As an LGBTQI lactation provider, I sometimes feel that I live in a parallel universe to those colleagues who are unaffected by, and largely unaware of, the kind of prejudice and discrimination LGBTQI people experience and how this affects our lives and our work.

Two days ago, on December 4, the state of Michigan passed the “Michigan religious freedom restoration act”. The passing of this bill means that lactation professionals, such as IBCLCs, in that State can now legally refuse to provide services to LGBTQI families. Many health professionals, lactation consultants, breastfeeding peer counsellors, and doulas, by their own accounts and documented in health research, already refuse services to LGBTQI patients and clients and legislation like gives them legal protection to do so. Refusal of health services or the provision of inadequate or sloppy services impacts LGBTQI people’s health and that of our families, and impacts the work environment that LGBTQI providers operate within (which I have written about in a recent article in the Journal of Human Lactation and spoke about at the 2014 Lactation Summit).

For LGBTQI lactation professionals the “Michigan religious freedom restoration act”, if not revoked,  will also limit our ability to travel and work in that state, as we are limited in our travel and ability to work in many places of the world. For example, two important events for lactation professionals, the ILCA conference and the 2014 Lactation Summit were held this year in Arizona. In February, the state of Arizona passed a bill which would have allowed businesses to discriminate against LGBTQI people by refusing services in the name of religious freedom. While Arizona’s bill was hanging in the balance, lactation professionals planning to attend one or both of these events were holding our breaths to see what the outcome would be. The bill was vetoed because it would have allowed businesses and service providers the legal right to deny basic life needs. Had it become law, the LGBTQI attendees of this year’s ILCA conference or Lactation Summit would have risked the humiliation (and potential danger) of being refused entry to the hotel where the meetings were held, refused taxis, refused being served in restaurants and cafés, refused emergency medical care if required, along with the loss of work or education, loss of time and money.

Michigan and Arizona are not alone, many US  states have passed similar legislation or have proposed religious freedom bills, and worldwide there are currently 79 countries where it is illegal to be gay, some with a death penalty, stoning, or flogging. Many countries restrict LGBTQI autonomy and do not guarantee basic human rights – this impacts our personal safety, our health, our families, our work, and where we can live.  Living in Europe, I often travel to adjoining countries and even as far as the US to present my work as conference speaking is an important part of my professional life. One of  the first things I do before accepting a speaking engagement in another country is to check their anti-gay laws and whether it is safe for me to travel there and to speak freely. Anti-gay and anti-LGBTQI  sentiment and is increasing worldwide despite, or perhaps because of, an increase in social acceptance and legal rights.

In October I spoke at the European meeting of the Academy of Breastfeeding Medicine in Bucharest – an important moment for my career – yet I thought long and hard about attending as the world-renowned author Andrew Solomon had reported on his Facebook page that his speaking engagement at Bucharest’s Central University Library was cancelled due to the fact that he would talk about his gay identity. My talk did not touch on my sexual orientation nor gender, and the meeting was held in a private hotel not a State owned institution, but the same I did not feel entirely comfortable travelling to that country. My gay identity and my andogynous gender are part of myself and my work and are not separable.

Working in these conditions adds stress to our lives that is unwarrented. LGBTQI providers know that if we speak out, we risk compromising our careers and opening ourselves up to scrutiny and attack by those colleagues and clients who benefit from the legal protection offered by religious freedom legislation.  Our allies also take risks by supporting us, and I greatly respect and appreciate those who do, as support from our colleagues and professional organisations is vital if we speak openly out about the discrimination experienced by LGBTQI lactation professionals and the families we serve – many, many LGBTQI lactation professionals do not feel safe to live openly their sexual orientation and/or gender identity and are therefore unable to or unwilling to speak out on these issues. Some LGBTQI providers, such as LGBTQI people of colour in the US at this present moment face  more urgent issues that affect the immediate safety of themselves and their families, and the points raised here may only be a  minor part of their difficulties.

I debated for a long time whether to write this post, as it is so hard to write about discrimination when it affects me directly and personally. Encouraged by supportive colleagues (thankyou!) I am posting this so that we do not have to suffer this humiliation and restriction to our personal freedom, our health and safety, and the freedom to practice our profession, alone and in silence.



Many of you may already know that some very exciting news was announced a couple of days ago by the world’s largest ‘mother-to-mother’ breastfeeding support organisation, La Leche League. They have revised their applicant policy to include men ‘who have breastfed.’ From the LLL International website:

As the cultural understanding of gender has expanded, it is now recognised that some men are able to breastfeed. In the spirit of non discrimination and with this awareness, La Leche League International has refined the eligibility qualifications for its volunteer breastfeeding counsellors to include men who otherwise meet the prerequisites for becoming a volunteer applicant. Prerequisites include organizational experience, personal experience breastfeeding a baby for at least nine months, and a demonstrated commitment to La Leche League philosophy.”

