The National Health Service of the United Kingdom is advising “transgender” females who take testosterone to continue doing so even while breastfeeding a baby despite acknowledging the unknown risks the hormone may have to the child.
The worrying guidance was first called to attention by users on social media, prompting a wave of backlash from advocates concerned with women’s rights and child safeguarding.
In a screenshot from the page posted by @GenderReceipts to X (formerly Twitter), the NHS states: “If you have taken testosterone in the past then your milk supply may be affected. So you may not be able to chestfeed your baby,” but continues that if “chestfeeding” is possible while on testosterone, the milk may have trace amounts of the hormone in it.
@GenderReceipts also posted a link to the page, titled Testosterone and Pregnancy, and asked why the NHS would suggest “trans-identified women who ‘chestfeed’ take testosterone” if the impacts on the child’s health were unknown.
“It is unclear what, if any, effect this could have on your baby,” the guidance read. “It is also important to consider your own wellbeing if you are finding that not taking testosterone is triggering dysphoria.”
Speaking to Reduxx, retired family physician Dr. Maja Bowen condemned the NHS for what she labeled an “alarming” guidance.
“There’s a paucity of research into the effects of elevated maternal testosterone on breast milk and breastfed infants,” Dr. Bowen said, noting the existence of three available studies which analyzed the issue of maternal testosterone usage.
“One looked at non-masculinizing dose of testosterone given for depressive symptoms, and two involved masculinizing doses of testosterone given to trans-identifying females as a part of ‘gender affirming’ regimen. In all these studies, either the sex and age of the infant wasn’t noted, or the age of infant was over one years old, or the sex of the infant was male. Therefore we have no long-term data on how this practice would specifically effect female infants, and the evidence of safety in male infants cannot be said to be adequate.”
Dr. Bowen also points out the apparent contrast between the guidance given to trans-identified females, noting how pregnant women and nursing mothers are often inundated with warnings about avoiding certain medication, food, and drink deemed risky.
“In medicine, we always err on the side of caution when we are advising mothers about which medicines are safe to take during pregnancy or lactation. However, the evidence for safety of masculinizing doses of testosterone on breastfed babies of trans-identifying females is inadequate. Therefore, I am alarmed that the NHS is putting the wishes of trans-identifying adults to be ‘affirmed in their chosen gender’ above the safety of children.”
This is not the first time concerns have been raised about official guidance on transgender adults breastfeeding children, though many previous issues have surrounded the phenomenon of trans-identified males inducing lactation for the purposes of “gender affirmation.”
As early as 2018, an endocrinologist from Boston Medical Center claimed that breastfeeding was an important method of validating a trans-identified male’s gender identity.
In an interview with The New Scientist, Dr. Joshua Safer said: “Many transgender women are looking to have as many of the experiences of non-transgender women as they can, so I can see this will be extremely popular.”
Since then, reports of trans-identified males seeking support from lactation consultants have increased. On social media, many new and breast feeding mothers have also stated they’ve noticed an increase in men attending breast-feeding groups.
As previously reported by Reduxx, two women in Australia received notices from X informing them that they had broken Australian law after posting about a trans-identified male who had been breastfeeding a child.
Issues have also emerged regarding the adoption of “inclusive” language in maternity care, such as utilizing “chestfeeding” in place of “breastfeeding.”
Last year, a collaborative research paper led by Australian academic Karlene Gribble concluded that the adoption of “desexed” language in female-specific healthcare had “serious implications” for women and children.
“Desexing the language of female reproduction has been done with a view to being sensitive to individual needs and as beneficial, kind, and inclusive,” they wrote in the paper. “Yet, this kindness has delivered unintended consequences that have serious implications for women and children.”
Gribble and her team assert that neutralizing the language around motherhood, including “disembodying and undermining breastfeeding,” would result in “reducing protection of the mother-infant [bond]” and the dehumanization of women.