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By
Rachael Rettner
published February 16, 2018
A transgender woman was able to produce enough milk to breast-feed her partner's newborn baby for six weeks, according to a new report of the case.
The report is the first in the medical literature to formally document lactation in a transgender woman, the researchers said.
The transgender woman was able to breast-feed after undergoing a regimen of hormonal therapy along with the use of a breast pump, in a process similar to what's done for women who cannot produce breast milk on their own (including women who want to breast-feed after adoption). [ Men vs. Women: Our Key Physical Differences Explained ]
"We want to present our patients with the full range of reproductive choices, and this is one step closer to that," Dr. Tamar Reisman, an endocrinologist at Mount Sinai hospital's Center for Transgender Medicine and Surgery in New York, told the Washington Post .
The report was published in the January issue of the journal Transgender Health.
It's known that people who are born male can produce milk — for example, men who undergo hormonal treatment for prostate cancer can, in some cases, develop breast fullness and lactate, said Dr. Maurice Garcia, the director of the Transgender Surgery and Health Program at Cedars-Sinai Medical Center in Los Angeles, who was not involved with the case. However, men don't usually lactate much because of the differences in hormone levels between men and women. But the new case shows that this transgender woman produced enough milk to sustain a baby for six weeks, which is "terrific," Garcia said.
The report underscores the anatomic similarity between the sexes, which is greater than many people appreciate, Garcia told Live Science. It's "encouraging that we can build on this anatomic homology between the genetic sexes … to help [transgender people] bring their bodies more in line with their gender."
In the new case, the patient first began taking feminizing hormones in 2011 as part of her gender transition . Then, in 2017, she asked her doctor about the possibility of breast-feeding her partner's baby. Her partner was pregnant at the time, but did not plan on breast-feeding. The transgender woman hoped to be the primary food source for the child, whom she would also adopt, the report said.
The patient underwent a three-month course of treatment, which included the drugs domperidone and the hormones estradiol and progesterone. (Domperidone is a drug that increases levels of prolactin, which aids in lactation. The drug is not approved for use in the United States, and the patient in this case obtained it from Canada.) She also took spironolactone, which blocks testosterone.
The woman breast-fed the baby for six weeks and then began supplementing the breast milk with formula because she was concerned that her milk supply had become insufficient for the child. The baby is currently 6 months old, and is growing and feeding normally, the report said.
More research is needed to optimize treatments for transgender women who want to breast-feed, the report said. For instance, it's not known whether all of the hormones and drugs used in this case were needed to achieve lactation, or whether adjusting the doses could lead to even greater milk production.
Rachael has been with Live Science since 2010. She has a master's degree in journalism from New York University's Science, Health and Environmental Reporting Program. She also holds a B.S. in molecular biology and an M.S. in biology from the University of California, San Diego. Her work has appeared in Scienceline, The Washington Post and Scientific American.
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NY 10036.
Discovery of 'hidden world' under Antarctic ice has scientists 'jumping for joy'
Dinosaur 'reaper' with massive claws found in Japan
Perseverance rover accidentally adopts hitchhiking 'pet rock'
Contact me with news and offers from other Future brands
Receive email from us on behalf of our trusted partners or sponsors
The ultimate action-packed science and technology magazine bursting with exciting information about the universe
More stories to check out before you go
Live Science is supported by its audience. When you purchase through links on our site, we may earn an affiliate commission. Here’s why you can trust us
By
Rachael Rettner
published February 16, 2018
A transgender woman was able to produce enough milk to breast-feed her partner's newborn baby for six weeks, according to a new report of the case.
The report is the first in the medical literature to formally document lactation in a transgender woman, the researchers said.
The transgender woman was able to breast-feed after undergoing a regimen of hormonal therapy along with the use of a breast pump, in a process similar to what's done for women who cannot produce breast milk on their own (including women who want to breast-feed after adoption). [ Men vs. Women: Our Key Physical Differences Explained ]
"We want to present our patients with the full range of reproductive choices, and this is one step closer to that," Dr. Tamar Reisman, an endocrinologist at Mount Sinai hospital's Center for Transgender Medicine and Surgery in New York, told the Washington Post .
