Author’s note: I recognize that the topic of transgender parenting, and transgender people in general, can be divisive and hard for some people to understand. It is my hope that by writing about the topic of transgender pregnancy, parenting and breastfeeding in this post, other doulas, birth workers and parents will have a greater understanding of– and empathy for– the transgender experience. And hopefully, we can all come to see that in so many ways, we’re all in the same boat, just doing our best to get through this crazy journey called parenthood.
“People are different from each other. It’s astonishing how few respectable tools we have for dealing with this fact.” – Eve Kokofsky Sedgwick, Epistemology of the Closet, 1990
I recently had the pleasure of reading the memoir Where’s the Mother?: Stories from a Transgender Dad by Trevor MacDonald. Trevor is a transgender man who became pregnant and birthed a baby, and even went on to breastfeed. (note: many transgender people prefer to use the term “chest feeding” when referring to feeding their babies, but Trevor uses the term “breastfeeding” throughout the book, so that is the term I will use in this post.) The book chronicles Trevor’s journey as he transitions from female to male, including taking hormones and getting chest surgery. Eventually Trevor meets Ian and gets married, and together they decide to start a family. The decision to have a baby is huge for any family, but Trevor and Ian have added societal expectations to manage, such as the idea that all babies are born to female-identified people.
To give you a glimpse into Trevor’s journey, I’ll share with you Trevor’s own words that he shared at the first La Leche League meeting he attended:
“My name is Trevor. My baby is due April 17th. I am able to be pregnant because I am transgender. That means I was born female, but I transitioned to male by taking hormones and having chest surgery. When we decided to start a family, I went off the hormones to become pregnant. I don’t know how much I’ll be able to breastfeed because of my surgery but I want to learn as much as I can and do my best.”
Transgender Pregnancy and Birth
Although we may not hear about it often, there are transgender men all over the world who are quietly starting families, getting pregnant and having babies. Some of you may have recently seen the posts and articles online about Trystan and Biff, a gay couple in Seattle. Trystan, a transgender man, got pregnant and gave birth to a beautiful baby, and they have been very open about sharing their journey. If you haven’t followed their story, I highly recommend starting from the beginning and listening to their four-part series on The Longest, Shortest Time podcast. You can also check out their Facebook page, where they share links to articles about their pregnancy, videos, and personal stories.
In the forward to “Where’s the Mother?,” the author shares that “Obstetrics and Gynecology [published a report] in which researchers interviewed forty-one transgender males who had given birth ‘after transitioning from female to male gender.’ Similarly in Barbara Walters’ interview with [transgender man Thomas] Beatie, who has given birth to three children, California midwife Stephanie Brill reported that she is aware of at least forty cases, and the number is increasing…Numbers of this kind suggest that underlying the television specials and magazine cover stories, there exists a quiet groundswell of social change, which has mostly been hidden from view.”
“Obstetrics and Gynecology [published a report] in which researchers interviewed forty-one transgender males who had given birth ‘after transitioning from female to male gender’…Numbers of this kind suggest that underlying the television specials and magazine cover stories, there exists a quiet groundswell of social change, which has mostly been hidden from view.”
The Breastfeeding Journey
Reading the book, one of the questions that kept popping into my mind was, “how can a person who has had chest surgery to remove their breast tissue go on to breastfeed?” As I continued to read, I learned that there is a difference between a woman getting a mastectomy to entirely remove the breast, and a transgender man getting chest-contouring surgery. Male chest-conturing surgery actually leaves some of the breast tissue intact so that it looks like pectoral muscles, and the nipple is carefully preserved. The type of chest surgery that Trevor had actually kept many of the nerves and milk ducts directly underneath the nipple and areola intact. Therefore, when Trevor attempted to breastfeed his baby, there were milk ducts there to produce milk. Trevor also explains that “…pregnancy hormones drive the body into high gear, developing more breast tissue and sometimes healing milk duct injuries, a process called recanalization.”
The entire second half of the book is dedicated to Trevor’s journey through breastfeeding. Even though he had some milk ducts still intact after his surgery, there were far fewer than there would be with a typical breast. Also, his breast tissue was drastically reduced, so there wasn’t much there for the baby to latch onto. He used an at-breast supplementer and fed his baby donor milk along with whatever milk he was able to produce himself. Finding and procuring donor milk can be tough for any new parent, and Trevor and Ian had the added hurdle of needing to explain their family structure to all the potential donors, and facing potential prejudice or harassment in the process. They used known donors, friends-of-friends, and the Facebook group Human Milk 4 Human Babies.
Reading this book was eye-opening, educational and informative. Trevor gives the reader a personal, intimate glimpse into his pregnancy, birth and breastfeeding experience as a trans man. Where’s the Mother?: Stories from a Transgender Dad is a great read for all doulas who are interested in learning more about the transgender parenting experience so they can be better informed and open-minded with all of their clients.
Where’s the Mother?: Stories from a Transgender Dad is a great read for all doulas who are interested in learning more about the transgender parenting experience so they can be better informed and open-minded with all of their clients.
Resources and Further Reading
5 Ways to Make Your Birth Business More LGBTQ Inclusive – a blog I wrote for birth workers
Transgender Parents and Chest/Breast Feeding a great overview by Trevor MacDonald featured on Kellymom.com
Birthing and Breastfeeding Transmen and Allies Facebook group. This group welcomes anyone trans* identified or with strong ties to the trans* community, as well as allied health care providers or other professionals interested in contributing to the group.
Facebook Group Transgender Parents Support for trans families.
Human Milk 4 Human Babies Utah Facebook group
World Professional Association for Transgender Health An international, multidisciplinary group of professionals devoted to promoting evidence-based care for transgender, transsexual, and gender variant people. WPATH publishes standards of care and ethical guidelines. Website includes a searchable database of care providers who are WPATH members. The group holds a biennial symposium for sharing new research and ideas.
LGBTQ Parenting Network Toronto-based group that does advocacy, education, support, etc. for LGBTQ parents. Website includes an astonishing number of useful articles, reports and links for queer parents (topics range from sperm donation to birth registration and legal issues to single parenting).
La Leche League International Breastfeeding support and information. LLLI holds chapter meetings all over the world, as well as maintaining excellent web resources and books.
Breastfeeding After Reduction Surgery Information and support for breastfeeding parents who have had previous reductions, augmentations, or nipples surgeries.
Human Milk 4 Human Babies Global breast milk sharing network. Operates on a model of informed choice, and is completely commerce-free.
Research paper on Transmasculine individuals’ experiences with lactation, chestfeeding, and gender identity
Article: The Midwives Who Help Trans & Non-Binary Parents Give Birth.
Article: Gender Identity: Transgender Dad, article on Breastfeeding Today
Article: Chestfeeding Through Dysphoria, article on Doula Trainings International
Beth Hardy, SCMT, MT-BC, PCD(DONA)
Music Therapist | Birth Doula | Postpartum Doula
Beth is a birth doula, postpartum doula, and board-certified music therapist. She serves families throughout the Salt Lake City, UT area, and loves working with all families, including LGBTQ parents, adoptive parents, and single parents. Learn more about Beth at www.HeartTonesDoula.com.