Breast feeding for trans feminine people

tags: trans rights

Last updated on 2024-11-05 .

If you have had an estrogenic second puberty and have or are considering getting a baby, you may have wondered if your boobs would be good for breast feeding. As usual, the answer is "maybe", and "we don't know a lot". Here's my collection of notes on what we do know. Also, this is a bibliography of research articles and case studies, not medical advice.

Papers I've found

"Induction of lactation in a patient with complete androgen insensitivity syndrome" (2023)

Not about transgender people per se, but still relevant:

Induced lactation is possible in chromosomally XY individuals with the use of pharmacological and non-pharmacological therapies. There are no standardised guidelines regarding the optimal regimen for induced lactation. Progesterone exposure to the breast is essential for ductal branching and alveolar maturation. In the published literature, induced lactation is more successful in transwomen and other XY individuals who have had prior progesterone exposure. The addition of progestogen to our patient's treatment regimen would have improved her chances of establishing successful lactation.

"Case Report: Induced Lactation in a Transgender Woman" (2018)

After implementing a regimen of domperidone, estradiol, progesterone, and breast pumping, she was able to achieve sufficient breast milk volume to be the sole source of nourishment for her child for 6 weeks.

"Medication and Facilitation of Transgender Women’s Lactation" (2019)

"Lactation Care for Transgender and Non-Binary Patients: Empowering Clients and Avoiding Aversives" (2019)

"Lactation Induction in a Transgender Woman Wanting to Breastfeed: Case Report" (2021)

Readily available lactation induction protocols for nonpuerpural mothers were reviewed and used to guide hormone therapy selection. Daily dose of progesterone was increased from 100 mg to 200 mg daily. The galactogogue domperidone was started at 10 mg 3 times daily and titrated up to effect. She was encouraged to use an electric pump and to increase her frequency of pumping.

"Experience of Induced Lactation in a Transgender Woman: Analysis of Human Milk and a Suggested Protocol" (2023)

"Lactation Induction in a Transgender Woman: Macronutrient Analysis and Patient Perspectives" (2023)

These findings provide reassurance about the adequacy of nutrition from human milk produced by non-gestational transgender female and nonbinary parents on estrogen-based, gender-affirming hormone therapy, and support the importance of this experience on a personal level.

"Novel Lactation Induction Protocol for a Transgender Woman Wishing to Breastfeed: A Case Report" (2024)

"Induced lactation in a transgender woman: case report" (2024)

"Lactation induction in a transgender woman: case report and recommendations for clinical practice" (2024)

To induce lactation, we implemented a hormone-regimen to mimic pregnancy, using estradiol and progesterone, and a galactogogue; domperidone. Our patient started pumping during treatment. Dosage of progesterone and estradiol were significantly decreased approximately one month before childbirth to mimic delivery and pumping was increased. Our patient started lactating and although the production of milk was low, it was sufficient for supplementary feeding and a positive experience for our patient. Two weeks after birth, lactation induction was discontinued due to suckling problems of the infant and low milk production.

"Inducing Lactation in a Transgender Woman Without Galactagogues: A Case Report" (2024)

While previous case reports describe successful lactation induction in transgender women, their protocols involve domperidone, a galactagogue recommended against by the US Food and Drug Administration (FDA) [...] Here, we present a case report of lactation induction in a trans woman using a protocol not involving galactagogues.

Surveys, reviews, pop. sci content, etc

A survey (2020) suggests this has happened more often than you'd think:

We surveyed 82 respondents (response rate 10.5%), the majority of whom were healthcare professionals (84%). Average age of respondents was 42.3 years old. They represented 11 countries and averaged 8.8 years of work at 21.3 h/week with trans populations. Healthcare professionals in this sample primarily specialized in general/internal medicine, psychology, endocrinology, and obstetrics/gynecology. One-third of respondents (34%) stated that they have met trans women who expressed interest in inducing lactation. Seventeen respondents (21%) knew of providers, clinics, or programs that facilitated the induction of lactation through medication or other means. Seven respondents (9%) have helped trans women induce lactation with an average of 1.9 trans women in the previous year. Two protocols for lactation induction were mentioned in free text responses and 91% believe there is a need for specialized protocols for trans women.

2023 review:

Lactation induction was achieved in all the case reports. There is a fragile and recent body of evidence affirming the success of lactation induction in transgender women. There is a necessity to support this demand by health professionals and robust studies to optimize necessary interventions.

There's also an old article titled " Yes, trans women can breastfeed too. Here’s why it’s safe, healthy and good for both mum and baby" in Pink News that pops up a cookie consent form. It does have cute baby pictures and a Human Interest-type reporting.

Possible search terms

To help search engines (and me, when I use grep) find this note. They may also be used as keywords if you're looking into scientific journals.

Induced lactation in trans women
Breast feeding for trans women
How do I use boob?