Trans Women, Lactation, and Exclusion

While I have discussed the obstacles faced by cis women who wish to breastfeed many times, I have neglected to delve into the reality of trans women and their experiences with breastfeeding. This is unacceptable, and a reflection of the cis privilege that I enjoy. Contrary to popular belief, almost every person regardless of gender has the necessary equipment to nurse a child. If you have a healthy breast, you can probably breastfeed.

Now, when a cis woman wants to breastfeed, she is in for an uphill battle. She will get so much misinformation from health care professionals, well-meaning relatives, friends, and advertisements. Her decisions on when and how frequently to nurse are going to be policed by total strangers. If she nurses for “too long,” people will accuse her of being selfish (as if there were no health benefits to full-term nursing or child-led weaning); if she doesn’t nurse “long enough,” then people will accuse her of being vain or lazy (as if there were no legitimate reasons to choose not to nurse or to choose mother-led weaning), which not only is disrespectful to a woman’s bodily autonomy, but also feeds the “rabid baby-fetishing mommy-guilting breastfeeding zealout” meme and turns more women off to even considering breastfeeding in the first place. If she wants to take breaks at work to pump, she will have to deal with coworkers and superiors who may be less than understanding.

That’s just the tip of the iceberg for cis women. For a trans woman, take all of those issues and multiply them by a million.

Misinformation regarding, well, almost anything about trans women’s lives is regurgitated and unchallenged by the vast majority of the cis population (who, naturally, dominate the medical profession as well as every other discipline of our society). Trans women have to deal with discrimination from the medical community on a horrific level; things that cis women do without much thought, such as filling out medical forms, are not such a carefree task for trans folks. When I see a new doctor for the first time, I don’t have to wonder if she is going to be so bigoted against me that she will not even enter the room or touch me.

While I feel snug and protected by the laws in my state that guarantee my right to nurse publicly, trans women do not have the same luxury. They cannot take for granted that someone will not challenge them (or arrest them!) on the basis that they are “not really women.”

While many cis women can take for granted that their milk will come in without much effort on their part, there are many trans women who will not be able to afford the hormonal regimen that will allow them to simulate a pregnancy and induce lactation. Insurance companies already overwhelmingly fail to provide support and supplies for lactating cis women; trans women can expect to get exactly squat to even spur lactogenesis in the first place.

The books that I’ve been reading about breastfeeding are of course filled to the brim with cis-sexism. There is a complete black hole in regards to the needs and concerns of trans women who wish to nurse their children. This is something that needs to change. When the “pro woman” battle cry really means “pro cis woman” (and let’s be honest – it almost always certainly means just that), then we are failing. We are neglecting our duties as supporters of health care, as womanists, as decent damn people.

My silence about the needs of trans women in breastfeeding advocacy is a testament to my bigotry. I’ve been fucking up. And I need to do better.

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20 Responses to “Trans Women, Lactation, and Exclusion”

  1. Nicole Says:

    Would you consider dedicating a post to discussing what trans means? I feel like I’m not clear when you talk about it, and I’d also like to know more about what you mean when you say that anyone can breastfeed, regardless of gender. Also, I know I’ve asked a hundred times, but what does cis mean again?

    • August Says:

      Basically, a trans person is someone whose assigned gender at birth does not match their identified gender. So a trans woman is a woman who was [wrongly] assigned male at birth, and a trans man is a man who was [wrongly] assigned female at birth.

      Cis means that your gender identity and your assigned gender are the same. You and I were both assigned female at birth and we both identify as female, which makes us both cis women.

      Anyone can breastfeed: men or women, cis or trans. When we think of breastfeeding, the default in our mind tends to be recently pregnant cis women because that is by far the most common scenario; but trans men, cis men, trans women, and cis women who have never been pregnant are all physiologically capable of breastfeeding an infant, although it may take a bit more work to induce lactogenesis.

  2. Jo Says:

    I would be less likely to say that you’ve been fucking up and more likely to say that in your devotion to many topics, you haven’t covered them all yet!

    For serious.

    Though paying attention is super important and I’m glad you posted this!

    Also interesting must be breastfeeding for people who are more gender fluid in general and who identify differently on as much as a daily basis. Not only from a difference in support / rejection they must receive daily from strangers depending on presentation but also in their own socialized feelings about being a “woman” or “man.” I realize that’s a broad generalization and doesn’t cover everyone, but I still find it interesting!

    And another issue is that some transwomen may be in the process of transitioning, may be taking drugs that could be harmful to the child, and may not be able to safely breastfeed… and may still, again depending on presentation / public perception, face a variety of attitude and crap from people who think she SHOULD be breastfeeding, an attitude about “thou must parent this way though I know nothing about you” which time and time again DRIVES ME INSANE.