For the full press release read here.

Although LLL announced this rather quietly, the news was received joyously, loudly and proudly by those of us who have been following Trevor MacDonald’s leadership quest via his ‘milkjunkies’ blog.

Trevor’s application request became public knowledge in 2012 when he wrote:

Men cannot become La Leche League Leaders. I was told that LLL is all about mothering through breastfeeding, not simply supporting anyone who wishes to breastfeed.”

Trevor was not put off and set up his own online support group  for transmen and cisgender allies (many of whom, including myself, did not initially realise who the term ‘cisgender’ actually referred to) which is how I came to know Trevor and many other transgender men, women and gender non-conforming parents and prospective parents. After some months in the group, and upon experiencing one member’s pregnancy journey and being moved by the announcement of his child’s birth, I wrote to the Board of LLL International in support of Trevor’s application and transgender inclusion with a message including these words:

When this man gave birth, I was touched by the text he typed one handed into his phone from the hospital while cradling his newborn. In that moment his gender disappeared for me – he was writing as a parent, a birth parent in exactly the same way I am.”

Looking back, I could have just written, “We should include trans* folk because there is no valid reason to exclude them.” But I was surprised at first to know that men can and do give birth, and knew little about transgenderism. It would take me quite some time to express my thoughts on inclusion in such simple terms. I realise that it is normal for those who have not encountered fathers who experience pregnancy, birth and breastfeeding (or chestfeeding), to be surprised, to pass through the cognitive dissonance that Cynthia Good Mojab so well explains in her ‘Unpacking the Invisible Diaper Bag of White Privilege.’ Cognitive dissonance happens when we are presented with knowledge that does not ‘match up’ with our old knowledge. Cognitive dissonance, she recounts, causes us to go through an uncomfortable period of not knowing what to do with our new knowledge, or how to act.

Not only are we brought up in a society where whiteness is considered the norm (and also superior), most of us have also been brought up in society where heteronormativity and cisnormativity are the predominant, superior norm, and this is precisely why  LLLs new policy is so very important. Heteronormativity and cisnormativity, along with white oppression, are terribly damaging to people who are affected by it (which is actually all of us, whether we are on the side of oppression or the oppressed). Those of us who experience discrimination can survive by putting up filters and barriers to dull the constant stream of messages that we are excluded or invisible but the message is clear – when society presents information, services and entertainment representing only one section of society, that is a constant reminder that we are considered lesser, undeserving of the same right to be here, to form relationships and to create families and this affects our health, mental health and quality of life (as well as that of our children).

The steps that LLL takes over the next weeks, months and years will have a lasting impact on the form that male inclusion, and LGTBIQ inclusion will take not only within the organisation but also more widely. LLL is the largest ‘mother-support’ organisation in the world (and hopefully will now choose a gender neutral form of that description), with Leaders present in approximately 60 different countries, and with a long list of publications on diverse topics within breastfeeding and parenting in many languages. LLL is recognised as an authority on breastfeeding by organisations such as WHO and UNICEF, and is one of the access points to the professional lactation consultant profession (IBCLC). What LLL has done is an important message to the rest of the reproductive health, birth and breastfeeding world.

My concern as an LGTBIQ person and ex-LLL Leader is ‘what next?’ What form will their inclusion take? Will the possibility of male Leadership remain as wording in their policy or will men really be encouraged to participate in the organisation at an active level and supported through the application process?

In order for LGTBIQ people to be really included within an organisation or within society, it has to be safe for us to be ‘out’ (to live our sexual or affection orientation and/or gender identity openly,without fear of repercussion). LGTBIQ people are subject to overt discrimination which many of you may recognise and abhor, but you may not recognise or be aware of covert discrimination. Messages such as ‘I don’t wish to work with LGTBIQ people’, ‘I don’t approve of their ‘lifestyle’’ (note; being LGTBIQ is not a lifestyle) or, ‘My religion thinks they are immoral’ are hurtful and discriminatory, as are unsolicited opinions on conception choices and feeding choices, such as co-nursing or the use of donor milk. These kinds of messages and comments are commonplace on message boards, and within work discussions and personal communications with colleagues in the breastfeeding and birthing fields.

