How Illinois rewrote its family law, who wrote the script, where the money came from, and why the change had nothing to do with science

A rewrite no one was asked about.

In 2025, the Illinois General Assembly passed a bill that struck the word “father” from the state’s parentage law fifty-five times, “mother” thirty-four times, and “man” thirty-eight times — and along with them, “paternity” twenty-three times and “his” and “her” more than forty times between them.

The bill was the Equality for Every Family Act, signed as Public Act 104-0448 on December 12, 2025. The way this came about tells you how the bill was meant to be seen. The advocates’ own bills, filed under honest titles in February 2025 by their chosen sponsors, were left to die in the Rules Committee. The substance traveled instead inside HB 2568, a bill introduced as trust-and-unclaimed-property legislation, gutted in March and refilled by amendment with the 86-page parentage rewrite.

Anyone tracking family-law bills by their titles watched the announced bills stall while the real one moved under a label that gave no notice of what it carried. In the Senate it bypassed the Judiciary Committee for the leadership-controlled Executive Committee, and only after passage was secured was sponsorship handed back to the advocates’ original sponsor. None of it was illegal. All of it was built so the words would change before most people knew there was anything to discuss.

Two years earlier, in 2023, Illinois had already adopted House Bill 1591, the state’s version of a national model law that began replacing “mother” and “father” with “parent” throughout the code and introduced terms like “gestating parent.”

Most people in Illinois have no idea this happened. The family vocabulary of their state’s law changed, and it changed quietly, on purpose.

Set that against what the same political side says about the people this language is meant to serve. When the subject is girls’ sports, we are told the number of transgender athletes is so small that the concern about them amounts to a manufactured panic over a handful of cases. When the subject is school bathrooms or pronoun policy, we hear that the affected students are rare, that the worry is overblown, that reasonable people should move on. The argument from that quarter is always the same: the population is tiny, and the people raising concerns are bigots inventing a crisis.

So this raises the obvious question. If the population is that small, why rewrite the foundational vocabulary of an entire state’s, an entire nation’s, family law to accommodate it? You do not strike “mother” and “father” out of a legal code fifty-five and thirty-four times for a handful of cases. The scale of the effort and the size of the stated need do not match, and they do not come close.

When the effort runs this far past the need its own sponsors describe, the need is not what is driving the effort. Something else is.

This investigation traces that something else from the Illinois statute books back to its source, through the professionals who carried it, the method that shaped it, the ideology that powered it, and the money that paid for it all.

Where the words first changed

The trail in the field of infant feeding starts earlier than most people think, and it does not start with doctors. The term “chestfeeding” entered the academic literature in 2016, in a study of transmasculine parents by Trevor MacDonald, Joy Noel-Weiss, and colleagues, published in the journal BMC Pregnancy and Childbirth. It came from an advocacy community describing its own experience, not from a clinical finding about better care. The year before that, in 2015, the same framing had already entered the profession’s own literature, placed there a full year before MacDonald’s study by a single lactation consultant named Aiden Farrow.

The first hand on the language

The language did not arrive from nowhere, nor from any scientific study. It arrived from a person. The first to introduce gender-inclusive language into the professional literature of lactation was Aiden Farrow, and who Farrow is explains a great deal about the reasoning behind the language.

Farrow is a biological female. She built her early career and published her first work under the name Alice. At some point, she came to identify as transmasculine, took the name Aiden, and adopted the pronouns they/them.

She did not enter the lactation field as a scientist. She entered it as an advocate. Farrow earned the field’s international credential, the International Board Certified Lactation Consultant certification, and then worked as an author and speaker advancing LGBTQI health equity and gender-inclusive language. Her standing in the profession was that of a movement figure, built through advocacy rather than any body of research on what produces healthier mothers and infants.

That distinction runs throughout this investigation, and it begins here with the first source.

