Written by Dr Ruth Livingstone
Breast binding seems to be very common among young women who wish to identify as men. It is the process of strapping your chest in order to reduce the size of your breasts and to make yourself look more “masculine”. But how common, exactly, is breast binding? And what are the health risks?
There is plenty of advice to be found about binding – both from personal accounts on social media, and from official web sites supporting trans health.
The commonest official advice is to wear a correctly sized commercial binder, to avoid the use of DIY devices such as elastic bandages, duct tape, or plastic wrap, to remove binders when sleeping, and to limit binding to 8 hours per day. But these recommendations are based on individual personal experiences. What does the evidence tell us?
Astonishingly, for something that seems so common and is promoted so widely by various health sites, there is very little proper medical research into the effects of breast binding.
The best research data we have is from America, from a study performed by university departments in Boston and Baltimore, called the "The Binding Health Project". This was an online survey of 1800 chest-binding females and was conducted in 2014. Observations from the data obtained in this survey have been released as 3 separate papers (see references below) in 2017 and 2018 and 2021. This series of separate publications give the illusion there have been multiple research projects, but in fact they all originate from responses to the same online questionnaire – The Binding Health Project. In addition, we have a much-smaller online survey about binding and tucking, also performed in Baltimore, but this only had around 76 female (FTM trans) respondents.
In summary, in the Baltimore survey, 80% of the females (FTM trans) had bound their breasts and 62% were binding for more than the recommended 8 hours a day. The Binding Health Project discovered that most had started binding before the age of 21, a third before the age of 18, and the average time spent bound was 10 hours a day. In both studies, around half said they bound their breasts every day, and almost all of the young women surveyed reported some physical symptoms due to breast binding (around 90%).
Which girls/women were at risk?
Unsurprisingly, the more hours they spent bound, the more likely the participants were to have symptoms – and, the larger their breasts, the more symptoms they suffered. But, unexpectedly, commercial binders did not turn out to be better than the DIY versions. In fact, there were more problems reported from using commercial binders, compared to DIY binding with bandages, tape, tight clothing, or plastic wrappings.
What problems did binding cause?
The two surveys asked slightly different questions, but the commonest problems reported were pain, musculoskeletal, and neurological symptoms, along with shortness of breath and light-headedness. Most of the young women suffered physical symptoms from binding.
From the smaller Baltimore study, the incidence of the commonest symptoms:
65% (nearly two thirds) got back pain
49% (nearly half) had shortness of breath
32% (a third) reported bad posture
30% developed of chest pain
30% complained of feeling and light-headed (which might be down to restricted breathing patterns).
From the larger “Binding Health Project“ study, the figures were even worse. 97% reported some sort of health problems, with ¾ experiencing skin problems and/or pain of some sort:
76% reported skin problems
54% reported back pain
54% reported overheating
49% reported chest pain
47% reported shortness of breath
45% had itching
3% reported rib fractures
Although most symptoms were obvious in the first year of binding, pain increased over the next few years, peaking at 5 years of binding, while some problems occurred later - specifically skin problems and rib fractures could occur some years into binding.
The usual health advice given to breast-binding females is to limit binding to 8 hours a day, and to use commercially available binders. This advice was either ignored (over half the women in both studies were binding for more than 8 hours) or was plain wrong – as commercial binders were associated with more symptoms, not fewer.
Breast binding carries significant health risks. While many symptoms appear minor in nature – such as back ache and skin soreness – permanent discomfort is not a natural state for young women to be experiencing during their formative years. Shortness of breath, along with pain, might well interfere with ability to participate in sports and other healthy activities. Worryingly, pain symptoms do not subside within a few years, but continue escalating. Some serious complications, such as rib fracture, also occurred later.
Simple Message to Take Home
If clothing has health guidance attached, and recommendations to restrict the time it is worn, that should be a good indicator that it is not suitable for young people whose bodies are still developing.
There is no safe limit, and no safe method, of breast binding. Binding your chest is bad for your health and should not be encouraged.
Information about The Binding Health Project
Link to Binding Health Project questionnaire: The_Binding_Health_Project (wordpress.com) and the results given to participants are here: RESULTS | The Binding Health Project (wordpress.com)
Papers published from The Binding Health Project
Other clinical papers
Non-clinical advice and commentary
Selection of binders for sale, image is author’s own screenshot from Amazon.co.uk web page.