David Michael Newstead | The Philosophy of Shaving
Amy Agarwal is an experienced writer and editor who has learned to communicate effectively about the most vital subjects across different languages and cultures. But how she actually accomplishes that is a work-in-progress. Below we discuss inclusive writing and editing, how language changes overtime, and Amy’s work at the nonprofit, EngenderHealth.
David Newstead: EngenderHealth promotes sexual and reproductive health internationally. How do domestic issues in the United States come up in conversations and how does your team navigate that?
Amy Agarwal: Yeah, it’s tricky. When I started, we did have programming domestically. We had an adolescent sexual and reproductive health program in Texas in Travis County, which is one of the counties with the highest teen pregnancy rates in the country. It was a really cool program and I actually worked with that team a lot. They did a number of curricula products. One of the most interesting things to me was that they had such a large youth population that wasn’t identifying as heterosexual. Yet, all the curriculum was really focused on heterosexual sex. Those kinds of conversations I would have with my teammates quite frequently in that office. This was before the current nonsense. Roe comes up in our staff meetings on a regular basis. We don’t have an advocacy wing. We do advocacy where we’re working nationally, but not in the U.S.
Thinking about overseas, Ethiopia is the country where we’ve had the most success. We haven’t done a lot of direct lobbying, but certainly support for abortion advocacy and safe abortion. And over the last 15 years or so, they have made some pretty strong changes both in their legal policy and also in how health systems are operating to be able to offer safe abortion services. So things can change. Things can change both ways.
David Newstead: I guess watching too much U.S. news, it’s easy to get tunnel vision. But your team would really have a great, comparative lens on these issues. Other than Ethiopia, are there other notable experiences from your time at EngenderHealth?
Amy Agarwal: One of the things I think about a lot when people bring up the situation in the U.S. is the fact these ideas about six-week bans or other bans or the Texas thing where you can sue doctors and sue pregnant clients. To me, it comes across as a lack of understanding of what an abortion is and how bodies work. People use the term “miscarriage” and the medical term for a miscarriage is a “spontaneous abortion.” I can think of people who I know that are very conservative and would argue that it’s not the same. But if you took medicine for that, you took medication that abortion clients need. You could have an abortion or you could have a miscarriage and still need the same kind of treatment that post-abortion clients would need, people just don’t want to use that language. I don’t know. I guess I’m pulling back to language, because that’s my callback on so many things. The rhetoric that I see in the news just annoys me. We had a program that closed like two years ago and part of what they did was a series of short briefs on abortion status, legal status, accessibility, implementers, that kind of thing across 25 countries. And there were very few countries that were fully outlawing all abortion and all abortion care services. A lot of the time it was limited to if the health of the pregnant person was in danger or the health of the fetus was an issue, rape or incest were big issues. A lot of them had classes if the pregnant person was unable to care for the child, whatever the case may be. So it almost seemed a lot more flexible, even when we’re talking about countries that are largely Muslim or devoutly Catholic.
David Newstead: Do you feel like your writing and editing work connects well with your organization’s mission and that you’re able to convey those messages in an impactful way?
Amy Agarwal: I do and I don’t sometimes. I think it depends. It’s a lot easier to write and edit in areas where there already is general support at least in our sector. About two years ago, I was asked to write this series of language guides. Actually, what I was told to do was “do a language refresh.” I don’t know what that means. I didn’t know when I was asked. I’m still not sure if what I did was what was intended. But what we ended up doing was a series of language guides. I just finished another one on gender-based violence, but the one that I did on gender, sex, and sexuality had so many people up in arms about stuff. The idea that we would refer to people as “pregnant clients” to be inclusive had several women complaining that they didn’t want to be referred to as a “parent.” Or that they earned their mother status and that they weren’t going to have that taken away from them. And I thought, no one is taking that away from you. All we’re saying is when you’re writing literature, use “parent,” because you don’t know. This is not written specifically for you.
