Chest binding: A Modern Day Version of Foot Binding?

Harming your body to support an ideology

I recently read a study entitled “Health impact of chest binding among transgender adults: a community-engaged, cross-sectional study” Health impact of chest binding among transgender adults: a community-engaged, cross-sectional study: Culture, Health & Sexuality: Vol 19, No 1 (tandfonline.com)

But the study isn’t actually about “chest” binding and it’s not about “transgender adults” either. 

The first sentence of the abstract sets the tone for what is to follow:

“Chest binding involves the compression of chest tissue for masculine gender expression among people assigned a female sex at birth, particularly transgender and gender non-conforming individuals.”

The first untruth is that chest binding consists of compression of chest tissue. Chest binding has nothing to do with compressing chest tissue, and everything to do with obliterating the visual aspect of one of the more visible secondary sex characteristics that women share: breasts. This alteration is an attempt to create the appearance of changing one's sex, which is not possible to do.

Secondly, the study states that people are assigned a sex at birth. No one is doing any “assigning” at birth. As a midwife, I have been in the room to see many babies born and not once was there any debate or discussion around what box to tick for the sex of a baby. Neither myself, nor any of my medical colleagues had a unit in our training on ‘how to assign babies a sex’. For those of you who perhaps have never had the joy of seeing a newborn, I assure you it is glaringly easy to tell if a baby is male or female.

Those who are born with a DSD (disorder of sexual development) constitute between 0.10% and 0.018% of the population. Ambiguous Genitalia And Disorders of Sexual Differentiation - StatPearls - NCBI Bookshelf (nih.gov) 

Very few babies will have genitalia that makes it difficult to observe their sex. Chromosomal testing will determine whether a baby is a girl or a boy and there are no other sexes to choose from. Activists who insist on promoting DSDs as an integral part of public health messaging are creating a distraction that derails cogent discussions about the long-term effects of binding (and other medical interventions for “gender reassignment” purposes) perpetrated upon women and girls. Those individuals who are born with a DSD will have access to tailored medical support that is appropriate for them. Large scale public health messaging is not necessary. Those girls who are being harmed by binding are the ones who need public health information that addresses the dangers of binding.

The third objective of the above-mentioned abstract is to: “develop preliminary evidence-based recommendations for healthy binding based on these risk factors.” Instead of "recommendations for healthy binding," aren't harm reduction strategies what is needed? How can there be a healthy way to practice an unhealthy activity? If someone injects heroin, there are ways to mitigate the transmission of diseases such as hepatitis and HIV by using clean needles, but this does not mean there is a “healthy” way to use heroin.

Conflicts of interest

The standard author disclosure at the end of this paper states, “No potential conflict of interest was reported by the authors.” I disagree. Under the Methods section it states, “the research team itself also includes individuals who bind”. Here is a paper purporting to research an admittedly unhealthy practice that at least one of the authors engages in. So, there is no pressure to achieve a particular set of results then? This does not lend itself to the impartiality expected of a genuine research project.

One of the aims of this research (as stated in the Methods section) is, “(4) the overall goal of diminishing disparities in health and healthcare for this underserved population.” This is a very confusing statement.

How can you cater to the special needs of this minority population (by giving them extra care), while at the same time diminishing any disparities between them and the remainder of the population? Either they need different care, or they don’t. If they identify as men, won’t it be offensive to treat them as women? But men don’t bind their chests so there are no health care protocols to work with here.

As “participants were given the option to skip any question they did not feel comfortable answering” there is a strong possibility of selection bias. As we are not told what questions were not answered or how many questions were left unanswered, we have no way of knowing how accurate the results are.  

Research confirms harm

But even so, considering that the researchers are clearly sympathetic to their study population, the results are alarming:

“Experiencing any health outcome related to binding was nearly universal, with 97.2% of participants reporting at least one negative outcome they attributed to binding. The most commonly reported outcomes were back pain (53.8%), overheating (53.5%), chest pain (48.8%), shortness of breath (46.6%), itching (44.9%), bad posture (40.3%) and shoulder pain (38.9%). Of the categories examined, skin/soft tissue and pain symptoms were most common, with 76.3% of respondents reporting any skin/tissue concern and 74.0% reporting any pain-related concern.”

The authors admit that chest binding is not a physically healthy practice but claim there are mental health benefits to binding, but for reasons already mentioned this cannot be assumed based on their sampling technique. How can the authors of the study claim to be concerned with “all aspects of their [chest binding women’s] physical and mental health” when the results show that this practice causes actual physical harm? Doesn’t this create a conflict between physical and mental health?

Pregnancy and breastfeeding

And although this study did not consider women who are pregnant or breastfeeding, this is another area of great concern for those of us working in this arena.

I do confess to bias here; if women really want to be men and their mental health depends on them being recognised as men, then why not live their lives as men? Becoming pregnant would seem antithetical to any concept of normal masculinity, as only women can engage in the extremely sexed activities of pregnancy, birth and breastfeeding.

