'We were really excited': Doctor describes first case of helping transgender woman breastfeed

Dr. Tamar Reiseman says it was exciting to be able to help a transgender woman achieve her goal of breastfeeding her child — and having it be the first known case made it even sweeter. 

The results were published in the journal Transgender Health, making it the first case of induced lactation to be documented in an academic literature.  

The 30-year-old woman went to doctors when her partner  —  who was not interested in breast feeding —  was five months pregnant. She had been taking hormones for six years, but had not had gender reassignment or breast augmentation. 

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Reiseman is a physician with Mount Sinai's Center for Transgender Medicine and Surgery in New York City.

She spoke with As It Happens guest host Gillian Findlay about what it was like to help her patient lactate. Here is part of their conversation. 

Tell us about this patient. What was her request when she came to you?

This was a patient whose partner was pregnant, and so the patient was interested in breastfeeding, shortly after the child arrives.

When she said this, did you think this was possible?

I was pretty frank with the patient. I said that I hadn't personally done this before, that I wasn't sure it was possible, but that I would look into it for her.

When I did my research, what I found was that there was actually a small, but available [amount of] literature for what's called non-corporal lactation. Basically meaning breastfeeding that doesn't follow pregnancy in cisgender women. So by sort of taking some of those protocols, we were able to modify them and apply them for our patient.

We were excited for the patient that we were able to help her achieve her goal and we were really excited that we were able to publish in an academic journal.- Dr. Tamar Reiseman

I understand that this woman had in fact been on hormonal therapy for some period leading up to this point, right?

Yes, so that's sort of important to understand. This was a woman who had been taking estrogen and progesterone for several years, and for several years she had been on a medication to block her testosterone. At the time that I first saw her, she had essentially fully formed breasts.

What was the therapy going forward?

So the gist of the protocol was, essentially, to create a hormonal profile that sort of mimicked the hormonal profile of pregnancy, and then to reduce her hormones to sort of mimic delivery. And the last piece of that was to help increase her prolactin level, which is a hormone that is very important for breast milk production.

And then, I guess, the baby arrives. What happened?

For six weeks the patient was breastfeeding exclusively. [She] was the exclusive source of nourishment for that child. But unfortunately at six weeks or so, there was concern about lack of breastmilk volume. And so at that point the patient continued to breastfeed, but also supplemented with formula.

What was it like, that moment when you realized that this trans woman was breastfeeding?

We were really excited. We were excited for the patient that we were able to help her achieve her goal, and we were really excited that we were able to publish in an academic journal. It's really important to sort of understand that transgender endocrinology is really young as a subspecialty. Any time we can contribute to the academic literature, help patients make medical decisions based on data, and contribute to the standardization of care, we're really excited.

Is there an application beyond transgender women?

There's already a small body of literature that describes the ability to induce lactation — functional lactation — right? Meaning lactation that's productive for breastfeeding in, let's say, adoptive cisgender women. So that ability has been documented.

But definitely any time it's out there, it's in the media, people are talking about it, there will likely be cisgender women who maybe have always wanted to breastfeed but didn't know that it was possible. So maybe there are some cisgender women who will maybe now breastfeed as a result of this news.  

This has been edited for length and clarity. For more, listen to our interview with Tamar Reiseman.