Wearing a binder is sometimes the only way that a person with dysphoria related to having breasts can leave the house. The psychological and emotional impacts of dysphoria are often worse than the physical discomfort from the binder. But that doesn’t mean we should ignore the binder’s effects on our body.
I strongly believe that the more you know about something, the more you can do to make it better.
If you are someone who wears a binder, occasionally or regularly, and just suffers through the physical discomfort in order to manage dysphoria, I’m here to tell you there are ways to make the physical pain less. I can’t guarantee the strategies I talk about will get rid of it, but they will prevent worsening and decrease the pain.
This post is not designed to scare you. It is designed to give you accurate anatomical and physiological information about the various ways a binder can affect your body. In the next post, I will give you concrete ways to minimize these effects.
Disclaimer: I am a physiotherapist and as such have a strong understanding of anatomy and physiology. I am someone who wears a binder and has experienced these effects. I have not done any scientific research on the effects of binder use nor read any scientific research on this topic. I have attended a lecture by researchers who have looked at binder use and I have talked to many trans people about their experiences.
LUNGS
Your lungs are like an upside down tree. They have a main trunk, large branches, then smaller branches, all leading to little round bubbles called alveoli. They are roughly pyramid shaped with the smallest part at the top by your collar bone and the largest part in line with the bottom of your breastbone. They are a self-cleaning organ that requires a consistent exchange of clean air to remain healthy.
When you wear a binder, your lungs cannot expand to their full capacity. The restriction is mostly in a circle around the widest part of the lungs. In order to breathe, you have to expand more through the upper parts of your lungs which are much smaller. This restricts your body’s ability to get more oxygen when exercising and can make you lightheaded. The parts of your lungs that stay closed can become sticky and develop mucus which holds and breeds bacteria. Without taking time to fully expand your lungs when you take off the binder, this could develop into a chronic cough or pneumonia.
SPINE
Your spine is made of vertebrae stacked on top of each other with discs between the bodies and many ligaments and muscles connecting them together. It has a natural inward curve in the neck, outward curve in the upper back, and inward curve in the low back. The different areas of the spine are designed to move in different ways but over all it can bend forward and back, side to side, and rotate. These large movements are created by a small amount of movement between each vertebra.
When you wear a binder, it restricts the movement in the mid spine or upper back forcing the areas above and below to compensate and move more. The areas above and below become hypermobile which can cause pain. Because of the lack of movement in the mid-spine (the section under the binder), the ligaments and muscles become tight, short, and weak which will cause stiffness and pain even when not wearing the binder.
RIBS
Your ribs connect to your spine in the back and your sternum in the front. The joints in the front are more flexible than the ones in the back. The ribs are designed to move out and up when we breathe in. They have ligaments connecting them to the spine, cartilage connecting them to the sternum, and muscles connecting them to each other.
When you are wearing a binder, your ribs are restricted and compressed. The ligaments and muscles can tighten and shorten over time, decreasing your lung capacity even when not wearing the binder. The joints at your spine stiffen up, forcing the joints at the front to move more than they should in order to expand your chest to breathe. This can cause sharp pain by the sternum, or costochondritis. If you use something other than a safe binder to bind with, wear a binder that is too small, or wear your binder too long or too often, you can also cause fractures in your ribs.
SHOULDERS
Your shoulders are designed to have a large range of motion. In order to do get your arms above shoulder height and reach above your head, the structures around the shoulder have to rotate up and out of the way. This includes the shoulder blade, collar bone, and upper ribs. When these three structures rotate up, the tip of your shoulder comes towards your ear.
When wearing a binder, there is more pressure downwards on the collar bone and compression around the ribs. There can also be tension on the skin under your arm and around your shoulder. This all causes restriction in the ability of those structures to move up and rotate when you raise your arm. This can lead to a feeling of weakness in your arm, pain at the shoulder joint from tendons being pinched, and a loss of the body’s natural mechanics, and therefore strength, for overhead movements.
PELVIC FLOOR
Your pelvic floor is made up of many different muscles that form the bottom of your abdominal and pelvic cavity. If you think of this cavity as a pop can, the diaphragm is the top and the pelvic floor is the bottom with the abdominal muscles forming the sides and your organs inside. When you take a deep breath in, your diaphragm pushes down on your abdominal organs, increasing the pressure in the abdomen and pelvis. Your abdominal muscles and pelvic floor muscles absorb this pressure by expanding slightly while maintaining their contraction.
When wearing a binder, your diaphragm is not able to flatten fully and you are unable to take a full deep breath. This means that your pelvic floor muscles do not get the regular exercise of maintaining a contraction while stretching. They become weaker, tighter, and shorter. This can lead to pelvic pain from trigger points in the muscles, pain on penetration, and sometimes incontinence.
RECOMMENDATIONS AND EXERCISES
Again, this post was not designed to scare you. In Wearing a Binder: Recommendations and Exercises, I give you concrete ways to minimize these effects – general recommendations for binder use and a variety of exercises I recommend to counteract some of the effects discussed above.