Pilot Survey Assessing Lactation and Breastfeeding Experiences, Attitudes, and Knowledge Among Transfeminine Individuals.

Background: Transfeminine individuals are capable of developing breast tissue that is indistinguishable from cis-females, allowing them to breastfeed effectively. Breastfeeding affords known health benefits for both members of a lactating individual-infant dyad and supporting this experience for transfeminine individuals fosters reproductive equity. Objective: This study assessed experiences, attitudes, and knowledge regarding breastfeeding and lactation among a group of transfeminine individuals receiving hormone therapy within a specialized gender care clinic. Methods: Transfeminine individuals on estrogen therapy who were part of the Duke Research for Equitable Access to Medicine (DREAM) Registry were invited to complete a 15-question online survey about experiences, goals, attitudes, and knowledge regarding lactation and breastfeeding. Results: A total of 71 out of 130 eligible DREAM individuals completed the survey (54.6%). No survey participants had breastfed and three (4.2%) had experienced lactation. One in four participants designated lactation a health care goal. Four out of five participants reported it was important, most commonly to affirm their gender identity (n = 41, 57.7%) and/or to bring their breasts to full maturity (n = 36, 50.7%). One in eight participants designated breastfeeding as a health care goal. Four out of five participants reported it was important, most commonly for parent-child bonding (n = 34, 47.9%) and/or health/nutritional benefits to the newborn (n = 34, 47.9%). Conclusion: Transfeminine individuals may be interested in experiencing lactation for multifaceted reasons, including goals for parent-infant feeding (breastfeeding-dyad bonding and breast milk health benefits) and for their gender transition (affirming gender and breast maturity). Future community-engaged research is warranted to inform both clinical practice and lactation protocols for transfeminine individuals hoping to breastfeed.

Duke Scholars

Author Andrea Dotson Family Medicine and Community Health, Family Medicine

Author Carly Elizabeth Kelley Medicine, Endocrinology, Metabolism, and Nutrition