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On 24 September 2021, The Lancet medical journal highlighted an article on its cover with a single sentence in large text;“Historically, the anatomy and physiology of bodies with vaginas have been neglected.” This statement, in which the word “women” was replaced with the phrase “bodies with vaginas,” is part of a trend to remove sexed terms such as “women” and “mothers” from discussions of female reproduction. The good and important intention behind these changes is sensitivity to, and acknowledgment of, the needs of people who are biologically female and yet do not consider themselves to be women because of their gender identity (1). However, these changes are often not deliberated regarding their impact on accuracy or potential for other unintended consequences. In this paper we present some background to this issue, describe various observed impacts, consider a number of potentially deleterious consequences, and suggest a way forward.

Sex (a reproductive category), gender (a societal role), and gender identity (an inner sense of self) are not synonymous (2, 3). Sex is salient to reproduction, as there are only two gametes and pubertal pathways to adulthood and gamete production, and only one gamete producing body type that becomes pregnant (2). As a general principle of communication it is well established that the sex of individuals should be made visible when it is relevant and should not be invoked when it is not (4–9). This facilitates avoidance of sex stereotyping while ensuring that sex-based needs and issues are not overlooked (4–9). In communication related to female reproduction, sexed language including the …