Because of this kind of pervasive discrimination, together with their decision to remove restrictions on who can become a Leader, I hope that LLL will be considering further steps towards active inclusiveness of LGTBIQ applicants and Leaders and families. Active steps might include:

  • Addressing the concerns that have been raised by Leaders and parents (for some time) on the gendered and heteronormative nature of their philosophy, literature and the language used within the association in paperwork and policies
  •  The creation and implementation of an anti-discrimination policy and grievance committee. Discrimination can be covert and pervasive – applicants, Leaders and families would benefit from the possibility of being able to report discrimination in order to bring about improvements and changes
  • Provision of Leader training on LGTBIQ issues, heteronormativity, cisnormativity and discrimination and inequities generally

Within the LGTBIQ community there are many of us who are more than willing to contribute our time and knowledge to the creation of such policies and initiatives.

This is an exciting time in history for LGTBIQ people. LLL has taken a historical step forward towards inclusiveness at a moment when LGTBIQ people are being recognised as not having equal rights and discussions of this have moved firmly into the public arena. I hope that LLLs spirit of non-discrimination is far reaching and widely imitated.

Well done Trevor, and well done LLL,




Good Mojab, C., Unpacking the Invisible Diaper Bag of White Privilege: An Overview of Racial Inequities in Breastfeeding Support, GOLD Lactation Online Conference, April 2014


I’m not exactly sure what people have in mind when they use the term ‘biologically normal’. I know that it comes up frequently in discussion on access issues regarding LBTBQ people which is why I am so aware of it, but I am having a hard time finding a definition of it. If this is a term you use, then feel free to add your definition below.

Normal has so many definitions. The Free Dictionary (1) tells me that normal is being something that is common. Common behaviour can be a standard or ‘norm’. Common is something that most people do. If I dig a little bit deeper, I start to feel a little uncomfortable. Normal becomes a standard, a measure. After normal we then have ‘abnormal’. Do we use abnormal to mean ‘uncommon’, or differing from what most people are doing? Is it a word that is valued positively or negatively? Abnormal is followed by unnatural. We tend to use natural to describe things that are positive, that are found in nature, and unnatural for negative things, that are also found in nature but for some reason are negative. I’m beginning to feel uncomfortable. I am gay and that, according to some, is not biologically normal.

So what is the definition of ‘biologically normal’? I presume this to mean something that is common in nature. It is something natural. Many natural things are uncommon and does that make them biologically abnormal? I’m beginning to confuse myself here. Let’s look at congenital malformations for instance. One of my daughters was born with a congenital malformation that affects approximately 1 in 700 newborns. Is that biologically normal or abnormal? Her malformation is considered an ‘abnormality’ but the incidence of it is biologically normal. Diversity in nature is common and therefore normal (and also desirable for the survival of the species).

In biology I have not come across the term ‘biologically normal’. My biology texts use the term ‘biological determinism’ i.e. the argument that we are a product of our genes. In lay terms I describe that as something we are programmed to do. Biologists themselves have defined biological determinism (the way our genes are programmed) as a ‘reductionist’ argument. We are all partly a product of our genes and partly a product of our environment.

A simple example; you are most likely reading this post on a computer, perhaps with reading glasses (as I am) sitting in a chair, wearing clothes, within some kind of building. None of these behaviours is biologically determined. When you have finished reading this, you will probably stand up, which was once not biologically determined – it is an effect of evolution, as is all of the other behaviours I have just described. You might go to the kitchen and prepare a cup of coffee – coffee that was cultivated at great distance to your house and may have arrived at your local supermarket via aeroplane, ship and other motor transport. None of this is determined in your genes. Being addicted to coffee may have a genetic basis, along with our desire to move faster and farther than our bodies were biologically determined to accomplish, but acquiring that coffee and that speed and ability to cover distances required evolution.

I often come across the argument that there are biologically normal ways to become and to be a parent. I am told that heterosexual families are normal and LGTBQ families are not. As to which is more common, then yes heterosexual families probably are, although the ‘traditional’ family seems to be less common than might be assumed (2). Statistically it is difficult to determine how common LGTBQ families are as people who identify within the LGBTQ umbrella may not be accurately counted on census populations (3). We assume that most families are heterosexual, but we don’t really know. Since I came out as a lesbian, many women and mothers I have met have privately disclosed that they do not identify as heterosexual, nor cisgender, but to all apparent purposes they appear to be so.

I am told that LGTBQ issues are difficult to discuss at an institutional level, as they raise emotions about what is biologically normal. My answer to that is if you have never been accused of not being ‘biologically normal’ then perhaps you have really nothing to get emotional about. To be told that you are biologically abnormal is an accusation that cuts like a knife, and if you haven’t felt that then please reconsider the effect of your words.

Just this morning I came across a blog discussing health policy and noted this question;

“Perhaps the need to view and walk in someone else’s shoes should be a requirement for deciding policy”.

