Chest binding and its associations with mental and physical health outcomes in trans and gender diverse adolescents attending a specialist paediatric gender service

Background Chest binding is a common strategy for addressing gender dysphoria in transgender and gender diverse (trans) young people. While it can improve well-being, past research has identified potential physical health risks.Aim and Methods This cross-sectional study aimed to better understand the prevalence and nature of chest binding and explore its associations with mental and physical health among Australian trans adolescents assigned female at birth, who were attending their first pediatric gender service appointment between January 2017 and June 2024.Results The sample comprised 1278 adolescents: of these, 814 (63.7%) were chest binding (CB). Compared to the non binding (NonB) group, the CB group were more likely to identify as transmasculine (CB n = 508, 62.4%; NonB n = 220, 47.4%; p-value: < 0.001), be older (CB: 15.3 years; NonB: 14.3 years; p value: < 0.001) and report more chest dysphoria (Chest Dysphoria Scale: Mean CB: 28.1; NonB: 23.4; p-value: < 0.001). In those CB with available data, mean lifetime binding period was 15.4 months and mean daily binding duration was 9.6 h, and the vast majority (98.2%) used commercial binders. Anxiety, depression, pain, sleep problems, skin problems or activity restriction did not significantly differ between CB and NonB groups.Discussion In conclusion, we found that CB is common in trans adolescents—especially in those with higher levels of chest dysphoria, and those of older age, and those who report a transmasculine identity. While previous research has highlighted potential physical health risks, significant differences were not observed between CB and NonB groups in our study. Taken together, these findings highlight the importance of CB as a gender-affirming practice.