kids who also didn’t shave her legs and didn’t wear makeup and shopped in the boys’ section, plus all

the boys who wanted to paint their nails

and listen to Ani DiFranco. I honestly knew *nearly all of us.* And while many of us had depression to greater and lesser extents, and there was a suicide attempt or two and lots and lots of cutting, I never even heard of anyone saying that not being actually treated as a boy (or a girl) was the defining feature of their distress, or was contributing to their depression, except insofar as we were all bullied for being GNC.

So, since it is definitely possible to create situations in which people decide they need or want to kill themselves (or cut themselves) because that’s the socially correct thing to do, and since my personal experience over years of being a GNC kid (not the words used then) and knowing lots of other GNC kids suggests to me that it is perfectly possible to navigate that experience without feeling suicidal every time you had to use the locker room assigned to your sex, I worry — no, I more than worry, I outright suspect — that insisting over and over that gender dysphoric or GNC kids are definitely going to kill themselves if they hear the wrong language used is actually contributing to the situation it is trying to prevent.

Having been a depressed GNC kid, it is incredibly important to me that we get this right, don’t suggest superficial causes of very deep problems, and don’t paper over actual needs with equally superficial non-solutions.

That was a very long way of saying “we have fundamentally different beliefs about the truth of what is going on,” heh.

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Thank you for sharing your story, Rosemary, and your expertise.

I think there is a lot more we agree about than disagree about, and I appreciate you digging into this complicated and heavy work.

Here's where I think you and I agree, but correct me if I'm wrong:

- Everyone should have access to excellent healthcare, including mental healthcare

- We need to take abuse seriously.

- Abuse includes verbal, emotional and physical bullying in schools. Our goal should be no bullying.

- I also think you agree that bullying can take the form of aggressively using someone's wrong pronouns, deadnaming them, telling them they're crazy for being trans, etc.

- LGBTQIA kids being kicked out of their homes is also not okay, and should qualify as abuse.

- Child homelessness also needs to be taken seriously & solved. Heck, let's make that homelessness in general, everyone should have homes!

- I also agree that we all, societally, need to be careful talking about suicide. I'm no stranger to suicidal ideation myself, and an 'everybody's doing it' perception, or 'here's a convenient reason to think this is okay or normal' etc is very problematic, and you are completely right to point out "that insisting over and over that gender dysphoric or GNC kids are definitely going to kill themselves if they hear the wrong language used is actually contributing to the situation it is trying to prevent." That said, I think we do need to take suicide seriously and look at the stats here, but I think we both agree on that too.

I honestly think the place where we most disagree, if we agree on all of the above, is in the nature of the debate versus the actual world we want to live in.

If every time this debate came up, folks said we need to take violence against trans folks really seriously, provide gender neutral bathrooms, take bullying in our schools seriously, and generally create a world where Trans folks can exist without fear of violence, I'd be coming to this whole discussion in a very different headspace. If everyone recognized that right now the fear of getting kicked out of homes, facing homelessness as a kid, and being horrifically bullied in school is a reality for *WAY* too many kids, and that societally that's a problem we 100% need to confront and discuss and tackle, I think this whole debate would have a work-together vs Trans-men-are-coming-for-my-womanhood vibe?

And part of that work-together energy would, I think, go into a productive and creative disagreement about how to build that world where we have abundant healthcare, a lack of bullying, etc. Gender neutral language is a tactic in creating that world. Changing up Mother & Baby Centers to "Family Birthing Centers" is a signal that it is *safe(r) to exist* in a birthing ward as a trans man. *And* signaling to bullies that their bullying won't be tolerated (hopefully, or at least as much). I think these signals matter quite a bit, although you're right that they need to come with the real work of inclusion, beyond just signaling.

I have trouble imagining the world I think we both want where gender neutral language isn't used as that signal, reflecting society's desire to include trans folks and welcome them with open-arms, but I'd love to hear your alternative ideas!

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We agree on all the points you think we agree on, with some slight nuance around pronouns and deadnaming; I think intent is really important in both of those instances, and while both can certainly be used abusively, neither is per se hate speech or abusive on its own.

Regarding building the world we want, and signaling about that world, in large part I feel that we should build a culture without bullying, and that having no bullying is kinda its own signal. There was a big push against bullying in general in schools in the early aughts, and for the most part I think this was accomplished by changing school policies, doing teacher trainings, that sort of thing, rather than putting up big signs that said NO BULLYING HERE.

