Types Of Chest Binding
There are several ways to bind your chest. Some are safer, more comfortable, or more effective. The most popular method of chest binding is with a dedicated binder.
Binder. A binder is a piece of compression clothing that flattens your chest down. Binders come in a half-length or full-length . The style you choose depends on your own preference and comfort.â
Kinetic tape. This type of medical tape is for your skin and can be used to bind your chest. Do not use other tapes or binders, such as duct tape or plastic wrap. Products not meant for use on your skin can cause irritation and do significant damage to your skin. If you have sensitive skin, you may experience irritation from binding tapes.
Sports bra. As an alternative to a dedicated binder, a good sports bra with high compression can serve as a binder. Sports bras wonât provide as much compression as a binder but can be a stepping stone to binding later.
When To See A Doctor
If you have side effects from chest binding that don’t get better by switching to a different type of binder or changing how you wear one, see a doctor. If possible, find a doctor who specializes in transgender health. You’ll feel more comfortable and they will have training and compassion focused transgender medical issues.
A doctor will be able to treat whatever symptoms you’re experiencing, such as skin damage. They also can figure out what’s causing your side effects and help you come up with ways to prevent them.
If you and your doctor aren’t able to make chest binding work for you, you may want to consider gender-affirming top surgery. There are various procedures for altering the breasts in order to create a smoother, flatter, masculine chest. If you have insurance, your plan may even cover top surgery: Many companies regard it as medically necessary gender care.
Beyond Binding: Chest Reduction Surgery
According to Peitzmeir et al., roughly two-thirds of the individuals surveyed expressed interest in eventually getting top surgery, surgical reduction of breast tissue to permanently achieve a flatter chest.5Peitzmeier S, Gardner I, Weinand J, Corbet A, Acevedo K. Health impact of chest binding among transgender adults: a community-engaged, cross-sectional study. Cult Health Sex. 2017 19:64-75. Epub 2016/06/15. doi: 10.1080/13691058.2016.1191675. PubMed PMID: 27300085. Discussing the option of surgery with patients can serve as a way to mitigate the negative impacts of long-term binding, since getting top surgery would reduce or eliminate the need to continue binding. There are patients, however, who either do not want or cant afford top surgery, which costs between $3,500 and $9,000 in the United States.
In summary, when talking to patients about chest binders, its important to discuss the options available, the risks involved and how to minimize them, whether they want a more permanent option such as top surgery in the future, and where and how they can acquire a binder.
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How Testosterone Can Impact Breast Tissue
The breast tissue of trans men taking testosterone has less glandular tissue and more fibrous connective tissue . Breast cancer occurs in the glandular breast tissue, so itâs possible that testosterone could be protective against breast cancer by shrinking this type of tissue.
Prolonged exposure to estrogen is believed to be a component of breast cancer development . The body can convert testosterone to estrogen in a process called aromatization. There is concern that the converted estrogen could increase the risk for breast cancer . Breast tissue also contains receptors for androgens , so abnormal growth could be stimulated by the testosterone itself .
How Do People Bind Their Chests
People bind in many different ways: Some people wrap their chests with elastic bandages, some wear a sports bra, neoprene or athletic compression wear, or layer several sports bras or shirts. Others wear commercially-available binders specially designed for this purpose .
Everyone binds differently. Some people bind only for special occasions, others every day. One study surveying people who bind reported that the average person bound their chest for around 10 hours per day, with the most popular methods being commercial chest binders, followed by sports bras, shirt or bra layering, and bandages or elastic materials .
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Other Hormones And Breast Carcinogenesis
Elevated circulating androgen levels are consistently associated with increased breast cancer risk, but the underlying mechanism of action is unclear . Androgens may increase risk indirectly through aromatization to estrogens, whose role in breast cancer etiology is well established , or decrease risk by exerting antiestrogenic and antiproliferative effects via androgen receptor signaling . Androgenic activity via the AR is responsible for healthy functioning of many organs in women including the breast, where estrogens stimulate while androgens inhibit development, and the balance between these regulates breast development. In breast tumors, AR expression has been detected in up to 85% of cases , although this varies by breast cancer subtype while almost all ER+ cancers express AR, only 1035% of triple negative breast cancers express AR .
