The 30-year-old went through months of treatment.
A new mom just became the first transgender woman to breastfeed her own baby.
According to a recently published case report from Tamar Reisman and Zil Goldstein, two doctors at New York City's Center for Transgender Medicine and Surgery, a 30-year-old transgender woman came to their clinic to inquire about breastfeeding her infant.
The woman's partner was pregnant but did not want to breastfeed, and the woman hoped her doctors could find a way to help her feed the baby herself.
At the time, she had been on a feminizing hormone regimen since 2011 and was taking testosterone-suppressing spironolactone, along with estradiol and progesterone. While she had not undergone gender confirmation surgery, her breasts were fully developed, so Reisman and Goldstein set about inducing lactation.
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The woman took a drug that fosters milk production (called domperidone) on top of increased doses of her hormones. As New Scientist reports, the Food and Drug Administration cautions against using domperidone to increase lactation out of concerns for cardiac health and general safety, so the patient had to procure the drug from Canada instead. On top of all this, she used a breast pump on each breast for five minutes every day.
After a month of treatment, she was producing milk drops, so doctors upped her drug dosage and accelerated her pumping schedule: After three months—two weeks before the baby was due—the woman was producing eight ounces of breast milk per day. Once the baby was born, she functioned as the sole food source for her baby for six weeks. According to the case report, "the child's pediatrician reported that the child's growth, feeding, and bowel habits were developmentally appropriate" throughout breastfeeding.
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Reisman and Goldstein know of no other case like this documented in medical literature, and it opens up big possibilities both for transgender mothers who don't want to rely on formula, and for women who have trouble with lactation.
"We want to present our patients with the full range of reproductive choices, and this is one step closer to that," Reisman told The Washington Post.
The above procedure mimics the common protocol for inducing lactation—minus the feminizing hormone spironolactone. But spironolactone, which can also be used to treat hormonal acne, high blood pressure, and heart conditions, appears safe for use by breastfeeding people.
What may be less safe, according to Madeline Deutsch, M.D., director of clinical services at the Center of Excellence for Transgender Health at the University of California San Francisco, is the makeup of this woman's milk.
"There are unknowns about the nutritional picture of the milk," Deutsch (who is herself a trans woman and a new mom) told the Washington Post. She would like to see more data on what medications mothers might pass to their infants during breastfeeding in general, and in this particular case, a milk analysis to gauge whether or not this baby was getting the nutrients it needed.
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Still, breastfeeding helps build newborns' immune systems, and is thought to lower their risk of obesity, asthma, type 2 diabetes, sudden death, childhood leukemia, and a laundry list of other maladies.
While research is preliminary, this case does offer hope to transgender moms who want to feed their babies themselves.
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