There are a fair few trans women – men who want to be seen as ladies – who long to breastfeed real babies, and some who actually give it a good go. A few years ago this would have seemed unthinkably surreal, but I’m afraid this is the new reality and you’ll just have to get used to it.

A man who wants to breastfeed first takes hormones to grow breast tissue. Then he uses a technique adapted from something called the Newman-Goldfarb protocol, which was designed to help adoptive mothers breastfeed: he takes hormones and a hefty dose of an anti-nausea medication called domperidone and then begins an intense breast-pumping routine after which, if he’s lucky, he produces something a bit like milk.

Many trans women (these are men, remember) have been in the grip of their obsession for decades

After more time than I care to admit in forums for trans women online, I have a weary half-understanding of why a trans woman might want to try to breastfeed a baby. Many trans women (these are men, remember) have been in the grip of their obsession for decades. They’ve spent furtive years fossicking about in their wives’ knicker drawers and a small fortune on hormones and often unspeakable surgery. From what I can gather, they fancy breastfeeding because they crave ever more definitive female experiences, chasing a feeling of final validation which recedes, like a mirage, as they approach.

I have some sympathy for these poor men. They’re driven mad by hormones and the mental strain of trying to believe they’re female. The people I have no sympathy for – only cold, vengeful loathing – are the activist medics of the NHS: doctors who have sworn to do no harm and should care for babies before all others, but who instead choose to prioritise the feelings of cross-dressing men.

Over the weekend a letter came to light written recently by a Dr Rachael James in her role as medical director of Sussex NHS Foundation Trust. In this letter, Dr James insisted that the milk a man can sometimes induce is just as good for babies as their biological mother’s breast milk. They’re both ‘human milk’, says Dr James, and therefore ‘ideal food for infants’. She includes in her letter, by way of proof, a link to the WHO page on the subject of breastfeeding.

Dr James is engaging here in a truly ballsy bit of subterfuge. Yes, the WHO says that breast milk is best, but it’s referring only to ordinary breast milk produced by actual women. It makes no mention of man milk. But Dr James knows that. She’s a senior consultant in the NHS and there’s not a chance she doesn’t also know that the milk produced by a baby’s biological mother is by far its best bet. Unlike man milk, a mother’s milk at first contains colostrum, which has all the antibodies, antioxidants and nutrients a newborn needs and it changes magically, in response to the needs of a child. No man has ever produced colostrum, hard as he pumps, nor anything like enough milk to feed a baby.

But Dr James’s really unforgivable omission is not to mention that domperidone, the drug used to induce lactation, might well be unsafe for a child. Domperidone has not been licensed for use in America because of concerns that it causes heart problems. Trans activists can insist till they’re blue in the hair that the small amounts of domperidone in chest milk are unlikely to harm a baby, but they just don’t know. Dr James hasn’t a scooby doo whether the milk she advocates is safe for babies. So what in God’s name does she mean when she calls it ‘ideal’?

In all studies cited, much is made of the ‘affirmation’ a trans woman (man) feels when he’s allowed to breastfeed. It helps with his dysphoria, we’re told. There must be some official NHS document that shows how to weigh the brief satisfaction of a trans woman against the possibility of lifelong harm to an infant. I’d love to see it.

I’ve been studying the board of the Sussex Trust, and in particular its chairman, Alan McCarthy MBE, so that I know who to come after should the babies fed with trans milk suffer heart problems. McCarthy has dimples, implausible teeth and the sort of tan you get from weekends sailing in the Solent. He’s due to retire in June and I’m betting he just wants a quiet life now, no fuss before he goes.

If I had Mr McCarthy’s ear, I might have recommended that, in the interests of minimising later fuss, he distanced himself a little from Dr James when he was asked about her this week. He could have apologised for her comments – or at least made it clear that any risk to a child outweighs the momentary satisfaction of a man in the grip of a fetish. Instead, the Trust doubled down and, with the air of the righteous sticking it to nasty bigots, said: ‘We stand by the facts of the letter and the cited evidence supporting them.’

Well of course they do. University Hospitals Sussex Trust is a member of Stonewall’s ‘Diversity Champions’ programme and it has admitted that it took advice from ‘external organisations’ when it cooked up its breastfeeding policy. It’s like listening to hostage victims read from statements prepared for them by their kidnappers. Say just what we’ve practised, Mr McCarthy, or your diversity score gets it.

On Monday night, the BBC chose to discuss the man-milk affair with a young woman called Kate Luxion, an unqualified ‘trainee lactation consultant’ and a researcher at UCL. With a composed and serious expression, Luxion insisted that not only was man milk safe, but ‘studies’ had actually found that a trans woman’s milk contained more nutrients than the milk of a baby’s mother. The presenter nodded happily along. Nod, nod, smile, smile. Yep, sounded right to her. 

The BBC didn’t think it necessary to quiz the trainee consultant, to examine the study she cited or to ask how it could possibly be true that trans milk is actually suddenly more nutritious than the milk from a biological mother. Neither the babies nor the truth matter any more.