I would like a world where the word “woman” means “adult human female,” and where it is normal and expected for there to be women-only spaces, perhaps men-only spaces, and also gender-inclusive spaces. Then signage can be a direct signal as to what policies to expect where.

I think in part I object to the jettison of gender-specific language because it goes along with the jettison of women’s-only spaces.

On the one hand, Family Birthing Center as opposed to Mother Baby Birthing Center seems straightforward and unproblematic to me, since, ever since we started letting male partners into the delivery rooms decades ago, no one expects birthing centers to actually only be for mothers and babies.

On the other hand, other spaces have been entirely shut down (the Michigan Womyn’s festival springs to mind as perhaps a not very salient example but hey that’s my disorganized mind for you) for being unapologetically women-only. (Again, defining women as “adult human females” here.)

But I think it’s not only reasonable but also clearly good for there to be not just women’s music festivals but women’s spas, women’s gyms, women’s prisons, and especially women’s rape crisis centers and women’s domestic abuse shelters.

In my dream world, the women-only-ness of these spaces could be clearly signaled by the use of the word “women.” These would probably be a minority of all the facilities available, just as women’s gyms are the minority now, but they could exist without receiving hate mail and being picketed until they close.

In that world, where it is normal for there to be women’s spaces, I agree with you that using inclusive language could and should signal facilities with sex-inclusive policies. If the sign says “Gym” or “Rape crisis center” or “music festival,” then one could assume it is open to all.

I get off the boat when the call for gender inclusive language involves the call for the removal of all women’s spaces.

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I think this is a helpful place to dig in! If I'm reading you right, while you would prefer that women meant 'biological women', and men 'biological men', you also want to respect that trans men do not refer to themselves as women, and have language reflect that. If that's the case, then I think we're in agreement on gender inclusive language in cases like medical journals? With the caveat that the lancet headline was terrible, and there are *clearly* better alternatives (I really like Gemma's "primarily women" option above.) Is that right?

On women only spaces including only women, not trans women, I think the core question folks want asked is, 'why?'. Is it aesthetics? Is it fear? And then, does the choice to not include trans women align with that organizations stated values?

I do think in most cases it is fear - and I don't want to invalidate or minimize fear. I just think there are a lot more direct ways of tackling it. A spa or gym could have a policy that women with penises wear bottoms in any public spaces, out of respect for the guests who have been assaulted, Noting: that seems to reflect the status quo at the moment, but one enforced by bullying/violence against trans women.

If the fear is that someone will pretend to be a woman to disrupt the organization or hurt someone, we can create policies that confront *that*. Imagine a trans woman coming to a rape crisis center or DV shelter, hurt & in pain, and being turned away out of broad policy crafted out of fear, instead of welcomed because there was a sensible policy that recognized she deserves help.

I have trouble imagining women only spaces where I think a person's genitals *really* matter, but I can imagine it on par with having spaces for 'straight married women' or 'straight single women'. There are all sorts of groups that have every right to meet and discuss their shared experience. We no longer assume all women are straight, it doesn't seem like much of a stretch for me to assume that not all women have wombs.

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We’re running into significant core disagreements, I think.

We’re not in agreement on language in medical journals. As I mentioned way up thread at this point, ovaries, uteruses, vaginas, mammary glands, etc etc are all traits that co-occur because they are not isolated traits; they are part of a significant biological category that is called “female.”

I am not ok with any language that obscures that these are not randomly occurring traits but in fact are shared features of one group, a group to which trans men belong but trans women do not.

“Female” seems like a possible acceptable alternative to “women,” if we absolutely must have an alternative. “Female” has been largely used previously when we are referring to members of any species ordered and patterned to produce large gametes, and works for humans when we’re referring to an age range, like girls and women. It certainly includes trans men. I personally prefer “woman” to “female,” since “woman” connotes humanity while “female” does not, but if “female” is a more inclusive word than “women” for trans men, sure, we can switch to “female” when having medical conversations. It’s a clear English word that does not obscure the reality of what we’re talking about.

Perhaps tangentially, I don’t understand the desire to have all words be psychologically comfortable for all people at all times. This is simply not possibly if we are ever going to use collective nouns at all. I think most of us, if we reflect a little on our experience, can think of plenty of times a collective noun was used to describe us that (while perhaps technically accurate) was a very uncomfortable fit. This sort of problem seems well within the normal discomfort of the human experience, and generally I don’t think it’s a reason to change language.

