The second in a series authored by Memorial University faculty members on the value and importance of diversity, equity and inclusion policies to build a more just society. Check back next Thursday for Drs. Katie Wadden and TA Loeffler’s op-ed.
Language impacts patient experiences and health outcomes and should evolve over time.
In 2021, at a meeting of the U.S. National Institutes of Health, I first heard the recommendation to use the gender-neutral term “pregnant person.”
This change in language aims to be more inclusive, recognizing that the pregnant population can include women, trans men, intersex, non-binary and other gender-diverse people.
Pregnancy can be a stressful experience for many and the use of language that is accurate and inclusive is an easy way to help decrease this stress.
Understanding social determinants of health
When Donald Trump returned as the president of the United States, one of his first actions was an Executive Order stating that “Agency forms that require an individual’s sex shall list male or female, and shall not request gender identity” and a list was created of terms that could no longer be used by researchers at the Center for Disease Control and Prevention, including pregnant person.
As a Canadian researcher who studies pregnancy and thinks about the integration of sex and gender into health research, I want to reflect on the consequences of these actions.
“It is critical to consider all of the physical, economic and social factors that influence the pregnancy, including sex and gender.”
We know that pregnancy outcomes are impacted by a variety of sociodemographic factors, including maternal age, education, socio-economic status, race and ethnicity.
The reasons for these inequities are complex and are thought to include systemic discrimination, unequal access to health care and a lack of understanding of the social determinants of health.
In pregnancy care and research, it is critical to consider all of the physical, economic and social factors that influence the pregnancy, including sex and gender.
Good datasets = good science
Yet, we know little about pregnancy in trans and gender-diverse populations.
Is the pregnant person receiving gender-affirming hormone therapy? The use of hormones may change their physiology, impacting potential treatments and outcomes.
This was the recent experience of a trans man in St. John’s, whose physician suggested stopping testosterone once he discovered that he was pregnant.
What are the person’s gender roles and responsibilities? Pregnant people who identify with more traditional masculine norms may be less willing to utilize health-care resources, highlighting the critical need to ensure gender-diverse populations feel included and safe by using affirming terms like “pregnant people.”
Scientific research is only as good as the datasets and ignoring the importance of social determinants of health in study populations, either by restricting access to demographic data or controlling language, will limit the data’s usefulness to improve everyone’s lives.
“Pregnant people and their families in N.L. . . . are overwhelmingly positive and supportive of scientific research and make the job richer by sharing their stories.”
My research team is lucky to work with pregnant people and their families in Newfoundland and Labrador.
They are overwhelmingly positive and supportive of scientific research and make the job richer by sharing their stories and being actively involved in the research.
The actions in the United States provide an opportunity for Canada to lead the way on inclusive practices, open science and studying fields that have been historically underfunded, such as pregnancy.
I am part of a group of Memorial researchers who have joined forces to highlight the importance of diversity, equity and inclusion (DEI) and the study of sex and gender in research.
If you are interested in joining us, please reach out!
