Symptoms and Experiences of Chest Binding: A Cross-Sectional Survey Using a Patient-Oriented, Harm Reduction Approach

Purpose: People bind their chests to relieve gender dysphoria. Most people who bind experience negative physical symptoms as a result. The purpose of this research is to (1) explore the incidence, overall impact, and level of concern of adverse symptoms related to chest binding and (2) describe the experiences of chest binding-related symptoms that generate the most care seeking. Methods: A cross-sectional, online, purpose-made survey was conducted from June to September 2022 using a patient-engaged, harm reduction approach. Binding history, demographics, and detailed experiences of 29 symptoms were explored. Results: The survey was completed by 356 people. An importance rating for each symptom was calculated using symptom incidence, overall impact, and level of concern. The symptoms rated as most important were shortness of breath (SOB), overheating, and chest pain. Back pain, chest pain, shoulder pain, SOB, shoulder instability, and rib and spine changes generated the most care seeking. The frequency and intensity of these symptoms were less when not binding but were still present and impacted social/recreational activities. Despite moderate frequency and intensity of symptoms, participants rarely modified binding habits. Conclusion: Chest binding was important enough to participants to warrant enduring significant discomfort. Patterns of symptom presentation suggest underlying physiological changes from chest binding. Treatment should focus on symptom management and minimizing the physiological effects without requiring modifications to binding behaviors. Clinicians should consider educating patients on clinically concerning symptoms and screening for symptoms most important to patients.