Breast Binding is a Medical Transition Intervention.

Here's why honest people should stop calling chest/breast binding 'social transition'

(This written essay will also be accompanied by an audio recording of me reading it. Those listening should scroll through to see any relevant images or links. At the end of this essay there are some announcements.)

It has been over two years since I stopped binding my breasts in order to ‘pass’ as a man.

Initially, I hoped my body would naturally return to a state of health and wholeness, as was implied to me by those who claimed that breast binding is “safe and reversible.” However, I still experience daily pain while breathing, lying on my side, and while moving. Odd tingling sensations shoot from my shoulders down my arms. My breasts are visibly deformed, as is the skin on my chest which has become so weak in some places that simply trying on bras causes it to bleed. My ribs are deformed. I have posture issues, including an inability to sit up straight, and pain in my neck. I have no positive sensation in my chest— just a mixture of semi-numbness, irritation and pain.

In the past two-ish years since I have stopped binding, none of this damage has reversed itself. I am slowly grappling with the emotional reality that my decade of breast binding has done far more damage to me than anyone had prepared me for, and that what awaits me (should I wish to experience less pain in my body and regain some function) is a long road of unknown medical intervention from so many different specialists that the thought of it makes my head spin.

It turns out that my situation, though it feels uncharted, is not that unique. The complications from breast binding are among the most common transition-related harms that young women face. Yet despite its near ubiquity as a first-line transition intervention, shockingly almost no one even brings it up when discussing the physical and medical harms of gender transition.

That changed on December 18, 2025.

The HHS Breakthrough: December 18, 2025

On December 18, 2025, the Department of Health and Human Services did something truly unprecedented in the effort to protect vulnerable youth from the harms of pseudoscientific gender medicine. While the press conference announced restrictions on federal funding for hospitals treating gender-dysphoric adolescents with puberty blockers, cross-sex hormones, and surgeries, the most groundbreaking development has been largely overlooked: HHS officially classified breast binders as Class I medical devices that have been illegally marketed to children as a treatment for gender dysphoria.

This matters because breast binding is perhaps the most commonly used and most widespread of these damaging ‘gender affirming’ interventions, yet it has been routinely overlooked by clinicians in both North America and Europe. Until now.

What makes the American approach unique is the decision to investigate “gender-affirming care” through the lens of consumer fraud via the Federal Trade Commission (FTC). The FDA issued twelve warning letters to U.S.-based companies that illegally promoted breast binders as a treatment for gender dysphoria without engaging in the regulatory due diligence required for medical devices. This signals a recognition that these practices may constitute deceptive marketing of a purported medical intervention to vulnerable populations without warning them or their parents about the potential consequences.

But wait—medical devices? Most people think of breast binders as clothing, maybe compression sportswear at most. To understand why HHS’s classification matters so much, we need to look at what breast binders actually are and what they were designed to do.

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What Breast Binders Actually Are

HHS clarified that breast binders are Class I medical devices with legitimate, approved medical uses. They have established clinical uses in post-surgical recovery, including after mastectomy, breast reduction surgery, breast augmentation, and reconstruction. They’re also used after radiation therapy and in recovery from bariatric, cardiac, and abdominal procedures.

In these legitimate medical contexts, compression garments serve specific purposes: reducing swelling and bruising, preventing fluid accumulation, supporting the surgical site, protecting healing incisions, and minimizing scar formation. The critical difference: these interventions are time-limited—typically worn for approximately one month post-surgery under medical supervision with follow-up monitoring.

Breast binding was also historically used for postpartum lactation suppression. However, a 2003 study found that breast binding caused greater breast tenderness, more breast leakage, and increased use of pain relief compared to simply wearing a supportive bra, with no difference in reducing engorgement. In response to this evidence, breast binding for lactation suppression has been discontinued as a recommended medical practice. The same cannot be said for “gender affirming” breast binding.

So if breast binders are medical devices designed for temporary post-surgical use, and if they’ve been abandoned even for short-term lactation suppression due to evidence of harm; how did they become normalized as a years-long intervention for healthy adolescent girls? The answer lies in a deliberate misclassification.

Why This Is a Medical Intervention, Not “Social Transition”

Breast binders are medical devices with impacts on the function of the body and are advertised to be treating the condition of gender dysphoria. It is critical to recognize breast binding as a medical transition intervention because it has long been misclassified as a form of “social transition,” akin to a change of clothes. In reality, it frequently functions as the first medical intervention in the gender-affirming pathway for adolescent girls—one that causes direct physical harm while escaping the same scrutiny applied to cross-hormones and surgery.

