9 May 2013

Trans Women and Breastfeeding: A Personal Interview

Update: Read my interview with Jenna, another trans woman, here. Read my interview with health care providers who have assisted trans women with lactation here.

So far, this blog has exclusively addressed issues faced by transmasculine folks. I started writing it from my personal experience, and I am transmasculine. However, I've received several questions from trans women who are interested in breastfeeding. After doing some Google searches, I realized that just as there is little to no information for trans men on this topic, there is not much written for trans women. In particular, I haven't found any personal accounts or interviews. I will try to do my part to fill a little bit of this gap. This is part one of a mini-series on trans women and lactation. Enjoy!

Trans women, individuals who were assigned male at birth but identify and live as women, CAN breastfeed. It is possible, and totally awesome! Health care providers, volunteer breastfeeding counsellors, and trans women themselves need to learn this important, empowering fact.

Over the last few weeks, I spoke a couple of times with a trans woman and mother, who we'll call Sarah, to better understand how she became a parent and successfully induced lactation. Sarah's baby is now more than a year old and they still enjoy a wonderful breastfeeding relationship. I'll give a bit of background here on conception and then launch into our lactation interview.

Sarah and her wife are both genetic parents to their baby. Sarah explained to me that many doctors, endocrinologists and trans women erroneously believe that after taking antiandrogens and hormone replacement therapy for a relatively short period of time (depending on who you're talking to, they may say something between six months and two years), a trans woman will be permanently infertile, despite not having had 'bottom surgery'. This is to say that even if she halts her hormone therapy, it is claimed that she will not be able to produce viable gametes. Sarah believes this claim is based not on science, but on a widespread lack of understanding of trans women’s bodies and many healthcare professionals’ lack of interest in helping them preserve their fertility.

Despite having taken hormone replacement therapy and antiandrogens for 5 years, Sarah was still able to produce what she calls ‘baby-making ingredients’ following a six-month cessation of her medication. Trans women hoping to help make a little munchkin should note that it takes about three months for their gametes to grow and mature. In addition, this genetic material is very sensitive to heat and needs to develop away from the body, below core body temperature. A trans woman who usually ‘tucks’ will need to change how she dresses for a while to regain her fertility.
Sarah banked her gametes, a choice she believes all trans women should be offered. Another five years later, when she and her wife decided to conceive, Sarah went off her hormones once again to obtain a fresh DNA contribution if possible. She was again successful, after a total of ten years on hormones and antiandrogens. The couple was able to conceive at home, an option that was far less expensive than using the previously banked material at a clinic.

They chose to have a homebirth because they wanted to avoid unnecessary medical interventions. As a lesbian couple, they were also worried about their relationship being questioned by hospital employees.

SARAH: We had the most incredible midwife for the birth. When we first met her, we explained our situation, and she used the term "non-gestational mom," which I’d never heard before. I loved that when confronted with a situation that had been confusing for so many doctors and nurses, she had a perfect, descriptive word for my relationship to my baby, right on the tip of her tongue and didn’t stumble over whether to use ‘non-biological’ or ‘donor’ or something else inappropriate. I'm one of the two genetic moms of my baby, but I'm the non-gestational mom.

ME: So you didn't have to educate your midwife at all about trans issues. That's awesome! What steps did you take to induce lactation? Which health care providers did you approach for help?


SARAH: I didn't know where to start. I looked through my health insurance booklet for an endocrinologist. There was a section that said "reproductive endocrinologist," which sounded just right. I called a couple of different offices until I got someone to call me back.

I said to the nurse, "Here's what I'm looking for. I know that this doctor doesn't have any experience with this, because NO ONE has any experience with it. I'm not looking for her to know what's going on, but I have an idea what I want to do, and I think I know what I need. I just want somebody to work with me."


When I saw the doctor, she said, "I think this is very unlikely to work, but I'm happy to help you try."


I didn't feel like she added that much to the process, other than prescribing the hormones I needed.


ME: When did you first think that you might breastfeed?


SARAH: We definitely thought about it before we got pregnant. It had been a vague part of our plan. I was inspired by the book, Confessions of the Other Mother: Non-Biological Lesbian Moms Tell All. As an aside, I really don’t like this use of the word ‘non-biological,’ referring to both parents and trans people. Just because we transitioned, or just because someone's not genetically linked to their child, that doesn’t mean we’re made of styrofoam. We’re flesh and blood, we have real live bodies that are ours, and that hold and love our children. There is no such thing as a non-biological person. But reading the book was really worthwhile, and one of the things that struck me was the difference in a mom's experience when she had not had a breastfeeding relationship with her baby. I wanted our roles in caring for our baby to be defined as little as possible by who gave birth to him, and for us to be able to give the same kind of comfort to him. As we started reading more, I got pretty attached to the idea of breastfeeding and really hoped it would work out.

ME: What medications did you take to induce lactation?


SARAH: People sometimes say that birth control pills ‘simulate pregnancy.’ Another effect of this medication is to stimulate the development of breast tissue. If you haven't been through a normal female puberty and haven't had progestins in your system, birth control pills are necessary to help build milk ducts and glandular tissue. Estrogen increases during pregnancy, and then after birth it drops sharply.

I modified the Newman/Goldfarb protocol for induced lactation a bit, since I was already taking hormones. I started replacing my usual estrogen with birth control pills (Nortrel 1/35, each pill contains 1mg of a progestin and 0.035mg of synthetic estradiol) about six months before our baby's birth. Closer to the due date, I added half my regular dose of estrogen, and then stopped taking it after the birth. Two weeks after the birth I started pumping and taking domperidone. [Note: Domperidone is a drug generally used to control nausea, but has the side effect of increasing lactation output, often quite dramatically. Domperidone for breastfeeding support is an off-label use of the drug. It can be difficult to obtain for that purpose in some countries such as the US. In others, it is much more commonly available.]


