Analysis of the experiment of induced lactation in a transwoman

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Recently a case study was reported, where a doctor and a nurse at a clinic used a cocktail of medications to enable a transwoman to fulfill his goal to breastfeed his adopted infant.

In this article, I will refer to their patient as “trans-identified male” and “he” because there are few fields of medicine in which correctly identifying patient’s sex is more pertinent than in pregnancy, birth and breastfeeding.

As a doctor, I have multiple concerns regarding this study and this is my analysis.

The trans-identified male patient, who is referred to as a “she” throughout the study, “explained that her partner was pregnant but not interested in breastfeeding, and that she (the trans-identified male patient) hoped to take on the role of being the primary food source for her infant.”

There is no evidence that clinicians who conducted this experiment met with or interviewed the mother to confirm these claims or that they obtained informed consent from the mother by discussing possible risks that male drug-induced nipple discharge could pose to the infant.

The trans-identified male patient was reported to have a medical history of “gender incongruence”  but he hasn’t had any gender reassignment surgeries, which means that he was a fully sexed male. There was no other relevant medical history reported.

On presentation, the patient was on a gender-affirming regimen that included spironolactone (a heart medication used in this case as an androgen blocker), estradiol, micronised progesterone and “occasional” clonazepam and zolpidem for panic disorder and insomnia.

At initial appointment, the patient had gynaecomastia (abnormally enlarged breasts in a man, Tanner stage V) that was likely a side effect of spironolactone and cross-sex hormones he was taking.

Interestingly, it’s unclear what was the patient’s serum testosterone level, because two markedly different results were given, one in the body of text – 256 ng/dL – and another in the results table 1. – 20.52 ng/dL.

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This is problematic not only because it constitutes a glaring inconsistency within the report, but also because the higher result indicates that the patient had male testosterone levels. Considering that the study reported no further testosterone data, indicating that they didn’t measure his testosterone level at any other point in the study, and that  75% of trans-identified men on spironolactone fail to reach testosterone level in the female range, and those who augment the treatment with estradiol have variable response, there is no reliable evidence that adequate androgen blockade was achieved, even though authors claimed that androgen blockade was an important part of the regimen.

What we do know, however, is that in mothers with PCOS (Polycycstic Ovary Syndrome), elevated testosterone levels inhibit breastfeeding while exposure of female foetuses to high maternal testosterone in the womb results in female infants having the same testosterone levels at birth as normal male infants.

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This can cause medical complications such as precocious puberty, but also there’s evidence that such exposure is connected with gender non-conforming behaviour later in childhood.

Considering that gender non-conformance is currently an indication for diagnosing children as “transgender” and results in starting them on the highly experimental and potentially dangerous medical path to “gender reassignment”, which typically involves controversial treatment with puberty blockers and cross-sex hormones, the possible consequences need to be considered.

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Because there are no studies proving absence of risk, there are ethical issues with enabling a man whose testosterone suppression isn’t adequately demonstrated, to breastfeed a potentially female infant.

And this brings us to another glaring omission in this report. While the authors consistently refer to the trans-identified male patient as “she”, they don’t state the sex of the infant involved in this experiment, revealing a worrying disinterest in the infant itself.

Clinicians also reported that their patient used domperidone, a drug that is banned in the US and is only used off-label internationally to induce lactation. Domperidone was sometimes used to treat reflux, but has been discontinued for use in children due to potential cardiac side-effects.

Even in countries where domperidone is given to mothers to stimulate lactation, it requires ensuring that the infant doesn’t have heart or liver abnormalities. There’s no evidence that clinic attempted to ascertain this.

domperidone checks

Furthermore, there’s no evidence that the patient stopped using  clonazepam , which can cause sedation in infants, or zolpidem (also known as Ambien), which could exacerbate effects of clonazepam, after the breastfeeding commenced.

When we talk about safety of drugs in breastfeeding, we weigh benefits of breastfeeding on health and bonding between mother and child, with risks of withdrawing medically necessary medicines mother might be taking.

Mothers who take medications that could be passed to their babies via breastmilk often decide not to breastfeed just so that they don’t risk affecting their baby’s health. Contrast this with a man who takes unnecessary medications, one of which is banned in the US, just so that he can fulfill his desire to breastfeed.

It’s worth mentioning that nipple discharge in men (galactorrhea) is always abnormal and a consequence of pathologically elevated prolactin due to certain medical conditions or a side effect of some medications.

There’s historical evidence of some men breastfeeding babies, eg. after wife’s death, but it was recognised that men’s milk was a poor substitute which, by maintaining hydration, may have helped infants survive in most adverse circumstances. We have no way of knowing if these rare historical reports describe men who suffered from abnormalities that caused galactorrhea.

