The scene is a familiar one: three o’clock in the morning, the baby wakes for yet another feed. Exhausted mum drags herself out of bed and soothes her crying infant at the breast.
She looks enviously at her sleeping male partner as he snores contentedly, and feels a surge of irritation. How unfair it is that he can’t share this particular load, she thinks.
And yet the latest row in the world of transgender politics might make her think twice.
Because an NHS Trust says drug-induced milk from transgender women who were born male is as good for babies as a mother’s breast milk.
A leaked letter from the medical director of University Hospitals Sussex NHS Foundation Trust, published this week, describes both as ‘human milk’ and says that they are the ‘ideal food for infants’.
The letter was sent on behalf of the Trust’s chief executive in response to a campaign group’s complaint about gender policies.
Last year, trans woman Mika Minio-Paluello – who was born male but identifies as a woman – posted a picture appearing to show her breastfeeding her baby on a bus, with the accompanying message ‘Trans women can breastfeed’. Feminists were outraged.
Labour MP Rosie Duffield said: ‘Babies can’t be used as guinea pigs for someone else’s lifestyle choice.
‘When a man has not and cannot grow a baby, why on earth are we pandering to this? Who does it benefit? Not the children. We wouldn’t do any other medical experiments on babies. Breast milk made by a baby’s biological mother is tailor-made for that baby.’
Have women been doing this wrong all along, the frazzled mum might well wonder.
So what’s the truth? Can a biological male really breastfeed a baby by producing milk from their nipples?
The complex answer is yes and no.
By using a regimen known as the Newman-Goldfarb protocol, originally developed in 2000 for adoptive mothers, the body can be tricked into lactating even if it’s male.
It works by mimicking the hormonal changes that take place naturally in the body of a woman who has just given birth, and involves several weeks of regularly using a pump to stimulate the breast, taking a combination of contraceptive hormones and the anti-nausea drug domperidone, which increases levels of the milk-producing hormone prolactin.
But if that sounds simple, it really isn’t. For a start, domperidone is banned in the US over concerns it causes heart problems.
The NHS sometimes offers it to breastfeeding women who are struggling with low milk supply, as long as neither mother nor baby has any heart issues, and with clear instructions to report any changes in the baby’s behaviour.
It should be used, says guidance, only ‘for a short time’. (Minio-Paluello says she breastfed her child for ‘a few weeks’.)
What’s more, it’s not at all clear what else is in a trans woman’s ‘milk’. Since trans women are likely to be taking other prescription drugs as part of their transition, such as anti-androgens to lower their production of testosterone, and oestrogen and progesterone to help them create a less ‘masculine’ appearance, critics say the milk is potentially unsafe for a newborn, or at the very least should be rigorously tested.
Feminists mutter darkly about yet more double standards from the medical establishment — women, after all, are told to avoid aspirin while breastfeeding and to abstain even from the odd glass of wine because no one knows how much gets through to the milk.
Until very recently, of course, the idea of a small baby being nursed by a biological male would have been regarded as quite bizarre, and the truth is there is very little research into male ‘milk’.
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