(CNN)From patient waiting rooms to the halls of Congress, the language being used to talk about reproduction is shifting.
Across the US, mainstream institutions such as the American Civil Liberties Union, the Centers for Disease Control and Prevention and CNN are increasingly opting for gender-neutral terms such as "pregnant people," "people who get abortions" and "birthing parent" in favor of "women" when referencing pregnancy, fertility and abortion.
These shifts in terminology signal an effort to be inclusive of transgender and nonbinary people who can also get pregnant. But the changes have also prompted pushback -- not just from Republican politicians who are openly hostile to LGBTQ people but also from some cisgender women (women whose gender identity conforms with the sex they were assigned at birth) who consider themselves LGBTQ allies and who support abortion rights.
"We're not just talking about the same people that we were before. We're broadening the scope," said Kristen Syrett, an associate professor of linguistics at Rutgers University. "And I think that's where people get more uncomfortable because it's so different from the way we've been thinking of reproductive rights and pregnancy for a long time."
Debates about language can seem arbitrary at a time when so many no longer have access to abortion services in their home state. But at the crux of these debates are questions about who is targeted by restrictive laws and policies, who is affected and who is included in the conversation.
Advocates say inclusive terms make room for everyone affected
Using inclusive language to talk about abortion recognizes that not only cis women can get pregnant, said Gillian Branstetter, a communications strategist at the ACLU's Women's Rights Project and LGBTQ & HIV Project.
Some trans men and nonbinary people can also get pregnant, as can cis girls and trans boys. This is also true in the opposite: Not all women are able to get pregnant. Some cis women struggle with fertility, while trans women lack uteruses. Opting for gender-neutral terms such as "people" or "patients" allows for these nuances in a way that just saying "women" does not.
There's scant data on how many trans and nonbinary people get pregnant and receive abortions given that medical systems in the US track them as female. A 2019 study from Rutgers University suggests that up to 30% of trans men experience unplanned pregnancies, and a 2020 study from researchers at the Guttmacher Institute and Planned Parenthood estimated between 462 and 530 trans and nonbinary people received abortions in 2017 (the CDC reports that approximately 609,000 total abortions were performed that year). As more adults identify as trans or nonbinary, experts say that such estimates are likely undercounted.
Still, those numbers pale in comparison to the numbers of cis women who access reproductive health care -- a point often made by critics of more inclusive terms. Branstetter acknowledged this reality, noting that "99% of people who are going to become pregnant or are in need of birth control or an abortion are women."
But it's necessary to make room for trans and nonbinary people precisely because of the significant barriers they face in receiving reproductive care, she added. "It's important to remember that transgender people do not have the privilege of pretending we do not exist."
Some feel gender-neutral terms erase the role of sexism
Others are concerned that forgoing the term "women" obscures what they see as the driving force behind attacks on abortion rights: Misogyny.
Carrie Baker, professor of the study of women and gender at Smith College, considers gender-neutral terms such as "pregnant people" to be inaccurate and imprecise. In theory, she said, "people" also includes cisgender men, whose bodies are not affected by abortion restrictions.
Baker said she recognizes the importance of being inclusive, and tries to reference in her writing when possible the various groups who are affected by abortion restrictions. But because she sees cisgender women as the primary targets of abortion bans, she said she makes it a point to emphasize women.
Not doing so, Baker said, erases the sexism underlying laws that seek to exert control over women's bodies.
"'Pregnant people' doesn't say who we're talking about. It makes (pregnancy) sound like it's a gender-neutral phenomenon or a sex-neutral phenomenon," she added. "I believe that bans on abortion are motivated by sex discrimination and by bias against women and cisgender women, or just femininity."
A person holds a transgender pride flag on June 28, 2019 at a rally marking the 50th anniversary of the Stonewall Riots in New York.
As some abortion rights supporters now look to the Equal Rights Amendment to establish a constitutional right to abortion, Baker said being explicit about the role of sexism in abortion restrictions is necessary to challenge such laws. Doing that effectively, in her view, means naming women.
"I think we need to talk about that or we, in essence, do what the right does, which is trying to erase the significance of the discriminatory impact of abortion bans," Baker said.
Some have gone as far as to suggest that women as a class are being erased. Earlier this year, The New York Times opinion columnist Pamela Paul decried the use of terms such as "pregnant people" in a piece, writing that "This isn't just a semantic issue; it's also a question of moral harm, an affront to our very sense of ourselves." The Atlantic's Helen Lewis accused the left of "declaring a war on saying 'women.'"
"By substituting people for women, we lose the ability to speak of women as a class. We dismantle them into pieces, into functions, into commodities," she argued.
Syrett, the Rutgers University linguist, understands where these anxieties are coming from, but encourages people to reflect on what they're signaling with their word choices.
"It seems natural for some individuals to (feel) like this is taking away something or maybe it's not honoring a part of what they've associated with womanhood for so long," she said. "It's an opportunity for everyone, regardless of their own stance with respect to reproductive issues or their own experience, to take a step back and ask what it means to talk about 'women' versus 'females' versus 'people with the ability to reproduce.'"
Others say the debate presents a false dichotomy
For the ACLU's Branstetter, claims that women are being erased are overblown.
Progressive organizations are opting for terms such as "pregnant people" in their own public messaging campaigns, but no one is forcing women to stop describing themselves as such, she said. Additionally, the word "women" continues to be centered in many national conversations about abortion -- from the Women's Health Protection Act that sought to codify Roe v. Wade to the Supreme Court ruling Dobbs v. Jackson Women's Health Organization that overturned it.
"I think that the demise of the word 'woman' is greatly exaggerated," Branstetter said. "And I don't think that there's any harm in making space for the many people who do need this care who are not women."
Advocates of more inclusive terms also feel that such debates present a false dichotomy.
Oliver Hall, trans health director for the Kentucky Health Justice Network, said critics of terms such as "pregnant people" are missing the ways that trans and nonbinary people are also hurt by misogyny. Recognizing what drives abortion restrictions and making space for trans and nonbinary people aren't mutually exclusive, they added.
"I think people feel like not just saying 'women' means that we can't talk about the role that misogyny plays in these laws," Hall said. "But I think that also does a disservice to trans people who are also affected not just by those laws, but by misogyny as a whole."
Including trans and nonbinary people in the fight for abortion rights doesn't mean taking away something from cisgender women, Hall said. Rather, a more inclusive coalition has the potential to strengthen the abortion rights movement.
At the heart of abortion bans is a desire to uphold traditional gender roles, Branstetter said, comparing them to attempts to ban gender-affirming care.
"What the effort to ban abortion and the effort to erase transgender people from public life have in common is the enforcement of a very strict gender binary based on the exploitation of reproductive labor," she said. "That is a more complicated story to tell than 'They're doing it because they hate women.' But it's a truer one."
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The language we use to talk about pregnancy and abortion is changing. But not everyone welcomes the shift - CNN
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