Be as it may, following the regimen of medications and usage of a breast pump (as per stated protocol) the patient started to lactate, producing 8 oz of milk daily, and after the baby was born, he was reported to have been the sole source of this baby’s nurishment for 6 weeks.

Considering that a 5 lb baby needs about 12 oz of breastmilk, and more as their weight increases. 8 oz was clearly never enough, so authors’ claim that their patient managed to achieve the volume of milk that allowed him to be the sole source of nourishment for her child for 6 weeks is incorrect.

Furthermore, the authors’ claim that at 6 weeks, the patient began supplementing breastfeedings with 4–8 oz of Similac brand formula daily and they ressure us but give no evidence that “the child’s pediatrician reported that the child’s growth, feeding, and bowel habits were developmentally appropriate”.

This raises serious concerns about authenticity of the entire report. As far as can be ascertained from the study, authors never observed any breastfeeding nor did they meet the mother or the infant.

But let’s assume for the sake of the argument that somehow this case study was indeed based on real events, and that the infant survived for 6 weeks on 8oz of male drug-induced galactorrhea a day.

Mother’s breastmilk in context of pregnancy isn’t the same as drug-induced galactorrhea in a man, nor is breastmilk static in composition. It starts as colostrum (birth – 4 days) which is a thick fluid full of fat, vitamins and immunoglobulins. Then it changes to more calorific transitional milk (4 days – 2 weeks), which is high in fat and vitamins, and after that it becomes mature milk which is 90% water.

The authors of this study gave no indication that they analysed the content of this man’s nipple discharge, even though they talked at length about benefits of breastfeeding on mother and baby, none of which were applicable to their male patient or indeed the infant he allegedly fed.

Furthermore, mothers who don’t want to or are unable to breastfeed, are required to use baby formula, which closely approximates the nutritional content of mother’s milk at each stage, and are obliged to use it in adequate amounts. Why was their trans-identified male patient held to a drastically different standard of infant care?

Why didn’t this study explore reasons for this fully sexed male’s interest in breastfeeding a newborn?  Considering that psychosexual disorders such as autogynaephilia are present in a proportion of typically fully sexed heterosexual males who identify as transwomen, this is an ethical issue.

There was also no mention of what kind of clinic this was. If this was an Obs&Gynae clinic, their primary responsibility was to the mother and child. If this was a transgender clinic, they had no business managing breastfeeding of an infant.

In my opinion, this study is an example of how transgender health clinics prioritise emotional needs of trans-identified males over the welfare of women and children and it is an unethical study, fraught with incomplete and misleading information, disingenuous analysis and undeclared conflict of interest.

 

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29 thoughts on “Analysis of the experiment of induced lactation in a transwoman

  1. Spryfield Homegrown says:

    Thank you for this excellent analysis.

    Reading between the lines of this case report, it becomes clear that clinicians didn’t actually prescribe this (unethical) regimen. No responsible clinician would have prescribed for this unnecessary experiment. The patient obtained drugs online, and self-medicated.

    This is one more example of transgender patients utilizing off-label drugs in experimental protocols, and getting clinicians to normalize it after the fact. (Often transgender clinicians, incidentally.)

    Watch for this to show up in WPATH treatment standards within the next few years.

    Liked by 2 people

    1. la scapigliata says:

      You are right Spryfield. I also see no evidence that any “breastfeeding” actually happened. Nobody witnessed it, or interviewed the mother. All they have is a word of their patient.

      It would be in line with WPATH “research” to use this piece of medical fiction. I fear that frameworks for safeguarding children are being demolished.

      https://www.thestranger.com/queer-issue-2017/2017/06/21/25225867/my-first-time-breastfeeding-my-daughter

      Liked by 1 person

  2. triciafrasman says:

    Thank you for this detailed, excellent analysis.
    One can only hope that this study is a fiction, for the sake of the child. But still it feeds the myth that men can do anything that women can – even the fundamentally female role of mothering.

    Liked by 2 people

    1. la scapigliata says:

      Very well put Tricia. The study is exercise in male narcissim, delusion and total breakdown of safeguarding mechanisms for both the mother and the child. There’s a sinister undercurrent to transactivism that is using children for validation and sexual gratification of some trans-identified men, and even though paedophiles try to legalise their crimes every decade or so, it never stops being absolutely urgent to stop them. Case in point: https://www.thestranger.com/queer-issue-2017/2017/06/21/25225867/my-first-time-breastfeeding-my-daughter

      It’s not an accident the fathers of post-modernism, Foucault and Derrida, and the fathers of transgenderism, Money, Kinsey, Benjamin, were all paedophile activists/apologists, or that WPATH is a rebranded Harry Benjamin International Gender Dysphoria Association (HBIGDA), or that this is being disseminated through queer theory, which is a brain child of post-modernism. But so many people aren’t aware of it, because the connections are not advertised and passive-aggressive male narratives are used to smear mothers and emotionally blackmail and gaslight general population and legislators, into, ultimately what, time will tell.