I believe so and quite strongly. I think that anyone who makes policy decisions in reproductive health, birth and breastfeeding support – areas that are staunchly heteronormative (heterosexual couples at the head of a family are the ‘norm’) – should wear ‘biologically abnormal” for a time. You may never have the opportunity to experience it applied to something as fundamental as your right to become a parent and to receive support to do so.

So much of what we humans do in our everyday lives is not biologically determined. If we were to stop at what our bodies are genetically programmed for, then many of us would not have survived beyond infancy. Infants with a metabolic disorder such as PKU or Galactosaemia, require infant formula in order to survive and grow. Infants with diabetes require synthetic insulin. Many of us have used some form of birth control and have experienced technology during gestation and birth. Yet, we use the biological determinism debate to judge the way some people parent or how they become parents. Some people will contest IVF as a form of conception for any couple, heterosexual or not. But of those who accept IVF as a form of conception, not all accept LGBTQ access to it. Those who argue that IVF is not ‘biologically normal’ may also contest transgender parents or gay parents who conceive naturally. I will not discuss conception within or without ‘wedlock’ as marriage is a social construct, not biologically determined.

There are many ways to conceive a child. Our genes require that humans unite two gametes – an egg and a sperm. There are many ways to go about this the most common of which is penis in vagina sex – consciously or unconsciously, and sometimes violently (i.e. rape). Sometimes that happens within a relationship and sometimes not. Some couples, whether heterosexual or LGTBQ become parents via donor gametes, some through adoption and some through surrogacy. Can you show me where the line is drawn between biologically normal or determined and non? When is a form of conception normal for a heterosexual person and not for a person who is LGTBQ?

Is there a parenting gene that is linked to a heterosexual gene? Are heterosexual relationships the standard against which we must all be measured because they are more common (although we haven’t accurate proof of that)? I think not. The desire to parent appears to be universal across the heterosexual and LGTBQ communities. In nature, difference is normal. Diversity is desirable for the survival of the species. Diversity in parenting is however, frequently not considered normal, and therefore access to care, support and legal recognition is not equal.

To those policy makers, and professionals in the reproductive health, birth and breastfeeding communities who oppose the introduction of measure that would recognise LGTBQ people as having equal right to parental support I propose one question; “Are you biologically normal?”

I look forward to your comments,



  1. The Free Dictionary; definition of normal (accessed 05.2.2014)
  2. Angier, N., The Changing American Family, New York Times (online) 25.11.2013  (accessed 05.2.2014)
  3. Barker, M., What’s wrong with heteronormativity?, Rewriting the rules (accessed 05.02.2014)

LGTBQ, put simply, is an initialism that stands for Lesbian, Gay, Transgender, Bisexual and Queer. It is an umbrella term which attempts to describe a diverse group of people. You may have come across many other versions; LGB, GLB, GLBT, LGTB+, LGTBIQ……the variations are endless and controversial. Each version has its own reason for being and none is all-inclusive of the people who are frequently referred to as part of the LGTB umbrella – it should perhaps read LDGTBIPAGFGQA+. Being left out is not only exclusionary, those letters can be important for funding of projects and determines who has access to the services provided by funded projects.

Things become particularly complicated when people from outside the LGTB/Queer community begin to criticise those within and the terms we choose (yes, really).

My suggestion to anyone who is unsure what term to use; ask, or wait until the person you are talking to uses a pronoun or label to describe themselves. Use that term that that person uses to define themselves – don’t decide for them. Listen to your audience – ask for feedback – respect your audience’s choice of terms and their right to self-determine even if it makes your writing job a little more difficult.

When choosing a term; think about who you are naming and whether the term you have chosen includes everyone that you wish to include – it is often possible and preferable to avoid labels all together. Of course, don’t forget to use gender neutral language also.

This is just my version of the L-Q of the LGTBQ community. The letters themselves have different meanings to different people (especially across generations), and there are a growing number of people (especially of younger generations) who use Queer as an umbrella term for the whole LGTBQ+ community. I look forward to your comments if you use different terms or don’t agree with these definitions.

An L-Q guide to the LGTBQ community (particularly for birth and breastfeeding workers);

  • L is for Lesbian;

many women who partner with women identify as lesbian (and may also use the term gay). Some women who partner with women may refer to themselves as dyke, pansexual or bisexual.

  • D is for Dyke;

some gay women identify with the term ‘dyke’ – do not use unless you know that as some may find this offensive

Women in same-sex relationships are underrepresented in birth, breastfeeding and parenting literature and research into reproductive health, birth and breastfeeding .

