No, The CDC Has Not Endorsed Men Breastfeeding Infants

Quit playing

Contrary to what erstwhile California gubernatorial candidate-turned-Twitter-media-conglomerate @shellenberger breathlessly reported today, quoting such paragons of science journalism as Fox News and the Daily Mail, the CDC has not, in fact, endorsed biological males breastfeeding infants. (Note: the “Chestfeeding” section of the post is signed AG, which I’m assuming means @galexybrane.)

The articles referencing the new guidance for lactation in trans-identified males link back to two sections of the CDC’s website that… do not talk about trans-identified males at all. The first, under Breastfeeding and Special Circumstances, specifically addresses breast surgery. Towards the end of the page, after paragraphs on implants, breast reduction and mastectomy, we find this:

Can transgender parents who have had breast surgery breastfeed or chestfeed their infants?

Yes. Some transgender parents who have had breast/top surgery may wish to breastfeed, or chestfeed (a term used by some transgender and non-binary parents), their infants. Healthcare providers working with these families should be familiar with medical, emotional, and social aspects of gender transitions to provide optimal family-centered care and meet the nutritional needs of the infant. These families may need help with the following:

• Maximizing milk production

• Supplementing with pasteurized donor human milk or formula

• Medication to induce lactation or avoiding medications that inhibit lactation

• Suppressing lactation (for those choosing not to breastfeed or chestfeed)

• Finding appropriate lactation management support, peer support, and/or emotional support

The text is obviously referring to trans-identified females: top surgery means removing the breasts; it’s an elective mastectomy. So what the CDC is saying is that biological women who have had their breasts surgically removed may be able to breastfeed their babies.

Observe then the last sentence, emphasizing “optimal […] care and […] the nutritional needs of the infant,” followed by a list of likely areas of support. Sure, medication to induce lactation is mentioned, but again, this is clearly about females who have had most of their breast tissue removed, AND the text makes it clear that the health of the entire family is important, especially the baby.

The second page of the CDC’s supposed guidance for breastfeeding men is located under Nutrition, and addresses Health Equity Considerations (because of course.) Halfway down the page there is a section on Language, which is a perfectly boilerplate recitation of the current rules for linguistic inclusion and equity. Underneath the inevitable section on pronouns, there is this, in a highlighted box:

Remember that:

• Transgender and nonbinary-gendered individuals may give birth and breastfeed or feed at the chest (chestfeed). The gender identity or expression of transgender individuals is different from their sex at birth. The gender identity of nonbinary-gendered individuals does not fit neatly into either man or woman.

• An individual does not need to have given birth to breastfeed or chestfeed.

• Some families may have other preferred terminology for how they feed their babies, such as nursing, chestfeeding, or bodyfeeding.

Again, the transgender individuals mentioned here are obviously female: the “may give birth and breastfeed” makes that very clear. I suppose that if we were to squint, we could see the second bullet point, “An individual does not need to have given birth to breastfeed” as sort of maybe possibly hinting at the fact that men could breastfeed. But the fact that this passage is part of a discussion on equity, specifically “inclusive language,” and it is nestled between a point on gender identity and a point on preferred terminology makes it very hard for me to read it as anything other than an exhortation to not automatically dismiss a non-birthing parent who may want to breastfeed. It is certainly isn’t an endorsement of men lactating.

@shellenberger, as well as media outlets that makes it sound like the CDC provides, on its own website, a protocol for inducing lactation in men. The CDC does no such thing. At the very end of the page on Breastfeed and Special Circumstances, there is an external link to a paper on Lactation Care for the LGBTQ+ Patient, from the Academy of Breastfeeding Medicine (which, to be clear, is not a governmental body). The CDC website makes it very clear, via pop-up window, that you are leaving hallowed CDC ground and venturing into the land of content that the government cannot vouch for. Let me repeat: an endorsement this is not!

And what of the paper itself? Does is promote a lactation protocol including ”a contraceptive pill to produce estrogen, an anti-nausea medication, a heart medication, an antipsychotic, a sedative, and an off-label lactation drug called domperidone”?

No. In fact, on page 4, it states the following:

There exists no standard guidance on inducing lactation for any patient population. Different methods have been used for inducing lactation, including visualization/meditation, expression by hand or pump, feeding at the breast/chest, and combinations of oral contraceptive use followed by hormone withdrawal combined with galactogogues and expression

Sounds like not even the Academy of Breastfeeding Medicine is able to endorse a lactation protocol for males! WOW!

Look, I am not entirely unsympathetic to some of the concerns about “trans discourse.” I do think there is an element of social contagion in the rising number of autistic teenage girls identifying as trans; I think we should be curious about all children’s reasoning rather than defaulting to “affirming” their statements. I think it’s probably a bad idea to allow convicted male sex offenders to self-id as female in order to be housed in female prisons.

But

The kind of running-with-a-shocking headline that Michael Shellenberger et al are engaging in here is deeply unhelpful. There is no story here. Making a nothingburger into a story only cheapens your message and alienates anyone who isn’t already in the ingroup.

Make a bigger circle folks, always.