Being a woman is not reducible to biology. It never was. Gender identity is an innate, persistent sense of self that exists independently of anatomy, chromosomes, or reproductive capacity. Trans women are women not despite their biology but because their identity is as real, as felt, and as valid as anyone else's.
Where this question came from
Back in January 2017 I appeared on BBC Radio 5 Live's Your Call with Nicky Campbell. A caller posed a question that stopped me in my tracks, not because it was new, but because it was asked with such certainty. To paraphrase: "I know I am a woman because of my biology. I have a vagina, I have ovaries, I can bear children. I would like to know exactly how trans women define themselves as women in the absence of biology."
I wrote about it for the Huffington Post shortly afterwards. I reached out to trans women and allies and gathered their responses, because I felt, as a cisgender woman, that those voices deserved to lead. Reading it back now, in 2026, I am struck by two things at once: how sharp and clear those responses still are, and how much heavier the political weight around this question has become.
So let me revisit it. What has changed? And, honestly, what hasn't?
The problem with a biological definition of womanhood
The caller's argument felt logical on the surface. Biology: check. Anatomy: check. Reproductive capacity: check. Therefore: woman. But the moment you apply that definition consistently, it starts excluding people it was never meant to exclude.
Jenny-Anne Bishop, who joined the original conversation, put it plainly. Does that definition mean that women born without those organs, or who have them removed, or who cannot bear children, are not women? Of course not. We do not strip a woman of her womanhood because she has had a hysterectomy. We do not ask a woman who is infertile to justify her gender. The biology-only definition has never actually been applied consistently, because if it were, it would collapse immediately.
What the caller was really asking, I think, was: what is the thing I cannot see that makes someone a woman when the body I am looking at does not match what I expect? And the answer is gender identity: an innate, deep, persistent sense of who you are. Not a preference, not a feeling about pink or dresses, but something as fundamental and as irreducible as the caller's own certain knowledge that she is a woman.
What gender identity actually is
Jane Fae, a feminist and writer who contributed to my original piece, made a point that I keep returning to. She described gender identity as "a fundamental and persistent sense of being part of that category." Everything else, she said, what you wear, how you speak, even your body, is simply an attribute, a way of expressing gender, not the thing that defines it.
That is worth staying with. When a cisgender woman is asked why she knows she is a woman, she rarely reaches for her chromosomes or her uterus. She knows, in the same way anyone knows. That knowing is gender identity. Trans people have the same knowing, pointed in the same direction, and the mismatch is between that knowing and the body they were given, not between their identity and reality.
Sarah Lennox, children's author and co-founder of AllAboutTrans, offered a comparison that I find useful still. How do you explain being left-handed? You just are. No trans person can fully explain why they feel as they do, any more than a cisgender person can explain the opposite. It is not ideology. It is not performance. It is a very real experience that has been documented in every culture throughout recorded history.
What medicine has learned, and kept learning
In 2017, I wrote that the medical profession had tried, and failed, for over a hundred years to change the gender identity of trans people. That remains true in 2026, and the consensus has only hardened. The current international standards of care, including those published by WPATH and the Endocrine Society, are built on the understanding that gender identity cannot be changed by intervention. The only ethical and effective approach is to affirm it.
What has changed is the political noise around that consensus. In the years since I wrote that original piece, several governments have moved to restrict access to gender-affirming care, particularly for young people. The UK has banned private prescriptions of puberty blockers for trans youth. Other countries have followed. These restrictions have not come from new clinical evidence that undermined the consensus; they have come from political pressure on a medical system that was already under-resourced and under strain.
The science has not reversed. The evidence base for gender-affirming care is supported by the World Health Organisation, the American Medical Association, the American Academy of Pediatrics, the Endocrine Society, and many other bodies. The American Academy of Child and Adolescent Psychiatry reaffirmed its support for evidence-based gender-affirming care as recently as 2025, directly in response to federal pressure in the United States. None of that is ideological. It is medicine doing what medicine does: following the evidence about what helps people live better lives.
What feminism has to do with it
Jane Fae raised a point in 2017 that feels even more pointed now. She noted that some feminists, in trying to distance themselves from trans women, have reinstated the very idea that feminism spent decades dismantling: that being a woman is something that can be biologically defined and constrained. That is the definition that has been used historically to tell women they are too emotional to vote, too physically weak to work, too biologically determined to lead. Feminism fought that definition. And yet here it is being deployed again, this time against trans women.
Trans women are not attempting to invalidate womanhood. Sarah Lennox drew the comparison clearly: being trans does not diminish womanhood any more than being gay diminishes heterosexuality. These are simply different experiences of being human, and they deserve equal acceptance and respect. The idea that including trans women in womanhood takes something away from cisgender women rests on a notion of identity as a finite resource, and identity does not work that way.
The legal picture in 2026
One thing that has changed since 2017 is that the legal question of what makes a woman has been subjected to a Supreme Court ruling in the UK. In 2025, the UK Supreme Court ruled in For Women Scotland Ltd v The Scottish Ministers that, for the purposes of the Equality Act 2010, the terms "woman" and "sex" refer to biological sex. A person with a Gender Recognition Certificate in the female gender does not fall within the Act's definition of woman under that interpretation.
It is important to be clear about what that ruling did and did not do. The Court interpreted one piece of legislation. It did not define what a woman is in medicine, in everyday life, or in society. It did not remove trans people's legal protections: the Court confirmed that trans people remain protected under the characteristic of gender reassignment. And it has been widely criticised by legal commentators, equality organisations, and human rights advocates who argue that the interpretation is inconsistent with Parliament's original intention when both the Gender Recognition Act 2004 and the Equality Act 2010 were written.
A court's interpretation of a law is not the last word on what that law means, and it is certainly not a definition of what a woman is. Those are two very different questions.
What has actually changed since 2017?
Honestly? The answers haven't changed. Gender identity is still real. Trans women are still women. The medical consensus is still firmly on the side of affirming care. The experiences of trans people are still as documented, as consistent, and as human as they ever were.
What has changed is the volume of the argument. The political stakes have been raised, the media coverage has become more hostile in many places, and the legal landscape has shifted in ways that have caused real harm to real people. Trans young people in the UK cannot access puberty blockers on a private prescription. NHS waiting lists stretch to years. The uncertainty and the hostility have consequences for mental health, for safety, and for lives.
And yet the people at the centre of this, the trans people who wrote to me in 2017 and the many more who have spoken to me since, have not changed their answer. They know who they are. They have always known. The question of what makes a woman has a simple answer when you ask the right people: they will tell you.
Where I stand
I reached out to trans women in 2017 because I felt, as a cisgender woman, that the answer was theirs to give. Nine years on, I still feel that. But I am no longer willing to be neutral about whether the question deserves a serious answer. It does not. It deserves a clear one.
Trans women are women. That is not a political position dressed up in medical language. It is the conclusion of over a century of medical evidence, the position of every major international health body, and the lived experience of millions of people across every culture and period of history. The noise around it has grown louder, but the answer has not changed.
What has to change is the access to care, the safety of trans people in public life, and the willingness of those with platforms to say clearly what they know to be true. I wrote this in 2017. I am writing it again now. I will keep writing it for as long as it needs saying.
If there is a topic that you would like me to cover, just let Sammy know.
Dr Helen Webberley is a Gender Specialist, Medical Educator, writer, and advocate, and the founder of GenderGP. She writes about gender diversity, trans healthcare, and the lives around them.
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