A qualitative systematic review of the implications of desexed language in women’s healthcare and healthcare literature

Abstract

Introduction: Increasing numbers of people identifying as transgender and gender diverse (TGD) have introduced challenges regarding language used in women’s healthcare. TGD individuals are defined as those whose gender identity does not align with their sex. This growing patient group has ignited debates over whether language in women’s health should be desexed to accommodate TGD individuals, for example, replacing “mother” with “pregnant people.” Some argue such language is inclusive, while others are concerned it is inaccurate and disrespectful. Objective: To examine the implications of desexed language in women’s healthcare and healthcare literature. Design: Qualitative systematic review synthesising primary research on desexed language in women’s healthcare. Data sources and methods: Qualitative studies examining desexed language in women’s healthcare, published 2010–2024, were included. A systematic search was conducted across MEDLINE, PsycINFO, and CINAHL. Risk of bias was assessed using the Critical Appraisal Skills Programme checklist and data analysed thematically. Results: Six studies were included, with 80 participants, 13 of whom were women who were not TGD. Themes identified: (1) Language and communication – reflecting differing views on desexed language and the importance of consistent definitions of sex and gender identity; (2) Education – gaps in healthcare professionals’ confidence highlight the need for improved clinical education on TGD language use; (3) Structural challenges – issues with clinical documentation and environments; and (4) Barriers to care – poor healthcare experiences meaning TGD patients may avoid seeking care. Conclusion: This review highlights the need for resources tailored to TGD individuals, clinician education on personalised language use and improvements to clinical documentation to ensure sex is always recorded, with gender identity included if relevant. Insufficient evidence exists to support universal implementation of desexed language in women’s healthcare. Findings suggest it is not well understood or accepted by women who are not TGD and research is needed to understand its impact on wider groups.