    • August Says:

      I appreciate the sentiment Jo, but this one is very much on me. When considering the populations that I intend to serve, I neglected to mention trans women time and again because I didn’t think that I could have any lactation services to offer them or that they wouldn’t want/need help from a lactation consultant. I made this assumption without even so much as a Google search to verify whether there is a need or whether it would be posssible to induce lactation for trans women. It was bigotry, plain and simple, and I’ve got to own it and do better.

      P.S. “Trans woman” is more appropriate than “transwoman,” since “trans” is an adjective and shouldn’t be turned into a noun. Just like you wouldn’t call someone a “gaywoman” or a “whiteman.” 😉

      • choleandjo Says:

        re: transwoman / trans woman – I know of people who do feel comfortable using it as a one word noun though I have no problem separating it out for those who do not identify that way / as a more inclusive generalization.

  3. Valerie Keefe Says:

    I’m going to agree with Jo that trans feminine lactation doesn’t come up very often.

    But more importantly, I’m going to say that you are about fifteen-and-a-half different kinds of awesome, including one of the best explanations of cis and trans that I’ve seen from a cis person, oh and putting a space between trans and womon. Good show!

    • August Says:

      Thank you! Of course the question I have is: what is really contributing to the rarity of trans women nursing their children? My original [and faulty, privileged, cis-sexist, and embarassing] assumption was that trans women did not nurse their children because it is not physiologically feasible, or that they merely “didn’t want to”; of course, when you take a bigger look at our society and how our [cis people’s] culture of collective bigotry and transphobia has made it nigh impossible to even find information on helping trans women, let alone allow them the chance or resources to try.

      • Valerie Keefe Says:

        It’s been so long since I was here… no matter.

        One of the big reasons is that there’s a negative correlation between hormonal transition that allows nursing and fertility. If non-medical insemination is the means, then the stars have to align pretty nicely for a trans woman to be of nursing age with a child that she was involved in conceiving:

        1. She has to be fertile or the couple has to be willing to conceive through medical means which are often more expensive, this while coinciding with transition which is, in itself rather expensive, especially if one is denied informed consent and thus is forced to get psychological assessments to ‘prove’ she is really a woman.

        2. She has to be with a fertile partner: So a cis woman or a trans man who is off testosterone. Or a surrogate… or adoption, but the barriers to trans adoption are large and unexamined, often uncodified.

        3. Her partner needs to be free of enough internalized cissexism to not think that having a trans woman nursing a child is ‘not natural’ / ‘wrong’ / ‘[insert degendering language]’

        Add that to the low incidence of social transition, (somewhere around 1 in 250 in North America, going on 1 in 100) and you’ve got a recipe for trans women being invisiblized with regards to nursing.. but then, I don’t really want any children of nursing age so I might not have the most accurate perspective on this. I’m just an economist by training.

  4. GallingGalla Says:

    Hi, August, I came across this post from a trackback to Questioning Transphobia, and I wanted to thank you for raising an issue that even I – a coercively assigned-male-at-birth genderqueer person – had not thought about much. Even though I have given thought to the difficulties that cis women face in breast-feeding (the bigotry against nursing mothers is appalling).

    I’m not personally in a position to be nursing, as I’ve no children of my own, but yeah there’s no reason I shouldn’t be able to nurse a partner’s or family member’s baby.

    Now, responding to Jo, who says that trans womenmay be taking drugs that could be harmful to the child…, what drugs would that be? I take estrogen. The fact that it comes from a bottle rather than from ovaries is of no significance; estrogen is estrogen. Similarly, the hormones that I’d take to induce lactation are just that – hormones.

    It’s true that I take a number of drugs that could wind up in my breast milk. But these medications are to treat conditions that have nothing to do with my being trans – high blood pressure, gout, neuropathic pain, etc. If any of these drugs are a counter-indication to breastfeeding, they will be so for *anybody* who is breastfeeding, trans or cis, male, female, or genderqueer

  5. theroamingnaturalist Says:

    Okay, for one: what does lactogenesis mean and how may a man produce milk? Or are we talking something altogether different?

    Thank you for helping me to understand trands & cis. You didn’t mention someone with both sex organs as “trans,” so I assuming it to refer to ANY person that does not identify with, essentially, what everyone tells them they are gender-wise? And I am also assuming that trans people face a good deal of trouble when they identify with “straight” or “gay,” even more so than cis people?

    • August Says:

      I’m going to email you about your other questions since I do want to keep the focus of this thread on specifically on trans women and lactation rather than cis men (although I will add that there are intersex folks who identify as trans; also, intersexuality covers a much broader scope than just having “both sex organs”).

      As for your last question, I’m going to give you two examples:

      First, a common complaint among breastfeeding cis women is that they are sometimes asked to nurse their children in the bathroom, out of public view. Nursing in public is often compared to excretion, which is offensive and disgusting to a mom who just wants to feed her child. A cis woman who is harassed or humiliated or guilted into taking her nursing child into the bathroom will likely feel understandably outraged afterwards.

