Embracing Diversity in Birth & Lactation: The Path to Inclusive Care
Miriam Main, a director of La Leche League Great Britain (LLLGB), recently resigned in protest of LLLGB’s directive to inclusively support all lactating individuals, regardless of sex or gender identity. Her resignation letter, echoing sentiments from some birthworkers, expressed opposition to terms like “chestfeeding” and “birthing person,” citing concerns about the presence of “men” (including trans men and non-binary individuals) in meetings and potential impacts on group dynamics, safety, and mother-baby relationships. This discussion highlights broader debates over gender, inclusivity, and evolving language in birth and lactation support spaces.
Miriam Main’s Points
Main’s objections include:
- Women cannot be emotionally and physically open with “men” present
- Men will make LLL meetings feel unsafe
- It might be dangerous and unhealthy for men to feed babies
- Men feeding babies separates them from their mothers, causing damage to the mother-baby dyad.
She further argues that their inclusion could deter women from discussing topics like breastfeeding challenges and intimate partner violence. However, a Canadian 2019 study reveals that trans women are more often victims of gender-based violence, contradicting fears about their presence being inherently dangerous. Addressing myths that trans individuals cause harm is critical in reducing violence against this vulnerable population.
Main’s language suggests a belief in gender essentialism, asserting that only binary definitions of sex and gender are valid. This perspective, while common, conflicts with historical and contemporary evidence of diverse gender expressions across cultures. Birthworkers must challenge myths that hinder inclusivity, such as fears that “men” disrupt group dynamics. The reality is that shared challenges like sleepless nights, nipple pain, and societal pressures on infant feeding create a bond transcending gender.
The REAL Evidence
Concerns about safety and mother-baby bonds reflect unfounded fears, not evidence-based risks. No data supports the idea that trans parents harm babies through feeding. Trans men often serve as their children’s gestational parents, and non-gestational parents—including cisgender women, trans men, and trans women—may induce lactation through hormone protocols to share feeding responsibilities. Such decisions are made with mutual consent among parents and offer support to families, not disruption.
Main’s statement that “men” feeding babies is inherently dangerous lacks supporting evidence. Ashley Pickett, IBCLC, cites some evidence against all of Main’s assertions. Relevant research affirm the safety of milk produced by trans parents, noting no adverse effects for nursing infants when hormones are involved. For example, studies indicate minimal transfer of substances like spironolactone and cyproterone acetate to breast milk, causing no harm. These findings, combined with decades of postpartum GnRH usage, highlight that gender-affirming treatments do not endanger nursing infants.
The potential for trans women to lactate and nurse is a new phenomenon, and as such, bound to raise concerns. Ashley Pickett, IBCLC addresses this with the best available evidence also. She cites two articles showing no cause for concern at this time:
https://pubmed.ncbi.nlm.nih.gov/37138506/
https://pubmed.ncbi.nlm.nih.gov/7462406/
The broader issue surrounding Main’s resignation involves fear of erasure among cisgender women due to inclusive language. Cisgender women remain the majority of those who birth and lactate, while inclusive terminology extends support to trans and non-binary individuals. Recognizing and addressing the courage it takes for marginalized individuals to seek support can foster empathy and inclusion. Rather than excluding trans people, we should embrace the opportunity to learn from diverse experiences, enriching birth and lactation spaces for all.
Trans inclusion does not erase cisgender women’s experiences; instead, it expands freedom and authenticity for everyone by challenging restrictive gender norms. The contributions of trans individuals can deepen our understanding of gender oppression and violence. Creating inclusive spaces ensures community support is available to everyone who needs it, without diminishing anyone’s role in the circle of care.
About the Author
Keira Grant (she/her) Inclusion and Engagement Lead – Racialized Communities
Keira brings a wealth of experience to the Online Community Moderator role. She is a Queer, Black woman with a twenty-year track record in Equity, Diversity, and Inclusion (EDI) education, projects, and community building initiatives.