I’ve seen it in other areas too. In my personal life, I had a conversation with a friend of a friend and the topic of Latinx or Latine came up. This guy got really angry and was like “No one says that. No one in Mexico would say that. That’s ridiculous. I’m not going to be referred to as that.” Well, you don’t have to refer to yourself as that, but if you are talking about an X group this is now the appropriate way to use non-gender specific language. So yeah. From that perspective, it’s been a little tough. I also did a guide on maternal obstetric care and working with some older doctors and taking language from the British Medical Journal and the American Journal of Public Health and the Australian Journal of Midwifery. They were also saying let’s stop using some of this terminology, let’s start using this new terminology to be more respectful of our clients. And some people’s reactions were “People aren’t going to understand that. That’s not what we say. It didn’t mean to be offensive.” Well, it doesn’t matter if you meant for it to be offensive. It is offensive to some people and just because you’re used to saying it doesn’t mean you have to continue to say that. But the idea of a shift in language I find interesting, because people have a really, really hard time being open to that concept.
David Newstead: Speaking of medical journals, some of the racial categorization language only changed maybe five years ago. And that’s stuff that’s straight out of the colonial era that really shouldn’t have made it out of the 1960s. So, somethings have to change.
David Newstead: What do you think is behind that hesitancy?
Amy Agarwal: I think the fact that it’s hard and it’s changing and you’re likely to make mistakes. I make mistakes all the time. That’s just what happens. And from my perspective, people don’t want to go down that path where they even have to try, because they’re at risk of making a mistake. And I also think people take things personally. A lot of this isn’t about me as an individual. I mean, the two examples I just gave don’t affect me at all. I have neither given birth nor am I Latina, but that doesn’t mean that I can’t understand that someone who is Transgender and is becoming a parent might not want to be called a “mother.” Or I had this conversation just a couple weeks ago on our abortion guideline about using the term “mother.” More than half of pregnant people in the United States who have abortions already have children. So if they want to be called mothers, they’re already mothers. But for the default terminology for someone who has never given birth and is looking to have an abortion to be “mother” just makes no sense to me. Like the idea that that wouldn’t be offensive or potentially emotionally distressing… I don’t know. It doesn’t seem that hard to me. And it’s not a huge change.
I have a cis child who is nonbinary. And I’ve had so many years of calling her “her” and “she” and using her name. And this is just within the last year that she’s now said that she wants to use she/they pronouns. We took her on vacation to Puerto Rico and when we were filling out the form, I asked her what she wanted to identify as and she said nonbinary. And I still in my head, and sometimes out loud, call her “she” because I’m just so used to it. But when I do, I also know they are very cool with it, because they understand that it takes practice. But to not even be willing to take that first step, I think maybe it comes from a place of privilege. It’s not affecting you, so you don’t have to think about it.
David Newstead: Maybe an unwillingness to see the variety of different circumstances and life experiences. There’s got to be a generational aspect to that, I’m sure.
Amy Agarwal: Yeah.
David Newstead: So these are things you work through? Other than wordsmithing, there’s also discussions and debates about how things should be referred to or updated?
Amy Agarwal: I kind of take the approach most of the time “here are track changes of my suggestions.” But like take them or leave them. I’m not going to be the police about this whole situation. I will tell you what I think could be more inclusive. And a lot of times my teams get it. They’re not argumentative about it as long as I haven’t misrepresented something clinical. They’re very willing to take my feedback. I find it’s more my U.S. colleagues who like to argue about stuff or like to reject my feedback. Like I was doing something for conference abstracts and I was saying that the conversation now is really against using “low- and medium-income countries.” There’s these colonial aspects to how we’re grouping countries just by their economy and what the Western economic ideals are. And people are like “Well, what do you want us to say instead?” You could name the country specifically. If you’re talking about regions, you could refer to those. And when doing these abstracts, I went back to do a copy edit after I’d done the more substantive edit and they ignored all my feedback. They ignored feedback on gender. They ignored feedback on economic issues. They ignored it all. Like okay, I’m going to fix your commas again and not let it ruin my day, I don’t know.
David Newstead: I guess that same generational factor to language affects international development circles as much as anyone else. Like in our lifetimes, terms like Third World and First World were still in regular use. I vaguely remember the transition to phrases like Global South and things like that. Because you differentiate between U.S. teams and other teams, I wonder whether that has to do with some topics being more politicized here.
Amy Agarwal: I’m sure it’s one of those things where there are multiple factors and different factors for different people.
David Newstead: Other than writing at work, do you write outside of work?