The irony is stark: a device designed for temporary (approximately one month) post-surgical recovery is being used by adolescent girls for years to compress healthy, developing tissue—with no medical supervision, no monitoring, and no treatment of actual physical pathology in the tissues being compressed. To put it more bluntly: a gender dysphoric young woman could have bound her breasts for a decade starting in early adolescence, thinking she’s got a legitimate medical or mental health reason to do it. But in reality, the only time that her lifelong breast binding practices will actually be medically indicated is for the month she binds her chest after her breasts have been amputated.

Breast binding as an intervention for treating gender dysphoria occupies a uniquely dangerous regulatory gray zone. It is a medical device used off-label without required medical oversight, marketed as a mental-health treatment, and shielded from scrutiny by being mislabeled as “social transition.” Unlike hormones or surgery, breast binding never requires a prescription when used explicitly as a treatment for gender dysphoria. Doctors need not formally prescribe it, yet they recommend it despite the known health risks and gender clinics in children’s hospitals even publish safety guidelines, despite the absence of a single study demonstrating its safety for use in this patient population.

I know this regulatory gray zone intimately, because I lived in it for over a decade.

I’ve written about that experience in my essay titled Breast Binding, Genital Tucking & the Lie of ‘Safe Gender Affirmation.’

My Binding History

I initially started trying to use an ace bandage to bind my breasts at age 12. It was so painful and uncomfortable that I didn’t last more than a few hours. I began flattening my breasts on a regular basis shortly thereafter with multiple tight sports bras worn in different directions at 12, and a back brace that my chiropractor gave me at 13 in a smaller size upon my request, which I wore to sleep and only took off once a week while showering.

Though regularly flattening my breasts as a young teenager certainly did me some harm, the bulk of the problems came from the moment I turned 18 and was able to get a commercial breast binder from Gc2b. The relative comfort of the so-called “safe” breast binder compared to the other methods I had used, in addition to the sensory soothing aspect of compression, totally caused me to not realize just how much damage I was doing to myself. I wore it consistently until the age of 24.

The promise that I could bind “safely” turned out to be a complete lie. One that I wish I had seen through before a decade of damage was done. But how was I supposed to know? The research backing up these safety claims simply doesn’t exist.

The Research on Harm: What We Know and What We Don’t

There is no evidence to suggest that there is a healthy way to bind breasts (especially developing breasts) for months or years at a time, even when used “as directed,” limited to 8–12 hours a day (and this recommendation changes based entirely on who you ask). Yet commercial ‘gender affirming’ breast binders are marketed to healthy girls and women as a mental health treatment for gender dysphoria.

The limited information available shows that over 97% of patients in a 2016 cross-sectional study of 1,800 transmasculine adults experienced at least one of 28 measured adverse effects from regular breast binding. The frequency of binding was the strongest predictor of harm—22 out of 28 negative outcomes were consistently associated with how many days per week someone bound. Over half the participants (51.5%) bound daily.

Most damning: commercial breast binders were associated with 20 out of 28 negative outcomes—more than elastic bandages (14/28) or even duct tape and plastic wrap (13/28). The “safe” commercial binders cause more harm than the supposedly “dangerous” DIY methods.

Despite the fact that these harms have been published in multiple journal articles since at least 2016, companies that sell breast binders do not include this information. For that reason, the FDA has issued warnings to 12 of these companies.

To this day, there is not one peer-reviewed study which supports the assertion that breast binding can be done safely, either in children or in adults. At the time the 2016 study was published, it noted that “there are no peer-reviewed studies that directly assess the health impacts of chest binding,” meaning companies and clinics had already knowingly been making safety claims with zero evidence to back them up.

What’s even more telling is just how much we still don’t know. The 2016 study documented THAT harm occurs—the 97%+ complication rate, the specific symptoms. But there are still no peer-reviewed studies investigating HOW the harm occurs mechanistically. We don’t have research examining what chronic chest compression does to developing rib cages, to intercostal nerves, to respiratory function over years of daily use starting in adolescence.

This absence of research on mechanisms is not incidental. It is, in fact, central to how breast binding has been able to operate in a regulatory gray zone. Gender medicine promoted binding as “safe” with no studies on whether it causes harm, no studies on how it causes harm, no monitoring protocols for patients who bind, and no treatment protocols for the damage it causes.

I can tell you from lived experience that binding damages nerves, deforms ribs, impairs breathing, and causes chronic pain that persists years after stopping. The 2016 study confirms these outcomes are nearly universal. But medicine has never bothered to investigate the mechanisms, establish safe limits, or develop treatments for the injuries— because to do so would require acknowledging that this practice causes serious, lasting physical harm to healthy tissue.

Anyone who makes the claim that breast binding can be done safely, or that it is reversible, is either lying to you out of malice or out of ignorance.

But “reversible” in gender medicine doesn’t mean what most people think it means.