In 2015, the Journal of Human Lactation published Farrow’s article “Lactation Support and the LGBTQI Community,” in a special issue the journal devoted to equity. The piece appeared online in October 2014 and in print in February 2015. Its keyword list already carried “chestfeeding” and “cisnormative” as settled terms, a full year before the academic study usually credited with bringing “chestfeeding” into the literature. The article was not based on any study. It was an argument, placed in a sympathetic venue, for treating the profession’s ordinary language as a barrier and a harm.

From there, Farrow worked the field the way an organizer works a field. She took part in the 2014 Lactation Summit and the 2016 Lactation Equity Action Committee Global Forum, the rooms where the profession’s equity agenda was being set. In July 2017, she reached the center of the profession as a plenary speaker at the International Lactation Consultant Association’s annual conference, presenting “Gender Diversity, Language, and Inclusion for Lactation Specialists.”

In the interview the association ran alongside that appearance, she reduced the thesis to a single line: non-inclusive language is itself a barrier to practice. She wrote for inclusion-focused blogs, ran an online network for LGBTQI health professionals, and, in 2021, co-authored a guide to sex- and gender-inclusive writing for the same journal that had carried her first article six years earlier. The arc holds from one end to the other. Farrow’s subject was always the language, and her aim was always to change it.

Now place her in the chain, because that is what makes her matter. Farrow supplied the argument in 2015. The International Lactation Consultant Association made it the profession’s policy. The academic literature gave the policy a citation to stand on.

The Academy of Breastfeeding Medicine wrote it into clinical protocol. The field’s most trusted authors carried it to the working consultants. Each link took the language on trust from the link above it, and the link at the very top was not a finding or a measured outcome. It was an advocate with a cause, a personal cause.

The significance is not who Farrow is. It is what Farrow did, and the position she did it from. The vocabulary that a dozen institutions would later press on mothers across the English-speaking world was first set into the professional record by one activist who had a stake in the outcome, and every authority downstream adopted it without ever producing evidence that it helps a mother or a child. Trace the language to its source, and you do not find science. You find Aiden Farrow.

From one advocate to a profession

The institution that turned Farrow’s argument into policy was the International Lactation Consultant Association, the professional body for board-certified lactation consultants worldwide. In January 2017, ILCA published new Style Guidelines for written professional resources, making gender-inclusive language the preferred standard for the field.

The guidelines stated that the change came “in recognition of the diversity in gender identity around the world,” and they faulted the profession’s literature for referring to “mothers breastfeeding” without acknowledging that “transgender fathers and genderqueer parents may breastfeed, chestfeed, or lactate.”

They adopted Farrow’s framing almost word for word, calling the profession’s “predominant use of female gendered language” a form of “institutional erasure.”

The president of ILCA at the time of this change was Michele Griswold, a PhD nurse and lactation consultant who would later move into an advocacy advisor role for the association. By early 2019, the change had a successor steering it, Mudiwah Kadeshe, and gender-inclusive language had become a plenary topic at the association’s annual conference. The professional body had spoken, and the working consultants who trust it took their cue.

Then the association’s journal made the framing compulsory. In March 2021, the Journal of Human Lactation, ILCA’s academic journal and the field’s flagship, issued a formal policy statement declaring that its own prior practice of referring to “women” and “mothers” was “cisnormative,” did not accurately represent the lactating population, and had “the potential to be biased, inaccurate, and harmful.”

Effective July 1, 2021, authors submitting research were required to use gender-inclusive language.

The journal grounded the mandate in the American Psychological Association‘s publication manual, citing the manual’s bias-free language chapter as its governing authority, the psychology establishment’s style rules pressed into service as the warrant for outlawing “mother” in a breastfeeding journal. And read the byline on the policy. It was issued by the journal’s editorial team together with two named co-authors, and one of them is Aiden Farrow. The person who supplied the argument in a 2015 essay is a named author of the rule that, six years later, binds every researcher in the field. The originator’s own hand is on the law.