Women who partner with women and bisexual women are at a higher risk of such as uterine, ovarian, cervical, endometrial, colon, lung, and others. The LGTBQ community is medically underserved; in countries like the US many people go without health insurance because work policies often do not cover unmarried partners. In many parts of the US and many countries marriages between people of the same sex is not allowed.

Another challenge that women who partner with women face is feeling comfortable with certain providers – being uncomfortable can lead to avoiding regular check-ups. A health care professional who assumes that all women are heterosexual may force a woman to reveal her sexual orientation, forcing her to come out which can be extremely stressful.

An important step forward towards closing the gap in these inequities is acknowledging that some women have wives and girlfriends by changing the words ‘father’ and ‘husband’ to the gender neutral ‘partner’.

  • G is for Gay;

men who partner with men and women who partner with women

Gay has become the word of choice over homosexual due to it has a negative, clinical history such as the inclusion until 1973 in the DSM (Diagnostic and Statistical Manual of Mental Disorders). The word homosexual also emphasises sexual behaviour and not attraction and romantic feelings.

Gay men are generally unrepresented in parenting literature and popular media. Many gay men recount that they simply did not think that becoming a parent was a possibility when they first came out and that exposure to other gay dads has helped them ‘realise their dream’ of parenthood.

Gay men face discrimination due to the stereotyped belief that they prefer pleasure to responsibility. In reality, same-sex couples have a high rate of relationship instability due to various factors such as being ‘closeted’ (not living openly as gay or bisexual), lack of relationship counselling , and of course, lack of social support such as lack of recognition of same-sex relationships, both legally and socially.

Gay and bisexual men may become parents via various routes – some men have children from previous opposite sex relationships, transgender men may be able to conceive naturally or through IVF and birth and chestfeed their own baby. Adoption and surrogacy are also common with some fathers opting for breastfeeding via privately donated breast milk, sometimes by maintaining a relationship with the gestational carrier. Gay men can be acknowledged in breastfeeding literature by using the gender neutral term parent.

  • B is for bisexual;

women and men who partner with both someone of the same sex or someone of the opposite sex, or someone who partners with people of any gender

Similar to, but not the same as Pansexual and Omnisexual

Bisexual people suffer invisibility and discrimination at a higher rate than gay members of the LGTBQ community (bisexuality report), along with transgender people. Bisexual and pansexual parents’ needs may be ignored if they are in an opposite sex relationship. Health care providers may classify them as gay or straight, ignoring some of their needs.

  • T is for transgender; 

also transexual, trans*, trans man, trans woman, trans masculine, trans feminine

Transgender people suffer people suffer invisibility and discrimination at a higher rate than other members of the LGTBQ community. Transgender people are more likely to go to prison, have higher rates of suicide, and are less likely to seek medical care, due to discrimination and lack of access to services and health insurance and may be and may be denied adequate and appropriate care.

Transgender people undergoing sexual affirmation transition (hormonal and surgical) were once required to undergo sterilisation, and still do in some parts of the world. Transgender people may be given incorrect information on reproductive health and may not have equal access to reproductive health services such as IVF, gender appropriate gestational care, and inclusive breastfeeding/chestfeeding support.

  • Q is for Queer;

The term Queer has grown in popularity, especially over the last decade and amongst younger people and is frequently used as an umbrella term for the whole LGTBQ+ community. Queer was once used as a derogatory term and may be considered offensive by older people. Queer is often used by LBTBQ activists, academics and those who do not identify on a gender binary, or distinct sexual identities. Queer is inclusive of a wide range of identities and avoids the strict boundaries of other labels.

Other terms that I have not yet approached – and I would appreciate any help with these, especially with regards to parenting issues;

A is for asexual

G is for Gender queer,

Gender fluid,

Gender non-conforming

and Gender creative

I is for intersex

P is for Pansexual

P is also for Polyamorous

and Q is also for questioning

For some more suggestions on how to be inclusive in your birth or breastfeeding practice read ‘save someone coming out to you’. Also, more reading in the references below. I look forward to your comments,



LGTB, Wikipedia

Homosexuality, Wikipedia

Lesbian, Wikipedia

Gay, Wikipedia

Bisexuality, Wikipedia

Transgender, Wikipedia

Queer, Wikipedia

Homosexuality and psychology, Wikipedia

Women Who Partner With Women, Breast cancer resource directory of North Carolina,

Stigma and Discrimination, Centers for disease control and prevention,

Gay Dads; transitions to adoptive fatherhood (book review), Psychology Today

Tips for Transgender Breastfeeders and Their Lactation Educators, Milk Junkies blog

The Bisexuality Report; bisexual inclusion in LGBT equality and diversity,

Recently I  have met people online who are from without the LGTBQ community who have approached or initiated conversations on LGTBQ issues, to then withdraw when they have received what they perceive as people ‘coming-down’ on them. I have written this post with these people in mind, as a peace offering, and some suggestions for the well-intentioned ‘would be allies’ who are having trouble entering that sometimes ‘hostile-seeming-to-outsiders’ LGTBQ world.

