In the first formal report in the medical literature, practitioners at the Mount Sinai Center for Transgender Medicine and Surgery have demonstrated that it may be possible to induce lactation in transgender women.
The study’s authors, Dr. Tamar Reisman and nurse practitioner Zil Goldstein, report on their 30 year old patient who expressed desire to breastfeed the baby her partner was carrying. The patient was advised to use a breast pump to increase prolactin and oxytocin levels, was given doses of estradiol and progesterone that were changed over time to mimic pregnancy levels, and was advised to use domperidone (an off-label galactogogue) to increase prolactin levels. After three months of treatment, the patient was making 8 ounces of breast milk per day; two weeks later, the baby was born and was exclusively breastfed for 6 weeks.
One major difference between inducing lactation in cisgender women and in transgender women is the need in the latter group for androgen blockade–the patient in this study continued to take spironolactone while breastfeeding and the researchers note that the metabolites of the drug, which are excreted in milk, are considered clinically insignificant. Future research is needed to determine “optimal dosing of estradiol, progesterone, and galactogogues in inducing lactation, as well as the optimal frequency and duration of pump use,” but this study is an exciting step for transgender women and their healthcare providers.
You can access the full text in Transgender Health here: http://online.liebertpub.com/doi/10.1089/trgh.2017.0044
You can read the New York Times’ report here: https://www.nytimes.com/2018/02/15/health/transgender-woman-breast-feed.html