Royal College issues ‘chestfeeding’ advice
Obstetricians and gynaecologists present official patient care rights for trans community
Trans parents should be given “chestfeeding” support, the Royal College of Obstetricians and Gynaecologists has said in the first draft guidance of its kind. The college said trans men who chose to chestfeed should be offered “support in the same manner as for cis-women”. Its draft guidance, the first it has published for trans and “gender diverse” people, added that trans men should be asked about their preferred manner of feeding before their baby is born.
‘Appropriate steps should be taken to ensure easy access to care without their gender being questioned’
TRANS parents should be given “chestfeeding” support, the Royal College of Obstetricians and Gynaecologists (RCOG) has said in the first draft guidance of its kind.
RCOG said trans men who chose to chest-feed should be offered support “in the same manner as for cis-women”.
Its draft guidance added that trans men should be asked about their preferred manner of feeding before their baby is born.
The document also recommends that “individuals should always be addressed and referred to in their stated preferences with regard to title, name, pronouns and family relationships”.
It is the first time that the Royal College has produced guidance for trans and “gender diverse” people in obstetrics and gynaecology, and is now open for consultation until September.
It is designed to help medical professionals use the latest available clinical evidence on childbirth, contraception, fertility, gynaecological procedures and cancer treatment and care. The document makes a series of recommendations to help improve care, including that trans people should be offered advice about fertility preservation when considering gender-affirming surgery or hormone therapies.
Mode of birth should be discussed with all female-born trans men who desire pregnancy, it says, as while some “strongly prefer a vaginal birth as an emotionally meaningful experience, others desire disconnection with the process” so opt for caesarean section.
The draft guidance also stresses that trans men who plan to “chest (breast) feed should be advised that testosterone is likely to suppress lactation” and that “it is recommended that men who chestfeed do not use testosterone”.
“Appropriate steps should be taken to ensure easy access to care without their gender being questioned or their confidentiality breached,” the guide says.
Controversially among campaigners who defend women-only provision, it recommends that “gender-diverse people should be allocated in-patient accommodation in line with their gender presentation, unless there is a significant reason”.
Trans men who conceive whilst 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.
The document also states that “gender diverse people should be offered health screening in accordance with national public health policies and clinical guidelines”.
It follows the Government’s women’s health strategy which said that transgender men and non-binary people with female reproductive organs should always receive screening invites so they can access cervical and breast cancer screening.
RCOG president Dr Edward Morris said: “Sadly, trans and gender diverse individuals say they often feel judged and misunderstood by the health service.
“This draft guideline is our first attempt to ensure we are providing personalised care for all our patients.”
Welcoming the guide, which is open for consultation until September 6, Clare Ettinghausen, from the Human Fertilisation and Embryology Authority, said “there is a lot of work to be done to ensure that healthcare is fully inclusive”.