What Does Gender Affirming Lactation Care Actually Require?

I’m excited to share a newly published study I conducted with principal researcher Liat Shklarski, PhD, LCSW-R and co-author Heather Morgan Shott, MSW, examining how lactation support providers offer gender-affirming lactation care to transgender, nonbinary, and gender-diverse families.

The full study can be found here. It goes much deeper, but for now, here’s a quick summary of what we found.

At its core, this study argues for a shift away from one-size-fits-all models of feeding support and toward a more individualized, competency-based, and affirming approach. The question becomes less, “How much milk was produced?” and more, “What mattered to this family, and were we able to support it?”

In order to offer gender-affirming lactation care, providers described feeding goals that often extended beyond milk volume, latch, or infant weight gain. For some families, success included gender affirmation, reduced dysphoria, physical closeness, partner inclusion, role embodiment, combination feeding, formula feeding, donor milk, or the experience of feeding at the chest/body itself.

Affirming care was often described not simply as expertise, but as relationship. Providers talked less about mastering the “right” terminology such as chestfeeding or bodyfeeding, and more about cultivating humility: asking people how they want to be addressed, being willing to make repairs when mistakes happen, and resisting assumptions about bodies, identities, or family structures.

In many ways, the most meaningful interventions were not technical at all. They were moments that communicated attuned care.

The study also points to larger structural gaps. Many providers learned this work through self-education, community proximity, and informal mentorship rather than through formal lactation training. Participants also described documentation systems, hospital language, and clinical protocols that still often assume binary gender, cisgender motherhood, and one standard model of feeding.

For me, this feels like a meaningful direction not only for lactation care, but for healthcare more broadly: care that is clinically competent, emotionally attuned, structurally aware, and defined in collaboration with the people receiving it.