ME: We know that breastfeeding works via a supply and demand system. If the baby does not take enough milk from the gestational mother, her body will produce less milk as a result. If the baby nurses more and demands more milk, the gestational mom will produce more. In the early weeks, the amount that a baby nurses and draws milk helps to determine the gestational mother's milk supply later on. Having the baby nurse from you, Sarah, would also increase your supply, since a healthy baby is more efficient than a breast pump at removing milk from the breast. What did you do after your baby was born? How did you protect your wife's milk supply while bringing in your own?

SARAH: We wanted my wife to breastfeed him exclusively for about the first 4-6 weeks so that she could establish her supply. I pumped during that time. After about the third day of pumping, I started to produce some milk. It was weird, because I was used to pumping and pumping and not getting anything. I looked down that day and there were tiny milky droplets, and they were firm, almost like wax. I kept pumping, and I kept getting that weird consistency, and then the next day, it was softer. It got thinner until it was just milk. I didn't expect it to come in like that – it didn’t come in all at once like my wife’s milk did after she gave birth. It came gradually and it took days before the first drop fell into the pump bottle. But it looked like milk, smelled like milk, and tasted like melted ice cream. You could put it in your coffee or whatever!

ME: How was your experience of latching your baby in the beginning?


SARAH: It probably helped that it wasn't his first attempt. He pretty well knew what he was doing. He’d been nursing on my wife since he was five minutes old. I did find that, especially when I was very full of milk, my breasts were not really soft enough to go into his mouth. Some lactation consultants recommend making a sandwich to help smush your breast into the baby's mouth, and I had to do that. When he was little, I don't think he could get my breast far back enough in his mouth to trigger the sucking reflex without quite a bit of help from me. But after a few months I didn’t have to do that anymore. My wife and I both had more issues with nursing early on than we do now, because when babies are so small, you can't really get very much [breast tissue] in and you have to hold their head at just the right angle.

ME: Yeah, it gets so much easier as they get bigger and stronger. How did you and your wife share nursing duties?


SARAH: When I started nursing, my milk came in quite slowly, so it didn't seem to have any effect on my wife's supply. I would pump every time he nursed on her, and at first, she would try to pump every time he nursed on me. That way we wouldn't be hurting each other's supply. After a couple of months, we stopped pumping. We were sharing nursing and had a freezer full of milk – we decided to just let it be. Neither of us had enough milk to keep him happy all day long, but we both stayed home from work for quite a while so it worked out well.

ME: How was the experience of co-nursing overall?


SARAH: The breastfeeding relationship with my son is so amazing, it's more wonderful than I ever imagined. I feel so connected to him, and he is so bright and independent and I think part of that is having such secure attachments to both his moms. Plus, it's incredibly convenient. I think all parents who can manage to do it should try. In the early months we got twice as much sleep because we were cosleeping and he just rolled back and forth between us to nurse when he needed to. ["Or half as much sleep", Sarah's wife joked.] Either of us could take him out for an afternoon without worrying about bottles or getting him back home in time for a feed.

Then when our baby was about six weeks old, my wife had to go to the hospital for surgery. She was there for almost a week.


ME: Wow, how lucky that you were both nursing then!


SARAH: It was really, really lucky. We didn’t get good breastfeeding support from the hospital. We had doctors insisting she not breastfeed because of medications when our midwife and lactation consultant knew it was fine. They gave us no support with pumping. I think that for a lot of moms a situation like that could have been the end of the breastfeeding relationship, and it was a huge help that we were both able to nurse him.

ME: Do you have any idea how much milk you ended up producing?


SARAH: It's changed over time. I'm working outside the home now. I was pumping at work for the first four months, but he’s nursing less now and I’ve stopped needing to pump. Our baby is eating solid foods really well now. He still loves nursing and when he comes home he really wants a feed. Back when we were full on breastfeeding exclusively all the time... when I woke up in the morning if I hadn't nursed a lot overnight, I could pump and get 4 ounces.

ME: That's amazing! Lots of gestational moms have trouble pumping that much.


SARAH: Yeah, I had a lot of milk! I didn’t expect inducing lactation to work so well. When my wife was in the hospital and he was nursing on me all the time, I did have quite a bit of pain. We sorted that out with our midwife who realized I probably had low-grade thrush, which makes everything very painful. At first, I thought, "It must just hurt to breastfeed this much." I found out that it wasn't normal and we fixed it.

ME: Are you still taking domperidone now?


SARAH: I tried to wean off domperidone. The dose you have to take to induce lactation is quite high. I slowly reduced my dosage. I found though that if I took less than four 10 mg tablets per day, then my supply really suffered. The protocols for induced lactation say that if you take domperidone, you will probably need to take it until you wean. It's not quite the same self-regulating supply and demand system as experienced by a gestational parent. Also, I'm taking half of my pre-breastfeeding dose of estrogen, which is not recommended while nursing because it can have a negative effect on milk supply. It is considered safe for the baby though.

As well, I'm currently taking one combination birth control pill that is mostly a progestin. A lot of literature says that progestin is not advised for trans women because there is supposedly 'no benefit' to it: it doesn’t increase breast size over estrogen alone. But that is not why I take it. When I was preparing to induce lactation [and taking progestins], my moods were so fantastic. I felt much more calm and loving, and I just really liked how I felt in myself. So, I decided after being just on estrogen for a while that I wanted to go back to having a progestin as well.


ME: Did you try to get help with lactation from any other care providers besides your midwife and endocrinologist?


SARAH: I wrote to La Leche League through their web site where you can send a message to a local volunteer. I asked if they knew anything about what we were trying to do. The response I got back was from somebody saying I didn't have real breasts so I obviously couldn't breastfeed. It was from somebody definitely not educated about trans issues. I think this is actually quite commonplace among health care providers, too. I don’t know what goes on in some people’s heads about trans women – I guess they think we all strap on rubber boobs or something? Yet some feel qualified to give medical advice in spite of their total lack of knowledge.

