Non-Medical Gender Affirming Practices Among Transgender Individuals: A Systematic Review on the Health Implications of Chest Binding and Genital Tucking

Abstract

Objectives: This systematic review describes health implications of two non-medical gender affirming practices: chest binding and genital tucking. Methods: In January 2024, three databases (MEDLINE, Embase, and APA PsycINFO) were systematically searched using two comprehensive search terms related to: (1) chest binding or genital tucking, and (2) transgender people. Publications not in English, non-peer reviewed, insufficient data, and any forms of reviews were excluded. A manual search of relevant reviews and references was additionally done for additional resources. An updated search was done in July 2024. This systematic review was registered with PROSPERO (CRD42024500400) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: This review included 18 studies (11 on chest binding, 7 on genital tucking) with a total of 3,235 participants. Negative implications were frequently reported, including dermatological issues, pain, hyperprolactinemia, breathing difficulties, testicular torsion, and poorer semen quality. However, some studies also found positive effects on dysphoria, life satisfaction, and mental health. Several studies highlighted lack of knowledge among healthcare providers about these practices. Conclusion: Chest binding and genital tucking have complicated tradeoffs between physical health risks and potential psychological benefits of reduced dysphoria. Further research is needed, especially on long-term effects, safer methods, and promoting education to build a supportive healthcare environment.