It is more than ironical for people to engage in the only bodily process that can be done by only one of our two sexes, while at the same time claiming that they have created their ‘true’ authentic life as the other sex. There is no authenticity in claiming to be something that you can never be, even if you manage to convince those around you to go along with your beliefs.

I have great compassion for those suffering with gender dysphoria or any mental health issues around identity or reactions to societal conditions that leave people feeling overwhelmed and distressed. But physically altering one’s body is not fixing this problem; it is at best a way of temporarily ameliorating immediate feelings while leaving the real issues unaddressed. Opinion | What Teenagers’ Mental Health Can Tell Us About America - The New York Times (nytimes.com)

If women can’t safely bind their breasts while they are not pregnant or breastfeeding, the odds of damage escalate astronomically if a woman is in either of these situations. For most women, the first thing they become aware of when they conceive is breast changes. Breasts become a bit larger and can become exquisitely sensitive. Some women find that just ‘regular’ tight tops are too uncomfortable to wear.

Medical professionals will not support those who continue to bind during pregnancy. One of the common side effects of pregnancy is shortness of breath as the baby grows and lung capacity is challenged. Exacerbating this by deliberately restricting breathing is not a healthy choice and women need to realise that they are not just hampering their own physiology, but they could also be depriving their fetuses of oxygen for prolonged periods, and this can have disastrous outcomes for babies.

Prolonged binding can damage not only breasts, but the glandular tissue needed to produce milk. Breast binding used to be standard practice and advised for those mothers who had chosen to formula feed their babies so wanted to suppress lactation. But this has been largely discontinued as it can be harmful and is more painful for women. Breast Binding … Is It All That It's Wrapped Up To Be? - Journal of Obstetric, Gynecologic & Neonatal Nursing (jognn.org)

There is no way to accurately gauge just how many women calling themselves men are having babies because under the rubric of the trans “no debate” agenda, it is somehow considered “transphobic” to even ask questions. According to Medicare (Australia) a total of 294,369 births were registered in Australia in 2020 and in 2018, 22 of these were to non-female identifying women. If the number of births to those identifying as men grew to 29 in 2020, this would constitute 1:10,000 births or 0.01%. The remaining 99.99% would be births to females designated as women.

Many groups including La Leche League International formed to support breastfeeding mothers have been so busy being “inclusive” that they have lost their way. One might question why “mother” has become a nearly forbidden term for global health messaging and supporting women who want to breastfeed their babies when over 99% of the world’s population is born to women who are fine with claiming to be mothers.

Perhaps LLLI and other breastfeeding support groups should consider just sticking to the health consequences of breastfeeding and base their support on this? Rather this than erasing mothers and using dehumanised and desexed language to describe the most foundational relationship there is: the mother/baby dyad.

The World Health Organization recommends six months of exclusive breastfeeding for all mothers and babies. This is true for everyone, regardless of one's ideological beliefs. Exclusive breastfeeding is the gold standard for optimising the health of every woman and every baby (so actually all of society as many of those babies grow up to be men).

With the knowledge of the gold standard as established fact for decades, why is La Leche League International's Board of Directors so intent on advocating for transgender breastfeeding when it interferes with the bonding between mother and baby and the exclusive benefits of breastfeeding? This question has been put to the Board for several years by scores of LLL Leaders and the Board refuses to discuss the concerns brought forward to them. It has become obvious that LLLI is promoting trans ideology when on their own website they make statements that both undermine the breastfeeding relationship and cater to no breastfeeding at all such as:

Trans parents choosing to breast or chestfeed and those choosing to suppress lactation and bottlefeed may require the support of breastfeeding counsellors or lactation professionals.”  Transgender & Non-binary Parents - La Leche League International (llli.org)

When Leaders question this obvious contradiction to the organization's Mission Statement—to help mothers worldwide to breastfeed through mother-to-mother support and have concerns about their ability and willingness to assist men and women whose ability to breastfeed has been lost, they are disaccredited.  

Women have always harmed their bodies in an effort to adapt to the societies they live in. From eating arsenic (to give the cheeks a rosy glow) to wearing corsets so tight that the fainting couch was invented; sleeping in uncomfortable hair rollers to breast augmentation, women have demonstrated their compliance to some perceived standard of appearance without regard to the self-harm they are perpetrating. The difference today is that the harm being done involves much more long-term consequences to women's health.

Any attempt to normalise the binding of breasts harms women and young girls and has immediate and long-term effects on their health and their ability to breastfeed and so additionally introduces generational harm to their babies as well.

Those advocating for harm today will be called to account at some point. What will they say to those women who were supported and even encouraged into practices that left them unable to nourish their babies as their bodies were designed to do?

Breasts cannot be bound “safely” any more than those Chinese women who were forced by tradition could have bound their feet. Any organisation that implies otherwise is complicit in doing harm to women and babies.