ME: People also focus so much on the amount of milk that is made and not on the relationship. So what if you didn't produce a drop of milk?


SARAH: Yeah, exactly. People should be supported to breastfeed however they can do it. I think it's a shame that so many people don't think about trans people's bodies being capable of breastfeeding, and that they don't consider and value the breastfeeding relationship. They think it's just about gestational moms and that no one else can do it. That presents two problems: how they think about breastfeeding, and how they think about trans people as well. Health care providers need to be more flexible and help trans people have more control over our own healthcare. We deserve to have the same choices that most other people have when it comes to our fertility and to caring for our children.

Big thank you to Sarah for sharing her thoughts and experiences with us! Read the next post in this series on trans women and lactation – I spoke with lactation consultant, Mary Lynne Biener, and Dr. Jack Newman from the International Breastfeeding Centre in Toronto, and with Diana West, IBCLC.


Read my interview with Jenna, another trans woman who breastfed her baby.

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496 comments:

  1. I am very proud of these moms for the wonderful start on life they have given their son. I am sorry you encountered difficulties and am so happy for you that you were able to overcome them. I was raised to know that breastfeeding is not something only women can do. Scientific studies have documented men who successfully breastfed, it's time that the scientific community put that information to use for the transgender community. You are a pioneer and a hero and your son will thank you both for the wonderful benefits you've given him someday.

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  2. This is so limited and encouraging to read. Thank you for sharing. I look forward to the rest of the pieces in this series!

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    1. oops - I meant to type "informative",not "limited". Dern voice-recognition software!

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    2. Stop replying while driving..... :-P

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    3. or maybe they aren't driving and it's possible that is how they use a computer? ;)

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    4. May not want to make assumptions about that one - I know some people use voice recognition software because of carpal tunnel syndrome or other conditions that limit the use of their hands. . . just fyi ...

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    5. I think "replying while driving ;-P" was a joke.

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  3. This is very informative and helpful! I am so sorry the response you had from LLL was not helpful, though. Is it okay if I share this story with other Leaders? I think it could open some eyes!

    Teresa

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    1. So glad you found it helpful! Absolutely, share it far and wide, wherever you please :) I'd love for more people to learn abou this.

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  4. Thank you for this article. As a medical student, I know that I would never learn stuff like this (and I'm trans myself)! Bravo, truly, and may you have continued prosperity.

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    1. I can only hope I am merely ignorant on this matter, but wouldn't being a trans healthcare provider pose more barriers than searching for trans healthcare? I mean in terms of the sheer amount of ignorance you encounter.

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  5. Thank you so much for sharing this. I am a cis-woman who did the Newman/Goldfarb protocol so I could breastfeed my daughter who we adopted at birth. Like you I found the LLL to be completely useless. I attended one meeting, where the leader strongly discouraged me from attempting adoption lactation. She said she thought it would be upsetting to the baby's "real mother" for me to breastfeed and that I should save some money for psychotherapy bills for my daughter later in life because being breastfed by someone not her "real mother" would mess with her head. (for the record, I had discussed my plans to breastfeed with our daughter's birth mother and she was fully on board with the idea)

    Unfortunately due to lack of support I gave up after three days and switched to the bottle. I'm so happy for you and your wife that you both were able to successfully breastfeed your child. :-)

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    1. I am so sorry you had that experience. This is truly the worst thing I've ever heard LLL do. It would have been more of service to say nothing at all, rather than be insulting if there is no solid knowledge behind their words.

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    2. ..."real mother"?

      I am incredibly sorry you were treated this way.

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    3. I hate to say it, but are you sure she was a leader?! I know many leaders who are very knowledgeable about inducing lactation and adoptive nursing.. It just doesn't sound like something coming out of the leader's mouth at a meeting!!
      May be it was just an active member or something?!
      It's just so odd!

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  6. I appreciate all of this very geeky level of detail. :D You are planning on writing a book eventually, right? You'd better!!

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    1. Aw, thanks!! I actually *have* written a book. It's just that my nerdy, geeky side is not letting me finish editing it for good. Sigh. I keep finding things to improve. I hope I'll be ready to put it out there some time next fall.

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    2. If you need a copy editor who's also a lactation professional, look me up! :D

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    3. The nice thing about writing a "text" book is that you can send out another addition later on as information changes. Having this book out now would be great. I am about to begin studying to be a lactation consultant and I am thankful to have read this article. A Trans Woman's lactation never would have occurred to me. I am excited to see the possibility take form!

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  7. Love love love this! I have insisted for years that this was possible, but most people just wrinkle their noses at the idea. Milk or no milk, the nursing relationship can be lovely and important, and no one need be excluded from it for arbitrary reasons.

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  8. Disgusting story about creepy people.

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    1. What you say to others shall be said about you :)

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    2. dont read it then and keep being and ignorant close minded fool.

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    3. A mother feeding her baby is disgusting and creepy?! How? Remember, women breastfeeding babies they didn't give birth to has been part of human culture since the dawn of our species and indeed is present in almost all mammals - we've just refined the process a bit.

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    5. because feeding human babies with cow's milk is "natural" but breastfeeding your own baby is creepy and disgusting? Some people is really stupid! Excellent interview!

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    6. But they're not women. They're sick men. So it IS creepy and disgusting.

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    1. Chicken Author....Can't stand reading the truth? Don't publish it and ask for responses.

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    2. says the commenter hiding behind internet anonymity. Why don't you publish your name and photo so we know what bigotry looks like? What a coward.

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    3. I have to remove TONS of spam. 99% spam.

