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.