      Now let’s replace that cis woman with a trans woman who is told to take it to the bathroom. It’s not the same situation, not even in the same league, because trans women do not have the protected right to go into a woman’s bathroom (and note that this is a right that LGB so-called allies have repeatedly thrown trans folks under the bus over). If a nursing trans mom does not sufficiently “pass” as cis under the cis gaze, she may well be risking arrest (which is another enourmous ugly topic). If she goes into the men’s bathroom, she will be risking assault or worse from cis men. So what does she do?

      If she’s in a state that protects breastfeeding in public, she could try to hold her ground and nurse in public. Except…the laws specifically refer to a woman’s right to nurse in public, and if a trans mom’s womanhood has not been legally recognized (and there are a billion and one reasons why that might not be), and even if her womanhood IS legally recognized, she may STILL be harassed, arrested, or driven out because most cis people are going to say that she’s “not a woman” and therefore not offered protection by the law. They (cis folks) may even go so far as to try to charge her for a sex crime just for feeding her child, and there is absolutely no law in place that she can assume will protect her.

      And for the second situation: I’m sure you remember Constance McMillen, the lesbian who was not allowed to attend her high school’s prom? It was all over the news, LGB organizations and the ACLU stood behind her, everyone on my Facebook joined support pages, she won a $35K settlement, Ellen Degeneres gave her $30K for being a “hero,” and so on. All the support in the world was given to Constance because of the loss of her prom.

      Compare that to the treatment of Juin Baize, who attended the same school as Constance for a grand total of four hours before being sent home for wearing feminine clothing. Juin’s entire family was eventually run out of town , and not only did the ACLU decide against pursuing Juin’s case, but there was radio silence from every freaking LGB group, from Ellen Degeneres, from Facebook, from everywhere.

      Constance lost a prom and got fame, national support, and enough money to pay for college.

      Juin was not allowed to finish a single day of school and lost a home and no one even noticed.

  6. Soapbox Sunday: Mixed Bag Edition « Navelgazing Says:

    […]  She Has My Eyes followed up with “Lactivism is not Work for Whites Only” and “Trans Women, Lactation and Exclusion“. Then Analytical Armadillo wrote on one of the many booby traps that sabotage women’s […]

  7. Gabrielle Says:

    Do you have any links to information about hormone for trans women who want to lactate? It’s not something I need right now but is something I do want to be able to do eventually and have no idea where to find resources I can present to my doctor.

  8. Stage Fright « She Has My Eyes Says:

    […] my blog and I don’t like feeling like I have to perform for anyone here. So even though Trans Women, Lactation, and Exclusion became my second most popular post just a couple days after I published it, I followed it up with […]

  9. ThatDeborahGirl Says:

    I think there’s a difference between ignoring something and not even knowing in the first place. This is something I would never have thought of! But ok cool. So now that I know, the question becomes, how do we accomodate all people who want to breastfeed?

    And then we make that happen to the best of our ability and science and everything else. I get that dealing with bigoted people isn’t easy, but it’s a narrow-minded world out there.

  10. candlebright Says:

    Hi August,

    I see that you wrote this about a year ago, so I’ve no idea if you’ll see this comment, but I just wanted to say, thank you so so much for writing this.

    I’m a male-bodied person but I consider myself to be at a stage where I’m kind of “transcurious”, undergoing a process of exploring and finding ways to express a female identity which I feel that I’ve always had, but only now properly have the courage to approach. Since my mid teens, I’ve had a constantly powerful maternal urge to become pregnant and, perhaps even more so, to breastfeed a child of mine. It has no basis in rationality, it’s a purely instinctive feeling that it would be a deeply powerful bonding experience that would be just wonderful for me and my child.

    I once told a partner about this, and she said that I seemed like such a natural potential mother to her, and that if I had been born female-bodied, then society would interpret my desires in that way. Instead, the way that idea of cis men and/or trans women breastfeeding is treated with either silence or derision by society has given me deep feelings of shame and embarrasment for feeling like this, feelings than I’m only now beginning to overcome. Even in trans communities I visit, it seems like a topic which doesn’t really come up, so I find myself wondering how common people in my situation with such material feelings are.

    At the moment, I really don’t know whether I’m likely to undergo a sex transition. I also don’t really know the science behind the possibilities of cis men or trans women lactating, as I read contradictory things, and I’m not sure which to believe. It makes me so sad that for me pregancy is impossible and that breastfeeding, if possible, would be such a struggle to achieve, and that I live in a society which gives so little legitimacy to those desires, and where I feel I have to keep my sadness about them internalised and unexpressed.

    But an internet search on the issue brought up your post, and I can’t tell you how important and empowering it is to find somebody taking the possibility and rights of trans women to breastfeed seriously. It makes me feel that bit less alone and that bit more like my maternal instincts are legitimate, and that is so important to me.

    Thank you again.

  11. Tallie Trabert Says:

    Thank you for the blog. Where can I find more information about the regime allowing a post-op trans women to produce breast milk and lactation? Is the quality of the lactation any different? What are the cost involved? What is the time period involved?

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