UPDATE 4/28/22: Reduxx previously withheld the name of the University at the request of the whistleblowing students. It is now being made available with their consent.
Students studying midwifery at a prominent University in the United Kingdom were taught that biological males can get pregnant and give birth through their penis before instructors hastily edited a workbook they were given.
Reduxx has exclusively obtained teaching resources from concerned students studying midwifery at Edinburgh Napier University in Scotland. The students, who wished to remain anonymous out of concern for their careers, were initially provided biologically impossible instruction on giving care to males who were pregnant and in labor.
In a module about caring for women during childbirth the students were initially provided a “Skills Workbook” on catheterization that contained significant guidance about handling male genitals, and caring for biologically male “birthing people.”
According to the workbook, students were advised: “It is important to note that while most times the birthing person will have female genitalia, you may be caring for a pregnant or birthing person who is transitioning from male to female and may still have external male genitalia.”
While the introduction of the manual could perhaps be dismissed as a mistake, misprint, or uninitiated individual attempting to utilize ‘inclusive’ language, the University-made workbook clearly moves on to providing students instruction on how to accommodate a pregnant biological male.
The book informs students that they may need to be familiar with the catheterization procedures for “both female and male anatomy,” noting that, as a result of the fact both males and females may be giving birth, it will only utilize the term “birthing person” throughout the instruction.
The workbook reminds students that the “birthing person” may be a biological male in two separate sections.
In section 4.4 of the manual, catheterization processes for biological males are provided, with images of an instructor demonstrating the procedure on a male figurine’s penis and scrotum.
Anesthetic gel doses were also given based on male and female biology, with females recommended 6mls of analgesic gel, while males are recommended 11mls.
In another section, special instructions are provided for the removal of catheters with consideration for prostate glands, with students being instructed to warn “male persons” of “discomfort as the deflated balloon passes through the prostate gland.”
While instruction staff later realized the significant errors made, the hasty edit to the guidebook only corrected the initial wording in the introduction, changing “male to female” to “female to male.” All references to the handling of a penis, prostate gland, and other male biology remained, but also added the suggestion a female to male transgender person could give birth through a surgically constructed ‘penis.’
Despite the seemingly sloppy edit, concerns remain from students and experts about the lack of care given to the manual and instruction.
At the end of March, it was revealed that failures at Shrewsbury and Telford NHS Trust in England resulted in the needless deaths of over 200 babies and 9 mothers over two decades. According to internal investigations “repeated failures in the quality of care and governance” was to blame, with an additional 1,486 families and 1,592 incidents being recorded as a result of inadequate maternity care oversight.
Speaking to Reduxx on the contents of the workbook, Elaine Miller said she was “deeply concerned.”
Miller, a Fellow of the Chartered Society for Physiotherapy, is the creator of Gusset Grippers, an award-winning educational program focused on women’s pelvic health. When shown the course materials, Miller expressed disbelief at the amount of factually incorrect information being provided to students.
“It is not possible for a male person to get pregnant,” Miller said, continuing that even the hasty edits the instructors made were rife with impossibilities.
“A [female] with a gender difference can become pregnant but will not have male genitalia,” she notes, expressing concern that even if instruction was given on serving female-to-male transgender patients, the information was still both incomplete and unrealistic.
“Most [females] who use testosterone, at the doses used for ‘transition,’ will develop vaginal atrophy. The fragile tissue of an atrophied vagina may be unable to stretch to accommodate a baby’s head,” Miller says, also noting that female-to-male transgender people who wish to naturally deliver are at risk of sustaining “new types of birth injury” that have not yet been studied or investigated.
“Examining this potential risk is probably more important than learning to remove a catheter from a non-existent prostate gland.”
Miller’s concerns were supported by those of Dr. Susan Bewley, an Emeritus Professor in Obstetrics and Women’s Health at King’s College London. Commenting on the materials provided for her review by Reduxx, Bewley called them “puzzling” and said she initially questioned whether or not they may have been a hoax.
“There are no circumstances whereby qualified midwives can possibly be asked, or be expected, to catheterize a penis as part of their professional work,” she says, “The writers seem to have left school remarkably ignorant about basic biology, sex and anatomy.”
Bewley has written extensively on pregnancies involving female-to-male transgender people, but takes issue even with the edits made to the workbook after concerns were raised suggesting a female could give birth after having a penis surgically constructed through a phalloplasty.
“A few [female-to-males] undergo genital surgery but, in general, those with a surgically created neo-penis simply cannot get pregnant either because they undergo a hysterectomy as a prelude,” she says, concluding: “These materials are the opposite of the high-quality training that patients need from midwives and doctors. The project may have arisen from compassion and enthusiasm, but it is worrying that the writers don’t seem to know, care about, or check facts.”
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