My suggestion is – stay here – don’t withdraw. Hold that feeling of people ‘coming-down’ on you. If you are straight or cisgender – then the issue you were discussing was not about you. The people you think have ‘come-down’ on you probably haven’t. What you might be feeling is the weight of our issues and it might be one of the rare chances that you get of feeling what we are up against on a daily basis – by joining the conversation you have just walked into a minefield zone of high tension. This is the tension that we live with continuously. LGTBQ people (along with other marginalised groups) have higher rates of stress than the general population – which leads to high rates of ill health (both mental and physical) and suicide. Hold that tension that you have just felt – please, don’t turn and walk away – take a seat, take the time to stop, listen and understand why some of us are disgruntled (or enraged) and why someone might be critical of what you have said. Learn where the tension in their words (if that’s what you felt) is coming from, find out what you did (or someone from your community has done) to contribute to that tension and what you can do to help lessen the tension between you and the people that you have just (unsuccessfully) tried to connect with.

Why is there tension within the LGTBQ community? Read my post about heteronormativity (1). People who are not straight and/or who are not cisgender suffer discrimination. Discrimination leads to tension, often that tension can be enough for a person to decide to take their own life. Take this tension seriously. An LGTBQ person risks workplace discrimination, difficulties in accessing adequate heatlhcare, risks personal safety (gay/trans bashing), is the butt of denigrating humour, may be stereotyped, may be shunned by their family, may lack basic rights such as the right to marry (which also involves economic status as a legal spouse, other spousal rights such as access to intensive care and having the right to make decisions for partner as next of kin), the right to be named as a parent on their child’s birth certificate (and subsequent paternal rights such as access to visiting intensive care if that child is ill or parental recognition in the case of separation), the right to identification that matches their expressed identity, may be forced into surgical or chemical transition (which often results in sterilisation) in order to be able to change identity on official documents.

Discrimination is exclusion. When a group of people, or an individual, says that they feel excluded, then we should listen. When a straight, cis-gender person tells me they feel excluded, that they feel unwelcome in the LGTBQ equity conversation, I listen. I’m writing this because I have listened, and I have taken your feelings seriously. There is not much I can do, however, to make you feel comfortable. You are an outsider, and I can’t make you feel less of an outsider. You will stop being an outsider, when I am no longer an outsider – when there is no tension, when there is no exclusion, then neither of us will feel it. As long as there is tension, I can’t pretend it is not there. We need to change the paradigm – together. It takes both sides to shift. I have built up defensive barriers and will remove those when there is no longer a threat – when I no longer have to defend myself. Your side has built a wall or a closet that excludes and contains me. Yours is a heteronormative community which tolerates me,  but doesn’t actively include me. As long as we live in a world where everyone is assumed straight, cisgender and one of two options from a strict binary (male/female) division, then there will continue to be places where you and I, and others, will feel excluded and/or  uncomfortable.

There are ways to make yourself more at home in our LGTBQ community. Tread carefully – hold out a peace flag and use it when tensions flare. Mind your language – listen to the terms that people use to define themselves (if they define themselves) and use them. Mind your pronouns – not everyone identifies as a ‘he’ or a ‘she’, some people prefer the third person ‘they’ (rather than he/she) or gender alternative pronouns such as ‘zie’, ‘per’ or ‘hir’ (2). If in doubt, ask the person which pronouns they use and prefer. If someone corrects your use of language – stand corrected, make changes and be flexible. Different people – especially from different generations – may use and prefer different language. Be patient – we are all feeling our way and looking for language that is acceptable to all. If you feel hurt, wait for a quiet moment and voice that privately. Be open-minded – heterosexism and homophobia exist and you may have or be unwittingly contributing to that. I know that I have, and perhaps still do. This is how most of us were brought up – it takes a conscious effort to stop thinking in a ‘straight-minded’ fashion, even for LGTBQ people – it’s one of the reasons for the doubt, the questioning, the shame….the difficulties we have had to overcome to recognise who we are. By coming here, you also have the opportunity to overcome your ‘straight-mindedness’ – believe me a world that is diverse is much more colourful, it’s worth the eye-opening journey. So please, don’t close the door if you feel like an outsider – embrace that feeling of being an outsider and not completely at ease when you enter the LGTBQ conversation, it’s actually what makes you closer to being one of us, as here we are all outsiders, we all know what it feels like to be excluded.  Welcome to the conversation, together we can work towards a world that is inclusive – mind your step, I don’t want you to get hurt. It is a minefield over here.