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  11. I really enjoyed this article, thank you for writing it! It is too bad that LLL couldn't give you any support. I wanted to mention that LLL groups are made up of breastfeeding mothers in that particular neighbourhood, which makes each group unique. Possibly you would have found better support with a different group, so I hope that other mothers in your situation still reach out to LLL. The only way to make LLL better is for all breastfeeding mothers to become members - could you imagine the knowledge they would have then to share? Happy Mother's Day!

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    1. I agree. I'm sorry you didn't find what you are looking for, by LLL is a volunteer service. People give of their free time to help others. They are not paid lactation consultants. If you feel there isn't enough educated support for couples with you specific lactation needs you should def. start a group. It sounds like you have a great handle on the experience. The best teachers are those who have gone through it before themselves. There is no need to bash another group.

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  12. Reading this reminds me of how primitive humans still are. We have so much to figure out yet and to work through, that I feel all of us who have been born so far have been given the short end of the stick here. I envy those who will live when our society will be far more advanced than it will likely ever be in our lifetime. Hopefully, our society will get past the dogmas of today and be capable of working great masterpieces of science to better the lives of those yet to be born. We live in a time when majority of people have yet to separate gender (a construct)from sex (the anatomy of our bodies)let alone all the other hurdles we have to get through in enlightening people. It infuriates me that "Sarah" received such a response. On the other hand, I enjoyed reading the pros of her experience with breastfeeding. I honestly felt a lot of empathy likely because I could find myself in the same situation should I ever decide to be a parent. I appreciate this article deeply.

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  14. Great story! My name is Sherriea I am 11 years living as the woman I feel I am as a transexual. For several years I have tried to lactate as I have heard many of girls do feel the urge to make milk because it helps us feel more like real genetic woman- plus it raises a girls libedo to the max. So good for you. Sherriea

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    1. I've never heard of breastfeeding increasing sex drive, and our experience was just the opposite. It would be a cruel joke of nature if it did!

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    2. Sherria, the opposite is true! Breastfeeding hormones *decrease* a person's sex drive: http://www.bellybelly.com.au/breastfeeding/libido-and-breastfeeding-whats-happened-to-my-sex-drive-now-i-am-breastfeeding#.UY50NYy9KSM

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    3. Trevor, every person has a different experience and a different reaction to the hormones. Breastfeeding increased my sex drive starting 6 months post-partum with all three of my children until they weaned at about 3 years of age. Don't be so narrow-minded and try to lump everyone's experience into a single definition.

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    4. J, you're right. I definitely should have said that "*in general* breastfeeding hormones decrease your libido." That may not be true for every person. Quite a few studies have found that this is the case for most people though. Breastfeeding hormones also affect most people's fertility (usually for about six months or so), but a few people are fertile within weeks of delivering even if they are breastfeeding. I find it interesting that you mention that the breastfeeding hormones increased your libido starting at about six months postpartum. What did you feel was their effect during the first six months?

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  15. ... wow, some of these comments are exactly what I'm talking about. These people clearly haven't read my prior post. Eh, I guess I should be thanking them for proving my point. These anti-intellectuals are an embarrassment.

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  16. I have to ask, have you heard of adopting (non trans) mothers doing this too? I've thought of adopting, but never would have considered going through a bunch of hormone treatments in order to breastfeed.

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    1. Yes, many adoptive mothers induce lactation and breastfeed. The Newman-Goldfarb protocols for induced lactation were developed for adoptive mothers and mothers of babies born to surrogates.

      It's not really 'a bunch of hormone treatments' in the standard protocol, it's just one, and it's no different from being on a birth control pill for a few months. In fact that's all it is.

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  17. Wonderful inspiring story! Breastfeeding is so worth fighting for, and it's great to hear it went so well for you.

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  18. This is amazing to read, I like the term "non-gestational parent" a lot and shall try and remember to use that rather than the more common and less thoughtful terms I've seen.

    I know how hard it can be to get medics to help you with their brains using "first principle" or "your knowledge my experience" thinking - I'm so pleased it worked out.

    And yes, wtf to the not giving trans women progestins, I'm not a trans woman myself but I know so many here in the UK who find the combination of oestrogens and progestins are really important.

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  19. Amazing Story! Congrats Mama! That relationship you get is so worth all the work! and amazing how much milk you had! :)

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  20. I'm not trans but I am parenting with my female partner. I'm also a midwife (homebirth) and have done a bit of work in GLBTQ fertility, birth, etc. I personally don't like ANY of the labels. You are both moms. I'm assuming you both have names, and I'm sure they could be used when addressing you. if there's a label to be given it's Mom. When my son was little bitty his class did family drawings. The kids were to label the members of their family. My son labeled us mom 1 and mom 2.

    Congratulations to you and your sweet family. What great parents your baby has.

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    1. Wholeheartedly agreed! 'non-gestational mom' is only for people who might need to make the distinction, like healthcare providers we had for the pregnancy or with whom we need to discuss his family medical history. It's 'Mama' and 'Mommy' to our little one and everyone else. Thank you for such kind words! He is a great baby too. :)

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  21. Breastfeeding requires effort and commitment. I found pumping difficult and draining, and really respect any person who is devoted to that work. I am humbled by this devotion, as well as those that are able to share their milk via milk banking. So much to learn!

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  22. When I shared this on Facebook it described the story as a transgender "dad" feeding "his" baby. No, it's a non-gestational mum. Please correct this.

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    1. Oh my! How embarrassing! My apologies. I think that when someone shares my blog on Facebook, the tagline for the whole blog in general comes up (I normally blog about my life as a breastfeeding, transgender dad). Obviously for this post that doesn't work at all! I've changed the tagline on the blog to say "Breastfeeding and parenting from a transgender perspective." Hopefully that will work for all my posts!

