Lactation Induction in a Transgender Woman Wanting to Breastfeed: Case Report

J Clin Endocrinol Metab. 2021 Apr 23;106(5):e2047-e2052. doi: 10.1210/clinem/dgaa976.


Context: Breastfeeding is known to have many health and wellness benefits to the mother and infant; however, breastfeeding in trans women has been greatly under-researched.

Objective: To review potential methods of lactation induction in trans women wishing to breastfeed and to review the embryological basis for breastfeeding in trans women.

Design: This article summarizes a case of successful lactation in a trans woman, in which milk production was achieved in just over 1 month.

Setting: This patient was followed in an outpatient endocrinology clinic.

Participant: A single trans woman was followed in our endocrinology clinic for a period of 9 months while she took hormone therapy to help with lactation.

Interventions: Readily available lactation induction protocols for nonpuerpural mothers were reviewed and used to guide hormone therapy selection. Daily dose of progesterone was increased from 100 mg to 200 mg daily. The galactogogue domperidone was started at 10 mg 3 times daily and titrated up to effect. She was encouraged to use an electric pump and to increase her frequency of pumping.

Main outcome measure: Lactation induction.

Results: At one month, she had noticed a significant increase in her breast size and fullness. Her milk supply had increased rapidly, and she was producing up to 3 to 5 ounces of milk per day with manual expression alone.

Conclusions: We report the second case in the medical literature to demonstrate successful breastfeeding in a trans woman through use of hormonal augmentation.

Keywords: breastfeeding; hormone therapy; lactation induction; sex hormones; trans woman; transgender.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Breast Feeding / methods*
  • Female
  • Humans
  • Infant
  • Lactation*
  • Male
  • Milk, Human*
  • Transgender Persons / psychology*