Amy Agarwal: Not a ton. I’ve had opportunities to do different kinds of writing than I’ve done for work in the past, which has been interesting. Like I’ve written a couple of blogs about language. I’ve done some of our press releases and stuff like that. But I don’t find myself having a huge desire to write otherwise. I think because I spend so much of my time doing it now.
David Newstead: Yeah, I get that. I remember when I had a more physical job the last thing I felt like doing after work was something similar to how I’d just spent my entire day. And now, I don’t finish working on my laptop for eight hours, then turn around and do my taxes online.
Amy Agarwal: I feel like people I know expect my writing to be perfect. I’m sure half my friends think I’m drunk every time I text them, because I autocorrect and I can’t be bothered to fix it and things make no sense. It’s like you get the gist of it, it’s fine. And they’re like, “Aren’t you a writer? Don’t you do this for a living?” Well, you’re not paying me to text you, so…
David Newstead: I’ve heard that before too, which is always funny to me. But about me speaking. And it’s like if I was good at expressing myself, I wouldn’t have spent years being like “I’m going to go write in my journal…” I mean maybe something good eventually breaks through, but it’s not like all the emotions and everything are super articulate the first time around.
Amy Agarwal: Yeah, that’s why there’s editing.
David Newstead: Are there any recent accomplishments or upcoming work that you’re particularly excited about?
Amy Agarwal: I just finished a new language guide on gender-based violence. It was really great to be able to work on that. We have a Gender and Youth Social Inclusion Director that I co-authored that with. It was just really interesting to have some conversations around terminology like the idea of a victim versus a survivor. And when do we use which term? And who gets to choose which term we’re using? And that sort of thing. And because there’s such nuance and differentiation in what’s appropriate in what context, not just geographic, but individual circumstances. We were talking about doing a mini-orientation on gender-based violence for some of our country teams. That’s one of the things that’s on deck for when I get back to follow up on. I put together some ideas. And there were a couple other terms that were similar. For a while, I think the sector was using sexual and gender-based violence and now we’re back to just gender-based violence. So thinking about why that has shifted and why it’s important. Should we ever be using the term sexual and gender-based violence, because the idea is that gender-based violence includes sexual violence. So, do we need to exclusively call that out? Or if we are just talking about rape, how do we address that? I think it’ll lead to some interesting conversations with our country staff.
And then, we have the International Conference for Family Planning, which is usually every two years. But Covid has thrown everything off, so the last one was in 2018 and this year it’s in November. So, we had a dozen of our abstracts accepted for post or a presentation. So, I happily went on vacation two days after we got the notification of which ones were accepted and it’s like “I will reread those when I get back!” because I edited them in February and I don’t remember what any of them said anymore.
David Newstead: Always a good refresher activity.
Amy Agarwal: Yeah, it’ll be good, because I’m doing the design for those as well. So, I’ll have to rewrite those into post or presentation form and make them look all nice.
David Newstead: Regarding the language piece, you’ve discussed. And I’ve mainly heard this about French, but that some languages have more expansive or narrow vocabulary particularly around gender. How do you deal with those kinds of things?
Amy Agarwal: It’s interesting. We do have a significant West and Central Africa portfolio, so we really made an effort to have a lot of our materials translated into French and to have simultaneous interpretation available for trainings or for global meetings. And specifically on gender-based violence, I was briefly having a conversation with one of our directors who is based in India and she was explaining to me that she has had a lot of trouble with our teams constantly changing “survivor” to “victim” in French. So when we were doing the translation working with a professional translation firm, it was interesting to have that conversation with them. And I think that there’s a bit of difference between what has been normal. I think French just came out with a gender-neutral, third pronoun. But they just came out with it, are people actually using it? Are people even using it in Paris where I’m sure they’re more progressive than in Bamako? So how can we use language that’s more progressive, even though that’s not what people are used to. But at the same time, we know if we don’t start using that language, no one’s ever going to start using that language. French is definitely an interesting one for that reason.
David Newstead: And there might be other examples too that I’m not as familiar with. You know from what little I know about Arabic, I’m sure one or two things could be updated.
