Authors: Julian Grace, Arden Wong, Kai Schweizer.
There is a lot of information out there about chest binding, and it can be challenging to work out what information is based on research and clinical evidence. This blog post takes a harm-reduction approach and advocates for bodily autonomy by compiling up-to-date, evidence-based information for individuals who bind (or are considering binding), and for those who support and care for them.
What is chest binding, and how common is it?
Binding is the practice of flattening the external appearance of the chest without surgery. While cisgender (not trans) people sometimes bind for various reasons, the focus of this blog post will be trans men and non-binary people presumed female at birth.
In one Australian study, 87% of trans people presumed female at birth were either currently using or had previously used binders. These purpose-made compression tops are the most common binding method, but it’s good to have a variety of tools in your gender euphoria/dysphoria toolkit, so we’ll briefly explore other options at the end of this post too.
What benefits can people experience with binding?
People generally bind to feel more comfortable in their body, and with how others perceive them. Binding can be important for internal benefits (e.g. gender euphoria, mental health, and confidence), as well as external benefits (e.g. safety in public).
Trans research participants have reported internal benefits such as:
Increased self-esteem and confidence.
Improved mood and overall mental well-being.
Decreased dysphoria and anxiety.
In one study, participants generously shared some of their positive experiences:
“I feel an enormous amount of gender and body euphoria when I see myself in a binder… I can see myself as I want to be.”
“I would be able to not only just see my reflection, I’d actually be able to stop and look at it and be at peace, basically. It made me able to be at peace with myself.”
“It gives me comfort, gives me happiness, it gives me less anxiety, when I’m able to look and feel like the gender I identify as.”
External benefits can also be big motivators for people who bind. In one study:
95% of participants bind to feel more comfortable in public spaces.
63.7% bind for safety reasons.
Binding was associated with reduced misgendering.
Binding is also a practical, non-invasive, reversible, and more affordable option if top surgery either isn’t desired or isn’t accessible.
Having said that, not everyone experiences the same benefits from binding, and not binding (whether out of choice or for health reasons) doesn’t make you any less trans, or any less worthy of being correctly gendered and treated with respect.
Can binding cause health problems?
Binding is a balancing act between mental, social, and physical comfort, and thankfully there’s an increasing amount of research into the benefits and challenges involved, so that we can make informed decisions.
One of the challenges of binding is managing the common physical health effects and minimising the risk of longer-term health impacts.
The likelihood of health issues depends on:
Your unique health needs.
How you bind (e.g. fit of binder, type of compression).
How often and how long you bind for.
Research has found that people who bind experience a range of symptoms affecting different structures and functions of the body, with the most common symptoms including:
Pain (mostly back, chest, and shoulder).
Shortness of breath.
Overheating.
Skin issues (e.g. acne, itching, and changes to elasticity).
A study that looked at symptom timelines found that these common symptoms often start within the first month of wearing a binder regularly, so it’s important to start exploring different management strategies early on. This will help you to continue binding as sustainably and comfortably as possible.
Interestingly, the research we have so far suggests that symptoms related to breathing capacity are unlikely to have a continued effect if someone stops binding.
One potential health impact that trans people are often particularly concerned about is rib fractures. While possible, they are rare and usually only occur after binding daily for more than five years.
How can I reduce the risk of health problems from binding?
Of course, binding less can help to reduce the risk of health problems, but that isn’t always realistic advice. Additionally, despite knowing that it’s a priority for trans people, the research on chest binding is still evolving and we don’t have concrete protocols for managing symptoms and reducing the risks yet. This means it’s really important to find community and healthcare practitioners that you feel comfortable speaking to about both the good and the difficult parts of binding. Over time, and with support, you can try different things and find strategies that work for you and your unique health needs.
Some common practical tips to reduce the health impacts of binding include:
Choosing a binder:
Take more care with sizing than you would for other clothes. Aim for it being snug while still being able to breathe comfortably, without it digging in.
If your body size or proportions change (e.g. gaining muscle mass from testosterone), check the fit of your binder and get a new one if needed.
Try different styles and brands to find what works best for you. Finding stores with in-person fitting support, binder exchange programs, and other community members who bind can be useful for this.
Have a couple of different binders with different levels of compression, so that you can adjust your binding depending on heat and activity level (adjustable binders are useful for this too).
Some brands may offer styles intended to be less restrictive around the shoulders (e.g. racerback).
Some brands offer more sensory-friendly binders (e.g. smoother seams, softer material) which can be helpful for people with sensory sensitivities, including many neurodivergent people.
General safety and self-care:
As binding frequency is associated with increased health impacts, taking days off is a good idea if possible.
Hygiene is really important to prevent acne or infections, so make sure you’re washing your binder regularly.
Breathing exercises and movement help maintain the health of your rib cage as well as muscles like your diaphragm. It can be useful to have a short, achievable movement and deep breathing routine that you do every time you take your binder off.
Avoid using bandages or multiple binders at the same time, as they can give dangerous levels of compression.
Avoid wearing a binder while sleeping.
If you experience any breathing-related health issues, it’s recommended that you talk to a doctor about how it might impact your ability to bind safely. For example, if you have pneumonia you might need to take a break from binders until you recover, and you and your support team can collaboratively come up with a plan for how to make that period as stress- and dysphoria-free as possible.
Remove your binder and/or check in with the practitioner involved if you’re going under general anaesthetic. There has been one reported case study of someone wearing their binder while under general anaesthetic, and it unfortunately caused a dangerous drop in the levels of oxygen in their body.
