Chest Binding Can Restrict Your Lungs. But Many Trans Folks Don’t See Another Option.

As more and more states issue shelter-in-place orders, T-shirts and sweatpants have become the new "business casual." If you're a transmasculine angel, a non-binary babe, or just feel better with a flatter chest, binding may still be part of your quarantine uniform, so knowing how to safely chest bind amid coronavirus concerns can keep you feeling better in your body as you stay at home.

According to Dr. John Steever, M.D., assistant professor of pediatrics and medical director of the Trans Health Program at the Mount Sinai Adolescent Health Center, COVID-19 causes inflammation and fluid to build up in the lungs, making the lungs feel stiffer.

"COVID-19 attacks the lungs, so a person has to work harder to expand the chest to inflate the lungs and to get the air in and get the air out," Dr. Steever says. "If you’re going to use a binder, there's a potential problem of restricting your lungs, and therefore, you're not going to breathe as well as you could."

If you are not experiencing any COVID-19 symptoms, are breathing normally, and are feeling comfortable, Dr. Steever says it's fine to continue binding as you would regularly. But if you actively can't breathe or are struggling to cough, you may be better off limiting the amount of time you bind or switching to baggy or looser fitting tops, as these garments can flatten the appearance of your chest without restricting your breathing.

"When you’re sick, you don't want to be struggling to breathe, when you’re already struggling to breathe," Dr. Steever says. "It may be the time to say, 'OK, we’re not going out in public anyway, we’ll skip the binder, and we’ll get through this.'"

Additionally, Dr. Steever says it's important to nourish your body and prioritize your comfort. Avoid binding for more than eight hours at a time, don't bind while you sleep, and wash your binder regularly (especially if you think you've been exposed to coronavirus).

According to Dr. Karl Neff, endocrinologist and clinical lead of Ireland's National Gender Service, compressing your chest may accelerate existing symptoms of COVID-19.

"If you bind and get infected, then your infection could deteriorate more quickly if you continue to bind," Dr. Neff shared on Twitter. "If you bind and you get symptoms of COVID-19, then the safest thing to do is to avoid binding while you have symptoms."

But for a lot of trans people, abstaining from binding can spark feelings of gender dysphoria. And, according to The Binding Project, a 2016 study of 1,800 transmasculine adults, binding can be linked to decreasing rates of depression and anxiety. So, if you're unable to wear your binder right now, checking in with affirming friends or loved ones, reach out to other trans people who make you feel supported, and consider speaking with a mental health professional. And wearing comfy clothes can help you feel better in your body, even if you're just walking from the kitchen to the couch.

Experts:

Dr. John Steever, M.D., assistant professor of pediatrics and medical director of the Trans Health Program at the Mount Sinai Adolescent Health Center

Dr. Karl Neff, endocrinologist and clinical lead of Ireland's National Gender Services

Studies:

Peitzmeier, S., Gardner, I., Weinand, J., Corbet, A., & Acevedo, K. (2016). Health impact of chest binding among transgender adults: a community-engaged, cross-sectional study. Culture, Health & Sexuality, 19(1), 64–75. doi: 10.1080/13691058.2016.1191675