Chest Binding Explained: Process, risk factors and side effects

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Chest binding is the process of compressing breast tissue to give the appearance of a flat chest. This is common among anyone who doesn't want their chest to look feminine. However, it is not advisable to bind your chest with duct tape or plastic wrap. The most popular safe methods are to use commercial binders, sports bras, strategic layering, and bandages or elastic materials.

Moreover, you need to make sure to take breaks throughout the day and take days off, if you're binding frequently. Continuous binding can cause negative side effects.

If you decide to get top surgery (a procedure to reduce or remove breast tissue), binding frequently can affect skin elasticity and impact surgery outcomes.

This practice prevails among people such as transgender men and masculine-presenting AFAB (assigned female at birth) people.

Breasts are a source of gender dysphoria for some trans and non-binary people.. This is because they're a visual reminder of a person's birth-assigned sex . Binding can reduce gender dysphoria and improve mental health, but it can also cause negative physical health symptoms.

The Process

People bind in many different ways: Some people wrap their chests with elastic bandages, some wear a sports bra, neoprene or athletic compression wear, or layer several sports bras or shirts. Others wear commercially-available binders specially designed for this purpose .

Everyone binds differently. Some people bind only for special occasions, others every day. One study surveying people who bind reported that the average person bound their chest for around 10 hours per day, with the most popular methods being commercial chest binders, followed by sports bras, shirt or bra layering, and bandages or elastic materials .

Risks and side effects

Like many things people do to modify their outward appearance (wearing high heels, or shaving facial hair), chest binding comes with some risks.

Binding can affect skin, muscles, and movement, particularly over long periods of time. Tightly covering the skin and chest with materials that don't allow free-flowing air can create warm, moist environments for bacterial and fungal infections to develop. Wearing binders that are too tight can cause underlying tissue and muscle damage, prevent free movement, and even restrict a person's ability to breathe.

There haven't been many studies about the health effects of binding, so it's important to listen to experiences of others, and to talk to your healthcare provider. (Here's a guide for finding a trans-friendly doctor and how to seek better care from the ones you do have.)

Two studies have been completed that focus specifically on people who bind. They were cross-sectional studies, observing a specific population (people who chest bind) at a specific point in time, and were published in 2017 and 2018. Both of these studies are based on data from 1,800 responders to an online survey.

Across both studies, the majority of people (89-97%) reported experiencing at least one negative symptom from chest binding .

Risk factors for binding side effects

People who bind their chest more frequently (every day) are more likely to experience negative symptoms. For this reason, taking days off between binding may help decrease this risk. Long term binding (over years) was also more likely to be associated with negative symptoms, particularly skin, tissues, and musculoskeletal problems . People with larger breasts were more likely to experience skin and soft tissue issues .

What people use to bind their chests with is a very personal choice, and finding a standard "best type of binder" for everyone is unclear. One study showed that people who used commercial binders experienced increased risk for the highest number of negative symptoms from binding, followed by those who used bandages, and plastic wrap or duct tape .

The high amount of negative effects found from commercial binders in this study were a surprise to the researchers, since blogs and other informal resources dedicated to trans men and healthy binding often recommend commercial binders. This could be due to people wearing binders that are too small, wearing them for longer periods, or wearing more than one at a time. More research is needed, but if you choose to wear a commercial binder, do your research, read reviews online, and make sure it is the right size for you.

Some common side effects due to Breast Binding

76-78% of people in studies reported skin/tissue problems, like tenderness, scarring, swelling, itching, infections

74-75% of people reported pain in chest, shoulders, back or abdomen

51-52% of people reported respiratory problems (like shortness of breath)

47-49% of people reported musculoskeletal symptoms, like postural changes, muscle wasting, or rib fractures.

However, a lot of people feel better mentally and emotionally when they bind. According to these studies, chest binding helps people decrease their gender dysphoria, as well as feelings of anxiety or suicidality, while increasing feelings of confidence in public and self-esteem .

Healthcare and chest binding

The 2017 study found that almost 9 in 10 people experienced at least one negative effect from binding, and 8 out of 10 felt that it was important to discuss binding with a healthcare provider. But only 3 in 20 (15%) sought medical care for binding-related health issues.

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