It was widely reported over the weekend that the British Medical Association has issued guidance to its members that they should not to refer to pregnant women as 'expectant mothers' in order to avoid the risk of offending transgender people who may be pregnant and don't wish to be referred to as a 'mother'.
There are around 700,000 births each year in the UK and, as far as I can tell, there is currently one pregnant transgender man in the UK and he appears to be the first. I agree that we should always try to avoid causing offense and, as a practicing medical professional, I am very conscious of the importance of language and terminology surrounding transgender issues. In my experience, transgender people have invariably been through a great deal of psychological strife and the least they can expect from medical staff is that they take the care to use respectful language.
Nevertheless, I am still surprised that the BMA has issued guidance suggesting, in essence, that we change the way we interact with all our pregnant patients to avoid risking offence to someone in what remains an almost hypothetical situation.
In all honesty, this particular issue is not one that I feel very agitated about. If it is better that I refer to my pregnant patients as 'expectant people' rather than 'expectant mothers' it is no great hardship for me. But this advice is so cautious that it made me think more generally about the level of risk aversion in our society.
A few days ago, the Food Standards Agency (FSA) issued a warning about the potential for burnt toast or crispy roast potatoes to cause cancer because of the acrylamide content. In large doses, and under experimental conditions, acrylamide has been shown to cause cancer in mice, but there is no proven link to cancer in humans. Furthermore, the mice were exposed to doses of acrylamide that would simply not be found in anything like a normal diet, they were in fact ingesting somewhere between 1000 and 10000 times the amount of acrylamide found in a normal diet.
The FSA were widely criticised for issuing the warning, not least by cancer charities who worried that it would detract from important messages about stopping smoking or avoiding obesity, but the FSA defended itself by saying that it was simply trying to be as safe and cautious as possible. On the face of it this sense of caution from the body charged with maintaining the safety of our food seems reasonable, but living life as safely as possible is neither desirable nor realistic for most people. Instead, hysterical warnings such as this tend to make people disengage with health advice, and next time the FSA issues a warning, regardless of how sensible or serious it may be, many people will simply ignore it because they will remember the nonsense about burnt toast.
Something similar happened recently when the recommended alcohol limits were dropped to 14 units per week (about 5 to 7 pints a week depending on your tipple, or just shy of a bottle and half of wine) for both men and women. There is evidence that drinking more than 14 units each week will increase your risk of various serious, potentially life threatening, diseases but, even for many of my patients who already drank moderately, this figure seemed unachievably low.
In general, not only did these patients ignore this message, but many who had previously tried to stick to recommended limits simply disengaged with alcohol awareness messages altogether and decided that they would be happier living with the risks. Getting the balance of this type of public health message right is incredibly difficult but, sometimes, choosing to be as cautious as possible backfires quite dramatically.
Taken one by one none of these cautious messages present much of an issue but it seems to me that people are increasingly fed up with being told that the way that they have always lived or acted is wrong.
As I watched a guest on Sunday morning's BBC news programme saying that we should no longer be using terms such as 'mothering' or 'motherhood' because there are people who might find them offensive, I wondered how many hundreds of thousands of viewers were irritated by what she was saying. I then wondered, given what has happened in America, how many of those people might listen to a man with odd hair, abhorrent views, but undoubted charisma, if he appeared on TV shortly after and promised them that he would stop all this nonsense?
Much of Trump's success is due to his disregard for offending others and his willingness to break from modern, social norms. His reckless lack of caution in an increasingly risk-averse world is what appeals to many of his voters and this should be a warning to us.
There is definite risk in endless caution.
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