The World Health Organisation used to have a useful page on its website (archived here) entitled ‘What do we mean by sex and gender?’ The information on the page was concise, factual and clear:

When we looked for this page recently we found that it has been taken down. On searching we discovered a fact sheet simply entitled ‘Gender’ which is on the ‘Media Centre’ page. The original was on the ‘Gender, women and health’ page which now seems to have disappeared. Perhaps this is symbolic as women lose grasp of the very definition of ‘woman’ to a media circus intent on telling us we are now a ‘gender identity.’

Of course organisations are entitled to update the content on their websites as they see fit, but this change is worrying. Gone is the information that sex refers to biological characteristics which ‘define men and women.’ Gone also is the original list of clear examples of biological differences between men and women:

…together with the list of ‘gender characteristics’ which at least gives a nod to the way ‘gender’ works to place restrictions on women’s behaviour and exploit women’s labour:

In place of these examples, we now get this explanation:

The introduction starts with a definition of ‘gender,’ moves to ‘sex’ and then confusingly reverts back to ‘gender.’

It is not made clear how personal ‘identities’ fit in to the picture here, nor how they impact the ‘binary male or female sex categories’ but the implication is that ‘identity’ is a material reality on a par with biological sex. It is also not clear why ‘transgender’ and ‘intersex’ are conflated as ‘identities’ when intersex people are those born with genetic biological differences: ‘intersex’ is not an identity, it is a material reality.

If the WHO is to introduce ‘identity’ into the mix, then we need a clear definition of the word and the role it plays.

Although the ‘Sex versus Gender’ section recognises that people are born male or female and explains how ‘gender’ plays out, it carefully avoids any mention that it is biological sex which defines men and women. Although it is ‘important to recognise identities,’ nowhere are we informed that it is important to recognise sex differences, or even that there are any between men and women.

Without this information, the rest is confusion. The casual wording of the statement: “There is not a problem per se in socially constructed differences between women and men” stands out: in absence of any stated sex differences, does this mean that all differences between men and women are ‘socially constructed’?

It is hard to imagine that this was written with anyone except ‘transgender’ people in mind, in particular the following information:

“When individuals do not conform to established gender norms, relations or roles, they often face stigma, discriminatory practices or social exclusion – all of which negatively impact health.”

Women and girls face discrimination whether they conform to established ‘gender’ norms or not, because ultimately discrimination is based on the fact that they are female. We do not learn that women are female from reading the WHO’s ‘Gender’ page.

The WHO have either kow-towed to trans activists who see factual statements such as ‘women menstruate while men do not’ and ‘men have testicles while women do not’ as ‘transphobic’ or they are bowing to cultural and media pressure, or perhaps this is a genuine attempt to become ‘inclusive.’

Whatever the reason, it is not the place of the World Health Organisation to fudge an issue because of pressure from political activist groups or the media, or even to protect the feelings of one group of people. It is not, in any case, helpful for transgender people themselves to obscure sex differences: in the area of health biological sex is the crucial factor in diagnosis and treatment.

In a world where we are now told that men can menstruate and get pregnant, women’s specific healthcare needs are becoming unsayable. If ‘people’ can get pregnant, we can no longer campaign for women’s reproductive rights or maternity and female healthcare provision on a platform of ‘women’s rights.’ Discrimination against women in healthcare itself therefore becomes invisible, just as it has done on the WHO page. Women’s continuing fight against sexism in medicine – the historic basis of which is the male body – and the work to raise awareness of women’s need for sex-specific diagnostic testing and treatments is made impossible if women are not recognised as a distinct sex.

The changes may seem subtle but they are significant: the inclusion of ‘identity’ and exclusion of sex differences between men and women sends a strong message to global health organisations, services and practitioners on the ground. As health organisations all over the world are already striving to separate the word ‘women’ from female biological functions and healthcare, this change can only further impact harmfully on women and girls and the specific health issues they face as the female sex.

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