‘They better take away duct tape’: Trans men say they’ll keep binding despite FDA crackdown

In the early 1980s, Jamison Green needed to bind his chest so that he would be less likely to be perceived as female when he walked down the street or went into the men’s restroom at work. 

He first tried ACE bandages, but those didn’t work. The clips would sometimes come off in the middle of meetings, and the fabric was just too loose. Ultimately, he made do with girdles he bought through the Sears catalog. Each one was 10 inches wide, with a long Velcro closure. He would buy one and cut it in half to create two chest binders while also avoiding adding pressure on his waist. 

Binders have come a long way since then, especially in the last 15 years. Modern binders, typically made of nylon and spandex, are easier on the body for long-term wear and frequent use. Safe binding is key, since it’s common for some people to bind every day of the week, or all day at work. 

But now, the federal government is going after companies that sell chest binders to transgender people. By targeting manufacturers of the best binders on the market, the government could put Americans’ health at risk by limiting safe options and forcing them to turn to DIY binding.

When announcing that the Food and Drug Administration is taking action against manufacturers and retailers selling binders, Commissioner Marty Makary listed negative side effects from long-term binding — like pain and breathing problems. These issues have been found in multiple studies, which note that although binding supports mental health, it can cause musculoskeletal pain, skin irritation and shortness of breath. 

For trans people, these findings aren’t revelatory. Binding is uncomfortable. How to do it safely is a frequent topic of conversation: books and online resources suggest taking breaks throughout the day, never sleeping with a binder on, and avoiding the gym.

But although it’s uncomfortable, it is a necessity that allows trans people to go out into the world and function, said Green, who is now 77.

“Having a flat chest was really important, because if people couldn’t see who I was, it was devastating,” Green said. 

Green, a trans health expert and writer, is known as a historian of gender-affirming care. Binders are not medical devices, as the FDA argues, he said — they’re tools. And trans people have been binding by any means necessary for a long time.

“You just endure it because you need to,” he said. “Without it, you’re constantly aware of how miserable you are, how other people are judging you. Then you get this sort of stopgap, this appliance, and it’s just a huge relief.”

Sean Ebony Coleman, who turns 58 next month, remembers when trans people had no way to access gender-affirming care other than black market and DIY solutions. That includes binding, which helps trans men and nonbinary people deal with gender dysphoria by flattening the chest and concealing breasts. 

“Back in my day, we didn’t have binders. We used electrical tape. We would wrap with an ACE bandage, and then go around it with electrical tape. So just imagine wearing that for eight to ten hours a day, the harm that it caused,” Coleman said. He still has back problems and issues with his posture.

For Coleman, the FDA’s new stance on binders reflects how the administration is not listening to the actual experiences of trans people. 

“They may believe that a binder is not safe, because they don’t know what the alternative was,” he said. 

Coleman worries that the Trump administration’s policies will push trans health care back underground. Gender-affirming care rollbacks are reinforcing distrust of medical providers, he said. As founder and CEO of Destination Tomorrow, a nonprofit providing housing and other services to LGBTQ+ people, he sees many people in the community who aren’t sure what medical providers are safe for them to visit. 

“Some of the clients are dealing with isolation, anxiety, because of the climate that we’re currently in,” he said. 

Makary said in December that the FDA would send 12 warning letters to manufacturers and retailers for illegally marketing breast binders to children for the purposes of treating gender dysphoria.  According to him,  the agency will take enforcement action like import alerts, seizures and injunctions if “illegal marketing of these products for children” continues. 

But none of the warning letters mention selling binders to minors, or list any health risks associated with wearing them. Instead, they declare that binders are medical devices that must be registered with the FDA, since they are treating gender dysphoria. 

It is rare for the FDA to send these kinds of letters regarding low-risk devices, according to attorneys and specialists at Hyman, Phelps & McNamara, a food and drug law firm. It’s even rarer for the agency to issue this kind of warning over a procedural issue as small as failing to register a product. These letters are inconsistent with the FDA’s own policies, Hyman, Phelps & McNamara noted in the FDA Law Blog, their firm’s two-decade-old resource for industry experts. 

“FDA may be called to explain why it is publicly targeting safe, low‑risk products that support those seeking treatment for gender dysphoria, and why the warning letters cite a technical, easily-corrected violation while the rhetoric in its press release alleges different concerns,” the attorneys said. 

In response to a request for comment, the Department of Health and Human Services referred to the definition of “device” in the federal Food, Drug, and Cosmetic Act, which gives the FDA its regulatory authority. That act defines medical devices as items that mitigate or treat diseases, or affect the structure of the human body. 

“There is objective evidence that these articles are intended for medical purposes, including the medical condition of gender dysphoria,” the agency said in a statement. The FDA’s letters quote directly from binder manufacturers to find that evidence.  

Per your firm’s website: “Chest binding is the practice of compressing breast mass into a more masculine shape, often done in the LGBTQ community for gender euphoria … but also practiced by cis men with gynecomastia.” 

Per your firm’s website: “Our compression wraps are perfect for wearing after top surgery to keep swelling down without needing to lift your arms.” 

Per your firm’s website: “our product is aimed at helping to relieve dysphoria for trans folks”

Binders are more easily attainable these days, but that doesn’t mean that everyone has access. The nonprofit Point of Pride has given away thousands of binders to trans people who can’t afford them or safely get one themselves. They get 40 requests a day on average, said co-founder Aydian Dowling. 

“The need is still very much there,” he said. “You can’t just go to your local shop and purchase a binder.” 

Point of Pride only gives binders to trans people who are 18 and up. Still, young people are in greater need: the average age of someone requesting a free binder is 22, and many who ask are much younger. Many are low-income or living in poverty. To them, a binder represents a first step in exploring gender identity, Dowling said. 

“They’re a part of gender-affirming care. They’re not medical devices. They’re really just clothing that anyone can wear,” he said. 

Point of Pride plans to continue to support the binder manufacturers that they work with, which includes two of the companies that the FDA has sent warning letters to. 

“We’re going to continue to give out garments,” Dowling said. If there is an influx of more trans people needing free binders through their program, Point of Pride is prepared for that, he said. 

Dowling, who’s 38, bought his first binder in 2009 from Underworks, which sells shapewear for men, women, and pregnant people. That was the only game in town. There was nowhere else to buy one online. He remembers trying it on vividly. Looking in the mirror, it was like he recognized himself for the first time. He could picture what his future might look like. He started leaving the house more. 

“That felt like, ‘wow, maybe I could live this life and be okay,’” he said. 

That intense feeling of relief is why so many trans people bind, despite the annoyance of wearing a restrictive piece of clothing all day. And that’s why trans people will keep binding regardless of any potential federal restrictions, Green said. 

“They better take away duct tape if they really want to stop us,” he said.