I think “fear” is both an accurate and also kind of a dismissive way to describe the desire for female-only spaces, and not one that would be addressed by having people with penises keep them covered. In fact, that suggested solution falls into the exact same problem that bothers me so much when it comes to “vagina havers.” Having a penis, being physically bigger and stronger than most females, having a higher level of testosterone, etc etc are all *traits that go together* into one package that is called being “male.”

Therefore, removing one or more of the constellation of male traits (in this case, a penis) from view does absolutely nothing to address the underlying issue: many females, who have spent almost the entirety of their evolutionary history being violently brutalized by males, would like to be able to have access to male-free spaces where no male ever enters.

I am aware that this is not a universal female experience, hence my recognition that female-only spaces would probably be a minority, but it is far, far from an unusual experience. It’s not an unusual phobia, like fearing dogs or spiders or elevators. It’s not a faddish fit of the vapors, like Victorian women performatively fainting away at the use of the word “leg.” It’s a fundamental anxiety of the common female experience, as evidenced in part by the almost universal existence of female-only spaces throughout all societies in all recorded history. And absolutely, not all females experience that basic anxiety, just like not all females experience childbirth, and I get that.

But I really, really bristle at this fundamental anxiety being handwaved away, as if the female fear of being in the view of men while at our most vulnerable (or when we want to be at our most relaxed) is an irrelevant little hangup that can be solved by the judicious placement of a metaphorical fig leaf, or by telling us to calm our silly transphobic hysterics, or maybe by giving us a little extra “education.”

I deeply feel for any trans woman, or any person at all ever, who shows up at a shelter hurting and alone only to be told that there was not a space for them there. How horrible! That is why there should be shelters available for everyone of all identities, and why shelters should be much better funded than they currently are.

But just like some shelters have 12-bed limits and will turn away the unlucky 13th comer, while other shelters have 24-bed limits and will turn away the unlucky 25th arrival, and having bed limits is absolutely reasonable and does not make the 24 bed shelter an innately kinder, more generous, or more ethical operation than the 12-bed shelter, so too is it reasonable for some shelters to be open only

to females. The 12-bed shelter turning away the 13th comer and the female-only shelter turning away the trans women should both have a list of resources at their fingertips so that they can appropriately redirect or otherwise refer the person they must turn away. I would be very receptive to the argument that shelters who must turn folks away, either because they are over capacity or for other prudential reasons, are morally obligated to offer other resources: a meal instead of a bed, maybe, or use of a dayroom and access to a counselor and an attorney — because, as you say, every person always deserves care and shelter and aid. Absolutely.

But the individual pain of someone turned away from a shelter is mostly a cue that the region in question is underserved and needs either a few more facilities to raise the bed count, or a sex-inclusive shelter, or a shelter that can accommodate halal, or what-have-you — not that the region needs to do away with bed limits, or shelters that can’t accommodate halal, or female-only shelters.

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I don't completely lack the fundamental anxiety you refer to. I've caught myself startled by someone I thought might be a man out of the corner of my eye in a changing room. But every time it has been a cis woman. My being startled is my business, definitely not hers! And I don't mean to be dismissive of your concerns, but I don't see the difference between my being startled by a woman with a more masculine physique and being startled by a trans woman. That's definitely a clear fundamental disagreement we have. A very very real one.

I don't mean this as some sort of fruitless education attempt, or hand waving away your concerns. But I do want to share my perspective. The way I see it, we still live in a world where trans women (and men) live with a *lot* more anxiety than I do. I see my 'fundamental anxiety' about men and imagine that trans women have that anxiety magnified 1000x. My anxiety gives me more empathy for their experience. Acting in solidarity with trans women seems like an really vital part of creating the less-violent, bullying-free world I want to see.

I (rarely, these days) visit a wonderful women & nonbinary only coworking space. I *love* the energy of it, I love that it is free of men. It's designed by women, with art by women, just - an awesome awesome space. Including trans women in 'women' doesn't diminish my experience of it in any way. If anything, welcoming trans women enhances the celebration of different diverse experiences of womanhood that makes the space so special! I think we both want to have spaces that feel this way, despite our fundamental ideological differences.

