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.

Purpose: There are no standardized chest binding guidelines available to health care providers serving transgender and nonbinary individuals, exacerbating the significant health disparities affecting this community. Our study aimed to demonstrate the need for further evidence-based investigations into the association between chest binder type and health outcomes.

Methods: For this cross-sectional observational study, a community-engaged online survey evaluating individuals' experiences with their current or most recent chest binder was distributed to LGBTQ+ community centers, online forums, and clinics from July to November 2021. Participants rated their frequency of health outcomes in terms of both positive and negative changes, and the average score was calculated.

Results: Of 197 participants, 80% reported using commercial binders as their current or most recent binder type. Users of commercial binders reported significantly more positive mental health changes than noncommercial binders (=0.043). There was no statistically significant association between negative outcomes and the binder category (=0.595). Musculoskeletal complaints were more frequent with commercial binders. The frequency of skin changes was higher with noncommercial binders; however, acne was higher with commercial binders.

Conclusions: Our results suggest that the positive mental health changes associated with chest binding outweigh the negative side effects. However, the contrariety of adverse effects among binding methods suggests that chest binding must be evaluated by individual binder type rather than as a general practice. These findings will help providers guide conversations to identify which binder is best for each unique patient, as well as encourage future research in chest binding best practices.