All About Chest Binding

A clothes hanger line with 3 binders attached by clothespins

Author’s Note, 1/24/2022: Many people bind their chests for different reasons. The following is a handout I created and provide to patients at my Gender and Life Affirming Medicine (GLAM) Program at Anchor Health. I have included best practices: how-tos with finding and wearing a binder, how to minimize side effects such as chafing, sweating, and pain, what to do if you can’t bind and what not to do. I’ve also included pertinent research studies for interest.

Some people find that their chest causes significant gender dysphoria, with discomfort and distress. Binding is not just for trans guys and transmasculine people. Binding can be for anyone who wants a flatter appearance to their chest or to feel more comfortable. Binding is a common practice that compresses the chest tissue to achieve a flatter chest appearance.

Binder Use

  • Binders can be hard to put on and take off and take some time to get used to.

Measuring your Chest

  • 1st measurement: with measuring tape, measure under your arms just below the armpits and around your back and chest.

Sizing

  • Don’t get a binder that’s too small-this can cause you more pain. You need to be able to breathe!

Timing

  • Limit the time you spend wearing your binder. If possible, give your body a break every 8–12 hours.

Chafing Relief

  • Chafing is super common, especially in warmer weather. The following can help prevent chafing:

Sweating

  • Not all binders breathe well. Sweating can be a lot worse if you’re on Testosterone, too. Keep this in mind! A build-up of sweat can irritate the skin and cause rashes and sores. Sounds familiar? Try the following:

Hygiene

  • Make sure to wash your binder regularly with soap and water.

Binding and Top Surgery

  • Over a long period of time, binding can alter skin’s natural elasticity, meaning the skin will be more loose than for those who don’t bind. Don’t worry-this doesn’t ruin your chances of good results with top surgery, if you are planning to have surgery one day. The effects are minor.

Other Chest Flattening Options

  • sports bras-these will not achieve a completely flat appearance but can be more comfortable.

If You Can’t Bind

  • Try layering shirts. Start with a tight shirt or sports bra.

Careful!

  • Don’t use ACE bandages, plastic wrap, or duct tape.

Side Effects of Binding

  • Most common: back pain, overheating, chest pain, shortness of breath, itching, bad posture, and shoulder pain.

Pain from Binding

  • Binders are awesome but they’re not comfortable. If you start getting pain from regular binding, do the following:

Where to Get a Binder

  • The most reliable sites for binders are:

Evidence-Based Research on Chest Binding

The binding practices of transgender and gender-diverse adults in Sydney, Australia (Lee et al 2019)

  • In a 2019 study aimed at understanding the reasons behind chest binding, Lee et al. reported that many motives were driving the desire to bind distinct from the desire to be perceived as male.

Health impact of chest binding among transgender adults: a community-engaged, cross-sectional study (Peitzmeier et al 2016)

  • This first-ever study on chest binding examined 1800 trans adults and noted that binding is a positive experience for most, leading to improvements in mood, self-esteem, anxiety, and depression.

Association of Chest Dysphoria With Anxiety and Depression in Transmasculine and Nonbinary Adolescents Seeking Gender-Affirming Care (Sood et al 2021)

  • Chest dysphoria is associated with higher anxiety and depression in AFAB transmasculine and nonbinary youth.

The Impact of Chest Binding in Transgender and Gender Diverse Youth and Young Adults (Julian et al 2020)

  • Most trans people learn how to bind online and were not connected to any gender care

Additional Sources

Author’s Postscript: The true danger with binding is that healthcare professionals are largely unaware of the phenomenon and need to be educated on how to help people bind safely and effectively. Providers can minimize symptoms with proper education and guidance. Providers should learn how to size and fit a patient for a binder, advocate for insurance companies to provide coverage for this medical device, and work with trans-affirming binder companies to provide in-clinic binders. Providers should initiate non-stigmatizing positive discussions about binding with their transmasculine patients.

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The GLAM Doc

AJ Eckert (they/he) is Connecticut’s first out nonbinary trans doctor and Medical Director of Anchor Health’s Gender and Life-Affirming Medicine (GLAM).