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Oh it occurs to me to add that all of my thinking above regarding inclusive language only applies to the public sphere. I think about it very differently when it comes to an interpersonal or 1:1 interaction.

Even when I thoroughly disagree with the religious or philosophical beliefs of others, and think they should not be reflected in the public square (belief in gender identity as something akin to a gendered soul is definitely a metaphysical article of faith I do not share), I respect whatever the individual needs to be comfortable in the moment.

It’s almost exactly analogous to how I would never support making a kosher kitchen a requirement for a commercial restaurant license from the health department, if I had a friend who was an Orthodox Jew and I wanted to host them for dinner, you had better believe I would be hitting up the dollar store for an entirely new set of pots pans and dishes to keep on hand only for them.

When I am talking to trans people and anatomy comes up (it came up A LOT when I was working in urology), I use preferred language like “people with penises” without batting an eye. It’s basically a religious accommodation and I have zero problem with it.

But what’s right and kind and important in interpersonal relationships doesn’t translate neatly into what’s good public policy.

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I also really appreciate that Other Feminisms enables us to have these conversations across the aisle! And, like Rosemary says below, I obviously have some fundamental disagreements with you about what is and isn't true. But one thing I think we could productively argue about is that I think you are being overly permissive in your use of various studies as evidence for your claims.

I really, really doubt that we "know" that using inclusive language causes a reduction in suicidal ideation among trans people. I think the study you are referring to is a 2018 study from UT Austin? Looking at that study, it appears to be observational, and I would think it's a very serious problem for the results that using a trans person's preferred name is, well, highly correlated with just plain being nice to them. If you wanted to claim that inclusive language reduces suicidal ideation, wouldn't you need to randomize?

Studies around mental health outcomes among trans people who receive gender reassignment surgeries are also plagued by very similar problems. There are no randomized studies, and the differences between education, income, and overall health between cohorts who receive surgery and those who don't are just too different to trust any conclusions. Another way to put it is that if reassignment surgery were a drug meant to improve mental health outcomes, it would not meet the standards for FDA approval--and neither would cross-sex hormones or puberty blockers. You mentioned some studies earlier showing low regret among people who had received surgery, and that's not nothing, but it's nowhere near the bar of evidence to show causation.

I think that my overall impression of literature on various interventions for trans people is at best very very very slightly suggestive that some of these interventions are useful, and at worst so completely confounded that drawing conclusions about causation is actively irresponsible.

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I think you're absolutely right that causation is a bit iffy here, since pronouns can be a proxy for just treating people decently! But... maybe we should consider it a helpful proxy?

I was actually thinking of the 2021 Trevor Project survey, which is even *more* correlation vs causation than the UT study. "Transgender and nonbinary youth who reported having pronouns respected by all of the people they lived with attempted suicide at half the rate of those who did not have heir pronouns respected by anyone with whom they lived." https://www.thetrevorproject.org/survey-2021/

Yet.... if you put yourself in the shoes of a Trans kid living at home, whose parents, siblings, other family insist on using pronouns you say don't fit you... well, doesn't that seem like a pretty strong indicator that you're not being respected as yourself?

On sex reassignment and hormones, what do you think would be a study design that doesn't deny folks care they and their doctors say they need?

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"Being able (at least in theory) to have a baby is also a big part of how I understand who I am as a woman. When we claim these parts are neutral, or that linking them to womanhood is factually or morally wrong, it feels like we're stripping out the positive capacities of womanhood and reducing it to the negative experience of being affected by sexism."

Women's inherent femaleness being compromised in the face of a greater sexism, a refusal to acknowledge that there is an inherent femaleness that's worthy of recognition and respect.

Some of this comes, I think, from those biological women who become transmen because they want to like like men and become men. They resent that they are being identified as biologically female.

It really makes me wonder whether those transwomen--men who become women--who resent recognition of biological femaleness, won't be satisfied until they can take away everything that biological women have and seize it for themselves.

They want to look like us. They want our restrooms. They want our sports. Stay tuned for the womb transplants.

