A Trans Woman Was Able To Breastfeed For The First Time & It’s A Major Step Forward

As a transgender person, I often get awkward questions when people ask if and how I plan to have biological kids. I don't plan to, but since I was designated female at birth, I could conceive, carry, and breastfeed a child, if I wanted to. And now, thanks to a breakthrough case study report published recently in Transgender Health, trans women who were designated male at birth may be able to breastfeed their own children, too. The report documents the successful treatment that allowed a 30-year-old trans woman to breastfeed her child, the first ever documented instance of this being possible. According to the report, "[t]his case illustrates that, in some circumstances, modest but functional lactation can be induced in transgender women."

The woman approached a clinic for help inducing lactaction because her partner, who carried their baby, wasn't interested in breastfeeding, but she was. According to the report, the woman had been undergoing hormone replacement therapy, which is part of medical transitioning for many trans people, since 2011.

To induce lactation, "[t]he patient took a gradually increasing regimen of the female hormones progesterone and estradiol, stimulated her chest with a breast milk pump, and took domperidone, a nausea medication known to increase milk production," The Guardian explained. Domperidone, which the woman obtained from Canada, "is used internationally but it is not approved in the US [sic], because in some intravenous instances it produced cardiac arrhythmias, cardiac arrest and sudden death," according to The Guardian, which added that domperidone is licensed to treat nausea in the U.K.

Tamar Reisman of Mount Sinai hospital in New York, one of the doctors who reported the case, told The Guardian, "There have been self-reported cases online of transgender woman trying DIY regimens to induce breastfeeding, but this is the first case of induced functional lactation in the academic literature."

After one month of being on the prescribed regimen, which had been used to increase lactation in cisgender women, the woman was able to "express droplets of milk," according to the report. Doctors then increased her use of a breast pump to six times daily, for five minutes per session. At the three-month mark, which was two weeks before her baby's due date, the woman was producing eight ounces of milk per day,

Board-certified lactation consultant Nancy Mohrbacher says on her website that cisgender women who breastfeed can expect to be producing about 30 ounces of milk around day 40 of breastfeeding, and that many women produce just one ounce in the early stages of breastfeeding.

The trans woman documented in the case study "breastfed exclusively for 6 [sic] weeks" and "[d]uring that time the child's pediatrician reported that the child's growth, feeding, and bowel habits were developmentally appropriate." After the first six weeks, the woman began supplementing her own breast milk with four to eight ounces of formula per day in order to be sure her baby was getting adequate nutrition, according to the report.

At the time of the report's publication, the woman's baby was six months old, and was still successfully breastfeeding, the report indicated.

Reisman told The Guardian that "[t]ransgender medicine is becoming part of mainstream medicine," and that, "We're getting more evidence-based data, we're getting more standardized care, we're getting more reproductive options."

Another breakthrough reproductive option emerged in 2017 from scientists at the University of Pennsylvania medical center, who are due to begin clinical trials testing the possibility of full womb transplants. "The highly anticipated experimental procedure would allow women without a uterus due to the disease uterine factor infertility (UFI) a second chance at carrying a child, and even may offer transgender women born without the organ a chance to carry children as well," Newsweek reported.

Reproductive care and options for trans people have certainly come a long way since the much-sensationalized "pregnant man" case back in 2009, and the potential advent of trans women being able to breastfeed (and possibly even carry) their children is truly a breakthrough on many fronts. But considering how much stigma trans people still face in healthcare, we still have a long way to go.