Hi Alice,

I identify as transgender (ftm) and have recently begun binding my breasts using a commercially-available breast binder. I bind more or less all the time, except for when I'm sleeping. Although I know that the breast tissue will eventually break down some, what are other things that I should expect to happen? What should I watch out for? Are there any health problems that I'm more prone to as a result of binding?


Dear Reader,

As you probably know, binding, or the process of flattening one's breasts in order to create a male-appearing chest, can be done a number of ways. Depending on variables like the size of one's breasts as well as the materials and methods used, there are different effects on breast health to watch out for.

According to FORGE (For Ourselves: Reworking Gender Expression), many FTMs over-compress their chests, for fear of not "passing." But binding too tightly can inhibit the amount of air you take into your lungs, resulting in difficulty catching the breath or dizziness. Binding that is too tight can also cut and irritate the skin and can cause back pain and distort spinal alignment. Many people also adopt a slumped posture, hoping to further hide their chests, but bad posture can inhibit the ability to breathe easily and fully, and can also result in headaches and back pain.

Long-term compression of the breasts can result in permanent tissue changes — breast tissue may become elongated and more malleable, actually making binding easier, but it's unclear if this type of change in breast tissue may be dangerous over time. While there is no substantial evidence that breast binding leads to breast cancer, it might be a good idea to periodically refrain from binding (like you said you do when you sleep) to let the skin breathe and the lungs and spine have a break from the compression. Another thing to keep in mind is that even for folks who don't identify with their breasts, it's still important to keep up with breast health, including performing monthly self-examinations and talking with a health care provider about any changes you notice, or any concerns you have regarding breast health and binding.

When choosing a binding method it's good to keep in mind that the material used should wick away sweat. If it doesn't, skin may be prone to sores and irritations from a buildup of sweat. For example, neoprene is a very effective binding material, but because the material does not "breathe" it can cause acne, rashes, cuts and chafing. To minimize irritation, some wear a T-shirt under the binder or use talc or other powder to help keep the skin drier and less irritated. Keep in mind that ace bandages are usually not recommended, as safer methods exist. If wrapped too tightly, ace bandages may be very uncomfortable and cause injury. If using ace bandages, choose one that is wide and be sure not to wrap too tight as to allow for free movement and easy breathing.

For those with smaller breasts, methods like wearing the top portion of control-top pantyhose over the chest or wearing several layers of sports bras or shirts can be effective and inexpensive. Those with larger breasts may be better off purchasing commercially made breast binders like you have (FYI: For larger chests, compressing breast tissue down and out towards the armpits can help keep a flatter appearance. Certain types of loose clothing and button-down shirts can also help hide feminine qualities like wide hips and narrow shoulders. Hudson's Guide: FTM Binding provides an excellent review of commercially available breast binders, additional tips for do-it-yourself binders, and health consequences to take into consideration.

It seems you have a green light in terms of safety if binding is done properly, just remember to use a material that will let your skin breathe, and not bind so tightly that you can't breathe fully yourself. Keep asking the questions and know that you have lots of resources available to you!


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