Trans men should be supported to chestfeed their babies should they choose to do so, experts have said.
A new draft guideline from the Royal College of Obstetricians and Gynaecologists (RCOG) says trans men should be asked about their preferred manner of feeding before their baby is born and those who chose to chestfeed should be offered “chestfeeding support in the same manner as for cis-women”.
The guideline covers care for trans and gender diverse people though childbirth, contraception, fertility, gynaecological procedures and cancer treatment and care.
The document, which has been put out for consultation, makes a series of recommendations to help improve care.
What is chestfeeding?
Physically, chestfeeding is exactly the same as breastfeeding. Hormones trigger the body to make milk, the milk travels through glands and ducts ending at the nipple to feed a baby
Chestfeeding is used in the community of people who have recently given birth but don’t identify as women. They may be transgender people who were assigned female at birth but who now identify as men, or people who are non-binary
People who do identify as female may also prefer “chestfeeding” because of physical or emotional trauma related to their breasts. To them, the word “chest” is not as triggering as “breast” may be
It also says trans and gender diverse people should be offered advice about fertility preservation when considering gender-affirming surgery or hormone therapies.
It advises that trans men who conceive while taking masculinising hormone therapy should stop taking the hormones “as soon as possible” while those who are planning to conceive should stop their therapy for three months prior to conception.
And it urges healthcare workers to be aware trans and gender diverse people often face barriers when accessing healthcare services and to take steps to ensure they have easy access to care without “their gender being questioned or their confidentiality breached”.
Use of preferred pronouns
The document also states that “gender diverse people should be offered health screening in accordance with national public health policies and clinical guidelines” and that they should be addressed by their “preferred title, name and pronouns”.
It follows the government’s women’s health strategy which said transgender men and non-binary people with female reproductive organs should always receive screening invites so they can access cervical and breast cancer care programmes.
A barrier to care
RCOG president Dr Edward Morris said trans and gender diverse people said they “often feel judged and misunderstood by the health service”.
This, he said, created a barrier to accessing vital care.
“We, as healthcare professionals, have a role to play in making them feel listened to and recognised,” he added.
Commenting on the guideline, which is open for consultation until 6 September, Asha Kasliwal, president of the Faculty of Sexual and Reproductive Healthcare, said there were a number of instances of failure to “properly understand and evaluate gender diverse people’s healthcare needs”.
The guidelines, it was hoped, would “seek to break down barriers and improve the experiences” of trans and gender diverse people accessing obstetric and gynaecological services.
An ’emotional experience’
But Clare Ettinghausen, from the Human Fertilisation and Embryology Authority, said there was “a lot of work to be done” to ensure healthcare was fully inclusive.
“It’s important that a diverse group of voices further inform this work so once finalised, the guidance can be put into practice and begin making a difference,” she said.
“Treatment can be a very emotional experience so we also recommend that anyone thinking about having fertility treatment has the right support.”