The Impact of Chest Binding on Exercise Capacity in Transgender and Gender Diverse Adolescents

Transgender and gender diverse youth often wear chest binders to flatten the chest and alleviate gender dysphoria. Little is known about the impact of chest binding on exercise. This pilot study investigates whether chest binding impacts performance on cardiopulmonary exercise testing (CPET) and spirometry in transgender and gender diverse youth assigned female at birth.

Participants were recruited through a large, urban pediatric gender clinic. Participants completed a survey about exercising and binding practices and completed 2 CPETs with pre-exercise/post-exercise spirometry, once with and once without a commercially available chest binder. Results of the 2 tests were compared using paired t-tests and Wilcoxon signed-rank tests.

Eighteen youth completed the study. The mean age was 14.9 years. The average binder use was 5.2 days per week. Fifty-six percent (n = 10) reported binding with exercise most or all the time. No significant differences were detected in any CPET parameters between testing with a binder and testing without a binder. There was inadequate completion of pre-exercise/post-exercise spirometry to allow for statistical comparison. Most participants (83%, n = 15) had peak oxygen uptake levels that were mildly reduced (60%-80% predicted) or moderately reduced (40%-60% predicted) at both timepoints.

These findings suggest that wearing a chest binder does not impact exercise capacity. Participants had lower than expected cardiopulmonary fitness when tested with and without a binder. Further research is needed to delineate whether this finding is related to lack of participation in physical activity or a chronic effect on cardiopulmonary fitness due to chest binding.