AskDocQ: Some helpful chest binding tips for trans masculine folk


transgender chest binder
Photo: Supplied

Chest dysphoria is one of the most significant contributors to depression in transgender men.

Most trans masculine people would prefer flat chests, not surprising in a world where people’s brains automatically gender someone based on physical outline.

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Many trans guys have such strong dysphoria regarding their chests that they cannot stand to look in the mirror.

For young trans people their dysphoria worsens as puberty kicks in and breasts start to grow. Since top surgery to masculinize the chest is not immediately available to all (due to cost, accessibility or age) most will decide at some stage to use a binder.

Binding can make daily existence more tolerable for a trans masculine person but can also cause problems.

It’s important to get a proper binder in the right size, and not improvise with bandages or other tightly wrapped materials, which can cause injury due to rubbing and chafing, ranging from inflamed and broken skin through to serious skin infections.

Sometimes sports bras and compression sports shirts can be helpful, and layering clothes also works for larger chested folk.

Incorrect binding techniques can lead to very poor posture, muscular problems, rib injuries and chest pain, sometimes so bad that painkillers are needed.

All of this leads to avoidance of physical activity, worsening depression and weight gain. In the worst cases I’ve seen, the binding-related pain has caused breathing problems and visits to the emergency department.

If you’re getting chest pain, your binder is too tight or you’re wearing it too much and you need a break. Don’t wear it overnight.

Try to avoid wearing it for more than eight hours straight. The longer you wear it, the more you risk fungal infections.

You should wash your binder after a single use, so you will need several. Make sure you have the correct size, and if you’re still growing then it needs to grow with you — don’t stay with an old smaller binder — it might flatten your chest very nicely, but it will cause you big problems.

Contact the Binder Project in Brisbane to access affordable binders. Tap into the online community and you may find people who are giving away their old binders.

A patient of mine recently gave me all his unneeded old binders, and within a week I was able to pass them on to a 14-year-old whose family couldn’t afford them.

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The effect was instantaneous when he tried one on, as his back straightened and his eyes shone, and his delighted mother said it was the first smile she had seen in months!

Binding does not stop breasts growing and will not make them smaller. It doesn’t cause dangerous changes, but will change the eventual shape of the breasts, but our local top surgeon assures me that it isn’t an issue when it comes to surgery.

Chest binding is an important practice for most trans masculine people. It’s affirming and makes a huge difference to self-esteem and ease in social situations.

Following the basic rules of binding leads to better health and comfort. And once you’ve had top surgery, what do you do with your old binders that you no longer need?

If they’re not too scruffy, please consider paying it forward by donating them to your trans-friendly clinic for others in need!

Dr Fiona Bisshop specialises in LGBTIQ health and is available by appointment at Holdsworth House Medical Brisbane. Call (07) 3894 0794 or visit the website. For more by Dr Bisshop visit drfionabisshop.com, follow @DrFionaBisshop on Twitter, or send your health questions to doctorqnews@gmail.com.

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