Psychosocial Correlates of Chest Binding in Transgender and Gender-Diverse Youth

Chest binding involves the compression of chest tissue for masculine gender expression among transgender and gender diverse (TGD) youth. This study aimed to assess binding trends and their associations with quality of life, self-esteem, and psychological symptoms among TGD youth in Türkiye.

This cross-sectional study was conducted between November 2019 and November 2023 and involved TGD youth and cisgender controls. Data collection included a survey on binding practices, the Rosenberg Self-Esteem Scale to assess self-esteem, the Turkish version of the World Health Organization's Quality of Life-BREF (WHOQOL-BREF-TR) to evaluate quality of life, and the Brief Symptom Inventory to measure psychological symptoms.

Thirty-three TGD participants (20.2 ± 2.7 years old) and 30 controls (20.8 ± 3.0 years old) were included. Most participants reported that not binding posed significant challenges in social interactions, sports, and expressing gender-aligned behaviors. Anxiety and somatization were inversely correlated with weekly binding duration. The TGD group had significantly higher (p < 0.05) somatization and global severity scores, lower (p < 0.01) psychological and environment scores of quality of life, but similar self-esteem levels. The psychology domain of the WHOQOL-BREF-TR was lower (p < 0.001) in the shorter binding group compared with controls but similar in the control and longer binding groups. Overall, psychological symptoms were lower (p < 0.01) in the control group than in the shorter binding group and not different from the longer binding group.

These findings highlight the nuanced relationship between binding and mental health, with higher psychological distress and lower quality of life in the TGD group compared with controls, while longer binding may offer some psychological stability, underscoring the need for improved access to gender-affirming care for overall well-being.