Amy Agarwal: Yeah, someone was texting me today, because their work was doing something. I had been talking to them about trans issues recently, but they brought up Hijra and the person texting me said “India has a third gender called Hijra.” And I was like… yeah, actually all of South Asia uses those kinds of terms: Pakistan, Bangladesh, Nepal. It’s not exactly the same thing as transgender from my understanding, but also I don’t live there. I haven’t lived there since I was six months old. It’s interesting to see, I guess. Because I think a lot of things we were talking about earlier about terminology in the U.S. and what’s shifting here and how that shift is going in other languages and in other cultures, whether it’s faster or at the same pace or slower. Some of the language we have now was just not language we had when I was growing up. In medical books, probably when I was in high school, the term hermaphrodite was still in use and now we don’t say that. So the fact is language does shift. Whether you want to accept it or not, it’s going to keep happening. You can cling to the old and get comfortable being uncomfortable.
David Newstead: What else is important to you about language?
Amy Agawal: I think just the importance of de-personalizing language whether it’s in writing or in oral communication. Thinking a little more about the world around us. Having empathy for not only who we think our audiences are, but who our audiences might be. That’s where I get cranky sometimes when people push back on certain language. You might not like that or identify with that, but I don’t know who else is reading this. I might be offending someone unintentionally by using exclusive language. Just because you’re not thinking of someone as your primary audience doesn’t mean that they’re not also seeing that. Or just because you might not think that you have a family member or a friend who’s had an abortion, chances are you do know someone. Something like one-fifth of people with uteruses in the United States had an abortion at some time in their life. If you know enough people, you probably know someone who’s had one. So, the idea of being empathetic without knowing who your audience is or without having a personal connection is something I try to think about a lot when it comes to language in writing and editing.
David Newstead: My cranky thing is when I’m looking at a lot of news articles and things like that. There’s a lot of repeat phrases, so “ladies and gentlemen” falls into that category, but there are plenty of others. And they’re just a reflex. It’s a thing people say, because that’s what they’re used to. But all you would have to do is write “everyone” instead or “stakeholders” or fill in the blank. Crack open a thesaurus and figure it out, because you don’t have to phrase things the same way all the time. In fact, it’s more interesting if you try to diversify language. But when it comes to empathy for potential audiences, especially for your purposes, you’re making a gender-based violence guide that could be used by five different countries and for twenty different circumstances. It can’t just be one thing or about one group. It has to be inclusive.
Amy Agarwal: It’s hard too. One of the other things we’ve talked about in terms of decolonization and generalization. Don’t refer to people as just Africans. Africa is a big continent. Within countries, there are different tribal groups. There’s different ethnic groups. To make that generalization is not good. You’re probably going to be misrepresenting a lot of information. But at the same time, you’re trying to address everyone. Finding that general language is important, because that’s the point. But if you’re just talking about people in Senegal, then you want to say “For Senegalese pregnant clients dealing with the health system infrastructure is a challenge.” And thinking about where there are those distinctions. And I think that can be a challenge for people to realize that there often times are not easy black and white answers. But thinking about the context and thinking about the nuance and the audience, it can be tricky, but I think it’s worth the effort if we want to have messages that are well received and well understood by large audiences.
David Newstead: I had a friend in Hawaiʻi who had some political job and she was always fighting this battle with the DC office. The DC office would send them general communications and also state-level communications and they would address their messages to Hawaiians. And then my friend would constantly have to explain to them, “Hawaiians are a specific ethnic group in Hawaiʻi, not everyone in the entire state. But you’re trying to talk to everyone, so this doesn’t make any sense.” And this would turn into this back and forth battle she would have all the time where it’s just like, “Your campaign literature makes no sense and I’m trying to tell you!” Hopefully though, I think under the best circumstances these are educational opportunities for the person writing and reviewing as well.
Amy Agarwal: Absolutely. That’s definitely one of things I love about editing. It’s such a good opportunity to learn about so many different subjects. I mean over the years, I’ve worked in economic growth, in education. Having that opportunity to learn about things and that includes language. What is the appropriate terminology? What is the latest that we’re using for clinical terminology? Or that we’re using for pedagogy and sort of thing, because it’s always changing. There’s always opportunities to learn and get better. The first part of it is recognizing that no one’s perfect. You’re not perfect. You’re going to mess up and it’s a continual work-in-progress kind of thing.
Philosophy of Shaving 
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