      I believe any attempt at legislating child abuse will ultimately fail. The sociaty has shown firm distaste for it and it won’t be allowed. But even severely relaxed, or even holes in child safeguarding mechanisms ultimately benefit paedophile rings, who are, as we know, extremely well organised and often rooted in institutions which involve men with lots of resources in positions of power.

      I am now carefully watching all developments that insinuate children 1) have a sexual orientation=sexual attraction=are sexual beings in adult sense, 2) are capable of consent regarding touching of their genitals (which puts onus on the child instead on adults to know what is and isn’t appropriate, and it completely compromises childcare of the most vulnerable infants and small children), 3) aim to alienate and separate children from their parents and 4) are normalising detailed discussions about a child’s genitals, bodies and sexual function. All three feature heavily in trans activism, from telling pre-pubescent “drag queens” that if their parents won’t allow them to be sexualised “they need new patents” to “so brave” news articles about “openly gay 3 year olds” that suggest the toddler is advertising their sexuality, most recent sinister position that parents need “infant’s consent” to change their nappies, to the tragic case dissected in the media via programme “I Am Jazz”.

      https://www.advocate.com/youth/2017/6/05/meet-8-year-old-drag-queen-lactatia
      https://www.lifesitenews.com/news/openly-gay-3-year-old-goes-viral-on-social-media
      https://www.mirror.co.uk/news/world-news/im-going-change-your-nappy-12511101
      http://www.thepublicdiscourse.com/2018/04/21220/

      Like

  3. Reisen says:

    Very well done. I was disturbed, and yet had to roll my eyes, at this man talking about the ‘sexual excitement’ he got from ‘breastfeeding’ a child that isn’t even his. He has no biological connection to that child.

    I found the men lactating bit interesting, but it’s clear men were not meant to lactate, as they do not gestate a child and cannot produce the regime required for them.

    Liked by 1 person

  4. Tracy Smith says:

    The BBC “reported” on this incident. They virtually reproduced the Press Release.
    The Clinic is a PRIVATE trans clinic which states that if a trans individual has the money, they will try their hardest to accommodate your wishes. It is owned by a MtF trans nurse.
    The clinic claimed to have had the patient’s permission to publish exerts from their case notes. As you say, no analysis was ever provided for the child so no one appears to have given consent for the CHILD’S medical details to be plastered all over the internet.
    Even if we ignored all the inconsistencies and lack of due care, as you say the milk production was far below what was needed to sustain a baby, and the real mother was there on call who presumably was able to breastfeed.
    So I made a formal complaint to the BBC. I stated that they had done zero investigation to ascertain if any of the claims were true. That the drug regime was in fact dangerous for a baby and the drugs could pass through the breastfeeding system and enter the baby’s system if it actually happened, which was a problem since the baby was, in fact, a boy. I said that the “report” was actually an “infomercial” because a Private Clinic that specifically looked to buy an outcome for patients had issued this Press Release to drum up business. And finally I said that the milk production would have seen the baby starve to death within days on account of it being far too low.
    The BBC told me my complaint was nonsense and they were right to publish. When I tried to escalate it they wanted to limit my complaint to 50 words. When I refused to diminish it, and contacted the Executive directly I was told that I had pre-empted the complaint procedure and they could not consider it.
    This is the utter contempt the BBC hold the health and well-being of babies in … but then we knew that after Saville, yeah?

    Liked by 2 people

  5. Sheila says:

    I agree that it is disturbing there seems to be no care for the affect on the infant, and that it is unlikely this story is entirely true.

    However, a couple of points stuck out to me: if a mother pumps only 8 ounces, it doesn’t mean she only produces that amount. Babies are so much more efficient than a pump. I mention this because a main reason women start to wean from breastfeeding is a belief that they are not making enough.
    The other statement that disturbed me was that mothers are “required” to supplement with formula. There are other feeding options for babies including donor milk, and the mother should be the authority when making these decisions.

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    1. la scapigliata says:

      Thanks for your comment Sheila! Indeed you are right, there are other supplement options. I made a broad statement, as the supplementation with formula is the most common, and a baby couldn’t survive on 8oz of whatever that male was pumping (or saying he was pumping). To be honest, I think the whole paper is an AGP fantasy, but that it was published and what was described didn’t raise any formal child protection bells greatly concerns me.

      Like

  6. Vaska says:

    Reblogged this on vaskaxtumir and commented:
    “On presentation, the patient was on a gender-affirming regimen that included spironolactone (a heart medication used in this case as an androgen blocker), estradiol, micronised progesterone and “occasional” clonazepam and zolpidem for panic disorder and insomnia.”

