Binding

Chest binding is the practice of using commercial binders, binding tape, or clothing to compress the chest tissue and create the appearance of a flatter chest. For many transgender, Two-Spirit, and non-binary (TTNB) people, binding is gender affirming and improves overall quality of life [1,2]. Binding can help people feel less anxious, reduce depression and suicidality, improve emotional wellbeing, and enable people to go out in public confidently and safely [2]. Binding can help people to feel more at home in their body and provides a safe way to begin exploring their gender in a temporary and reversible way [3,4].

While chest binding is frequently associated with trans masculine people, binding is not exclusively a trans masculine practice [2,3,5]. People of any gender may bind their chest or breasts, including trans women who bind in situations where they are not out, or who feel more comfortable with a smaller or flatter chest, and cis women who bind to change their gender presentation.

TTNB people who do not feel safe or comfortable with their providers may not disclose adverse outcomes from binding practices [5]. Providers should be familiar with the practice of binding, aware of related complications, and willing to initiate non-stigmatizing discussions about binding [5]. This creates safer care environments where people feel comfortable bringing up questions and concerns about binding [2,5].

Commercial binders

A tight garment designed to flatten the chest, typically made of nylon and spandex. Most binders resemble tank-tops that pull down over the head or fasten with zippers or Velcro. Size and style of binder is dependent on brand, amount of chest or breast tissue, and personal preference. 

Waterproof medical grade tapes 

Medical or sports tape designed for use on skin is an effective way to bind the chest. Specialty brands, such as TransTape, TransGenX, and KT Tape make waterproof, latex-free medical grade tapes. These tapes can last for multiple days, are virtually undetectable under clothing, and are waterproof. They provide a good option for binding when exercising, swimming, and sleeping because they do not wrap around the chest or restrict breathing and movement.

Layering of shirts 

Sports bras

Athletic compression shirts

Neoprene waist and abdominal trimmers or back support devices

Clients may be hesitant to discuss their binding practices when they do not have a trusting relationship with their primary care provider [7]. Clinicians need to make it clear that they are asking about a client’s binding practices to support safer binding practices, not out of curiosity or to tell them to stop binding. Avoid making assumptions about gender or sexuality based on binding practices. The following questions may help start conversations about binding. 

Introductory questions

Social impact of binding 

Presence of side effects 

Harm reduction

Most people who bind will experience side effects at some point, many of them minor [2]. Common side effects include skin irritation, acne on the chest and back, itching, overheating, and back, shoulder, or chest discomfort [2,3]. Skin breakdown from binding, which may be worsened by warm climates and exercise, can lead to infections [8]. Shortness of breath may occur when binding too tightly [2].

Despite the side effects of binding, most people report experiencing immense benefits from binding and choose to continue the practice as long as it suits them [2,5,9]. 

When addressing minor side effects, consider harm reduction approaches rather than recommending clients stopping binding. Rather, engage clients in shared decision-making to create a treatment plan and identify ways to mitigate side effects [2]. Providers should consider how existing medical conditions (such as asthma) may be impacted by binding and work with clients to identify ways to decrease the associated risks [5].

General recommendations 

Regularly check in about binding practices and symptoms to ensure a proper fit, as body shape and binding preferences can change over time [5]. Encourage clients to discuss new symptoms related to binding as soon as they arise [2].

Fitting and selecting binders

Many brands provide sizing instructions on their websites. Alternatively, a certified garment fitter can be helpful. If someone is not satisfied with the results of a properly fitted binder, discuss alternative binding methods or multiple binding methods (such as layering shirts over a binder). Alternative binding methods such as sports bras, layering sports bras, and neoprene or athletic compression garments may decrease side effects [2]. Discourage the use of elastic bandages, duct tape, and plastic wrap as methods for binding [2].

Length of wear

To minimize side effects from binding, people should not bind for more than 8 hours a day or sleep in their binders, as this can restrict breathing and cause increased muscle tension [10]. Sleeping with a lightly compressive shirt may be an alternative for people who are uncomfortable sleeping without some compression. TransTape is designed to be worn for 3-5 days, including overnight and when showering. Where possible, people should take days off from binding [2].

Pain management

Along with appropriately sized binders and limiting length of wear, exercises and stretches to strengthen the back, shoulders, and chest wall will ease some of the pain caused by binding. 

