Breastfeeding men (ugh)
How a nonsense story about how men’s breast milk is better than women’s made it around the world.
Since last week’s issue, two big stories have demonstrated just how bad reporting on trans-related issues really can be. I had intended to write about both, but it turns out I have more to say about them than can fit in one post, so I’ll return to the second – the widespread misreporting of a man convicted of a particularly brutal murder as a woman – in another issue.
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In this issue, I’ll focus on the infuriating story about breast milk produced by men who identify as women, using a protocol developed to induce lactation in adoptive mothers. It all started because an ideologically captured NHS trust – the one that covers Brighton, the UK’s equivalent of Portland/San Francisco – muddled its messaging on breastfeeding and parenting more generally, and a small but very worthy pressure group representing the children of transitioners wrote to it to complain.
The NHS trust’s reply was full of stupidity and untruth: you can read it here.
It performs a sleight of hand that starts with the well-established fact that the ideal food for an infant is his or her mother’s breast milk. It then calls this “human milk”, and mentions the protocol for establishing lactation in women who haven’t given birth without stating their sex, just describing them as “parents”. It goes on to list five research papers, only one of which refers to using this protocol on a man (a “transgender woman”). That paper describes a single case study of a single man – and the researchers didn’t even take any steps to check that he was in fact the source of the milk samples he provided. Since he was living with the woman who had just given birth, it wouldn’t have been hard for him to get hold of actual mother’s milk to provide instead of whatever he had managed to produce.
For more details of this bait-and-switch, see Milli Hill’s Substack or this thread by Dr Emma Hilton (@fondofbeetles).
You know that story about breast milk from a man being as good - BETTER - than that from a woman? https://t.co/4MOyGRDe9J
— Emma Hilton (@FondOfBeetles) February 21, 2024
The letter came to the attention of think-tank Policy Exchange, which publishes a regular email newsletter entitled “Biology Matters” that collates gender nonsense. From there it got reported in a few papers – and then it went absolutely bonkers, getting picked up around the world.
Almost all the mainstream reporting was execrable. The low point was when the BBC brought on a trainee lactation consultant of indeterminate gender identity called Kate Luxion, who said, very dogmatically, that men’s breast milk was of equivalent quality to, or even better than, that from a woman. This obvious bullshit received no pushback from the interviewer. (The clip is embedded in Milli’s Substack above.)
Mad health stories do unfortunately break through into the public consciousness from time to time, and they can cause an awful lot of harm. The paradigmatic case was of the MMR (measles, mumps and rubella) vaccine, which was notoriously blamed for rising diagnoses of infant autism by Dr Andrew Wakefield and co-authors in a poorly designed case study of 12 children published in the Lancet in 1998. The resulting global scare led to plummeting vaccination rates, many outbreaks of measles and wider vaccine hesitancy that persists a quarter-century later.
That story took off, in part, by chance. But it couldn’t ever have done so if it hadn’t latched on to some deep-seated emotions – parents’ instinctive caution when it comes to their babies; fear of “unnatural” substances entering the body by “unnatural” routes; distrust of authorities.
My first child was born in 2001, at the height of the panic, and I remember how conflicted I felt about getting him his MMR shots. I was working at the Centre for Mathematical Sciences in Cambridge at the time, for a group promoting public understanding of mathematics and public numeracy more generally. I had already got my PhD in maths, and during my first degree I had taken all the stats courses offered. I went on to work for the Royal Statistical Society, in which I wrote and edited articles about the use and misuse of statistics in everyday life.
In other words, I was highly numerate. But it doesn’t matter how much you tell yourself that you know how to look at evidence and data, and that the worries here really don’t stack up: you cannot help feeling that there is no smoke without fire. You’re in a heightened state when you have a small baby, and you alarm easily. I remember the fuss starting me on a quest to look into the side effects of other vaccines, too – and I’m not someone who spends much time worrying about such issues; if there’s an opposite to hypochondriac, that’s me.
We’re probably all aware, post-Covid, that minorities with good reason to distrust doctors were less likely to get vaccinated. But this is just the extreme version of something that happens more generally: the more insistently public authorities tell you that something is safe, the more it makes you worry. That one poor piece in the Lancet caused untold harm. (It’s also an interesting case study in how long it takes to change an editorial position: the Lancet took 12 years to retract Wakefield’s paper, despite other medical outlets and research teams convincingly demonstrating that the work was baseless years earlier.) There’s a timeline of the whole affair here.
