Here's What You Need To Know About The Health Effects of Chest Binding

Groundbreaking research might finally help providers better care for their gender-nonconforming patients.

A new study in the journal Culture, Health and Sexuality is believed to be the first to look at the health impact of chest binding on transmasculine people.

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Chest binding is the practice of wearing something around your chest to flatten your chest tissue. It's done — often by transgender and gender-nonconforming people who were assigned female at birth — to masculinize the appearance of the chest. Some people use commercial binders (made just for binding) and others bind with athletic compression shirts, multiple sports bras, duct tape, elastic bandages, or other materials.

The study team, made up of researchers from Boston University Schools of Medicine, Boston University School of Public Health, and Johns Hopkins School of Public Health, analyzed 1,800 survey responses from people assigned female at birth and intersex-identified individuals who were binding at the time of the research.

The survey asked participants all about their binding practices.

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It included questions about binding methods as well as how often people wore a binder and for how many hours at time. It also asked participants what health outcomes they thought were a result of binding, said Sarah Peitzmeier, one of the study's authors, and a PhD student at Johns Hopkins Bloomberg School of Public Health.

The study concluded what many people who bind already know: Binding can cause pain and discomfort.

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Almost all (97%) of respondents reported at least one negative health outcome from binding — back pain, chest pain, overheating, itching, bad posture, and shoulder pain were the most common — though the survey did not ask about the severity of the outcomes.

Peitzmeier said the more days per week people reported wearing a binder, the higher their risk was for negative health outcomes, and that over half of the respondents bind every single day.

But the researchers also confirmed another common sentiment among people who bind: Wearing a binder improves mental health and quality of life.

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Although the authors are still analyzing the mental health data (a full paper just on that part of the study is coming soon), Peitzmeier said people reported that binding improved their mood and reduced dysphoria, depression, anxiety, and suicidality.

"People spoke very eloquently about how binding was so important to help them safely navigate public places, to go out and meet people, that it was hard for them to leave the house without binding," she said.

Because they found that the mental health effects of binding "were almost universally positive," the researchers recommend that healthcare providers "avoid making categorical recommendations against binding."

Instead, they suggest that doctors work with patients to help them make the best decision for their overall health.

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Doctors should familiarize themselves with the possible effects of binding on both physical and mental health, the study said. From there they should help patients minimize the risk of negative health outcomes (with, for example, tips on skin hygiene and resources on top surgery for interested patients, because top surgery would limit the length of time a patient binds), while empowering patients to make the best decision for their own physical and mental health.

This is significant not just because doctors have likely never gotten evidence-based recommendations about binding before, but also because they might not be equipped to address transgender health issues generally.

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As BuzzFeed Health has reported, there are various barriers to quality healthcare for transgender people. A 2011 survey on transgender discrimination in the U.S. found that the rate of HIV infection among transgender people is four times the national average, that one in four people experienced delays to medical care, and that 19% were refused care altogether. In fact, 50% of transgender patients in the survey reported educating their own doctors.

Peitzmeier pointed to a 2011 study on LGBT content in medical school curricula that found that "the median reported time dedicated to teaching LGBT-related content in the entire curriculum was five hours."

You can learn more about study and its authors and see the survey here.