Skin care

There are some skin hygiene that decrease the chance of skin breakdown and rashes [2]. The binder and skin should be clean and dry before applying a compression garment or waterproof medical tape. Applying body powder to skin before binding can help prevent chaffing. Wearing a thin shirt under the garment may help to wick away sweat.

For those using waterproof medical tape, a test patch on a small area of skin for 24-48 hours is recommended prior to applying larger pieces for longer periods of time [6]. It can be helpful to have a layer of protection between the nipples and tape (nipple guards, cotton, Vaseline, etc). To remove the tape, advise clients to follow manufacturer’s instructions, which often recommend saturating the tape with medical adhesive remover, or skin safe oils for several minutes before slowly peeling back the tape. Tape removal may be easier after a warm shower. 

Adolescents

Many adolescents who want to bind report that they do not bind because of unsupportive parents [9]. Without parental support to access commercial binders, adolescents may turn to unsafe binding methods such as duct tape and bandages [9]. Review available resources for free or low cost resources (see client resources, below). When parents are involved in an adolescent’s care, provide parents with accurate education on chest binding, including benefits, risks, and ways to decrease adverse events [9].

Breast implants

People with breast implants may choose to bind their chests. There is little research on this topic but it is unlikely that binding will rupture or harm breast implants unless it is painfully tight [11]. 

Chest reduction or construction surgery

Some people who bind do not want chest reduction or construction surgery [2,3], while others may use it as a temporary measure while waiting for chest surgery [12]. Long term binding reduces the elasticity of chest skin [5], which may cause minor effects on the final aesthetic outcome of chest surgery [12]. It does not usually impact the available options for chest surgery, but clients should review the plan with their surgeon for any individual concerns [12].

Cost

The cost of commercial binders ($30-$100+) may be prohibitive for some people, preventing access to safe and properly fitted commercial binders [13]. TransTape, while initially a more affordable option, does not last as long as a binder and will need to be repurchased on a regular basis. Not having access to safe binding methods may lead people to bind their chests with elastic bandages, duct tape, or Saran Wrap. These unsafe binding methods can increase the risk of adverse effects, including shortness of breath, restricted blood flow, rashes, bruising, and broken ribs [2].

Become familiar with free and low-cost options for accessing binders (see Resource section, below). For some Indigenous people, the cost of binders will be covered by the First Nations Health Authority. Clinicians can advocate for insurance companies to provide coverage for binding [9].

Estrogen-based hormone therapy

People who are taking estrogen-based hormone therapy may be concerned about damaging new breast tissue or harming breast growth when binding. While binders have been found to result in breast changes after long term binding, there is no research on the effect of binders on breast growth [2]. Depending on client preferences and amount of breast tissue, less compressive options may decrease this theoretical risk. 

Exercise and warm weather

Binding during exercise may result in restricted breathing, restricted movement, excessive rubbing, skin irritation, and infection from skin breakdown [8]. Swimming in a traditional binder may increase the risk of breathing restriction while swimming. For swimming, help clients explore options such as TransTape and binders made specifically for swimming.

For clients who exercise, recommend wearing a binder with less compression, one designed for physical activity (like a swim binder), or one size larger than usual and exploring alternative binding options (e.g., sports bras). After exercise, wet or sweaty binders should be changed as soon as possible. 

Safe binding is more challenging in warm weather as it traps heat and sweat against the body and can cause overheating, discomfort, and increased skin irritation. Alternate forms of binding, such as layering shirts, may also cause overheating in hot weather.

Strategies for binding in warm weather

Long term binding

Long term binding may contribute to worsening side effects, including increased pain [14]. Other potential long term binding side effects include rib fractures, skin infections, and respiratory infections [14]. 

As bodies change with age, binding techniques may need to be adjusted and binders will need to be replaced [13]. Offering regular assessments of binder fit and condition will help clients continue to bind in a safe manner and may decrease the adverse effects of long-term binding [5].
 

Pelvic floor

Binding may influence breathing (e.g., restrict diaphragmatic breathing) and posture in ways that affect the function of the pelvic floor muscles (e.g., ability to fully contract and relax). If the binding method compresses the rib cage significantly, it may put additional stress on the pelvic floor. It can be helpful for clients to practice diaphragmatic breathing and stretches before, during and after binding their chest [15]. 

People with larger chests

According to online forums (including Reddit), people with larger chests express that there are less binding options available to them as less compressive options (e.g., TransTape, layered shirts, sports bras) do not provide the desired level of compression. In some cases, a large chest size makes people feel like binding is not an option for them [9,16]. 