I look forward to your comments,




1. Farrow, A., Heteronormativity 2.01.2013)

2. Barker, M., Beyond the binary: Gender outside of the two-box world (accessed 2.01.2013)

This morning I happened to read an article about ‘why reproduction is a women’s issue’. At the bottom of the article was a disclaimer about language which stated that the author had chosen to use the terms ‘woman’, ‘women’, and ‘mother’ and related pronouns while at the same time recognising that some people who give birth ‘may identify with another gender term’. I have seen other disclaimers of this type recently and I wonder;  why not change the gendered terms to the gender neutral ‘person’, ‘people’ and ‘parent’ or ‘birth parent’ and related gender neutral pronouns? Would that not be more inclusive than such disclaimers?

Later today I had a discussion with an author who had used a similar disclaimer in an article about ‘dads’ – her disclaimer stated that she did not want the term ‘dads’ to make lesbians feel excluded, but that was the term she was going to use because she was used to it. I suggested that, to be inclusive, ‘parent’ might be appropriate. The conversation got quite thorny. Maybe I didn’t offer my suggestion very carefully, or maybe the author didn’t appreciate me asking her to make the effort to change? I don’t know – email communication has its limitations.

I know that it can take effort to change language. Sometimes I feel quite conspicuous when other breastfeeding support colleagues are using the terms ‘moms’ or ‘mothers’ and I use ‘parent’ and ‘gestational parent’ or ‘breastfeeding parent’ (of course I use ‘mum’, ‘mother’, ‘dad’, ‘father’, when applicable – when the person or people I am referring to identify as such – I’m not suggesting that gendered terms are never appropriate). But, when feeling conspicuous in my use of terms, I ask myself, what is the worst thing that could happen to me? Someone might ask me why I am using it and might challenge the use of the word (which happens – some people are uncomfortable with these words) at worst, I might end up in an uncomfortable conversation. What is the best thing that could happen? I might have a reader who is gay, transgender, queer or intersex, and it might just be the first time since they became a parent that they are referred to with the correct terms or  that they are not misgendered. They may feel included.

Is someone’s discomfort from being asked to move over and make a bit of room on the equity bench reasonable to ask in order to give someone room to sit down? I think so. I think that discomfort is a temporary condition of change. I have felt that discomfort myself; I identify as a ‘mother’ and the first time I heard the term ‘breastfeeding parent’ I felt displaced. After getting to know the people who first introduced me to those terms, I realised that I wasn’t being displaced, I realised that mother is simply not as inclusive a term as ‘parent’. There are times when the term  mother is fine – I still identify as a mother, there are times when I write about people who identify as mothers – there are times when the term mother does not include the people I wish to include. I don’t think it is right for me to expect them to ‘include themselves’ to make that mental effort to change my words in their minds. I can do that – I can make the effort to change the words I used habitually, that were not inclusive – after a while, it is no longer an effort.  I have colleagues, however, who believe that it is not necessary to use gender inclusive terms suggesting that since the majority of birth parents are women and the majority of partners are men, we should just continue to use ‘mother’ and ‘father’. I don’t know the statistics, I assume that what they say is true. But is it really acceptable to ignore a minority? Is it ethical to do so? I think not.

I realise that  change takes time, it requires dialogue, it requires effort from all parts, and it takes an element of risk taking, of stepping out of our comfort zone. I sat down today to write this post as a contribution to bringing about change.  I also took the opportunity to exchange messages with people in the birth and breastfeeding community, discussing change, and what we find uncomfortable about it. I asked for advice on words to use in articles. In  writing this article I’m taking a risk – taking the risk that someone will find fault with it, just as the author I wrote to this morning found fault with my comments and I found fault with hers. These are difficult conversations, but the discomfort of entering into difficult conversations could be worth it if there is a chance that the world becomes more inclusive for all of us. Writing a disclaimer, and then carrying on before, in my mind is not change. Reading something that makes you uncomfortable and not commenting, in my mind, does not bring about change either. Someone else will perhaps disagree.