The report was published in the January issue of the journal Transgender Health.
It's known that people who are born male can produce milk — for example, men who undergo hormonal treatment for prostate cancer can, in some cases, develop breast fullness and lactate, said Dr. Maurice Garcia, the director of the Transgender Surgery and Health Program at Cedars-Sinai Medical Center in Los Angeles, who was not involved with the case. However, men don't usually lactate much because of the differences in hormone levels between men and women. But the new case shows that this transgender woman produced enough milk to sustain a baby for six weeks, which is "terrific," Garcia said.
The report underscores the anatomic similarity between the sexes, which is greater than many people appreciate, Garcia told Live Science. It's "encouraging that we can build on this anatomic homology between the genetic sexes … to help [transgender people] bring their bodies more in line with their gender."
In the new case, the patient first began taking feminizing hormones in 2011 as part of her gender transition . Then, in 2017, she asked her doctor about the possibility of breast-feeding her partner's baby. Her partner was pregnant at the time, but did not plan on breast-feeding. The transgender woman hoped to be the primary food source for the child, whom she would also adopt, the report said.
The patient underwent a three-month course of treatment, which included the drugs domperidone and the hormones estradiol and progesterone. (Domperidone is a drug that increases levels of prolactin, which aids in lactation. The drug is not approved for use in the United States, and the patient in this case obtained it from Canada.) She also took spironolactone, which blocks testosterone.
The woman breast-fed the baby for six weeks and then began supplementing the breast milk with formula because she was concerned that her milk supply had become insufficient for the child. The baby is currently 6 months old, and is growing and feeding normally, the report said.
More research is needed to optimize treatments for transgender women who want to breast-feed, the report said. For instance, it's not known whether all of the hormones and drugs used in this case were needed to achieve lactation, or whether adjusting the doses could lead to even greater milk production.
Rachael has been with Live Science since 2010. She has a master's degree in journalism from New York University's Science, Health and Environmental Reporting Program. She also holds a B.S. in molecular biology and an M.S. in biology from the University of California, San Diego. Her work has appeared in Scienceline, The Washington Post and Scientific American.
Stay up to date on the latest science news by signing up for our Essentials newsletter.
Thank you for signing up to Live Science. You will receive a verification email shortly.
There was a problem. Please refresh the page and try again.
Live Science is part of Future US Inc, an international media group and leading digital publisher. Visit our corporate site (opens in new tab) .
©
Future US, Inc. Full 7th Floor, 130 West 42nd Street,
New York,
NY 10036.
Health | Transgender Woman Breast-Feeds Baby After Hospital Induces Lactation
Transgender Woman Breast-Feeds Baby After Hospital Induces Lactation
On Being Transgender in America Phalloplasty: The surgery, used to construct a penis, has grown more popular among transgender men. But with a steep rate of complications, it remains a controversial procedure . Elite Sports: The case of the transgender swimmer Lia Thomas has stirred a debate about the nature of athleticism in women’s sports. Transgender Youth: A photographer documented the lives of transgender youth . She shared some thoughts on what she saw. Corporate World: What is it like to transition while working for Wall Street? A Goldman Sachs’ employee shares her experience.
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When a transgender woman told doctors at a hospital in New York that she wanted to breast-feed her pregnant partner’s baby, they put her on a regimen of drugs that included an anti-nausea medication licensed in Britain and Canada but banned in the United States.
Within a month, according to the journal Transgender Health , the woman, 30, who was born male, was producing droplets of milk. Within three months — two weeks before the baby’s due date — she had increased her production to eight ounces of milk a day.
In the end, the study showed, “she was able to achieve sufficient breast milk volume to be the sole source of nourishment for her child for six weeks,” according to the journal.
Dr. Tamar Reisman and Zil Goldstein, a nurse practitioner, of the Mount Sinai Center for Transgender Medicine and Surgery in New York, say the case illustrates that, in some circumstances, modest but functional lactation can be induced in transgender women who did not give birth or undergo surgery.
