Chest is best, even if you're male?

(Trans)mother's milk

A branch of the NHS, Britain’s national health service, has come under fire after stating on the record that “milk” produced by “transwomen” (after taking a number of drugs to induce the body to produce it) is just as good as mother's milk.

[“Milk” produced by “transwomen”] is comparable to that produced following the birth of a baby.

The institution in question, University of Sussex Hospitals NHS Trust, was the first trust in the UK to adopt the term “chestfeeding.” Faced with public backlash at its statement on the “milk” produced by “transwomen,” it doubled down and defended its position, citing a number of studies from the 1970s related to genuine mother’s milk as well as a single short-term study that showed “no observable side effects” in babies who nursed from milk containing testosterone in small quantities.

The Trust also noted that it advises any parent taking any medication to seek advice on the “health implications for the baby.” Obviously, no male can “chestfeed” a baby without taking a variety of drugs, and most males identifying as females are already on a number of drugs to address their dysphoria. Since this phenomenon is relatively recent, there are no long-term studies on the implications for the growing child nourished on a bodily fluid produced by such men.

Possible effects on baby's cardiac health  

One of the drugs commonly taken by “transwomen” trying to nurse their babies is domperidone, which is actually an anti-nausea drug prescribed off-label to (among others) lactating mothers who want to increase their milk supply. Like any drug, it has side-effects; in fact, its manufacturer, Janssen, actually recommends against using it to stimulate milk production due to the possible effects on the cardiac health of the baby. 

Domperidone is also an “unintended antipsychotic,” a dopamine blocker which can cause anyone taking it to experience insomnia, depression, anxiety, and nervous system problems. It crosses the blood-brain barrier in unknown and unpredictable amounts, with similarly unknown and unpredictable results in a baby exposed to it or being weaned off any liquid containing it.

The NHS Trust has since removed its webpage where its trans chestfeeding guidance was published. Instead, it directs readers to La Leche League’s site.

La Leche League

One of the concepts La Leche League is founded on is that: human milk is the natural food for babies, uniquely meeting their changing needs.

Human milk is amazing. It has everything a growing baby needs in exactly the right amounts...

La Leche League (LLL) is probably the most well-known organization in the world promoting breastfeeding. It draws on established research when making statements such as the ones above, and one would be hard-pressed to find a medical professional anywhere who disputes that mother’s milk is by far the best of all options for babies.

Yet, when discussing trans issues, La Leche League suddenly veers away from rigorous science and enters the world of dogma:

Trans men, trans women, and non-binary individuals may choose to breastfeed or chestfeed their babies. You do not need to have given birth to breastfeed or chestfeed, as we can also see in the experience of those nursing adopted babies.

Citing women who have adopted babies as evidence that “trans women” can also nurse their babies is somewhat disingenuous. Interestingly, LLL doesn’t provide any evidence to support its assertion, although when discussing the ability of “transwomen” to “chestfeed,” it links to a (single) case study of a biological man who apparently managed to become “the sole source of nourishment for her child for 6 weeks.”

LLL also offers no opinion on the cocktail of drugs this biological man was taking to deal with panic disorder and other issues: spironolactone, estradiol, progesterone, clonazepam, and zolpidem.

No going back

If one wants to rely on isolated case studies as evidence, there are plenty describing women who have had so-called top surgery and were later devastated at their inability to nurse their babies. One woman writes:

I only got him to latch on once for like 10s and it was glorious. I was like, oh my God, at least I got to feel that at least—I got to experience that little bit and I’ll never forget it but beyond that he never would...

La Leche League touches only briefly on this topic, writing that

If you have had chest (top) surgery you may be able to produce some milk …

Who's the baby?

LLL also cites “a transgender dad” who describes describes a parent-centered approach to nursing:

some trans people experience severe gender dysphoria when breast or chestfeeding, and ... may decide not to nurse their babies for mental health reasons. 

Weighing in on the debate, “With Women,” a campaign group of midwives and breastfeeding experts, summed up the issue neatly: 

Breastfeeding is for babies, not their parents. Any emotional benefit gained by the parent is a bonus, and should never be viewed as a higher priority than the baby's own needs, both nutritional and emotional.