Commentary Maternity and Birthing

A Transgender Father Challenges Breastfeeding Norms

Miriam Pérez

Trevor MacDonald, a trans father in Canada who has breastfed his son for over a year, was rejected by La Leche League as a volunteer leader because of his gender identity.

Last week Trevor MacDonald made headlines with the news that La Leche League (LLL), an international breastfeeding support and advocacy group, had denied his application to be an LLL group leader. Trevor is a trans man who, after giving birth to a son last spring, was able to breastfeed him with the support of LLL group members. Despite having had top surgery that removed most of his breast tissue, Trevor says he’s been able to breastfeed using his own milk production along with donated breast milk.

Trevor is just one of many who is breaking ground in what I recently called the “trans baby boom.” As acceptance and visibility of transgender people increases, so do stories of trans people experiencing many things across the life cycle, including pregnancy and parenting. Because resources about transgender pregnancy are so scant, individuals have to be resourceful and figure out ways to adapt existing resources to their own situation. Trevor says he found useful information in resources about breastfeeding for women who’d had breast reductions, but this search for help also led Trevor to meetings of the local La Leche League in his Canadian town. While at first he was hesitant, he found acceptance from his pregnancy and parenting peers. He tells the story on his blog, Milk Junkies:

Near the end of my pregnancy, I went to my first breastfeeding support meeting, facilitated by La Leche League. I was excited at the opportunity to learn, and terribly nervous in a room full of strangers – I was a guy at a women-only peer-to-peer help group. La Leche League is an international nonprofit organization dedicated to supporting and educating women who want to breastfeed. When it came to be my turn to speak, I gave my carefully prepared spiel: “My name is Trevor and I am able to be pregnant because I am transgender. This means that I was born female but transitioned to male by taking hormones and having chest surgery. When my partner and I decided to start a family, we got advice from my doctors and I stopped taking my testosterone. My baby is due in April. Because my surgery removed most of my breast tissue, I don’t know how much I’ll be able to breastfeed, but I really want to try.”

With my face bright red and my palms sweating, I looked up to see many of the women in the room nodding their heads and smiling at me. By this point I was quite far along in my pregnancy, so they knew I was the real thing. Over the course of the meeting, people discussed their various nursing challenges and asked each other questions. I mostly remained silent. After it was over, several women came to me to say how impressed they were by my determination to breastfeed and that they hoped it would go well for me. I was ecstatic at their response – I’d been initially unsure of whether I’d even be allowed to attend an LLL meeting as a guy, and I certainly didn’t expect to be welcomed with open arms. This was the beginning of what became an incredible support system that I credit with helping me to nurse my baby for his first year of life.

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While Trevor wrote about his experiences as a breastfeeding dad on HuffPo back in April, his story made headlines last week after the news that he tried to apply to be an LLL volunteer leader and was denied because of his gender identity. La Leche League has since said they will be revisiting their policies in response to the incident. While we don’t know yet what LLL will decide about Trevor and other parents like him, it highlights some of the challenges brought up by our shifting understanding of gender and identity for the women’s health movement. For LLL, the question becomes whether gender is really the most important identity marker through which to be organizing their particular community. In this scenario, breastfeeding seems like the most important identifier, and regardless of gender, LLL could be a place where breastfeeding parents found support and kinship.

Similar questions have come in other feminist and reproductive health spaces. I’ve heard from trans or gender non-conforming doulas about challenges finding acceptance amongst doula groups. Big organizations, local groups, even all women’s colleges are dealing with the questions of how to adapt their missions, and who they include in their circles, to the changing notions of gender and identity in today’s society.

Whatever LLL decides, this controversy has served one huge purpose: by elevating the experience of one trans parent, resources and a community were created where there hadn’t been before. Trevor’s blog provides useful information on breastfeeding for trans parents, and he’s also started a facebook group that specifically supports trans parents. I learned a lot about the possibilities of breastfeeding post-top surgery from reading about Trevor’s experience. Milk production is possible after surgery, and supplementing with donated breastmilk using an at-breast supplementation system (a tube connected to a bottle that is attached next to the nipple) allows for additional nutrition while continuing to stimulate the parent’s milk supply (as opposed to bottle feeding which does not provide stimulation). It’s likely that what he has learned will help others who come after him, and I hope LLL sees that he and others like him can be a resource to all breastfeeding parents. 

Culture & Conversation Family

Breastfeeding, Bias, and Men Who Give Birth: Q&A With Trans Activist Trevor MacDonald

Britni de la Cretaz

In his new parenting memoir, Trevor MacDonald talks about pregnancy and breastfeeding as a trans man—and why we must dislodge the idea that bearing children is only women's labor.

