People with penises don't have babies
Last night a story was broken by the feminist website Reduxx that people found hard to believe: student midwives in Scotland had been given a training module on catheterisation that had been updated to teach them how to catheterise a male person, because, “….you may be caring for a pregnant or birthing person who is transitioning from male to female and may still have external male genitalia.”
It seems too ridiculous to be true, but I can tell you that it is true, and that the ‘whistleblowing’ students got in touch with me about it at the end of March 2022. I had been sitting on the emails over Easter (having offered the story to the Mail who initially weren’t interested - they are now!), and was planning to write about them on this substack in the next few weeks. Life is hectic and I am not a news outlet. I wish I’d written about it sooner but here we are.
For those of you who still find these things a mix of confusing and TMI, brace yourselves for a quick explainer. Midwives (and I’m not a midwife by the way), sometimes have to catheterise a woman during labour - it just means inserting a tube to empty the bladder. Anyone in front of a midwife having a baby will have female anatomy, whether they call themselves a woman, a trans man, non binary, or any other name. It’s understandable that people might get confused about this, in particular because of the insistence of trans ideologues that everyone calls a trans man a man at all times, uses he / him pronouns and even refers to the trans man as male.
Even Google will tell you that men can get pregnant. Just type in ‘can men get pregnant’ and you will get this as the top result. And yes, the linked article will qualify that they mean trans men, but many people won’t get that far, and the google result itself is misleading and inaccurate by any standards of reality or biology.
Added to this there are the social media memes that show us images of men being pregnant and having periods etc, for example this one, seen in a prominent breastfeeding group.
Or this one, from the campaign Bleeding Beyond the Binary.
There is already a lot of confusion about the female body and how it works that long predates gender ideology. Images like these will make sense to some people, “oh those are trans men with their periods, they still have female anatomy but identify as male”, but confuse others, perhaps those who were already a bit uncertain about the basics of women’s bodies. However, you would hope that a teacher of future midwives - who has apparently taught an entire term on Anatomy and Physiology, has a PhD and is a research fellow - would have a better handle on biology than the majority of us - but apparently not.
The midwifery module on catheterisation in question was updated to be more ‘inclusive’. This was not a hastily done update to change ‘women’ to ‘birthing people’ - it was a full overhaul of the module to include people giving birth who have a penis. Again, to reiterate for anyone confused - this is not biologically possible. Nobody with a penis will ever give birth (we’ll come to trans surgery in a minute). Here’s a section of the email midwives were sent about the updated module.
As some of you will have seen on Reduxx, the module was then fully changed to include male bodied people. For example:
There are then a full 2 pages on catheterising a male person (I’m not including screenshots of the entire 2 pages but I have them on file).
The teacher then clarified:
“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.”
Well, I’m afraid this takes us further down the rabbit hole, to a place where I don’t have all the answers and perhaps nobody does. Has a trans man who has had surgery to construct a penis ever given birth? Is this even possible?
As I said in an email to the student midwives at the time, “Can you even give birth after a phalloplasty? I have had a quick google and it looks to me like it’s most common to have a hysterectomy before the phalloplasty – but there are some sites that say you can keep your vagina if you want. Then not all surgery involves extending the uretha so you can pee out of your ‘penis’, in some cases you still pee out of the hole ‘where it used to be’ – this is how I understand it after 20 mins on google! (not a doctor!)
So whichever way you look at it, catheterising a FTM who is pregnant is complicated. It’s highly unlikely they will have had ‘bottom surgery’ (I’m prepared to be corrected on this but I think that’s probably right), and in the very unlikely event they have, it’s likely that there will be anatomical issues that make vaginal birth difficult or impossible and certainly there would need to be extremely specific guidelines on catheterisation!”
It’s not my job to have the answers to these questions, or to create midwifery modules to teach a future generation of health care providers. But it is the job of midwifery lecturers to fully understand all this and deliver training that, whilst it is inclusive of people with different gender identities who give birth, still remains grounded in biological reality and does not confuse or misinform.
One of the midwives on this training course has spoken to me about the almost ‘desperation’ of the trainers to push ‘inclusivity’, without any real understanding or underpinning of what that might actually mean. As she wrote to me, “One of our lecturers has told us about how "it's impossible to be a midwife without being a feminist" on at least three occasions. She makes a point in telling us that pregnancy is inclusive, she's inclusive and we all need to be inclusive in our care. That's in every single lecture. Again, not a single word about what that entails and ultimately how we can care for trans people, apart than change the way we refer to women in lectures. We have to write an essay for this course. I have only referred to women and pregnant women and I have this nagging worry that I'm going to lose points - I don't even know if she's allowed to do that.”
Her fears may be well founded. In another university, this time in England, I’m told that students have been told directly that they will be marked down if they use ‘woman’ or ‘mother’ in their essays - they must use ‘birthing person’.
I won’t name this university - or the one with the catheterising men module either - because students are scared. They don’t want to lose their future careers over this, but they are worried about what is being lost in the scramble to tick an ‘inclusivity’ box.
It also doesn’t matter which Uni this is and it would be unfair to start a witch hunt of the lecturer in question - that will just needlessly destroy one person’s career without getting to the root of the problem. Ideological capture of midwifery is not confined to these two training courses. It’s a massive issue and organisations like the Nursing and Midwifery Council, the RCM and the RCOG need to step in at this point - I’ve been saying this for a while. Midwives need clear guidance on how to give inclusive, kind and compassionate care whilst remaining grounded in the material reality of our sexed bodies. Because no matter how inclusive a world we want to create, giving birth is never going to include male people with a penis.
Thanks for reading. This substack is free but if you want to support me, I have 3 books which you can buy from any good book seller! They’re all about female bodies, not a penis in sight, I promise!
My Period is for girls age 9 to 13 and is filled with information and positivity about periods and puberty.
Give Birth like a Feminist is for anyone interested in why birth is a feminist issue. You don’t have to be pregnant.
The Positive Birth Book is a comprehensive guide to getting ready for birth with lots of humour and a dash of feminism thrown in. A new revised edition is coming out on May 26th, but you can still get the original if you need it sooner!
Or you can…