Tips for Transgender Breastfeeders and Their Lactation Educators

I've been in touch recently with several lactation consultants and they have all asked me similar questions: What is it like to breastfeed as a transgender man? Are there special challenges that you face? What do we need to learn in order to help people like you to breastfeed?

So here's a post for anyone out there who may one day be in a position to help a trans guy and his nursling in their journey towards achieving a kick-ass breastfeeding relationship, because it CAN happen.

Tip One: Simply know that it is possible for a trans guy to breastfeed even after a dramatic chest surgery like mine. A lot of people thought I was ridiculous and delusional for trying to breastfeed, but I did it. My son gets a little bit of my very own milk plus the milk of lots of wonderful women via a supplemental nursing system (SNS - see FAQ). All feedings take place at the breast.

Tip Two: Know that latching will likely be particularly tough. Lactation advisers should know that trans men may face special challenges in latching their babies - accomplishing a deep latch can be very difficult with next to zero breast tissue. Teaching a trans man to make an effective "breast tissue sandwich" is essential to successful and reasonably comfortable breastfeeding. Using an SNS on top of this makes breastfeeding even harder. A first time trans breastfeeder will need lots of extra hands to help with latching and using the SNS.

 Tip Three: Lactation consultants should be aware that in the case of a trans guy who has not had any chest surgery, he may have practiced years of breast binding to flatten his chest, and this, of course, may affect milk production.

Many FtM individuals practice breast binding, using very tight fitting garments to flatten the chest. As we know, even an ill-fitting bra can affect milk production.

Tip Four: Watch out for postpartum depression (PPD), even more than usual. Emotional factors surrounding breastfeeding should be given serious consideration by any lactation adviser. A trans man may be very averse to breastfeeding if he perceives the practice to be a feminine activity (I for some reason never felt this way myself), or depending on his own feelings about his chest and nipples. Alternately, even though he is happy he had his surgery, he may still feel very guilty if he is unable to make enough milk for his baby. Watching out for PPD could be very important since trans people as a group are already at higher risk of suicide and depression than the general population.

Tip Five: Act as a liaison between your client and others, such as La Leche League. Remember all those women you urged to contact La Leche League but they never did? Think they were anxious about going to a meeting full of strangers? Well, now imagine being a trans guy walking into a room of breastfeeding women who know nothing about you. How daunting would this be? To help a trans client find peer-to-peer breastfeeding support, locate a queer-friendly LLL chapter or similar group and let them know ahead of time that a trans breastfeeder may be joining them. Then tell your client that the group leader is familiar with the notion of a breastfeeding trans man and will be welcoming.

Finally, be prepared to learn, innovate, and improvise. Have fun!