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    2. I hope that changing your tagline means that you will post more articles like this! There is so little info about trans parenting in general, especially for trans women. Thanks so much for the work that you do, for getting your experience out there, and also for reaching past your own experience to give us information! So glad to remember that we aren't alone in this!

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  23. I'm a breastfeeding counselor. I am also gay and consider myself to have more of a clue about LGTBQ issues than your average person, but in defense of the LLL Leader I have to admit that I sort of had the same response when this was first presented to me. I simply wasn't thinking it through. I had a woman ask me if a transwoman could breastfeed. I didn't realize at the time that she was transgender. My off the cuff response was "I don't think it would work." She quickly shot back, "Oh yes it could!" I immediately said, "Of course. Sometimes men lactate so it would be very possible." We had a great conversation about it. She told me that she had lactated but hadn't breastfed her baby. I encouraged her to consider it next time. I'm glad she didn't end the conversation due to my first thoughtless response.

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  24. the supportive comments here are awesome! still, i can't help thinking it's too bad that a lot of people's reaction is 'well men can lactate so trans women should be able to.' here's a thing to please think about: trans women aren't men, and trans women aren't like men. trans women's breasts are women's breasts. they develop in response to female hormones, they grow over a period of years, and they hurt when they grow. they are made of normal female breast tissue. you shouldn't need to think about men lactating to understand that women can. :)

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    1. It's less a matter of viewing transwomen as men and more a matter of considering that pre-op transwomen share physiology with cis men, and if a cis male's body is capable of lactating, then so will a transwoman's. Although at this point, it's been made abundantly obvious that the human body as it is is capable of lactating, regardless of biological sex, so I agree that it shouldn't be necessary to liken the two. However, for many people who've never considered that transwomen could lactate due to the fact that they lack "real" breasts, it's a good stepping stone for getting people to view transwomen differently.

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    2. Pre or post-op do not matter here: normally when we speak of surgery (as trans women) we are talking about genital surgery, which would have no effect on one's physiology as it applies to lactation. Neither would the other (relatively) common surgery of breast augmentation (which is functionally the same for Tran and cis women).

      Hormones, on the other hand, matter VERY much. Though I most likely have a Y chromosome, after four years of estrogen and progesterone, my breasts are decidedly female: C-cup, Tanner Stage 4, feminine nipples & areolae, Montgomery glands, and all the inner milk-glands and ducts (as confirmed by my recent 3D mammogram). My breasts are still filling-out and I will induce lactation to bring them to TS-5 maturity. I specifically added progesterone to my hormone therapy so that I would have functional breasts - I may not be able to bear a child, but I want to be capable of breastfeeding one. Anyway, I hope to be able to donate breast milk at least.

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    3. I am transwoman and completly disagree with your statement that ore/post ops wouldnt matter. the sexul reassignment sugery or orchiotmy removes the gland responsible for testosterone production. as such it would make lactatio easier and involve less mediation to supress testosterong

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  25. Thank you, blog moderators, for removing bigoted comments. We deal with enough transphobia all the time, the last thing we need is to see it in a super posi article like this.

    As a cis partner of a trans woman who hopes to start a family relatively soon, I am overwhelmed by all the positivity and lovely comments on this piece. I'm a doula, and sometimes it seems futile to even get the birth world to pay attention to gender variance. So glad to have a space like this.

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  26. Thank you for this. My four year old is likely transgender (MtF). One of our first indications of "gender creativity" occurred over a year ago. My daughter (at the time, my son) was watching me nurse her little sister and asked when he would grow boobies. Not knowing the turmoil going on within her I said that she was a boy and therefore wouldn't grow breasts. He was absolutely devastated - sobbed over that for a long time. Now she is firmly identified and living as a girl. Recently, again watching her little sister nurse, she asked me if she will be able to nurse her babies. I am studying to be a lactation consultant and told her that I believed she could (I was thinking the same sort of protocol that an adoptive mother would use would work). This is fantastic information and so inspiring! I am printing out this post to keep for her - you never know if this will be around on the internet in 20 or 30 years. I am excited at the idea that I might be able to help her nurse her children some day.

    ReplyDelete
    Replies
    1. Omg this is the sweetest thing ever. Thank you so much for sharing!

      Delete
    2. Ok, Gina, your post made me cry a bit. It is so wonderful for you to be making such a whole-hearted effort to be supportive and loving to your transgendered daughter. She is so lucky to get to walk this path with her family firmly behind her, educated and loving. All of us who know, love, and support transfolks thank you!

      Delete
  27. Thank you for posting this informative story. Looking forward to your book and the rest of the series. I'm sorry to hear about the negative experiences with LLL that others have had.

    ReplyDelete
  28. Thank you kris for sending me this link. As a trans FtM I was not aware of this, I shall be passing on this info to other trans folk.

    ReplyDelete
  29. Thank you, thank you, thank you for writing this post, for having this blog, and for Sarah for sharing her story. What a wonderful resource of information for so many. As a mother, bodyworker, and trans-advocate, I am deeply moved and amazed by the dedication, creativity, and love pouring out from this story and I can't wait to explore more of this blog. I also must say, as someone who has worked within the trans community for a number of years, I am so happy and hopeful to see these connections of support being drawn between the trans-masculine and trans-feminine communities!

    ReplyDelete
  30. Truly excellent and inspiring interview/article! Information about using and obtaining the proper hormone therapies can be so difficult to come by. Coupled with a beautiful story of partners and their new baby, this post is a win win win.

    ReplyDelete
  31. I have to admit, this is the first time I've ever heard of these kinds of things - which is pretty weird, when you consider how many transsexual/gender people there are! Of course, this would come up, and I have a mixed reaction to it. I'll start with the bad feelings first, so I can end on a positive note.

