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The influence of cultural, individual, socioeconomic, and historical factors has greatly contributed to feeding practices. 

The significance of breastfeeding cannot be ignored, as it positively affects an infant’s health. However, with increasing global acceptance of gender and sexual minorities, the family structure has evolved. Multiple factors have impacted the normal practice of breastfeeding. A recent cross-sectional study published in EClinicalMedicine investigated the factors influencing breast or chest feeding (BCF) among transgender and gender-diverse parents. 

Participant’s Characteristics and Study’s Outcome

The study included data from 647 participants, with responses from 361 transgender women, 231 transgender men, and 55 individuals who identified as other genders. The average age of the participants was 30.8 years.

The majority of the individuals enrolled in the study identified themselves as transgender man (TM), with only one-third practicing exclusive breastfeeding for the first six months. Similarly, more than half of the population did not breast or chest-feed their child for at least a year. Finally, every four in five infants was given human milk as the first feed. 

Factors That Affect Acceptance of Human Milk as the First Feed

Participants who had hormonal therapy following the birth of their child, those with a history of family or partner violence, those who did not receive feeding education, and those who chose non-traditional methods of mating were less likely to accept human milk as the first feed for their child. Furthermore, participants with high gender dysmorphia scores, high family violence scores, babies born through assisted reproductive techniques, and low feeding-related education were least likely to breast or chest-feed their child exclusively.  

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Family Structure and Reproductive Methods Impact Breastfeeding Choices

Those who grew up in nuclear or extended families were more likely to choose exclusive BCF, whereas those with higher incomes preferred a shorter feeding duration. Those who conceived through traditional sexual intercourse were likelier to practice exclusive feeding than those who opted for artificial assisted techniques, adoption, and surrogacy.

Hormonal Therapy and Psychological Factors Affecting Breast or Chest Feeding Rates

Moreover, individuals receiving hormonal therapy before the birth of their child and psychological factors such as higher gender dysphoria scores and the early time of coming out were associated with lower exclusive BCF rates. In addition, environmental and social factors such as childhood abuse and intimate partner violence contributed to poor BCF outcomes in both cisgender and transgender populations.

Discrimination Hinders Breastfeeding Practices

Another important finding in this study was that discrimination while seeking childbearing healthcare and childcare education were independent factors contributing to unsatisfactory BCF practices. 

It is suggested that by improving the accessibility to human breast milk, providing family support, developing educational strategies, and abolishing discriminatory behavior while seeking healthcare the rate of exclusive and continuous breastfeeding can be increased and overall breastfeeding behaviors in this population can be improved. Moreover, strategies such as assessing fertility intentions, providing professional guidance before requesting hormonal therapy, and allowing TGD parents to access donated human milk from milk banks can be applied to promote BCF.


Yang, H., Na, X., Zhang, Y., Xi, M., Yang, Y., Chen, R., & Zhao, A. (2023). Rates of breastfeeding or chestfeeding and influencing factors among transgender and gender-diverse parents: a cross sectional study. EClinicalMedicine, 57, 101847. https://doi.org/10.1016/j.eclinm.2023.101847 

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