Boston University’s primary teaching hospital has updated a glossary used in diversity training to assert that biology and science do not define sex, drawing strong criticism from conservative observers. The glossary reframes terms like “assigned sex at birth” and “gender,” blurring the lines between biological science and social constructs in medical contexts.
Boston Medical Center — the main teaching hospital for Boston University’s medical school — rolled out a “Glossary for Culture Transformation” that includes dozens of terms associated with diversity, equity, and inclusion initiatives. Among the entries is one for “assigned sex at birth,” which asserts that “It is not valid to use ‘biology’ or ‘science’ to claim assigned sex at birth and/or gender are a fixed, concrete concept and/or binary.” This language rejects the scientific consensus that human sex is rooted in biological reality.
The glossary also offers a definition of gender as a “social construction that assigns particular characteristics, norms, and roles to sex and genitalia,” treating sex and gender as separate concepts. The hospital further directs staff to avoid the phrase “preferred pronouns,” saying it implies optional importance, and promotes the use of gender-neutral pronouns such as ze and hir.
Critics argue that these changes inject ideological frameworks into medical education and patient care. Dr. Kurt Miceli, director of the medical advocacy group Do No Harm, said the glossary is “awash in DEI ideology rather than clinically grounded content.” He warned that prioritizing activist terminology over biological science can undermine accurate diagnosis and treatment and steer clinicians into political narratives instead of medical ones.
The glossary goes beyond gender and sex to include terms such as LGBTQIA+, fatphobia, anti-blackness, pansexual, misgender, transphobia, and two-spirit. Its development involved Boston University’s Office of Equity, Vitality, and Inclusion in partnership with the medical and public health schools, reflecting efforts to promote “justice, equity, and belonging” through language choices.
Boston Medical Center’s website also encourages signing a “Words Matter Pledge,” committing users to use language that challenges “systems of oppression” and addresses bias. This further signals the institution’s embrace of progressive language norms in health care.
The debate underscores ongoing tensions over how sex and gender are treated in academic and medical settings, with scientific definitions rooted in biology contested by frameworks emphasizing social and cultural constructs. Mainstream biology historically defines sex based on reproductive characteristics such as chromosomes, gonads, and genitalia, establishing male and female categories biologically.
Parents, conservative groups, and clinicians concerned about scientific fidelity are likely to view this glossary as another example of political ideology influencing medical education and practice, potentially affecting patient care standards and public trust in health institutions.
