The Physical Health Effects of Binding
By: Peter Buggert | Last Reviewed: 10/12/19 Last Updated: 10/12/19
Disclaimer: Do not substitute this for the advice of a medical professional. I am not a medical professional.
There have been very few studies that have looked at the health effects of chest binding and even fewer have been peer reviewed and published in a recognized journal. In fact there is really only one. Even with the lack of studies, anyone who has tried binding can tell you that there are definite cons to consider. Any medical advice on binding or its health effects is really from a place of speculation.
There are notable issues in studying the effects of binding especially in the long term. You can’t really do an experiment, even if a large enough group is made to test the hypothesis there is no way to observe someone while binding 24/7 in the long term. The only real way to gather data, as per usual with human behavior, is with surveys or interviews and trust that the self reported data is accurate and precise. Binders also will not fit everyone the same way. Someone who is very overweight will have a significantly different binding experience than someone who is underweight, someone with very large breasts will have a different experience than someone with a small chest. Some people only bind a few times a week while some bind constantly. There are hundreds of different brands and methods out there, so it really isn’t a surprise that no good studies exist.
One study published in Culture, Health & Sexuality: An International Journal for Research, Intervention and Care used self reported data from an anonymous survey of 1800 people who were assigned female at birth and bound their chest for varying reasons. Despite only about 50% of the participants reporting that they bound on a daily basis, 97% reported that they had experienced at least one negative symptom of binding. The survey offered a list of 28 negative side effects and outcomes that someone could notice from binding and asked the participants to check those that applied. People who wore commercial binders actually reported the most symptoms (20/28), followed by elastic bandages (14/28) and duct tape or plastic wrap (13/28). This is significant because commercial binders are thought to be the safest binding method, but this survey would suggest otherwise.
That is not to say that commercial binders are dangerous and we should all go back to ace bandages. There are many different brands of commercial binders and some are very cheaply made. You could also say that someone who purchases a commercial binder probably plans on wearing it more and has probably been binding using other methods for a longer amount of time. A commercial binder might also offer the user a false sense of security making them think wearing it for longer is okay. Then again, commercial binders could actually be dangerous, we really have no idea. We do know that when health professionals talk about binding, they recommend never using ace bandages or duct tape, never spending less than $30 on a binder, never wearing it longer than 8 hours in a 24 hour period, if you are in pain or feel sick take it off, and only wearing one binder of the proper size at a time. Even these guidelines are unofficial and seem to be based off of “common sense”.
The study found that the most common symptom of binding was pain with 74% of respondents reporting some sort of pain they believe was caused by binding. The most common symptoms were:
- Back Pain (53.8%)
- Overheating (53.5%)
- Chest Pain (48.8%)
- Shortness of Breath (46.6%)
- Itching (44.9%)
Fifty respondents even believed they had suffered from rib fractures as a result of binding, which is less than 0.03% of participants, but that is still a very concerning side effect and probably the most severe. From my own personal experience (and I am sure others will agree) those people were almost certainly not following safe binding guidelines, especially as one of the basic guidelines is “if you feel pain take it off”. Also, most of these symptoms are, at least in some situations, preventable. You can do stretches and see a chiropractor for chest and back pain, you can avoid wearing a binder during exercise or in hot environments to prevent overheating, making sure your binder is clean and dry can take care of itching. Wearing a binder of a proper size for the proper amount of time could also potentially decrease all of these side effects.
There is also additional concern to be had when binders are worn by youth. These teens are still growing and developing and we aren’t sure how compressing the chest affects their health in the long run. With body parts still growing, what will happen to those body parts if they are forced to grow under pressure? There is also the question of youth’s capability of making decisions about their long term health. Teenagers are emotional, their brain is not fully developed, and they tend to take much bigger risks when it comes to their physical health. I am not saying that teens shouldn’t bind, because once again this is all speculation, but because of these factors it is recommended that a guardian should supervise a teens use of a binder.