How Gender Medicine Defines “Reversible”

flared ribs from breast binding

Within gender medicine, reversibility is defined in an unusually narrow way. Even when an intervention causes lasting harm—to the form and function of the breast tissue itself and the skin on the chest, chronic pain, musculoskeletal injury, respiratory restriction, or loss of bodily function—it is still deemed reversible so long as it does not permanently masculinize or feminize the body. In practice, this means that nearly any degree of physical harm is treated as acceptable, provided the intervention preserves the possibility of achieving a desired sexed appearance in the future. The entire field of gender medicine is thus premised upon sacrificing bodily integrity and function in service of an aesthetic endpoint, while dismissing injuries that fall outside that framework as either irrelevant or as the patient’s responsibility.

This twisted definition of “reversible” sets up a perverse pathway where binding, sold as a safe alternative to surgery, actually accelerates girls toward the operating table.

The Path from Binding to Mastectomy

Speaking from a bit of lived experience here— breast binding is so physically uncomfortable and damaging that many girls cannot tolerate it long-term. Instead of alleviating distress, binding often worsens it by damaging breast tissue and causing significant, function-impairing harm to surrounding muscles, ribs, skin, nerves, posture, and skeletal structures. That damage is then interpreted as further evidence that the breasts themselves are intolerable or ‘wrong’ on the body. As a result, many girls become even more desperate to remove them entirely.

In my case, and in the cases of many others, the practice of breast binding makes it nearly impossible to get used to the fact that you have breasts. Many of the families I have consulted with tried to strike a compromise with their kids’ doctors who wanted to start them on the pathway of cross-sex hormones and surgeries. This compromise included buying the girl a breast binder, socially transitioning her, and hoping that by the age of 18 she would somehow reverse course. These parents genuinely believed that breast binders are the lesser of two evils—that they are a compromise for mastectomy, that binders are just like tight sports bras. The content they had consumed from gender critical sources, which caused them to proceed with caution about testosterone, clearly failed to warn them about the potentially devastating and permanent injury their daughter would experience from breast binding. Because the fallacious, unsubstantiated claims of trans activists remained uncontested, and because the harms of breast binding are so commonly dismissed and overlooked, they were evidently persuaded by the pediatrician who brought up the breast binder as a “safe and reversible compromise” that would allow their daughter some temporary reprieve without permanently altering her body. Or so they thought.

As their kids near 18, these parents contact me in full panic that their “compromise” of a breast binder has only made their 17¾-year-old daughter more hell-bent on a mastectomy than ever before.

Doctors then promote the lie that breast binding is a safe mental-health treatment for girls who hate their breasts—until the patient’s pain worsens or her psychological condition fails to improve. At that point, “gender-affirming” top surgery is presented as the solution. Even girls who detransition before mastectomy, like me, often suffer lasting pain and damage from years of binding. Those who proceed to surgery carry forward injuries already incurred to their rib cage, back, skin, nerves, and muscles—injuries that do not disappear when breast tissue is removed and are compounded by additional, unnecessary surgical trauma.

Given the clear evidence of harm, you’d think the response from both sides of the gender debate would be unequivocal condemnation. You’d be wrong.

How Both Sides of the Trans Debate Get This Wrong

Both trans activists and many gender critics often dismiss or downplay the damage caused by breast binding, though in different ways.

Trans activists treat breast binding as safe, reversible “social transition”—something akin to a haircut or wearing different clothes. When confronted with testimony about lasting harm, they blame the individual for “misusing” the binder rather than acknowledging the practice itself is damaging. They dismiss the 97% complication rate and ignore the complete absence of peer-reviewed evidence supporting safe binding practices.

In response to Secretary Kennedy’s declaration, The Advocate published a piece claiming breast binders have “no use beyond aesthetics” and that “the effect disappears as soon as the binder is removed.” This framing reveals everything wrong with how trans activists think about reversibility. When they say “the effect disappears,” they’re only talking about immediate aesthetic reversibility—whether the chest looks flat. They’re not talking about the rib deformities, nerve damage, chronic pain, or damaged breast tissue that don’t disappear.

here’s that excerpt from The Advocate

But many gender critics misunderstand the practice of ‘gender affirming’ breast binding, just in a different way. They tend to view breast binding as problematic primarily because it leads to mastectomies, not merely because it is permanently damaging in and of itself. Breast binding is often downplayed even in circles which are critical of gender medicine, treated as a minor or lesser harm within the trans debate, a gateway to the “real” harms of hormones and surgery.

I have been told by prominent gender critics that I have no right to refer to myself as a detransitioner because the ‘gender-affirming’ medical device that permanently harmed my body was not prescribed to me by my doctor. Though it is important to note that when my doctor did become aware of my breast binding, she recommended I continue doing it (albeit with extra breathing breaks) so I didn’t have to miss a day of affirming my gender even while I was deliriously sick with the flu and sitting in her office. I have also been told that I should refrain from referring to my experience as detransition because the transition harms which occurred to my body did not specifically masculinize me.

