Side Effect Profiles of Nonhormonal, Nonsurgical Gender-Affirming Body Modifications

Purpose: Binding, packing, using stand-to-pee (STP) devices, and tucking are nonhormonal, nonsurgical gender-affirming body modifications (GABMs) that are used to affirm gender expression. This study sought to describe the sociodemographic characteristics of and side effects experienced by those using GABMs. Methods: We conducted a cross-sectional study of The Population Research in Identity and Disparities for Equality Study participants who completed the 2023 Annual Questionnaire. Data on sociodemographics and self-reported side effects were collected and analyzed using descriptive statistics. Results: Of 6296 participants, 1694 reported GABMs including binding (n = 995), packing (n = 590), using an STP device (n = 351), and tucking (n = 265). Each GABM had a distinct side effect profile. Pain (2.0%-48.2% past-year prevalence) and dermatologic concerns (0.5%-23.2% past-year prevalence) were reported across GABMs. Conclusion: While GABMs promote mental health and patient safety, they carry a risk of adverse physical health effects. Providers play a vital role in managing GABM-associated side effects to ensure patients can continue to affirm their gender identities.