What Is Chest Binding?

Used to Flatten the Appearance of the Chest

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Transgender men, non-binary individuals, and others who wish to present a more masculine appearance may use chest binding to flatten their breasts. Many transmasculine individuals who went through an estrogen-mediated puberty experience significant chest dysphoria—feeling that their prominent chests do not match their sense of who they are.

Chest binding allows them to present, publicly, in a way that feels more concordant with their gender identity. Chest binding may involve the use of a variety of different products or techniques to flatten the chest.

Chest binding supports male gender expression
LWA/Dann Tardif / DigitalVision / Getty Images

Use of Chest Binding

Transmasculine individuals are those people who were assigned female at birth and have a more masculine gender identity, including non-binary individuals and transgender men.

For many such individuals who went through an estrogen dominated puberty, having a feminine chest contour (breasts) is deeply discomfiting and makes it harder to exist comfortably in society.

In addition, for those individuals who choose to use testosterone to masculinize their bodies, testosterone may slightly decrease breast size but will not eliminate existing breast growth.

Chest binding is the only non-surgical option that can be effectively used to create a more masculine chest. (Cisgender women who prefer a more masculine gender expression may also bind their chests.)

Techniques

There are a number of different techniques that individuals may use to bind their chests. These include:

  • Sports bra(s)
  • Compression shirts
  • Ace bandages
  • Binders, garments that are specifically made for the purpose of chest compression
  • Trans-tape, a type of wide kinetic tape that is specifically designed for being worn for multiple days, including in the shower

Different methods of chest binding are associated with different potential problems. However, in general, devices made specifically for binding may be less likely to cause side effects when used properly.

Items such as duct tape or plastic wrap are not recommended for chest binding, and may be more likely to cause health problems when used.

There are a number of excellent resources for chest binding available on the internet, by transmasculine people, for transmasculine people. They discuss, in detail, how to find and fit a binder as well as how to wear one safely.

As good binders may be quite expensive, there are also resources out there for finding used binders, and a number of different charities provide free binders for individuals who could not otherwise afford them.

Side Effects

There are a number of potential side effects of chest binding that people should pay attention to and, if necessary, see a doctor for. If people bind their chests too tightly in ways that compress their ribs, they can experience chest pain and difficulty breathing. They may also experience back pain or difficulty participating in sports and other activities.

Binders that do not allow the skin to breathe can lead to rashes and skin breakdown, which may require medical attention. Binding too tightly can also lead to neurological symptoms, such as tingling or numbness in the fingers and hands.

Depending on the type of binder used, it may, rarely, lead to gastrointestinal symptoms or damage to the ribs and shoulders. Individuals with large chests are more likely to experience skin breakdown and rashes in general, as well as with chest binding. They may also be more likely to experience other symptoms, including pain.

Duration and frequency of binding also affect the likelihood of having symptoms. People who bind more often and for longer periods are more likely to experience binding related issues. However, the vast majority of people who bind their chests regularly will experience symptoms at some point in their lives.

Healthcare Concerns

When done properly and safely, healthcare for chest binding should just involve addressing any symptoms and performing checkups to make certain the binder is not causing any lasting health problems.

For patients who feel that binding is an effective way to address their chest dysphoria, initial interventions should focus on helping them bind correctly. This may involve connecting patients to resources for binding and using different types of binders to reduce the risk of pain, skin breakdown, rashes, and other symptoms.

Doctors may also need to work with patients around binder cleanliness and showering, if symptoms are associated with hygiene concerns. (People with severe chest dysphoria may have significant difficulty showering or touching their chests, and this may increase the risk of certain skin symptoms.)

Rashes and skin breakdown may require medical treatment, as may damage to the ribs or other body structures.

For individuals who want to have a flat chest, or for whom chest binding causes significant symptoms, surgery may be an option. Gender affirming top surgery to address chest dysphoria may take the form of either a breast reduction or chest reconstruction.

Breast reduction is more appropriate for individuals with large chests whose gender expression is less consistently male but who wish to be able to bind more comfortably and present as masculine some times and feminine other times.

Chest reconstruction involves the removal of all the breast tissue and the creation of a flat chest with a masculine profile. It is appropriate for people who would find a male chest contour to be affirming of their gender identity and expression.

A Word From Verywell

Binders, when used correctly, can be a safe and effective way for many individuals to address their chest dysphoria. However, they don't work for everyone, and chest binding can be particularly difficult for individuals with very large chests, who may experience symptoms simply from the weight of their chest as well as from the compression.

For some such individuals, gender affirming chest or top surgery may be a reasonable option. Top surgery is considered medically necessary gender care, where indicated, and is covered by a majority of insurers across the United States.

Furthermore, as the international standards of care for gender affirming care produced by the World Professional Association of Transgender Health (WPATH) do not require testosterone for people to be able to access top surgery, a lack of interest in starting testosterone should not be a barrier to getting chest surgery for those who desire it.

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  1. Peitzmeier S, Gardner I, Weinand J, Corbet A, Acevedo K. Health impact of chest binding among transgender adults: A community-engaged, cross-sectional study. Culture, Health & Sexuality. 2017:19(1), 64–75. doi:10.1080/13691058.2016.1191675

  2. Jarrett BA, Corbet AL, Gardner IH, Weinand JD, Peitzmeier SM. Chest binding and care seeking among transmasculine adults: A cross-sectional study. Transgender Health. 2018;3(1), 170–178. doi:10.1089/trgh.2018.0017

  3. Almazan, A. N., Benson, T. A., Boskey, E. R., & Ganor, O. (2020). Associations Between Transgender Exclusion Prohibitions and Insurance Coverage of Gender-Affirming Surgery. LGBT Health. doi:10.1089/lgbt.2019.0212

  4. World Professional Association for Transgender Health. Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People (7th Version). WPATH. 2011.