One person carried the new framing across the boundary between ILCA and the doctors. Kathleen Marinelli, a neonatologist and lactation consultant, was elected to ILCA’s board of directors in 2014 and sat there through the language change, serving as its Director of Professional Development. She came to that position from the physicians’ academy, where she was among the inaugural class of twenty named Fellows of the Academy of Breastfeeding Medicine, served for twelve years on the academy’s board of directors, and chaired the Protocol Committee for years, the body that writes the academy’s clinical guidance.

She appears on that committee’s roster in Protocol #33 itself. And she is named as a member of the Journal of Human Lactation editorial team that issued the journal’s 2021 language mandate. The consultants’ board, the physicians’ protocol machinery, the journal’s language law: one set of hands appears in all three.

The bridge between these institutions was not a shared sympathy. It was a person.

The academic seed

The respectable cover for the change came from a paper that was never about gender at all. In 2017, Kathleen Rasmussen, a distinguished nutrition scientist at Cornell, published a paper in Breastfeeding Medicine titled “The Meaning of ‘Breastfeeding’ Is Changing and So Must Our Language About It.”

Her concern was technical. High-efficiency breast pumps meant that a baby might now receive its mother’s own milk from a bottle or a cup rather than at the breast, and might receive another mother’s donated milk; Rasmussen wanted terms precise enough to distinguish those situations for research. Her paper used the word “mother” four times in five sentences. There was no “gender,” no “identity,” no “inclusive” anywhere in it. It was a sexed paper about a real, narrow problem in measurement.

Two years later, in 2019, a professor at Montclair State University named Lauren Dinour took Rasmussen’s precision argument and fastened a second argument onto it. In a paper titled “Speaking Out on ‘Breastfeeding’ Terminology,” also in Breastfeeding Medicine, Dinour agreed that the word “breastfeeding” was imprecise, then added that it “is nearly always associated with mothers and women,” which she said risked “alienating an already marginalized population” and corrupting “valid, high-quality surveillance data.”

There it is.

The precision argument was the front. The gender argument was the payload, and the appeal to clean data was the same data-capture logic that runs through the electronic health record systems we will come to later. Rasmussen had made a legitimate point about pumps. Dinour welded an ideological claim to it so that the ideology could ride on the science’s respectability.

There is a detail worth noting here. Dinour’s department at Montclair State, the Department of Health and Nutrition Sciences, is chaired by Eva Goldfarb, who is one of the principal architects of the National Sex Education Standards, the curriculum framework that teaches family-structure diversity to children as young as kindergarten. The author degendering breastfeeding language as well as a lead author of the national sex-ed standards work in the same university department, with the sex-ed architect as the chair.

Is that a coincidence?

I can’t claim the two collaborated on a shared project because, so far, the record does not show that. But the two separate streams of influence regarding this issue, sitting in one department under one chair, tell us something. It’s certainly a curiosity.

The doctors make it clinical

The Academy of Breastfeeding Medicine is the worldwide body of physicians who specialize in this field, and it made the language a clinical default. In 2020, it issued Protocol #33, “Lactation Care for Lesbian, Gay, Bisexual, Transgender, Queer, Questioning, Plus Patients,” with Casey Rosen-Carole among its authors.

The lead author, Rita Lynne Ferri, is credentialed in the document itself with a bachelor’s degree, listed ahead of the physicians. The protocol imported its terminology straight from a glossary produced by Boston’s Fenway Institute and from transgender-care guidance out of the University of California, San Francisco, and it sourced its definition of “chestfeeding” to a memoir, Trevor MacDonald’s “Where’s the Mother? Stories from a Transgender Dad.” Protocol #33 was the framework within which “chestfeeding” was institutionalized as clinical practice.

Read the protocol itself and the basis appears in its own words. Its clinical centerpiece, inducing lactation in transgender women, rests on what the document calls “many anecdotal reports and one case report.” On the standard medication regimen, the authors write that the practice “is not evidence based.” On the frequency of success, “there is no published research.”