Gynaecomastia And Anabolic Steroid Use
Whilst Niewoehner and Schorer note in their review of gynaecomastiaandbreast cancer in men that the use of anabolic steroids should beconsideredin the cause of gynecomastia , it is important to recognise thesignificantlevels of use of these drugs for performance- and image-enhancing reasonswithin the general population . Furthermore, many users practicecomplex, self-directed, polydrug regimes that include not onlytheuse of supraphysiologic doses of multiple types of anabolic steroids butalso,inter alia, growth hormone, human chorionic gonadotropin, spironolactoneand a wide variety of supplements ) substances that have allbeen
Given the high levels of self-reported gynecomastia in users andreflected in the widespread prophylactic use of self-prescribed tamoxifen, weconsider it particularly relevant to ask about use of anabolic steroidsandancillary substances inindividualspresenting with gynecomastia who have mesomorphic or hypermesomorphicbody types .
As the authors of the review highlight, however, patients can feelembarrassed and anxious by their condition and this can be compounded inthis population given the demonisation of anabolic steroids by society.Further, the historic low-level of engagement and trust by this population
with health professionals may act on this, which could increase areluctance to reveal their use of these substances . Alongside this,
1. Niewoehner CB, Schorer AE. Gynaecomastia and breast cancer in men.BMJ.
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Progesterone Formation Transport And Metabolism
Progesterone is a 21-carbon steroid that exerts its primary physiological functions through binding to the progesterone receptors A and B , which initiate transcription of targeted genes resulting in conversion of proliferative endometrium to secretory endometrium in an estrogen-primed uterus. The physiological role of progesterone is primarily confined to the peri- and post-ovulatory phases of the menstrual cycle, and to pregnancy. In the menstrual cycle, progesterone is produced by the corpus luteum beginning in the early postovulatory phase. Its production rate increases from about 1 mg/day in the follicular phase to about 25 mg/day in the luteal phase . The biosynthesis of progesterone by the corpus luteum requires continued luteinizing hormone stimulation. During the follicular phase of the cycle serum progesterone levels are < 1 ng/mL . The ovarian and adrenal contributions to the total progesterone production rate appear to be equal at that time. Subsequently, progesterone levels rise to about 12 ng/mL on the day of the LH surge and continue to rise, reaching a plateau of approximately 1035 ng/mL during the mid-luteal phase then levels decline until the end of the menstrual cycle . Most women have on average 35 years of predictable menstrual cycles with an average 14-day follicular phase and 14-day luteal phase.
Progesterone levels across the lifespan: .
Causes Of Breast Cancer: How Did This Happen
When youre told that you have breast cancer, its natural to wonder what may have caused the disease. But no one knows the exact causes of breast cancer. Doctors seldom know why one woman develops breast cancer and another doesnt, and most women who have breast cancer will never be able to pinpoint an exact cause. What we do know is that breast cancer is always caused by damage to a cells DNA.
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What To Expect When Taking Herceptin
Herceptin can only be given by intravenous infusion, which means it is delivered directly into your bloodstream through an IV or a port. The first dose of Herceptin takes about 90 minutes. After that, it only takes about 30 minutes to get other doses of Herceptin. Your Herceptin treatment schedule will depend on whether you are receiving it with other medicines. You can talk to your doctor about your treatment schedule options.
If youve been diagnosed with early-stage HER2-positive breast cancer, youll likely receive Herceptin together with a chemotherapy regimen. You will receive it for a specific amount of time.
If youve been diagnosed with metastatic HER2-positive breast cancer, you will keep being treated with Herceptin as long as you are getting benefits from the medicine and arent having troubling side effects.
Its important to know that women who are pregnant or planning to get pregnant should not take Herceptin. Herceptin can harm the developing fetus. If there is any chance you can become pregnant, you must use effective birth control while youre taking Herceptin and for at least 7 months after your last dose.