One person wrote to me today about her reluctance to change her use of language. Who isn’t reluctant to change? Writing about it, talking about it, talking about our own discomfort with change, is a good place to start. Taking a chance with new language, experimenting, making mistakes, starting again. Someone will get upset, someone will take offence. We can keep working at it until we find something that fits, that is ‘comfortable enough’ for all of us, if we really want to make inclusion happen. I think it is possible, I look forward to your comments,


A nice straightforward story of how co-nursing (via induced lactation) worked for this pair of mothers. The author (the non gestational parent) talks about bonding, confidence, the convenience of nursing, going back to work, donating surplus (from a double supply), the practicalities of induced lactation, balancing the beginnings of breastfeeding in the early days, and the relationship with her co-nursing partner.

How two lesbian mamas share breastfeeding duties – by Liesbeth Koning, from ‘Offbeat families’

Co-nursing may not be an option for all lesbian couples and there are a variety of ways to go about it which I will post about in the future. If you have co-nursed then please leave a comment about your experience, or send me your story if you would like to recount it here on this website.


Today is national coming out day. I thought it might be a good way to celebrate by offering some suggestions on how to save your clients coming out to you.

hope you were sitting down_ellen

It can be fun to come out, it can be a cause for celebration – when you get to choose your own moment. Often, though, we come out because we or our partner have been ‘mislabelled’, because someone assumes we or they are straight*, cisgender*, or that we identify within a gender binary*. There are moments, especially moments of vulnerability – and vulnerability is a typical situation for new or expectant parents – when coming out can be annoying, scary, humiliating, or even dangerous.

These days, with more and more celebrities coming out, it might seem that coming out is easy, and I hope it is easy for some – especially for the younger generation. I hope there is someone reading this post right now, shaking their head saying, “It was no big deal coming out, what’s all the fuss?” Or, better still, “I never came out, I just am”.

Ellen’s coming out humour has another face, a background story…..

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Every time I would sob….to say the words ‘I’m gay’ came from such a place of …..shame…..self hatred…that society feeds you on a daily basis…. Ellen DeGeneres

Ordinary, non-famous people, don’t have the ‘benefit’ of everybody knowing and so we find ourselves explaining over and over.

For those of you who have never ‘come out’, you may have lived a similar situation when you have had uncomfortable news to convey – a separation, diagnosis of a child’s diversity in pregnancy, receiving the diagnosis of an illness yourself, death of a loved one – I’m not not comparing these events to coming out,  rather seeking a way got some of you  to empathise by remembering some news that you didn’t enjoy recounting over and over again and may have wished you could recount just once and not have to repeat – I think we probably all have experienced something we don’t enjoy recounting – this is what coming out as LGTBIQ* can be like.

There are ways of avoiding the need for someone to come out to you. A first step is not assuming that someone is straight, cisgendered or that they identify with a binary gender.

(I’m not suggesting I have all the answers to this predicament – this blog is my attempt at finding solutions, not prescribing them)

Imagine a new patient/client in your birth/breastfeeding practice.

How do you know if the person is straight cisgendered and female as most of your clients possibly are? (This is particularly difficult over the telephone if you are a volunteer breastfeeding counsellor).

What could you ask the person in order to fill out you client  information record while communicating to them that you really do welcome all families?

  • Would you like to describe your conception story? (birth workers)
  • Would you like to tell me about the other members of your family? (breastfeeding workers)
  • Use the word partner.
  • Are you the birth parent/breastfeeding parent? (transgender men often prefer to use the term ‘chestfeeding)
  • How do you divide the parenting/feeding roles in your family?
  • Which pronouns do you use to describe yourself/your partner? Which terms do you prefer?

One father (FTM transgender – straight relationship) described his experience of assisting his daughter’s hospital birth. He recounts that it wasn’t questioned at all that he was the father, he was not required to show ID, he was given the birth certificate to fill out as the father;

I felt very validated and very respected…I just felt….bigger, taller….and not physically. It just felt really good

I think we all deserve to feel tall, to feel good. It can take a bit of mental gymnastics at first to get our head around a non-heteronormative, non-cisgendered, and non-binary gendered world (even writing that is a little complicated and possibly full of errors), but doing so might just make a world of difference to a lot of people. Helping parents stand tall is part of our mission after all?



*straight or  heterosexual; “Heterosexuality is romantic attraction, sexual attraction or sexual behaviour between persons of opposite sex or gender in the gender binary” Wikipedia

*cisgender; “an individual’s self-perception of their gender matches the sex they were assigned at birth” Wikipedia

*non binary or gender queer; “Genderqueer (GQ; alternatively non-binary) is a catch-all category for gender identitities other than mand and woman, thus ouside of the gender binary and cisnormativity”

*LGTBIQ;lesbian, gay, transgender, bisexual, intersex, queer (one variation of a much discussed initialism)

Further reading;

Supporting Queer Parents, tips for providers

Coming out to your doctor (with tips for healthcare providers)

Non binary gender