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I have a PROFOUND distaste for being reduced to my anatomy, and a profound discomfort with the gender policing of women-only spaces. Personally, being a parent and having given birth to 3 children: I greatly prefer 'pregnant people' as language, instead of 'pregnant women', or 'birth room' or 'birthing partner' or whatever, if we're talking about places where the pregnancy and birth is the relevant part of the experience. As anecdotal experience: people referring to 'this is where pregnant people go to give birth', or whatever, have made it explicitly clear that the point was people (a variety of people, each individual, with individual desires and needs - accurate, even in a group of completely cis women! People tends to be a group of individuals, women tends to be a group of people with a similar set of desires and wants and needs, in the language used... and that tends to mean pushing people into the wants and needs the speaker thinks they should have) being pregnant and giving birth (biological process, role change, responsibilities: logistical and emotional concerns, addressed here), whereas people discussing 'women giving birth' have generalized 'women' to a very narrow slice of experience, which I've generally had to argue my way out of to get what I need out of institutions or organizations.

I've had incredibly difficult experiences in places that try to center the womanhood (or, rather, the expected experience of womanhood, with the fairly obvious expectation that to not conform to that is to fail) - for example, language I'm seeing here about 'women's power is bringing life to the world' or 'women get pregnant', which is HUGELY (and I'm sure unintentionally!) excluding women with fertility issues, women with breastfeeding issues, women who have hysterectomies or mastectomies or who simply don't want to ever be pregnant or be mothers! 'Biologically' women, at that, and yet, still excluding. And the line is pretty straight from there to 'women are X (nurturing, mothering, etc)', even if, individually, that's ... not the case, or not exclusively so? For example: I work, my husband is a stay-at-home dad, and we're both delighted with the arrangement. People who talk about 'parents' include him in homework discussions and childcare groups, people who talk about 'moms' don't and message me exclusively, and then I have to transfer stuff to him to handle. Anecdotal, but so is the rest of this!

Also: I worked in insurance. A lot of companies will only cover breast cancer treatment for women, which is a HUGE issue (like, survival issue!) for men who get breast cancer. It's not a about 'eww, women', it's that the gender specificity means that people can't access necessary medical treatment, and need to beg the pharmaceutical company for compassionate access. It's horrible! De-gendering, in these cases, means access to medical treatment! From there, experiences with cancer and breast cancer is likely different, but there's legitimate medical value in de-centering the experience and ensuring access to care. (And, frankly, I've also seen a fair number of women who didn't want reconstructive surgery and wanted to stay flat - I sure would, I'm not a huge fan of the weight and back pain and bras are uncomfortable - and doctors leaving extra skin for reconstruction because 'women want reconstruction' - there would be a lot of value in asking what the people involved want, vs assuming a gendered monolithic experience.)

That said, honestly, the same applies to 'men' - an institution that de-genders 'women' but keeps 'men' as a category gets full side-eye. Either you open up language to individual experience, or you don't, but don't ONLY decenter women, that's nonsense.

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there's a problem here in identifying women as those who have vaginas. while that is/may be physically true, it's harsh. having a vagina implies that one can have children and that is an identifying characteristic of womanhood. does a woman have no value if she does not produce a child? of course that's not true, altho' i see that as a subtext. having a child should also not be the main reason that a woman exists, unless that's what she wants. not all woman are able to have children. and, there are people who identify as female who do not have vaginas. the pronouns matter, words matter, but actual treatment matters more. the flip side of this coin is that there are plenty of mothers who have never given birth. they have never 'birthed'. i hate that term. they are still mothers. kindness in one's words may be the surest guide.

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Would you be willing to write about "Difference Feminism", Mrs. Libresco? As in italian and french alternative to 2nd wave? Luce Irigaray, Carla Lonzi... I feel like it is the "lost genealogy", young women doesn't know about it and it's been kind of ridiculed by some strands of liberal or even radical feminism... We might find some particularly useful wisdom for today, from those women.

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Do you have favorite readings from those authors? I've really liked Erika Bachiochi as a contemporary American difference feminist.

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Oct 10, 2021Liked by Leah Libresco Sargeant

I read some texts by Lonzi that I think were from her book "Sputiamo su Hegel" (don't know how it's titled in english); I remember Irigaray wrote "Ethics of sexual difference". It was long time ago when I was at uni, but they are quite important here in Europe.

Yes, I've recently discovered Bachiochi and I quite like her mind, especially the fact that she speaks about concepts (such as virtue) that have gone completely underground nowadays. I'm a big admirer of Wollstonecraft so there's that too :) Certainly Bachiochi's book is on my wish list!

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Yes! Your last comment, Mrs. Libresco, "chapeau" :)

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