On the feeding devices it recommends, “there is no published evidence on the best methods of use.” The drug it identifies as having the strongest evidence is not approved by the FDA for use in the United States.

The justification for the whole document rests on discrimination surveys produced by advocacy organizations, and its closing section concedes that “significant research gaps exist in this field.”

A clinical protocol whose vocabulary came from advocacy glossaries and a memoir, whose rationale came from movement surveys, and whose own text states four times that the evidence does not exist. That is what the academy’s authority was stamped onto.

Then, on July 27, 2021, the academy published a formal language statement in Breastfeeding Medicine titled “Infant Feeding and Lactation-Related Language and Gender.” It was signed by eight physicians: Melissa Bartick, Elizabeth Stehel, Sarah Calhoun, Lori Feldman-Winter, Deena Zimmerman, Lawrence Noble, Casey Rosen-Carole, and Laura Kair, writing for the organization.

It listed “breastfeeding, chestfeeding, lactating, expressing, pumping, human milk feeding” as parallel terms and recommended “de-sexed or gender-inclusive language” in many clinical settings. One of its authors, Dr. Laura Kair of UC Davis Children’s Hospital, gave the premise its slogan. Language has power, she said, and clinicians should ask patients for the terminology they prefer. And the statement was not a fresh body of physicians arriving at the same conclusion.

Check the names against Protocol #33 from the year before, and every one of the eight is already there: seven on the Protocol Committee roster printed in the document, and the eighth, Rosen-Carole, an author of the protocol itself. The same small circle that adopted the framework in 2020 spoke again in 2021, and the second pronouncement was received as if the academy’s membership had reached a consensus twice.

So, in the space of five years, the chain ran from an advocacy community’s term to one consultant’s article to a professional association’s style rule to an academic paper that distorted the earlier assessment to a physician’s protocol to a formal physicians’ language statement. Each step borrowed the authority of the step before it. By 2021, a doctor could adopt the new words and tell herself, correctly, that her own academy recommended them.

The cascade

After the academy spoke, the language went everywhere, and fast. Healthline published a “What Is Chestfeeding?” explainer in September 2021 that named the Academy of Breastfeeding Medicine and La Leche League as adopters. Mayo Clinic followed with its own explainer in 2022, authored with the help of endocrinologist Caroline Davidge-Pitts. Salon ran coverage in 2023. La Leche League International and its national affiliates began publishing chestfeeding material. The United States Lactation Consultant Association issued a 2021 commitment citing ILCA’s 2017 guidelines as precedent. Academic medical centers picked it up, among them the University of Rochester Medical Center, the University of Chicago Medicine, and Drexel, whose Women’s Health Education Program ran an “Inclusivity in Chestfeeding” session as recently as 2025.

The government followed the professions. The Centers for Disease Control and Prevention put “breastfeeding or chestfeeding” on its pages for transgender parents, reportedly as far back as 2018. The Department of Veterans Affairs adopted “breast/chestfeeding” in system-wide communications. Arizona’s Department of Health Services hosted multiple continuing education presentations on its official state servers in 2021. And the change crossed the ocean. Britain’s National Health Service carries official guidance titled “Chestfeeding if you’re trans or non-binary,” a page that has stood on the national health site for years. A term that began in an advocacy community a decade earlier had become the recommended usage of medicine, of multiple governments, and of the press.

The Carriers

Among everyone who carried this language forward, almost no one carried it further than Nancy Mohrbacher, and to understand why, you have to understand who she is.

Mohrbacher came to breastfeeding the way most mothers do, by doing it. In the early 1980s, she nursed her three sons and fell in love with the work of it. She began helping other mothers as a volunteer, and the volunteering became a calling. When the profession created its certifying exam in 1991, she sat for the first one and passed.

