Diana’s Little Corner in the Nutmeg State: Interesting Paper

Wednesday, May 09, 2018

Interesting Paper

I remember when I first went on hormones and I was taking progesterone and I started lactating… surprise!

Case Report: Induced Lactation in a Transgender Woman
Transgender Health
By Reisman Tamar and Goldstein Zil
Published Online: 1 Jan 2018

Abstract
Objective: Our report describes a case of nonpuerperal induced lactation in a transgender woman.

Methods: We present the relevant clinical and laboratory findings, along with a review of the relevant literature.

Results: A 30-year-old transgender woman who had been receiving feminizing hormone therapy for the past 6 years presented to our clinic with the goal of being able to breastfeed her adopted infant. After implementing a regimen of domperidone, estradiol, progesterone, and breast pumping, she was able to achieve sufficient breast milk volume to be the sole source of nourishment for her child for 6 weeks. This case illustrates that, in some circumstances, modest but functional lactation can be induced in transgender women.

It isn’t that hard to stimulate the milk ducts…

Previous investigators have reported the following basic framework for nonpuerperal induced lactation: (1) increased estradiol and progesterone dosing to mimic high levels seen during pregnancy, (2) use of a galactogogue to increase prolactin levels, (3) use of a breast pump with the speculation that it would increase prolactin and oxytocin levels, and (4) subsequent reduction in estradiol and progesterone levels, with the intention of mimicking delivery.

I find it amazing that we can do this and it shows that male and females are not that different.

There is a little difference in the milk…

One major difference between the induction of lactation in cis and transgender women is the need for androgen blockade in the latter group. Our patient continued to take spironolactone while breastfeeding for androgen blockade. A known metabolite of spironolactone, cancrenone is excreted in human milk. This has been shown to be 0.2% of the maternal daily dose, which is thought to be clinically insignificant. Spironolactone has been reported to have tumorigenic potential in rats, but according to the American Academy of Pediatrics, it is thought to be compatible with breastfeeding.

I wish that I knew beforehand that I could lactate because it wouldn’t have scared me when I saw a white discharge from my breasts.

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Quotes

Freedom is never voluntarily given by the oppressor; it must be demanded by the oppressed.

Morality cannot be legislated, but behavior can be regulated. Judicial decrees may not change the heart, but they can restrain the heartless.

A right delayed is a right denied.Like an unchecked cancer, hate corrodes the personality and eats away its vital unity. Hate destroys a man's sense of values and his objectivity. It causes him to describe the beautiful as ugly and the ugly as beautiful, and to confuse the true with the false and the false with the true.

Darkness cannot drive out darkness; only light can do that. Hate cannot drive out hate; only love can do that. Hate multiplies hate, violence multiplies violence, and toughness multiplies toughness in a descending spiral of destruction.

Martin Luther King Jr.

No one is born hating another person… People must learn to hate and if they can learn to hate, they can be taught to love, for love comes more naturally to the human heart than its opposite.
Nelson Mandela

We can disagree and still love each other, unless your disagreement is rooted in my oppression and denial of my humanity and right to exist
James Baldwin

There is a fine line between free speech and hate speech. Free speech encourages debate whereas hate speech incites violence.
Newton Lee

The world will not be destroyed by those who do evil, but by those who watch them without doing anything.
Albert Einstein

"The point is that there are always obstacles, whether they seem insurmountable or merely bothersome. The question is not how difficult the path, but whether in your heart, you wish to undertake the journey."
Zandru's Forge

Keep your thoughts positive because your thoughts become your words. Keep your words positive because your words become your behavior. Keep your behavior positive because your behavior becomes your habits. Keep your habits positive because your habits become your values. Keep your values positive because your values become your destiny.
Mahatma Gandhi

“I have a foreboding of an America in my children's or grandchildren's time -- when the United States is a service and information economy; when nearly all the manufacturing industries have slipped away to other countries; when awesome technological powers are in the hands of a very few, and no one representing the public interest can even grasp the issues; when the people have lost the ability to set their own agendas or knowledgeably question those in authority; when, clutching our crystals and nervously consulting our horoscopes, our critical faculties in decline, unable to distinguish between what feels good and what's true, we slide, almost without noticing, back into superstition and darkness...
― Carl Sagan, The Demon-Haunted World: Science as a Candle in the Dark

You've Got To Be Carefully Taught
You've got to be taught
To hate
And fear
You've got to be taught
From year
To year
Its got to
Be drummed in your dear little ear
You've got to
Be carefully
Taught
You've got to be taught
To be
Afraid
Of people
Who's eyes are oddly made
And people who's skin is a different shade

South Pacific
Songwriters: Oscar Hammerstein II / Richard Rogers

Wednesday, May 09, 2018

Interesting Paper

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