    Knowing a trans woman wants to genuinely breastfeed feels like a slap in the face, honestly. I mean, I'm born female, and I had a lot of adversity to overcome, so I feel like breastfeeding is womanly (born female kind of womanly) territory. It's also not something I'm used to even knowing about, so yes, I'm weirded out by this. I do not have phobias, nor do I go around judging others - but I do believe the Bible and as far as I know, it's pretty silent on this particular topic.

    On to the positives!

    I'm not sure if I should, from a Christian perspective, be honored that you want to be like those of us who have breastfed or see it as an insult...but it's obviously only out of concern for your baby, so I say kudos to you for having such dedication! You did what you believed was best for your son, and I congratulate you for it! And with all the adversity/ignorance you had to face? That's MUCH more than I had to face, as even I have some support to fall back on...even if it was mostly online (didn't get any RL support until 9 months into my BFing journey).

    Please don't take my negative points and blow them out of proportion or feel that I'm bashing those who are different from me. I wanted to congratulate this family on doing what they felt best for their child - whether I agree with the mechanics or not. But I also couldn't comment without offering my perspective, as I feel it would have been dishonest.

    ReplyDelete
    Replies
    1. "Knowing a trans woman wants to genuinely breastfeed feels like a slap in the face, honestly. I mean, I'm born female, and I had a lot of adversity to overcome, so I feel like breastfeeding is womanly (born female kind of womanly) territory."

      Thank you for that cissexist comment. It's so refreshing to read someone wallowing in their own privilege. We hardly ever hear from people like you. However, I think you'd be more at home at gendertrender(dot)com

      Delete
    2. This comment has been removed by the author.

      Delete
    3. (Typo-corrected version of the comment I removed above! I do my best prood-reafing after I hit "Send" {sigh})

      Goodness!!

      Kellan? You wrote: "I had a lot of adversity to overcome, so I feel like breastfeeding is womanly (born female kind of womanly) territory"

      Well, I too have had to overcome a *vast* amount of adversity to *become* myself, a woman: quite likely more than most natal women in the western world. My adversity has come from the male parts of my body, from men, from other women, family, and especially from fellow Christians who (from Jesus' example) should know better.

      Kellen? We *all* have our "stuff" and our bits of Hell to go through (mine include rapes, btw). Some have suffered more than us and some less. We are all responsible for how we live our lives in response...

      ...I have freely given-up what bits of "male privilege" I may have passively received (when I lived as a "man"), and I am not demanding "female privilege" by wanting to nurture children in this way. Those that can and are willing should be able do good works in loving-kindness that God enables them to do...

      ...Some natal women cannot nurse (my spouse is one), and some natal women are barren. Where is their birthright? Where is mine? I am female, and I got stuck having to "drive" a mostly male body for most of my life - can you even imagine the suicidal-grade **HELL** of what THAT felt like? (Please take a moment to try!)

      How about this? I will not claim to be a *natal* woman if you do not claim to be a *transsexual* woman. But it would probably be better for everyone if we simply dropped the adjectives from woman...okay?? please??

      Blessings & Joy!!

      Delete
  32. I finally finished researching and writing the next post in this series. You can check it out here: http://www.milkjunkies.net/2013/07/trans-women-and-breastfeeding-health.html

    ReplyDelete
  33. Wow!! This is quite inspirational. As a transwoman in the seventeenth month of my female puberty, I have been taking progestrone specifically so that my breasts will be fully functional. I may not be able to bear a child, but I want to at least be able to nurse one.

    ReplyDelete
  34. Thank you so much for this, it was a tremendously heart warming read! I'm adopted and my mother has frequently cried about not being able to breastfeed me and how she wished she had that bond, there was just zero support in the 80s for that kind of thing. She remembers judgey mothers in the mother's rooms looking at her formula bottle and sucking their teeth. Just awful.

    Thank jeebus for the internet, eh? I hope many women seemingly unable to breastfeed due to being non-gestational mothers see this and have hope and start arming themselves with the tools to make it happen.

    ReplyDelete
  35. Thank you, thank you, thank you!!!

    Previously the only info I've found on breastfeeding for trans* women was scattered newsgroup rumours. We desperately need harder information on this available. I DO hope to be a mother someday, and if so will do my darnedest to feed my child from my body. It's ever so important.

    I'd like to add that when I started on hormones ten years ago, that I over did it with the spironolactone a bit. The result was lactation! Turns out it's a a side effect. I was rather scared at first; I thought the puddle was from me drooling. When I found it was increasingly milky and from my breasts, I feared cancer. But it's actually a known side effect. Something to ponder for pre/non op TG women.

    ReplyDelete
    Replies
    1. I was told point blank by doctors that because i have been on estrodiol that i would never have children. im a transwoman maried to a cis female. were attempting to get pregnant now. untill i read this i was thinking it would never be possible.

      Delete
  36. I'm sorry you didn't reach a supportive, kind, dare I say intelligent LLL Leader. That was a bad luck of the draw--if you had reached me I would've been glad to work with you, and learn from you, too. Thanks for sharing your story.

    ReplyDelete
  37. Do you have a blog entry about trans men who would still like the option of having kids and breastfeeding? It's kind of implied, but I didn't see a link anywhere.

    ReplyDelete
  38. What an excellent blog you have here! Thank you for sharing this. I am a sociologist beginning a new research project into "queering" the notion of breastfeeding. One only has to scroll up on these comments to see someone express the prevailing idea that breastfeeding is somehow only for feminine birthmothers. I am looking for trans* folk to participate in anonymous interviews with me (also biological males who are cisgender yet breastfeeding), anyone who is co-feeding, adoptive parents, two-parent breastfeeding families, non-feminine identified breastfeeding parents, etc. Please send me an email at krwilson@cabrillo.edu if you think you may be able to skype, email, or meet in person (in person only if you are in the Bay Area, CA or in Atlanta). Also tell your friends who are breastfeeding or who breastfed in the past. I would so appreciate it! On a personal note, I induced lactation in order to nurse my adopted child. Kristin J. Wilson, Ph.D.