Also, women who are breastfeeding or plan to breastfeed shouldnt take Herceptin. Together, you and your doctor will decide if you should take Herceptin or breastfeed.
Risks And Side Effects Of Binding
Like many things people do to modify their outward appearance , chest binding comes with some risks.
Binding can affect skin, muscles, and movement, particularly over long periods of time. Tightly covering the skin and chest with materials that donât allow free-flowing air can create warm, moist environments for bacterial and fungal infections to develop. Wearing binders that are too tight can cause underlying tissue and muscle damage, prevent free movement, and even restrict a personâs ability to breathe.
There havenât been many studies about the health effects of binding, so itâs important to listen to experiences of others, and to talk to your healthcare provider.
Two studies have been completed that focus specifically on people who bind. They were cross-sectional studies, observing a specific population at a specific point in time, and were published in 2017 and 2018. Both of these studies are based on data from 1,800 responders to an online survey.
Across both studies, the majority of people reported experiencing at least one negative symptom from chest binding .
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What Are The Hormone Sources In Men
Testicular Leydig cells produce 95% of testosterone. The adrenal cortex produces the rest. About 50% of circulating testosterone is bound to sex hormone binding globulin. Much of the remainder is weakly bound to albumin. Only the free hormone is active. Oestrogen is less bound to sex hormone binding globulin than testosterone, so increases in sex hormone binding globulin reduce the ratio of active testosterone to oestrogen.
Testosterone can be converted to another potent androgen, dihydrotestosterone, by the enzyme 5 reductase in peripheral tissues. Testosterone also can be converted to oestradiol by the enzyme aromatase, found especially in adipose tissue. The weak adrenal androgen androstenedione can be converted by aromatase to oestrone, a weak oestrogen. Oestradiol and oestrone can be interconverted in peripheral tissues .
Fig 1Sources of hormones affecting breast tissue
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Steroid Receptor Expression In Gnrh Cells
An original finding in 1983 reported that, using a combination of immunohistochemistry and autoradiography , GnRH cells did not display estrogen binding properties.58 This led to the general concept that estrogenic regulation of GnRH synthesis/secretion is effected via intermediary neurons that express estrogen receptors, which is discussed in more detail below. Surprisingly, in 1999 Skynner et al.59 reported that polymerase chain reaction analysis of the contents of GnRH neurons did show the existence of ER and ER in GnRH cells. This turned out to be a mistake, and a later publication by the same group confirmed that GnRH cells do not express ER, but do express ER.60
Whereas sex-steroid feedback regulation of GnRH neurons involves intermediary cells that express ER , it is now clearly apparent that estrogens can act directly on GnRH cells. This may be via membrane associated receptors and/or ER receptors, which add complexity to the action of estrogen, beyond that effected by classical liganded estrogen receptor regulation of genes.
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What Causes Gynecomastia
Gynecomastia is usually a benign condition. It may be linked to many different causes of hormone changes. In many cases, the cause isnt known.
Gynecomastia is often caused by changes in levels of the female hormone and the male hormone . But it can be caused by other things as well.
Gynecomastia can be a side effect of certain medicines, such as antidepressants, antibiotics, chemotherapy, prostate cancer medicines, ulcer or cardiovascular medicines. Illegal drugs, such as anabolic steroids, heroin, or marijuana can also cause gynecomastia.
Some diseases and medical conditions may also cause gynecomastia. These include:
- Liver diseases
- Injury or trauma
- Obesity
Newborn babies may have a short-term form of gynecomastia. This is often because a mothers estrogen stays in a babys blood for a while after birth.
Gynecomastia is not linked to breast cancer. It is rare that men get breast cancer. But your provider may do some tests to rule out breast cancer.
What Exactly Is It
Chest binding, also known as binding, refers to the process of compressing or minimizing your chest tissue in order to create the appearance of a flatter chest.
While chest binding might be more commonly practiced among transgender, nonbinary, and androgynous people, the decision to bind ones chest doesnt actually indicate or determine identity.
Chest binding is for anyone who wants to flatten or minimize the appearance of their chest, either occasionally or regularly.