Pregnancy, birth, and breastfeeding are acts often associated with womanhood. We talk about pregnant women and nursing mothers, but this language—which depends on the male-female gender binary—seems inadequate as trans and nonbinary folks are increasingly visible in the parenting sphere.

With his first book, Where’s the Mother?: Stories From A Transgender Dad, Trevor MacDonald hopes to blow the conversation wide open. MacDonald is a Canadian author who has been blogging about his journey as a nursing man on his blog, Milk Junkies, since 2011. He also facilitates a Facebook group for trans folks who nurse, and he initiated and helped design a University of Ottawa study focusing on the experiences of transmasculine individuals with pregnancy, birth, and infant feeding.

MacDonald’s book explores his transition from living as female to living openly as a man, and how that transition ultimately led to his decision to carry and birth a child with his partner.

By sharing his experiences and documenting the many challenges he faced as a man who planned to give birth and nurse his baby, MacDonald asks readers to reconsider everything they think they know about what it means to be a gestational parent. By the end of the book, readers come away understanding that despite a person’s gender, pregnancy and nursing are universal experiences and valid regardless of how they happen. MacDonald’s voice is an important and necessary one in the birthing community, and there are surely many more people out there like him.

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Rewire: You talk a lot about struggling to find literature that you related to because pregnancy, birth, and breastfeeding are typically only associated with women—and motherhood. Can you tell me about the kind of language you’d like to see used to talk about these experiences and why it’s important?

Trevor MacDonald: I think I was a bit naive at first when I was reading those materials. I felt like, “If only the authors knew, I’m sure they would have used different language. They just didn’t know about people like me.” And that’s definitely been the case for some of those authors. Many are starting to change language and using words like “parents” or “pregnant people.” It’s a simple shift, really.

Where I was naive, though, is that there are some people who really don’t want to use inclusive language. Ina May Gaskin is one. I had read her book [Ina May’s Guide to Childbirth] during my first pregnancy and had been so inspired by her writing, and the birth stories are so valuable and needed. I was so hungry for information about what others had experienced. I love that book so dearly, and to realize she really was opposed to including gender-diverse people in her writing was really upsetting. [Gaskin signed this open letter by Woman-Centered Midwifery, a group of “gender-critical” midwives who believe that biological sex determines gender and were concerned about the Midwives Alliance of North America’s use of gender-neutral language to talk about pregnancy and birth.]

It’s also really important to me to point out that no one needs to throw out the words “mother” or “woman”; you just need to include more words. So you could say “women and men and gender-nonconforming people” or “parents.” It’s nice to have more than one word to mix things up a little bit.

Rewire: What was the decision to carry a baby like for you?

TM: It was something I’d never thought I would do until after I transitioned and after getting together with my partner. For me, transitioning in the medical way that I did [through hormone therapy and top surgery involving breast removal] made me comfortable enough with myself to contemplate carrying a baby. Before that, there was so much stress and constant background noise in my thoughts and in my life to do with gender, with bathrooms, and with all the ways I really wasn’t comfortable. When I transitioned and so much of that fell away, I started to consider things I never had before. It helped that I was able to present as male throughout my pregnancies because I had taken testosterone [before pregnancy]. Those things enabled me to express my gender and present myself during pregnancy in ways that were comfortable for me.

Rewire: Did you experience any gender dysphoriathe distress or discomfort that occurs when the gender someone is assigned does not align with their actual gender—during your pregnancy?

TM: For sure, but for me it was more around medical stuff than around everyday living. In my everyday life, I was still presenting as male. But with health-care providers, especially providers who specialize in prenatal care, they’re so used to everything being woman-centered, and it’s really important to some providers to use woman-centered language.

I didn’t have any providers who had worked with an openly trans client before, so people certainly had trouble with the language. One midwife offered a blanket apology that she was going to have trouble remembering to use the right words and that she didn’t mean to be offensive. For me, I think I would have preferred if she had made more of a commitment to trying to change her language—going beyond apologizing, but trying to do something to remember to use my pronouns. I think it must be hard when it’s your first client who has asked you to use new language. It’s a new skill that has to be practiced and learned, like any other.

Another place where I sometimes experienced challenges was when people at work who had previously been using the correct pronouns for me switched to using the word “mom” and female pronouns when they found out I was pregnant.

But for me personally, in my body, I didn’t feel like the experience of being pregnant triggered dysphoria. It was more the way society responded to me that did.

Rewire: Birthing at home was something important to you. Can you talk a bit about why that option felt safest?