I don’t know a single trans guy who won’t tell you that binding sucks, but I also don’t know a single trans guy who won’t say that binding causes a drastic positive increase in their mental health. The study reflected this as well with participants reporting a significant improval in mood due to binding, as well as a significant decrease in gender dysphoria, depression, and anxiety. For trans guys the mental relief brought by binding makes it worth the negative physical effects, if it didn’t then they wouldn’t be wearing them.
I also feel inclined to discuss the fact that binders aren’t the only piece of clothing that one may wear that has negative effects on health. High heeled shoes are extremely bad for our legs and feet and this has been proven time and time again, yet their use is so common that we don’t even think about it. Try to wear high heels for longer than a few hours and you will be in significant pain. They can cause cuts, bruising, sores, broken or fractures bones, arthritis, back pain, sprained ankles, even back pain, but they are seen as a common if not a necessary part of a woman’s wardrobe. There are corsets which are less common now and are mostly replaced by shapewear which still alter the shape of the body using compression and is believed to cause digestive track issues, breathing issues, back pain, ingrown hairs, tingling, and numbness. It is becoming more and more common to peirce and gauge our ears and other body parts and those always bring a risk of tears or infection. Even if we just look at the chest and breasts many traditional bras contain wires and people are constantly complaining they are uncomfortable. For people with particularly heavy breast bras can even cut into sides and shoulders. Sports bras avoid many of these problems, but like binders they also compress the chest. This suggests that people are not against binders or binding, but they are against what they represent; transgender and gender nonconforming people.
The problem with binding is a problem of balancing mental health with physical health. If someone is suicidal due to the roundness of their chest, then does some pain in their ribs really matter? Who cares if down the road their ribs might be a little misshapen when they could decide to take their own life tomorrow? The question with binding isn’t really ‘is it safe”, the question with binding is “do the benefits outweigh the risk”. The problem with that is physical health and mental health are apples and oranges, they are related, but we have no good system to compare the two. Because of this we really only have one choice: educate people as good as we can and then let them make their own informed choices. Almost everything that we do, especially in health, comes with risks and benefits and binding is no different.
In summary, yes, binders definitely have some negative effects on physical health, but we don’t know the severity of these effects, how long they may last, even what exactly they are. They don’t seem to affect everyone the same and we need more data before we can really figure out why. As a community we need to acknowledge that binding may be harmful to your physical health, because denying it is going to hurt nobody but ourselves. We need to advocate for more studies, better binders, better education, and transgender healthcare. Transgender men also need to look out for their own health, both physically and mentally.
Sources and Resources for more Information:
Morosini, D. (2017, October 9). What your doctor wants you to know about your shapewear. Retrieved October 10, 2019, from https://www.cosmopolitan.com/uk/fashion/style/news/a43245/spanx-shapewear-health-risks/.
- A piece by cosmopolitan that looks at the possible health effects of shapewear.
Mosser, S. (n.d.). FTM Breast Binding guide and safety before surgery. Retrieved October 10, 2019, from https://www.genderconfirmation.com/breast-binding/.
- An article from “Gender Confirmation Center”, a website run by gender confirmation surgeon Dr. Mosser, that talks about binding safety and its possible health effects.
Peitzmeier, S. (2016). Health impact of chest binding among transgender adults: a community-engaged, cross-sectional study. Culture, Health, and Sexuality, 19(1), 64–75. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/27300085
- The study that most of this article is referencing, you can see the abstract here, but you have to pay for the full version unless you are a college student or employee from certain universities.
Takenaga, L. (2019, June 17). ‘It’s Binding or Suicide’: Transgender and Non-Binary Readers Share Their Experiences With Chest Binders. Retrieved October 10, 2019, from https://www.nytimes.com/2019/06/17/reader-center/chest-binding.html.
- A good New York Times piece that discusses some of the stories of their readers who bind.
Tsjeng, Z. (2016, September 28). Inside the Landmark, Long Overdue Study on Chest Binding. Retrieved October 10, 2019, from https://www.vice.com/en_us/article/7xzpxx/chest-binding-health-project-inside-landmark-overdue-transgender-study.
- An article by Vice that mostly references the same study we talked about, but also looks at individual experiences, its just really well written and I wanted to include it.