The elements that gave the men’s breast milk story were a bit different. One is a strong tendency to think lightly of anything that only women can do. Growing an entire new human, somehow getting it out of your body and then nourishing it exclusively for months is the most extraordinary feat that the human body, of either sex, is capable of. Just because most of the female half of the human race can manage it doesn’t make it less amazing. And yet every time we talk about the sex differences where women come second – that we’re smaller, slower and less muscular and therefore need our own sport categories, for example – it’s forgotten that these sex differences are the flipside of the extraordinary things our bodies, and our bodies alone, evolved to do.
One way the female body has historically been belittled is by imagining pregnancy as mere incubation of the generative force supplied by the man. Feminist philosopher Caroline Whitbeck memorably described Aristotle’s view of the woman’s body as the lowly vessel in which the man’s seed grows as the “flowerpot theory of pregnancy”; I hear echoes of this every time I read another breathless and totally unrealistic story about how uterus transplants for transwomen are coming soon. I wonder how the boosters think the exquisitely regulated supply of nutrient-rich blood to that uterus will work in a body that doesn’t have the right plumbing, and how the relevant signals from the man’s brain and glands to the baby’s developing bodies will be orchestrated through the entire nine months.
I really think some people think a woman is just a small, flabby man with an extra hole and an internal growbag something like the ones gardeners use for seedlings. And if that’s the case, since men can indeed grow breast tissue if they take oestrogen, why couldn’t they breastfeed as well as women – indeed better, since apparently the only sex differences that count are those where men excel?
Alongside this contempt for and belittling of what is amazing and special about pregnancy and childbirth runs a deep envy. I often wonder where Freud even got the theory of penis envy from. It seems obvious that men find the fact that only women have the godlike ability to create new life far more envy-inducing – after all, they have always sought to control and co-opt it in an endless variety of ways. All this is highly relevant to poor reporting: things that are both belittled and envied are rarely talked about sensibly.
Separately, breastfeeding advocacy is in trouble. This isn’t my area of expertise, but women who know a lot about it say that it has struggled to recover from the backlash against the message that “breast is best”. That was taken to stigmatise women who couldn’t, or who chose not to, breastfeed their babies. Breastfeeding advocacy groups are still atoning for that, and it’s paralysed them.
It definitely is a delicate task to get across the message that yes, breast milk is the ideal food for infants, but the alternatives are good enough that if you don’t breastfeed you really shouldn’t beat yourself up about it. Give it your best shot – but don’t fret if it doesn’t work. We know what helps establish breastfeeding and that’s not supplementing it at all – but don’t worry if you do use formula either alongside breastfeeding or instead of it. Individual women are best placed to make their own choices – but it’s important to create an environment that makes breastfeeding the easiest option and avoids suggest-selling the alternatives…
I do see the difficulties, but it’s hardly as if this is the only difficult public-health messaging anyone has ever had to try to get across! And we don’t just throw our hands up in despair when messages are important but nuanced. We do the research, test options and use the feedback to hone them. Instead breastfeeding advocates seem unable to speak with a confident united voice.
And then, all the money is on the other side. The “product” breastfeeding advocates are selling is free; formula is a multi-billion dollar business. The upshot is a lot of small, volunteer-led or run, cash-poor organisations unable to articulate a clear mission – ripe for institutional capture.
And captured they have been. Probably the best-known is the La Leche League, founded in 1956 by seven mothers who wanted to help each other and friends to breastfeed. It now has chapters all over the world – and they’ve all lost the plot. Here’s what the British chapter says on its website:
Trans men, trans women [remember, these are men] and non-binary individuals [these can be either sex] may choose to breastfeed or chestfeed their babies. You do not need to have given birth to breastfeed or chestfeed, as we can also see in the experiences of those nursing adopted babies.
Transgender dad [remember, this is a woman] Trevor MacDonald writes that, “It is equally important to note that some trans people experience severe gender dysphoria when breast or chestfeeding, and that they may decide not to nurse their babies for mental health reasons. Trans parents choosing to breast or chestfeed and those choosing to suppress lactation and bottlefeed may require the support of breastfeeding counsellors or lactation professionals.”