    ReplyDelete
  39. My only concern is if the medications she takes to indice lactation and the hormones would effect a developing boys body. Im not sure if these medications metabolis quickly and do not appear in the milk or if u pumped around doses...

    ReplyDelete
  40. the only thing i don't understand is why they choose to coercively assign a gender to their child when they're still so young? are they just taking bets and pretending like in-all-likelihood their "son" will be cis-gendered?

    ReplyDelete
  41. I am so glad I found this Article. As a trans woman who is about to become a mother this article has been a wonderful inspiration to me and the possibilities of being transexual and able to breastfeed my baby. There is so little information on this topic available that it really makes this article even more inspiring and I appreciate and thank you for sharing your story with me.

    ReplyDelete
  42. Hi Trevor,

    I tried to contact via email, but I'm not sure it went through…so forgive me for trying here as well! I'm working on a project in collaboration with an endocrinologist (Dr. Brad Kolb): "Love Comes First: Creating LGBT Families." We try and address all aspects of family building through personal stories, cultural interview and up-to-date medical information. As such, we would love to talk to you about your inspiring experiences as a dad. Would you be able to email me at: mmaerker@me.com? Thank you so much! Melinda

    ReplyDelete
  43. I had been taking estrogen for several years before attempting to induce lactation, and I also followed a variation of the Newman protocol. I continued taking my normal estrogen dose (instead of a birth control pill) but added progesterone and domperidone for the month leading up to "delivery", and then ceased the estrogen and progesterone, leaving only the domperidone (the drop in estrogen and progesterone is what triggers lactation)

    The very first time I tried using the breast pump 3 or 4 miniature beads of clear liquid emerged from each nipple (I wasn't aware that milk came through multiple pores and not a single stream until then), but like Sarah got virtually nothing more than that for over a week. After 4 weeks I was still barely making enough per day to cover the bottom of the pump bottle, so I gave up.

    Just over a year later it was time to try again, and this time I started the progesterone and domperidone 4 months prior to inducing lactation. This time I got a few drops of milk right away, but on one side the milk had a brownish color (something called "rusty pipe syndrome") but that cleared up after a day or so. At that point I also decided to increase the domperidone to the maximum recommended dose and after a week I was pumping almost an ounce a day. Over the course of several months as I started to decrease the dose, I found that my milk supply *increased* each time I did (with a lag of about 3 or 4 days). By month 5 I was pumping about 6 oz per day, which is where I stayed.

    Some interesting things I learned:

    1) Each time I pumped I immediately started to feel thirsty, and also slightly aroused. Apparently this is normal, and the arousal is because the hormone responsible for let-down (aka milk ejection reflex) is the same one that involved in orgasm (oxytocin). Apparently it is not uncommon for nursing mothers to release milk during "adult activities" as well.

    2) It took anywhere between 45 and 90 seconds for let-down to happen and the milk to start dripping, and then after a few minutes build up to a stream, then back down to a drip, then back to a stream in a cycle every 4 minutes or so.

    3) One day a week in particular I was unable to follow my normal pumping schedule and had to wait until early afternoon to have my first pump. These days my breasts became very hard and it was painful to lean against anything (like a railing). When I did finally pump I was still only able to pump a typical "morning" amount, though the following day I would always make more than average but would then level back out the rest of the week.

    ReplyDelete
  44. "assigned at birth"? there are bigger issues than using this nomenclature. It just makes transexuals look petty.

    ReplyDelete
    Replies
    1. "bigger issues"...um I suppose so, but as a transsexual woman myself, I find the nomenclature to be useful, even important in many ways. I was assigned male at birth, but if the one who did this had more information, even in interpreting my body's appearance, I might never have had that assignment. Sorry if this makes me "look petty" - I assure you, I am anything but!! Blessings!! :-)

      Delete
  45. I am an LLL Leader and I'm sorry to hear of the disappointing encounters some of you have had. Please don't judge all of us by those who let their personal opinions influence what they say. My kids are in their 20s and 30s now, but way back in the day, before any trans issues were in the media, I always said that I felt like men had nipples so that they could soothe the baby if mom was busy and they needed quiet in the cave while the lions, tigers and bears roamed nearby. It's nice that with modern day innovations anyone who wants to nurse their baby can give it a try. Good luck to all and ignore any naysayers.

    ReplyDelete
  46. Hi, Is it possible for "Sarah" to contact me? Please give her this message, if you can. My girlfriend and I are about to start the lactation process of this and I would love to be able to talk directly with this couple for more support and questions. We already learned so much about this process from this blog post so thank you so much for this. My e-mail is dalina.student@gmail.com

    ReplyDelete
  47. It would be nice if the moderator could clean-up the spam messages here. This is a useful article with (often) helpful comments, but the spam is *really* a problem. I am seeing 10 spam messages for every legitimate one. {sigh}

    ReplyDelete
    Replies
    1. I'm so sorry! The spam really did get away from me. Thought it was just going into a spam folder but it must have switched over to getting published and I didn't notice. This should be better now.

      Delete
  48. Thank you, thank you, thank you for this post! I am a ciswoman and dating a transwoman, we were wondering if it would ever be possible for us to conceive a child. Hearing that Sarah was able to after 10 years of hormones is very exciting and gives me a lot of hope! Prior to this my girlfriend had tried to find some answers about fertility from the internet and wasn't having much luck. We cannot afford to have her sperm frozen, unfortunately. I wonder how common Sarah's experience is, do some transwomen have more difficulty conceiving a child?

    ReplyDelete
    Replies
    1. I am so glad that you found this post helpful! Unfortunately, I have no idea if Sarah's experience is common or not, simply because there is zero research about this at this time. I would love to organize a research study to investigate this at some point in the future. Please email me at milkjunkies (at) ymail (dot) com if you think your family might be interested in participating and you wouldn't mind me contacting you.