When I express frustration that the incredibly common and significantly impairing transition-related harms I have experienced are being dismissed, these prominent gender critical individuals have suggested that I should step aside as an advocate, or that I should use my platform to highlight the voices of young women who have “actually been harmed.” That I’m lucky because I’ve lost “only” my sanity and 12 years of my young life to this ideology, rather than any body parts. That I should be grateful for still having my now damaged breasts attached to my damaged rib cage. That I should perhaps… jump for joy that things did not turn out ‘worse’ as I contend with the totally preventable chronic pain and mobility issues I now have at the ripe old age of 26 because of a bad idea I encountered on the internet as a 12 year old.

Here’s what everyone is missing: Breast binding causes severe, lasting physical harm even when breasts remain intact, and even when used as directed. The damage to ribs, muscles, nerves, posture, respiratory function, and skeletal structure is permanent and function-impairing. This harm matters regardless of whether it leads to further surgical harm—and it deserves recognition as serious medical injury, not as a lesser evil or merely as a stepping stone to something ‘worse.’

Which brings me to why I’m writing this essay in the first place: we need policy change, and we need it now.

Call to Action for Policymakers

While much of the public attention both in the United States and across Europe has focused on puberty blockers, cross-sex hormones, and chest/genital surgeries, we cannot gloss over the significance of HHS’s ruling on breast binding companies.

No current legislation aimed at protecting vulnerable youth from gender-affirming or sex-rejecting body modifications will meaningfully protect girls from permanent bodily harm unless breast binding itself is recognized as a medical intervention.

It is long past time we take seriously the dangers of all gender-affirming medical interventions. These practices do not merely affect impressionable minds; they also alter (and often permanently damage) the objective health and integrity of female bodies. HHS has now clarified what breast binders already were: medical devices with legitimate uses in defined clinical contexts. What remains is to confront how those same devices have been misused as a first-line intervention for distressed adolescent girls. Until that happens, efforts to protect youth from the harms of gender medicine will remain fundamentally incomplete.

But policy change alone isn’t enough. Medical professionals, particularly those tasked with caring for detransitioners, need to fundamentally rethink how they define and study medical transition.

Call to Action for Medical Professionals (with a focus on NHS England)

In its recent call for evidence on detransition care, NHS England defines detransition narrowly as “the process of discontinuing or reversing a gender transition” and specifies that “this definition generally includes individuals who have medically transitioned through medical intervention (hormone therapy or surgery) and who subsequently self-identify with a process of detransition.” This limited framing excludes commonly used gender transition interventions including puberty blockers like Lupron, alternative hormonal suppression interventions such as Depo-Provera, and breast binding altogether.

(I will be bolding a lot in this section because I will be making truly original arguments which I am shocked are not common-sensical enough to make it into the popular disocourse— so here goes.)

This incredibly limited framing will fundamentally impair the NHS’s ability to understand detransition-related harm. Each transition intervention carries its own risks, some well documented and others still poorly understood; those risks intensify with duration and compound when multiple interventions are used sequentially or simultaneously. A patient who bound her chest for years and later underwent mastectomy does not present the same clinical picture as a patient who only had surgery. A patient who bound for two years will have distinct patterns of harm, functional impairment and damage from a patient who bound her breasts for ten.

Yet by excluding binding (and early hormonal suppression) from the category of medical transition, clinicians will lack crucial context for why rib deformities, chronic breathing restriction, spinal changes, nerve injury, and postural collapse appear so frequently in their post-mastectomy patients. The damage caused by prolonged chest compression will be misattributed entirely to surgical technique, to cross-sex hormones, or to undiagnosed pre-existing musculoskeletal or genetic abnormalities—obscuring the reality that many patients entered surgery with an already compromised chest wall.

Without recognizing breast binding as a medical intervention, clinicians cannot integrate existing research on nerve and tissue compression, cannot develop a mechanistic understanding of how years of binding interact with surgical trauma, and cannot design appropriate treatment protocols for the injuries they are seeing. ¹

The consequences extend beyond clinical care: excluding puberty blockers, substitute hormonal suppressants, and breast binding from the medical record also distorts public’s understanding of the truth, allowing early, cumulative harms—often incurred long before hormones or surgery—to remain invisible. This narrow definition does not merely exclude certain detransitioners from recognition; it ensures that even those the system does recognize will receive fragmented explanations, incomplete care, and yet another potentially traumatic experience of a medical industry that refuses to learn from its own mistakes.

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1. I am a 26 year old lay person. I’m not sure why other people, namely clinicians, have not considered making these arguments. Guys, it really is just common sense.