“We believe that this is the first formal report in the medical literature of induced lactation in a transgender woman,” said the study’s authors, Dr. Reisman and Ms. Goldstein , a transgender activist and program director at the center. They were not immediately available for comment on Thursday.
Some hailed the case study, published in January, as a “breakthrough” for transgender families; others called it “dangerous” and “disturbing.” But if confirmed in wider studies, the regimen could represent a next major stage in transgender parenthood. Transgender men like Thomas Beatie , Trystan Reese and Kaci Sullivan have made headlines by giving birth. But breast-feeding for transgender women had not been officially documented.
Breast milk is considered the best form of nutrition for infants. Breast-fed babies have healthier immune systems, score higher on I.Q. tests and may be less prone to obesity than other babies. Advocacy campaigns have noted that the practice facilitates mother-child bonding, and saves families from spending money on infant formula. The World Health Organization, in setting new international bench marks for children’s growth, has said that breast-feeding is the biological norm.
But in the case published in Transgender Health, it is not known whether breast milk from this kind of induced lactation is equivalent to milk produced after giving birth by women who are not transgender.
Dr. Joshua D. Safer, medical director of transgender medicine and surgery at Boston Medical Center, called the study “a very big deal” and said he expected it to become very popular among transgender women.
“It’s out there on internet forums, but there’s a lot on the internet that’s true or untrue to varying degrees,” he said in an interview with the weekly magazine New Scientist. “It’s a very big deal to have this recorded in a reliable document.”
Others were skeptical about the study and what it could mean for transgender women.
“We all want to have the same experiences as women,” Maria Clifford, 38, a British transgender mother who has been using a surrogate to breast-feed her child, said on Thursday. “We need further testing and evidence to show that these drugs aren’t going to cause harm to the baby.”
“Breast milk is the most important product for the development of a child,” Ms. Clifford added. “We need to make sure it’s pure and hormone free.”
The transgender woman in the experiment — she, her partner and their hometowns were not identified — approached the medical professionals for hormonal medications in 2011 as part of transgender treatment. She had been receiving it for several years before she began breast-feeding, according to the study. She had not had gender-reassignment surgery nor breast augmentation.
She took on the responsibility of breast-feeding because her partner, who was five months pregnant when they approached the hospital, did not want to.
As part of the lactation treatment, the woman stimulated her chest using a breast pump. The study’s authors prescribed progesterone and estradiol, hormones that can influence lactation and that normally occur in pregnant women. They discussed with the couple using domperidone, an anti-nausea drug known to increase breast milk production.
The couple obtained it on their own in Canada, and Ms. Goldstein and Dr. Reisman advised them on the dosage. Though used in many countries, including in Britain , domperidone has been banned in the United States because of Food and Drug Administration concerns about its associations with cardiac arrest and sudden death.
Previous studies with transgender women have reported only the basic framework for what is known as nonpuerperal induced lactation, the process by which women are stimulated to lactate.
“There have been self-reported cases online of transgender woman trying to D.I.Y. regiments to induce breast-feeding, but this is the first case of induced functional lactation in academic literature,” Dr. Reisman was quoted in the journal as saying.
The study’s authors said that the woman was able to exclusively breast-feed the infant for six weeks. During that time, a pediatrician reported that the child’s growth, feeding and bowel habits were developing normally.
At six weeks, the woman began to supplement breast-feeding with a formula because of concerns about milk volume.
The woman’s hormone regimen was considered safe and similar to ones used on mothers who are unable to produce milk. But she continued to take the drug spironolactone, which blocks testosterone and “is excreted in human milk,” the study said.
The baby is now 6 months old, the study’s authors said. They wrote that it was unclear which parts of the regimen were most beneficial to producing milk.
Future areas of study include “the optimal dosing of estradiol, progesterone and galactogogues in inducing lactation, as well as the optimal frequency and duration of pump use,” they said.
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