TM: I think the difference for me was that care is different. In Canada, we have midwifery care that is part of the health-care system, and it is covered by insurance. We still have a shortage of midwives, so not everyone who wants one can get one. I was fortunate to get midwives for both my births. For me, the continuity of care that they provide and that you get with a home birth is important.

At a hospital birth, there is no way to meet all your providers before you go there and labor, and I felt like there might be a lot of explaining that I might have to do. I did go to a hospital during pregnancy and another time when I had a miscarriage. I had to come out to every provider there, starting with the first nurse and every subsequent person that I saw. Each person needed to hear the same story about how I, a man, was pregnant. One doctor even had a lot of questions about how I could no longer be taking testosterone and still have facial hair. I couldn’t imagine having to explain those things and educate during labor.

Even with midwives, though, it’s not a magical recipe for getting exactly the kind of care that you need. I still had midwives at my first birth that I hadn’t met before.

Rewire: How do you think care providers—whether they’re doctors or midwives, or lactation consultants—can best support families like yours, or people who are not women but may be giving birth or nursing their babies?

TM: I think considering the topic, doing reading and practicing using the language ahead of time, before they ever meet their first trans or gender-nonconforming client is really important. There are more and more resources available now and places to go to read about people’s experiences, and there are a number of different medical associations who have called on their members to do exactly that. This is so they are not asking their individual patients to educate them, particularly when that person needs care and is in a vulnerable position. That’s not the time to be asking questions that they could learn about in other places.

Rewire: Finding donor milk for your son Jacob seemed to be quite a challenge. You mention that you produce about a quarter of the milk your baby needed, and the rest had to come from donors. Can you talk about what some of the challenges to finding donor milk are? Do you think protocols that see milk sharing as “risky” keep babies from being breastfed who might otherwise benefit from receiving breast milk?

TM: I think some of the taboo against milk sharing is really starting to shift in our culture right now. Currently, a lot of regulatory bodies—for example, the Food and Drug Administration and Health Canada—have a position against peer-to-peer milk sharing—like through Facebook groups like Human Milk 4 Human Babies, where we found many of our milk donors.

But La Leche League (LLL) has actually changed their position on it. LLL’s leaders, who facilitate their local support groups, used to not be allowed to discuss peer-to-peer milk sharing in any way, but last year the organization released a statement with a new policy. Leaders are allowed now to share information and can say that these milk sharing websites exist. It would be a great shift if other groups start to take a position more like LLL, where they can provide information. It would be awesome if medical professionals started to tell patients that these networks exist. Karleen Gribble has written papers about the ethics of peer-to-peer milk sharing and the ethical implications of letting patients know about it and how care providers could discuss risks and benefits, not just of peer-to-peer milk sharing, but of using formula.

In pop culture, when people talk about being worried about milk sharing, the fear most often brought up has to do with diseases like HIV. But something we had to consider as well was the medications that people were taking and whether it could be passed through breast milk. Many people who donate milk through peer-to-peer sharing do so because formal milk banks have such strict requirements around who can donate to them. Formal milk banks are not necessarily in competition with peer-to-peer milk sharing, which is important to understand.

Rewire: You talk a lot in the book about milk donation and the community that sprung up around you to help your family achieve your breastfeeding goals. Can you speak about the support you received and how it affected your breastfeeding journey?

TM: We met people that we otherwise never would have met and never would have become friends with. Many of our milk donors are still our friends, and they were such a diverse bunch of people. From a Mormon donor to a military family to a Mennonite family, all these different kinds of families from different backgrounds came together to help us feed our baby. It was amazing to meet these different people and to realize that despite us being a different kind of family in this one particular way, what was most important to all these people was that a baby needed breast milk.

Rewire: It sounds like prior to having your son, you didn’t know any other trans people who had nursed their babies. Has that changed? Are their experiences similar to yours?

TM: Before Jacob, I only knew about the guy, Thomas Beatie, who went on Oprah. I didn’t know anyone in person. I knew a few trans people who had children prior to transition. Through writing my blog, that’s how I first started to connect to a lot of other trans parents and people who were carrying babies while being out as trans. People asked me questions through my blog about how I navigated the medical system and a lot of questions about breastfeeding.

I also got a lot of questions from cisgender women as well, who were grappling with all kinds of different breastfeeding challenges. Many people deal with low milk supply and try to use a supplementer, like I use to nurse my baby (since I only make about a quarter of the milk my baby needs, I use a supplementer to deliver the milk at my chest, which allows me to feed my baby at my chest). So many people can relate to these challenges. A lot of the time, it’s a private struggle that people have, and it’s intense but you don’t necessarily talk about it that much. All kinds of people reached out to me because they could relate to these issues.