      Delete
    2. while i didnt know about the breast feding i do know about the sperm. im a transwoman and with a cis woman. we actually concieved twis once a few years a go. ive been on hormones for 5 years. you just have to stop estrodiol and spiro for several months. yull se a differenc in color and consistency when the swimmers come back. hope this helps. add me on fb if you wanna talk

      Delete
  49. Always wanted to have a baby of my very own, even adopted would be fine for me to breast feed while I am medical retired. That is one of the things I always wanted to do.

    ReplyDelete
  50. This comment has been removed by a blog administrator.

    ReplyDelete
  51. You might like to contact a lady by the name of Beth Blair for sound, experiential, - tried and proven - protocols for inducing and maintaining (transgender) lactation. Start looking on the Yahoo Group, Do it Yourself Hormones.

    ReplyDelete
  52. Coming back from a hiatus of some duration, I am now in the "2nd trimester" of a simulated pregnancy as part of my lactation protocol.

    Over the last two months, I have boosted my prolactin significantly, have watched in wonder as my breasts are "ripening" and I have begun to express colostrum in greater amounts. My volume is still quite low.

    A few days ago, I more than doubled my estradiol and progesterone, simulating the steep increase in both of these hormones as pregnancy continues into the 2nd trimester. I am starting to feel the (hormonal) effects associated with pregnancy: bloating and appetite changes. No cravings yet.

    My goal is twofold: I wish to bring my breasts to full Tanner Stage 5 maturity (am TS-4+ currently) and I would like to wet nurse and/or donate breast milk.

    I am documenting my progress in the "Trans HRT Hormone Forum" on Facebook in post & thread titled: "INDUCED LACTATION - A Trans Woman's Experiment"

    The protocol I am using is the Newman Goldfarb Protocols for Induced Lactation. For safety sake, I modify the protocol by using bioidentical estradiol and progesterone instead using ethinyl estradiol and progestins from birth control pills (as the protocol suggests). Conjugate hormones are dangerous at the levels required for pregnancy, which is why I am going with bioidentical ones.

    Once my milk comes in fully, I will be looking to see how I can benefit someone else with it.

    ReplyDelete
  53. I just stumbled across this article and I have to tell you, I love it. My girlfriend gets very upset when she thinks about her inability to carry a child. Even though she has my two children that she loves dearly, I know that she wants one of her"own" and in a few years we may adopt. I breastfed both of mine, and know how rewarding it is, and feel that if she wants to breastfeed, she should. Now I can tell her its possible! Shes going to be so happy!

    ReplyDelete
  54. This comment has been removed by a blog administrator.

    ReplyDelete
  55. I am an LLL Leader and I'm sorry to hear of the disappointing encounters some of you have had. Please don't judge all of us by those who let their personal opinions influence what they say. My kids are in their 20s and 30s now, but way back in the day, before any trans issues were in the media, I always said that I felt like men had nipples so that they could soothe the baby if mom was busy and they needed quiet in the cave while the lions, tigers and bears roamed nearby. It's nice that with modern day innovations anyone who wants to nurse their baby can give it a try. Good luck to all and ignore any naysayers. - shahid maqbool

    ReplyDelete
  56. This comment has been removed by a blog administrator.

    ReplyDelete
  57. I am an LLL Leader and I'm sorry to hear of the disappointing encounters some of you have had. Please don't judge all of us by those who let their personal opinions influence what they say. My kids are in their 20s and 30s now, but way back in the day, before any trans issues were in the media, I always said that I felt like men had nipples so that they could soothe the baby if mom was busy and they needed quiet in the cave while the lions, tigers and bears roamed nearby. It's nice that with modern day innovations anyone who wants to nurse their baby can give it a try. Good luck to all and ignore any naysayers. - Sheikh Mohammad Bilal

    ReplyDelete
  58. Thank you so much for sharing this story! I was just Google browsing for tips on tissue growth/hormone stimulation/calorie burning— but I never thought of the gift of bonding it would give ❤ Thank you again for sharing!!

    ReplyDelete
  59. I've posted a new interview with another trans woman about her breastfeeding experience. Hope you all find it helpful! http://www.milkjunkies.net/2017/05/jennas-breastfeeding-journey-trans.html

    ReplyDelete
  60. http://www.dailymail.co.uk/sciencetech/article-2915086/Fat-women-s-bottoms-makes-babies-brains-say-scientists-curvy-girls-producing-intelligent-children.html

    ReplyDelete
  61. Jesus has saved me, and calls me Beloved :-)

    Most female people become women through their girlhood and adolescence. *This* female person has become through her transgender/intersex nature and experience. Part of that experience has included inducing lactation to the point where I can nourish a child!

    ReplyDelete
  62. I appreciate hearing your story and am very encouraged by it. However, I was disturbed to see your comment about the helpfulness of co-sleeping, by which I believe you meant bed-sharing. Bed-sharing is incredibly dangerous and a leading cause of SIDS. I'm glad you ended up having a positive experience, but please don't spread the message that it is a positive thing to do, when it can cause tragedy for many well-intentioned parents.

    ReplyDelete
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  64. Previously the only info I've found on breastfeeding for trans* girls was sprinkled newsgroup rumours. We desperately need harder information on this accessible. I DO expect to be a mom someday, and when this will do my darnedest to feed my kid from my body. It is ever so important.
    I'd like to add that when I started on hormones ten years ago, that I did it with the spironolactone a bit. The result was lactation! Turns out it has a a side effect. I was rather scared at first; I thought the puddle was from me drooling. As soon as I discovered it was increasingly milky and out of my breasts, I dreaded cancer. But it's actually a known complication.
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