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

Abstract

Objective: People bind their chest to relieve gender dysphoria and most people that bind experience negative physical symptoms as a result. The purpose of the current 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 would be most likely seen by health care providers. Methods: A cross-sectional, online, purpose-made survey was conducted using a patient engaged, harm reduction approach. The survey asked about binding history, symptom experiences, and demographics. Twenty-nine symptoms from seven physiological categories were included. Results: 356 people responded to the survey, which represents 1.1% of the target population. Symptom incidence, overall impact, and level of concern were used to calculate an importance rating for each symptom. The symptoms rated as most important were shortness of breath, overheating, and chest pain. Back pain, chest pain, shoulder pain, shortness of breath, shoulder instability, and rib and spine changes are most likely to be seen by general care providers in relation to chest binding. The frequency and intensity of these symptoms was less when not binding but was still present and impacted social/recreational activities. Despite moderate frequency and intensity of these symptoms, participants rarely modified their binding habits. Conclusion: Patterns of symptom presentation suggest underlying physiological changes from chest binding. Chest binding was important enough to participants to warrant enduring significant discomfort. Treatment should focus on symptom management and minimizing the physiological effects without suggesting or requiring modifications to binding behaviours. Treatment can include education on clinically concerning symptoms and screening for symptoms that are most important to patients. Research Impact: We provide a novel and detailed exploration of chest binding related symptoms, especially focusing on symptom management. Findings give HCPs clear guidance on what to look for and how to address symptoms with patients who bind their chest.