Healthcare practitioners have a big role to play in reducing health risks from binding. If you’re a practitioner reading this, don’t assume that your patient knows you’re safe to talk to about binding. One study found that 82% of participants believed it was important to discuss binding with their healthcare professional, but only 56.3% felt safe to initiate a conversation about it with their provider. Another study found that 95.7% of participants learnt to bind online compared to just 2.7% having received guidance from a medical provider. Adopt an open-minded, harm reduction approach, and link in with multidisciplinary care and peer support if appropriate and desired.
Can I wear a binder while exercising or playing sport?
Is it safe?
There’s limited research specifically looking into binding while exercising, and there’s such a huge variety of sports that it’s generally a subjective risk assessment best done with the support of a health professional and someone who understands your sporting practice (e.g. your coach or trainer).
The research we have so far suggests that breathing during rest or exercise is usually shallower while binding due to the compression it provides.
Binding options for exercise
Because of this, the general guidance is to use looser support of the chest whenever possible to minimise breathing difficulty. How you do this will depend on the activity you’re doing, and your personal balance between sport performance, dysphoria, safety, and physical comfort. Sports bras are a common option, as well as looser fitting or adjustable binders. We also explore some other options for less compression at the bottom of this blog, like taping.
Some companies sell swimming-specific binders, but keep in mind that this usually just means it’s chlorine resistant and quick drying, and often still has a lot of compression. They’re usually designed for having a splash around in the pool rather than doing intense laps or competitions.
Harm minimisation
If you’re physically active while wearing some level of chest compression, be extra mindful of your body temperature and ability to breathe comfortably, and err on the side of caution. Having a buddy that knows you’re binding and can check in with you is a really good idea, too. Sometimes when we’re physically active we’re so focused on our goals that we lose track of what we’re feeling in our body, and a buddy can help look out for us.
We know that sport and physical activity can have amazing benefits, so we want to avoid an all-or-nothing approach. If binding is a big barrier to doing a sporting activity that you love, then it’s time to get creative! By unpacking and exploring what it is you love about sport, you can find more binder-friendly options and fun work-arounds:
Love cardio but don’t want to do it in front of people without a binder? Online personal training, exercise bikes, and boxing bags can be great at-home options.
Enjoy the social side of sport? Watching matches with mates, playing e-sports, and other competitive activities like board games are worth a try. You’d be surprised how fun (and raucous) a friendly darts competition or game of pool can get!
Want an excuse to get outside and be active, but need a less strenuous option? Picnic games with friends in the park, bird watching, and casual bush walks are good options too.
You might also find that not wearing a binder is more comfortable if you’re surrounded by other trans people. Thanks to the hard work of our sporty peers, there are now lots of LGBTIQA+ sports clubs around! You can find links to directories, as well as inclusivity training options, on our sports resources page here.
What other options are there, as well as binders?
Taping:
Taping is the practice of using skin-safe, stretchy tape to flatten the appearance of the chest.
General taping safety tips:
There are many brands of tape that people use, some are trans-specific and others are made by sports brands. The important thing is that the tape is designed to be used on skin (e.g. not duct tape) and is stretchy (e.g. not rigid sports tape).
Even though it’s stretchy, tape isn’t designed to go all the way around your chest, so make sure you leave gaps for your body to move and breathe.
Just like with binders, it’s important to switch things up and give your skin a recovery break from tape sometimes.
If the skin where you want to tape gets irritated or damaged, take a break from taping (see other options below) and check in with a GP or dermatologist.
Preparing your skin:
Clean and thoroughly dry your skin beforehand (trimming hair can also be helpful).
Test a small patch of tape before your first time to check for a potential allergy.
Application technique:
Firstly, check the instructions on whatever brand you buy and follow those where possible.
Lay down each end of the tape flat with no stretch (about 1-2 inches at either end) to minimise pulling on the skin.
Avoid overstretching the tape, so that it still has some stretch left and can move with your body.
Rounding off the corners can help the tape stay on.
The tape adhesive is activated by your body heat, and rubbing the tape once it’s on can boost this process.
Some people find barrier spray and hypoallergenic undertape can help with skin irritation.
Tape removal:
Tape can generally be kept on for 3-5 days, but it’s a good idea to remove it if it gets dirty or is irritating your skin.
Remove the tape slowly and carefully, particularly if it’s over the nipple.
Apply gentle pressure to the skin adjacent to where you’re peeling the tape off with your other hand.
If you’ve got body hair in the area, peel in the same direction that your hair grows.
Soaking the tape in skin-safe oils can help, and pharmacies often stock purpose-made adhesive remover. As heat activates the adhesive, tape manufacturers don’t recommend using it for removal.
Clothing:
Layering tops (e.g. a singlet tucked into your pants under a loose-fitting t-shirt).
Vertical lines can help, such as an open button-up shirt over a t-shirt.
Sports bras/crops can be a great in-between option.
Mental health support:
Navigating the world as a trans person and dealing with dysphoria can be tough! Professional, peer, and community support are incredibly important tools in your gender euphoria/dysphoria toolbelt.
If you’re not sure how to find this support, we have a community resources page dedicated to mental health here.
Conclusion
Binding can be a powerful tool with many benefits as well as health considerations, so it’s important to make informed decisions. Everyone’s body and needs are different, so by staying informed, listening to your body, and reaching out for support when needed, you can make binding as safe and sustainable as possible.
If you choose to bind, know that you deserve respect, support, and access to accurate information. It’s okay to experiment with different methods, take breaks, and prioritise your well-being. And if binding isn’t right for you, that’s also a completely valid choice.
Whether you’re someone who binds, supports a loved one, or a healthcare professional looking to provide better care, we hope this guide has been helpful.
Take care, and bind safely!