Doctors hail breakthrough and say case shows ‘modest but functional lactation can be induced in transgender women’

This article is more than 2 years old

This article is more than 2 years old

A 30-year-old transgender woman has been able to breastfeed her child, the first ever case of induced lactation in a transgender woman to be documented in academic literature.

Doctors said the case shows “modest but functional lactation can be induced in transgender women”. The account was published in Transgender Health.

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Tamar Reisman of Mount Sinai hospital in New York, one of the doctors who reported the case, said: “Transgender medicine is becoming part of mainstream medicine. We’re getting more evidence-based data, we’re getting more standardized care, we’re getting more reproductive options.”

The transgender woman went to doctors when her partner was five months pregnant. She said her partner did not want to breastfeed the couple’s child, so she hoped to take on the responsibility.

Reisman and Zil Goldstein wrote that the woman was being treated for insomnia and anxiety, but otherwise appeared to be a “pleasant, well-nourished, well-developed woman”.

The patient had taken hormone therapy for six years, but had not had gender reassignment or breast augmentation before she approached doctors. Reisman and Goldstein used a framework known to induce lactation in cisgender women who had not experienced a pregnancy to promote the patient’s lactation.

The 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.

Domperidone is used internationally but it is not approved in the US, because in some intravenous instances it produced cardiac arrhythmias, cardiac arrest and sudden death. It is licensed to treat nausea in the UK. The patient obtained the drug from Canada.

Reisman said that with an optimized hormone regimen it may be possible to induce lactation without domperidone, because chest stimulation naturally increases the breast milk-producing hormone prolactin.

“There have been self-reported cases online of transgender woman trying DIY regiments to induce breastfeeding, but this is the first case of induced functional lactation in the academic literature,” Reisman said. There are also cases of transgender men carrying pregnancies and breastfeeding, she said.

However, Reisman said the case has also attracted questions about whether men could now breastfeed. “That, implicitly, is saying that you see transgender women as cisgender men, which is transphobic,” she said.

Joshua Safer, an endocrinologist at Boston Medical Center not involved in the case, told the New Scientist the report is “a very big deal”.

“Many transgender women are looking to have as many of the experiences of non-transgender women as they can, so I can see this will be extremely popular,” Safer said.