Written submission from Fair Play For Women [WRH0016]


1.                   Who we are

Fair Play For Women Ltd is a campaigning and consultancy organisation which raises awareness, provides evidence and analysis and works to protect the sex-based rights of women and girls in the UK. Founded in 2017, our work is focused on understanding when and how gender-and sex-based rights conflict in law and policy-making. Our aim is to ensure that everyone’s needs are fairly balanced and that women and girls are not overlooked in good policy-making. 

We believe in compassion and fairness for all. We support the rights of trans people to live in safety and to be treated fairly. We also support the rights of women and girls, and this is our focus. 


2.                   Areas of concern

We welcome this consultation about women’s reproductive health, which recognises the material reality of sexed bodies, and the consequential differences between the sexes, both in their health issues and in their experiences in the healthcare and social care systems. 

This submission focuses on the barriers which are being constructed by the health service’s adoption of activist demands to avoid references to sex, female and woman. Language matters in healthcare. Obfuscation is not progress. The language changes being encouraged and adopted in the health system are antithetical to progress in women’s reproductive health.

A second issue is NHS trust policies which enable male patients and clinicians to self-identify as women, even in circumstances where this could materially affect female patients’ access to care. This submission provides evidence that women’s charities and the NHS itself has previously identified these problems as barriers for women.  


3.                   Recommendation

There is ample evidence that:

i. clear accessible language and
ii. access to female clinicians

are highly material in the uptake of intimate screening such as for cervical cancer. Any programme to encourage such healthcare programmes must recognise and address these needs.


4.                   The problem, as described by the NHS and by Jo’s Trust

Women’s reproductive health relies on the recognition of female bodies. It is essential to be able to speak about female bodies in plain language which is widely understood. This applies both to patients and to the clinicians treating them.

Some conditions affect female bodies only. Not all women speak good English. The charity Jo’s Trust has reported that half of women do not know what the cervix is[1].

The NHS reports that women with learning difficulties and women from ethnic minorities are less likely to attend cervical screening. It lists factors in women not attending cervical screening including: “cultural or language barriers” and “no female sample takers being available[2].

It is clear that replacing words like “women” with “people with a cervix” can only increase these barriers. Making it uncertain that a woman can have female-only care puts up another barrier. Erasing female-specific language in healthcare to accommodate the sensitivities of those females who do not want to be women, or those males who do, comes at a considerable cost to the many women who find the new language less accessible.


5.                   Conclusion

This is a specific illustration within gynaecology of how wider NHS policies intended to address the needs of people with a transgender identity are creating barriers for women and girls. There are issues relating to sex in data collection, in medical records and in inpatient accommodation. These are covered in our submission to the government’s Women’s Health Strategy consultation in 2021, which is appended. All are relevant to treatment and diagnosis of gynaecological or urogynaecological conditions.

Any attempt to improve women’s reproductive health must consider the conflicts being created by attempts to remove references to women and female in the health system. More specific anatomical references such as “people with a cervix” do not widen access. Therefore by definition they cannot be more inclusive. These policies must now be reviewed to find solutions which address the needs of all groups.



August 2023


[1] https://www.jostrust.org.uk/node/666780

[2] https://www.gov.uk/government/publications/health-matters-making-cervical-screening-more-accessible/health-matters-making-cervical-screening-more-accessible--2