People with larger chests may experience more binding side effects than those with less chest tissue, including increased musculoskeletal pain, skin concerns, and overheating when in warm weather or when exercising [2,16].

Pregnancy and lactation

In theory, long term binding may impact milk duct growth and future ability to bodyfeed, but no research has been done on this topic [16,17]. 

For more information on binding during pregnancy and lactation, see Binding during pregnancy and lactation [link to clinical handbook section].

Tight or poor fitting binders

People may wear binders that are too small to increase the compression and make the chest appear flatter.

If people are unable to afford a new binder, they may wear a secondhand binder that fits poorly.  Binders that are too tight may lead to difficulty breathing, pain, or skin wearing away in spots [2]. 

See Resource section for information about free and low-cost options.

Resources for clients

Available funding for gender-affirming care and garments

Free or reduced cost binders

1. Hudson’s FTM Resource Guide. Mar 2004. Available: https://www.ftmguide.org/

2. Peitzmeier SM, 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: 64–75. doi:10.1080/13691058.2016.1191675

3. Lee A, Simpson P, Haire B. The binding practices of transgender and gender-diverse adults in Sydney, Australia. Culture, Health & Sexuality. 2019;21: 969–984. doi:10.1080/13691058.2018.1529335

4. Peitzmeier SM, Gardner IH, Weinand J, Corbet A, Acevedo K. Chest binding in context: Stigma, fear, and lack of information drive negative outcomes. Culture, Health & Sexuality. 2022;24: 284–287. doi:10.1080/13691058.2021.1970814

5. 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: 170–178. doi:10.1089/trgh.2018.0017

6. TransTape. Chest Masculinization. In: TransTape [Internet]. 2023. Available: https://transtape.life/pages/how-to-transtape

7. 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: 170–178. doi:10.1089/trgh.2018.0017

8. YSJ Active. Exercising Whilst Binding Considerations. York St John University; Available: https://www.yorksj.ac.uk/media/content-assets/ysj-active/documents/Binding-During-Exercise.pdf

9. Julian JM, Salvetti B, Held JI, Murray PM, Lara-Rojas L, Olson-Kennedy J. The impact of chest binding in transgender and gender diverse youth and young adults. Journal of Adolescent Health. 2021;68: 1129–1134. doi:10.1016/j.jadohealth.2020.09.029

10. Origami Customs. The ultimate guide to chest binding. In: Origami Customs [Internet]. 28 May 2025 [cited 16 Jun 2025]. Available: https://origamicustoms.com/blogs/updates-1/the-ultimate-guide-to-chest-binding

11. Wendel J. Can breast implants break by chest binding? In: RealSelf [Internet]. 27 Nov 2014. Available: https://www.realself.com/question/mexico-breast-implants-break-chest-binding

12. Gender Confirmation Center. Guide to binding your chest safely before surgery. In: Gender Confirmation Center [Internet]. [cited 30 May 2025]. Available: https://www.genderconfirmation.com/chest-binding-ftm-top-surgery/

13. Finney N, Slomoff R, Cervantes B, Dunn N, Strutner S, Martinez C, et al. Physical and mental changes reported by transgender and non-binary users of commercial and non-commercial chest binders: A community-informed cross-sectional observational study. Transgender Health. 2023; 1–11. doi:10.1089/trgh.2023.0051

14. Peitzmeier SM, Silberholz J, Gardner IH, Weinand J, Acevedo K. Time to first onset of chest binding-related symptoms in transgender youth. Pediatrics. 2021;147: e20200728. doi:10.1542/peds.2020-0728

15. Trans Care BC. Understanding the pelvic floor. In: Understanding the pelvic floor [Internet]. 2025 [cited 16 Jun 2025]. Available: https://www.transcarebc.ca/health-wellbeing/pelvic-floor

16. MacDonald T, Noel-Weiss J, West D, Walks M, Biener M, Kibbe A, et al. Transmasculine individuals’ experiences with lactation, chestfeeding, and gender identity: A qualitative study. BMC Pregnancy & Childbirth. 2016;16: 1–17. doi:10.1186/s12884-016-0907-y

17. Charter R, Ussher JM, Perz J, Robinson K. The transgender parent: Experiences and constructions of pregnancy and parenthood for transgender men in Australia. International Journal of Transgenderism. 2018;19: 64–77. doi:10.1080/15532739.2017.1399496