People bind their chests for many reasons.
Some of the more common reasons include:
- to conceal or minimize ones chest for a flatter appearance
- to manage gender dysphoria, including chest dysphoria and social dysphoria
- to support mental health
The most common products and strategies people use to bind include:
- shirt layering
- commercial binders or compression tops
- sports tops or bras, which are sometimes layered for additional support or compression
- kinetic tapes designed for skin adhesion and tissue support
Commercial chest binders and compression tops come in a wide variety of designs and colors, but typically fall into one of the following three categories:
- minimizing compression tops similar to sports bras
- short or half-length binders cropped above belly button
- long, full-length binders that cover the waist
When wearing a binder, its important to find the right style and size for your body.
This will depend on:
- what feels good to you, both physically and emotionally
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Chest Binding: A Physicians Guide
by Jamie Moffa·April 6, 2019
Transgender and gender nonbinary individuals may choose to engage in various gender-affirming practices to reduce gender dysphoria or present in a way that is more congruent with their gender identity. This article is a primer for physicians on counseling their gender-expansive patients on chest binding, a practice used primarily by transgender men and nonbinary individuals in order to achieve a flatter, more masculine chest appearance.
The mental health benefits that transgender and nonbinary individuals experience from binding are striking: according to a landmark study on binding practices in the transgender community, roughly 70 percent of surveyed individuals reported a positive mood after starting to bind compared to only about 7 percent who reported having a positive mood before binding.1Peitzmeier S, Gardner I, Weinand J, Corbet A, Acevedo K. Health impact of chest binding among transgender adults: a community-engaged, cross-sectional study. Cult Health Sex. 2017 19:64-75. Epub 2016/06/15. doi: 10.1080/13691058.2016.1191675. PubMed PMID: 27300085. This explains why, in the same study, approximately 87 percent of transgender-identifying individuals reported using binding as a method for achieving congruence between their physical appearance and gender identity.
What Is A Chest Binder
A chest binder is anything used to bind and flatten the breast tissue to minimize its outward appearance. There are commercially made products and binders available for purchase, Dr. Ng says, and there are also more DIY versions to choose from.
In addition to commercial binders, which are specially designed to bind the chest, common chest binding methods include:
- Wearing multiple sports bras.
- Strategically layering clothing.
- Flattening your breasts using kinesiology tape .
Some people also turn to homemade options such as elastic bandages, duct tape or plastic wrap, which are widely considered unsafe.
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Increased Risk Of Leukemia
Very rarely, certain chemo drugs, such as doxorubicin , can cause diseases of the bone marrow, such as myelodysplastic syndromes or even acute myeloid leukemia, a cancer of white blood cells. If this happens, it is usually within 10 years after treatment. For most women, the benefits of chemo in helping prevent breast cancer from coming back or in extending life are far likely to exceed the risk of this rare but serious complication.
How To Bind Your Chest Safely
Even without concrete medical data, Dr. Ng says there are some general guidelines to follow for safe chest binding.
Choose an air-permeable binder
Commercial binders can be expensive and may still cause side effects, but theyre made of lightweight materials designed to help your skin breathe, and theyre available in a variety of sizes designed to fit your body well. Sports bras, too, provide some breathability.
Materials such as duct tape and plastic wrap arent breathable, resulting in moisture that can cause skin breakdown and even infection. And you risk injuring your skin when removing them.
Keep cool
Because theres a possibility of overheating while binding, its important to stay hydrated while wearing your binder. Also try not to get overheated or too sweaty while wearing your binder, Dr. Ng advises.
Take days off
When it comes to safer binding practices, the biggest factor is judicious use of binders, Dr. Ng says. We do not recommend continuous binding.
Ideally, identify at least one day a week to go binder-free and if you experience gender dysphoria without a binder, try to choose times when youll be alone or able to wear comfortable clothing that covers your chest.
Dont sleep in your binder
Always remove your binder when you head to bed, especially if you suffer from sleep apnea or other breathing problems.
Having something that constricts you at night makes it even more difficult to get sufficient oxygen in your body, Dr. Ng says.
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