Rewire: What do you wish you had known before giving birth to Jacob?

TM: I wish I had trusted my own instincts a little bit more, and given myself more space to just see what my body would want to do in labor. I felt like I was looking to my care providers and my doula for suggestions, and I’m sure a lot of people have that experience when they’re going through something they’ve never been through before.

Rewire: What do you hope people take away from your book?

TM: I really hope that it will open up conversations. I hope it will provide opportunities for people to talk more about gender diversity, not just generally, but in parenthood and related to pregnancy and breastfeeding. If this book contributed to a conversation that way and opened up discussion, that would be amazing. I would be really thrilled.

This interview was conducted by email and by phone. It has been lightly edited for length and clarity. 

Commentary LGBTQ

Anti-Transgender Policies Go Beyond Bathroom Bills

Jordan Scruggs

It is an ongoing and constant battle in Tennessee for LGBTQ students and adults to find the support they need and deserve.

This piece is published in collaboration with Echoing Ida, a Forward Together project.

I was 8 years old in 1998 when gay college student Matthew Shepard was tied to a fence, beaten, and left to die near Laramie, Wyoming. Eleven years after that, President Barack Obama signed the Matthew Shepard and James Byrd Jr. Hate Crime Prevention Act making anti-LGBTQ violence a federal hate crime. It is currently the only protection LGBTQ people have in my home state of Tennessee. But I had already realized that I could be hated by or rejected from my community because of my sexuality or gender expression.

Only three of Tennessee’s counties protect people from being fired from their jobs due to their sexual orientation, and a transgender person can be fired anywhere in the state for simply expressing themselves in the gender they identify with rather than the sex listed on their birth certificate.

And the state is actively working to pass more discriminatory laws. In February of this year, Tennessee legislators proposed a bill that would allow mental health workers to deny services to patients if they disagreed with the patient’s sexuality or gender expression. They are also considering HB 2414, an anti-transgender bill similar to the one recently passed in North Carolina, requiring transgender students to use the school bathrooms that adhere to the sex on their birth certificate.

But I know this is about more than a bathroom.

It’s about Republicans and other conservative leaders using their positions and their power to discriminate against LGBTQ people. It’s about living in fear that they’ll come after you. Stressing over job security, bathroom security, and life security.

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I am very familiar with this fear. I live with depression and anxiety. Both began when I was 11 and realized that there were people who might hate me or want to harm me for something I couldn’t help or stop: being a genderqueer-bodied person whose sexuality was queer. I knew that it wasn’t something that was seen as positive. I knew that I wasn’t ready to leave my community. So I lived in fear of being outed. I hid myself from friends and family for years, and I would become anxious any time I had to talk about relationships.

I even had a “just in case” plan. Between the ages of 11 and 17, I had a packed bag hidden in the closet just in case I became homeless as a result of being outed. I had $120 stashed away in shoes, toys, and bibles. I was prepared with my plan because I was aware that I could be one of the 40 percent of homeless youth who identify as LGBTQ.

The push from powerful legislators to make this situation even worse in Tennessee is part of a consistent pattern of homophobic and transphobic rhetoric that my peers and I have experienced. When I was in high school, I watched a gay student pack up his locker and get escorted from campus. A month later, I would contemplate and come close to a suicide attempt. More recently, from 2011 through 2013, Stacey Campfield, a former state legislator and Republican, repeatedly tried to pass the notorious “Don’t Say Gay” bill, which would have prohibited staff members at Tennessee public schools from talking to a student about the student’s sexual orientation. Just this year, Franklin County High School had to fight to keep its Gay-Straight Alliance because parents likened the group, a national organization that focuses on preventing bullying and offering support for LGBTQ students, to terrorism.

It is an ongoing and constant battle in Tennessee for LGBTQ students and adults to find the support they need and deserve: the right to access mental health services, to marry, to share a home, to get an education, and, yes, to use the bathroom of their choice.

In 2011, I joined the Youth Advisory Council of the Trevor Project, a nonprofit organization that focuses on suicide prevention for lesbian, gay, bisexual, transgender, and questioning youth. Staff asked me what I wanted to do in my position. My only goal was to give LGBTQ youth in Tennessee the support I didn’t have when I was younger.

Anti-LGBTQ legislation did not start with having access to a bathroom, and it will not end with fighting for bathroom access either. This is about lives, and the discrimination that I still fear will prevent me and others from the pursuit of happiness, outlined in the Constitution, we are told about during our time in school. But, in today’s United States, pursuit of happiness means little without bathroom security, job security, and life security. I won’t stop until we all have them.