    Liked by 1 person

  7. Laurie Lyon says:

    Why are you not on Facebook? Many Radical Feminists groups are on FB and I get their articles everyday but with this blog I only get articles if other groups post to their sites. I would love to see your work on a regular basis.
    Great article. Truly frightening this frankenstein manipulation of healthy human bodies and the experimentation on children. I recommend, in case you are not already familiar with her, the “idge of reason”, a You Tube channel.. She talks about having been a social worker in the UK for a decade and the transgender activism actively moving towards the legalization of pedophilia of course, along with other pedophiles who have never really been able to accomplish this due to, as you say, the social unacceptability of pedophilia however, with the trans lobby everything is becoming acceptable through their activism being framed as transphobic if anyone argues against anything they desire.

    Like

    1. la scapigliata says:

      Dear Laurie, thank you for your comment! The reason I’m not on facebook is because the abuse by trans activists is very stressful and unfortunately, my chronic health condition forces me to avoid stress, or my asthma gets badly triggered and I’m out of action for months. I wish I didn’t have that limitation, but can’t really do much about it.
      I know Lisa Muggeridge and miss her greatly on twitter! Her contribution has been an eye opener for many of us. I also have long suspected paedophile activism is behind all this, certainly it is fundamental to queer theory which has spawned this ideology, and the fathers of gender reassignment intervention itself were all campaigning to lower or abolish age of consent (Kinsey, Money, Benjamin). It’s an old monster in a new frock, and it’s unsurprising they have the ear of institutions – it’s always been the case. If you haven’t seen this before, Dr EM has analysed a Paedophile Manifesto on twitter, and the parallels with methods of transactivists speak for themselves. https://mobile.twitter.com/PankhurstEM/status/991258041038368768

      Liked by 1 person

  8. ramendik says:

    You maintained a scientific appearance throughout, but some sources don’t look scientific to me.

    Most notably, you claim “psychosexual disorders such as autogynaephilia are present…”. Yet no researcher has ever claimed that autogynaephilia is a psychosexual disorder, or a disorder at all. It was claimed as etiology for (what was then known as) gender identity disorder, but not as a disorder in its own right. Your quoted source is an activist website. But you allege an ethical issue specifically based on it being a “disorder”.

    Like

    1. la scapigliata says:

      I have appraised a case study from a medical perspective, using my knowledge and references I deem fit in this context. Autogynaephilia is a paraphilia and as such is a psychosexual disorder. I’m not “maintaining an appearance” of anything. I’m offering my medical opinion.

      Liked by 2 people

  9. Kathleen Lowrey says:

    Excellent informative piece that is rightly attentive to what was ignored in the original “trans identified male bravely realizes his dreams” account: the health of the child subjected to experimentation

    Liked by 2 people

  10. Lady Mondegreen says:

    I’m on your side on this, but it’s important that we remain careful and fact-based.

    Paraphilias aren’t disorders. They can be, but not necessarily. Even Ray Blanchard has made this point.

    IIRC, Blanchard said that a paraphilia becomes a disorder if it causes its haver distress, or causes him to harm others. Lactating for personal gratification while ignoring, or, at best, showing minimal concern for, a baby’s needs, would qualify.

    Like

  11. Heather says:

    This highly questionable (from the truth point of view) report of a biological male breastfeeding has surfaced (yet) again, being lauded by the Milk Meg, who has run a Facebook page for years, supporting women all over the world with normally great knowledge and warmth. Her followers are thrilled too and even questioning posts are being deleted. It’s very sad that in the desire to be open minded and supportive of breastfeeding, Meg and her followers don’t see the inconsistencies and seem blind to the big question ‘why is someone making this stuff up’? I wonder if they’ve ever heard of ‘lactation porn’? (Only one of many possible elements in this).

    Liked by 1 person

    1. la scapigliata says:

      Unfortunately many women, and especially ambitious ones, are eager to virtue signal to men and the trans lobby. As a feminist I often wonder why this is so, and despair at lack of sisterhood and self-sabotage that seems inherent in female society. Women as a class are mostly unaware and in denial about patriarchy and oppression, and their reflex is to mollify and exalt men at all costs. We are violently socialised to be this way, nevertheless, it’s infuriating because this women policing and ostracising women who aren’t as eager to service men’s needs constitutes a betrayal that keeps our communities fractured and our liberation from male oppression out of reach. It’s all very tragic and disappointing. Still, we must persist and not lose hope. xx

      Like

  12. Maureen Minchin says:

    This is truly excellent and I am delighted to see it. Given the media rewards for being the “first” to do anything controversial, you are right to point out that it would be good to see some proof of breastfeeding. As for the meds: I think of the crazy concerns about women taking something for cold, or having a glass of wine,or trace pesticide residue…… yet if it is a man…

    Like

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