That’s an awfully long way to say: “breastfeeding? What’s that? Oh well, it doesn’t matter, don’t bother. Anyone can do it, and it doesn’t matter whether they do or don’t – at least for the baby; the only thing that matters when deciding is what validates an adult’s identity.”
But what really makes this story so poisonous, and so difficult to report well, is that breastfeeding has a fetishistic aspect for some men who identify as women. Autogynephilia – a man’s erotic fixation on the idea of himself as a woman – isn’t the only sexuality that’s basically impossible to understand if it’s not yours; why other people find what they do a turn-on is basically always opaque. But AGP, as it’s often called, is even more opaque to others than most desires. It’s so strange, and it’s so shameful – but above all, it’s central to that sexuality that it not be acknowledged, because the fantasy isn’t of pretending to be a woman, or even being mistaken for a woman, it’s of really, truly being a woman. In the words of writer and historian Alice Dreger, which I quoted in my book, autogynephilia the “love that would really rather you didn’t speak its name”.
So no mainstream journalists even engaged with the question of why a man who identifies as a woman might seek to breastfeed. If you’re willing to call such a man a woman (even a “trans woman”) and “she” – as every single mainstream outlet does – maybe the question doesn’t really arise in your mind. This individual is a woman after all, isn’t she, and breastfeeding is something that women do. The question of motive flies past without you ever even thinking, “hmmm, that’s odd...”
Even people who know perfectly well that this is fetishistic behaviour often misunderstand precisely what’s going on. They register that these men are getting a sexual kick from feeding their babies, but they think it’s about getting the baby to suck their nipples. It’s not, or at least not primarily: it’s because breastfeeding is coded female (because, duh, it is female). The men also find it exciting to be in women-only pregnancy and childbirth support groups – or groups where women support each other with endometriosis or menopause, neither of which are remotely sexy topics to actual women.
To quote Anne Lawrence, the self-described autogynephilic man who collected hundreds of testimonies from other AGPs in his book “Men Trapped in Men’s Bodies”, almost anything coded female or feminine can cause an “intense, perplexing, shame-inducing erotic arousal that seems to simultaneously animate and discredit [autogynephiles’] desires to have female bodies”. Among the subjects that featured in his informants’ erotic fantasies were pushing a baby buggy, joining a knitting circle, being called “ma’am”, having bubble-gum-blowing contests with girls, wearing clip-on earrings and taking birth-control pills.
Once you understand that the men seeking to breastfeed babies are probably all autogynephiles, and you understand what drives them, you realise that trans-identified men who use this protocol to induce lactation will, without a doubt, seek to do absolutely everything else that breastfeeding women do, even quite unusual things. They’ll join support groups, both online and in real life – and this is why La Leche League and the rest fell to transactivism so long ago; these groups, so intensely and exclusively female, were among the very first targeted by autogynephilic transactivists, along with rape-crisis centres and the like. These men will attend clinics for women who have trouble establishing breastfeeding. They’ll make a big deal out of pumping and storing their milk. They’ll even seek to donate to milk banks.
The final bit of the story of how La Leche League fell – and how we arrived at a place where an obviously nonsense story about the wonders of male breast milk could fly around the world – is the unholy alliance seen so often in trans advocacy between these men who fetishise womanhood, and women who despise it. The sad fact is that a lot of women think at least as poorly of women as the worst male misogynists. They’re desperate not to be seen as women themselves, they find it flattering when men claim to be women – and they spend their time forcefully denying that women have any sex-specific rights and needs.
These women are keen to cede anything that’s just for women because they see women, and women’s spaces and services, as low status. If a man wants in, that’s a compliment, and men make the best women. These women don’t like to be reminded that humans are mammals, and that means a fair bit of blood and mess, especially from the female half of the species. They find female bodily functions like menstruation, pregnancy, childbirth and breastfeeding low-class and animalistic. Their disdain for womanhood makes them denigrate anything that only women can do, deliberately deaf and blind to the fact that our strengths also create vulnerabilities and needs – and willing conspirators with the men for whom appropriation of womanhood is their deepest sexual pleasure.
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So what should journalists do? We do have to start talking about autogynephilia, but it will be a long slog: you can’t just drop the facts about autogynephilia in the middle of a sober article about the science of lactation when your readers have no idea such a thing exists, and moreover have been coached over more than a decade to think any negative story about trans people is motivated by bigotry. It’s going to take ages, as always, to undo even part of the harm done by years of unchecked propaganda and misinformation.