She went on to write the references the field trains on, the books a whole generation of lactation consultants learned their craft from, and she contributed the chapter on breastfeeding and growth to the association’s own core curriculum. In 2008, ILCA named her in its first class of Fellows, the highest honor the field gives. She works out of Arlington Heights, in the Illinois suburbs northwest of Chicago, and, decades into her career, she remains an authority. When a lactation consultant anywhere in the country wants the right answer, Mohrbacher’s books are where a great many of them look first.

That standing is precisely why her adoption of the new language carried the weight it did. In 2020, she published the second edition of Breastfeeding Answers, a 960-page professional reference that she revised throughout to use gender-inclusive language. It is not confined to one chapter. The book teaches “chestfeeding,” “co-nursing,” and “dry nursing”; it instructs clinicians on how to induce lactation in transgender and non-gestational parents; and its margin notes describe milk production for “transgender male parents” and “transgender female parents.”

She rebuilt the field’s standard reference around the new words and recommended them to everyone who reads her.

There is no reason to doubt why Nancy Mohrbacher did it. She has spent more than forty years caring for the actual mothers and the actual babies in front of her, and the case made to her was about care, about not turning away a patient who could not find herself in the old words. A woman who built her entire life on compassion for her patients adopted language she was told was more compassionate. That is no failure of character. It is the whole point of how this worked. The movement did not need to corrupt Nancy Mohrbacher. It only needed to persuade her, and persuading one of the most trusted authorities in a field is how you reach everyone who trusts her.

The sincerity was real. The science was not.

Mohrbacher is not the exception in this story. She is the rule. Across medicine, nursing, and lactation, the professionals who adopted this language did so for the same reason she did. They were caring people who were told the new words were kinder and that science stood behind them. They believed it because they are decent, and because the institutions they rely on told them so.

So the question that matters most is the one almost none of them were ever actually asked. Was the science there?

It was not.

Walk back through the chain and look for the evidence. The one genuinely scientific paper, Rasmussen’s, was about the precision of describing how milk is delivered; it was emphatically sexed, and it concerned pumps, bottles, and donor milk. There is no body of clinical research showing that stripping the word “mother” out of lactation care produces a healthier mother or a healthier baby.

None.

The gender-inclusive language was justified entirely by appeals to identity, to inclusion, and to cleaner data collection, by the claim that the old words alienated and erased people. Those are moral and political claims. They are not clinical findings. The decisive act, Dinour’s, was to attach the political claim to Rasmussen’s technical one so that the first could borrow the credibility of the second. What an entire profession took for science was an ideology wearing a lab coat. 

The chain produced its own dissent

The strongest evidence that the science was never there came from inside the profession itself. In February 2022, ten researchers and clinicians from Australia, Britain, the United States, and beyond published a peer-reviewed paper in Frontiers in Global Women’s Health titled “Effective Communication About Pregnancy, Birth, Lactation, Breastfeeding and Newborn Care: The Importance of Sexed Language.”

The lead author was Karleen Gribble of Western Sydney University, joined by the British obstetrician Susan Bewley and eight colleagues. The paper argued that stripping sexed terms out of maternity care degrades the communication that care depends on, that terms like “gestational carrier” and “human milk feeding” confuse the very patients who most need plain words, mothers with low literacy and mothers reading in a second language among them, and that desexed language risks dehumanizing the women it describes and undermining breastfeeding itself.

Now we find the third name on that paper. It is Melissa Bartick of Harvard Medical School, the lead author of the Academy of Breastfeeding Medicine’s own language statement. The physician whose name stood first on the academy’s July 2021 instruction signed the peer-reviewed case for sexed language barely six months later. The chain did not merely fail to produce evidence. It produced its own dissent, at the top, in the open literature, from the one author best positioned to know what the statement rested on.

The Gribble paper cataloged practical harms to comprehension, to care, and to mothers. The professional bodies adopted the first and looked past the second. If the question had ever been evidence, the paper with the evidence would have carried the field.

stay tuned for part two…