Make Milk. No Ovaries Needed. Inducing lactation for individuals without ovaries is a topic that's not often discussed, but it's important for trans and intersex women who may be interested in this process.

If you're already taking hormones as part of your gender affirmation journey, that can serve as the baseline for your inducing lactation plan. Hormone therapy can play a key role in inducing lactation, and it's essential to work closely with your healthcare team to adjust your therapy accordingly. Approaches to hormones for trans and intersex women are generally is as follows:

• Step 1: Estrogen is increased, sometimes gradually. Progesterone is added.
• Steps 2 and 3: Estrogen is discontinued or decreased to simulate menopausal levels. Although generally discontinued in case studies found in research, my clinical experience indicates maintaining progesterone may be helpful throughout lactation.^{1,2,3.4.5,6,7,8,9,10,11}

Some parents find a low or no estrogen dose difficult...