With all the talk of chest binders after mainstream media took aim at them and Mermaids UK we are seeing the same pattern. The voices of those actually affected by the issues are not being heard. Correcting that for Trans Writes is Keith Ramsted with his chest binding story about the need for harm reduction;

The paramedic shifted me in my bed and pushed lightly on my side. I winced. I had a chest infection and the coughing had gotten so severe that I had pulled one of the muscles between my two ribs while chest binding. As he examined my chest he pointed out the bruising under my armpit and asked me if I’d fallen.

Sheepishly I admitted it was from duct tape. He paused and looked up at me. I tried to laugh it off and insisted I just “hated wearing a bra”. He didn’t believe a word of it but I didn’t expect him to. He told me under no circumstances was compressing my chest like that safe. A course of antibiotics and painkillers later and my ribs felt mostly ok.

I went straight back to chest binding.

I had first started experimenting with chest binding and flattening at 15 or 16. I think I probably tried everything you could think of, clingfilm, masking tape, bandages. But it was the duct tape and two sports bra combo that I stuck to. It hurt to breathe, the tape ripped out my newly sprouting armpit hair. But it was 2015 in a conservative rural town and I didn’t even know what a “trans man” was, let alone “binders” existed.

I wouldn’t discover that I could buy a simple, pain free, item of clothing for thirty pounds until I was 18. By then, the damage was already done. Even the softest chest binder in a size up was painful if I wore it longer than a couple of hours.

You see, that muscle pulled in my ribs while chest binding? It never fully healed, and every time I get a twinge of it when I lay on my side or twist my torso I am reminded of that incident, and how I made it so much worse by compressing my chest so aggressively.

The discussion around whether chest binding is safe should not be one of moral panic over the “female body” but of course that is what it has devolved into. I would rather it be a discussion on harm reduction. There is no universally accepted definition of harm reduction and most descriptions are limited to substance abuse. But in the simplest language:

Harm reduction is about providing a less harmful outlet for someone exhibiting harmful behaviors that could cause them physical or psychological damage.

Harm reduction strategies include everything from contraceptives and sex education for teenagers to safe injection sites and clean needles to drug users. Like all mental wellness management techniques, harm reduction is an equation where the harm of one behavior is levied against another to find a strategy for that person that will keep them safer, and empower them to stop the harmful behavior in their future.

If a teenager is chest binding using unsafe methods, that is extremely worrying. It can lead to physical damage to the body, and also psychological obsession with getting the chest as flat as possible using any means necessary. Providing that child with a binder causes no lasting damage to their body, and also presents a baseline for their compression goals which is reasonable and cannot be incrementally intensified (it’s very hard to, for example, layer binders on top of themselves as you can with a sports bra).

Part of this process is also providing the individual information on safe chest binding: Binders can be bought all over the net, sometimes through specialized sites with information, graphics and size charts, but this is sadly not always available.

The binders listed on Amazon, for example, come with very little information and often models are seen wearing garments that are clearly too small for them. I will therefore unashamedly defend a charity that is designed to prioritize the safety of trans children, providing effective harm reduction strategies to its service users.

The myth that binders cause lasting damage to the body, or that they are “medical garments” requiring a prescription, can be debunked by another source, my goal is only to explain how a lack of safe binding options or harm reduction techniques caused me significant and long term pain that could have been avoided if Mermaids or similar resources were available to me at the time.

The alternative to harm reduction is of course abstinence, and so I didn’t bind for four years leading up to my double mastectomy. It was too painful and the duct tape method had left my breast tissue thin and stretched, I needed that skin to recover if I wanted a neat closure for surgery. Everyday I moisturized my damaged skin, I used electrical pulses to encourage tissue growth, and I only wore loose clothing.

By the date of my surgery my tissue had almost completely recovered, and so had my perception of my body. I can say that by the time I had them removed I had come to truly love my breasts, the skin was healthy, the scars were faded, and they provided a perfect canvas for my new chest to be built out of. Only the occasional twinge of pain from my ribs to remind me of what I’d put myself through with unsafe chest binding, all of my intense dysphoria and dysmorphia was just a distant memory.

I was laying in the recovery room when a member of the surgical team accidently brought all these memories back. I was shifting around and muttered about the discomfort from the compression garment which was holding my dressings tight against my flat chest.

“It will be uncomfortable, but a few weeks of this will be better than having to bind all the time like you did before.”

I nodded mutely. I didn’t bother to correct her, she was being kind. But the truth was I hadn’t been chest binding in so long I’d forgotten what it felt like. The tight pressure on my chest actually made me nostalgic for my 15 year old self, in his dark bedroom, trying to make his body look just a little bit more like something he could exist in.

I wished I could go back and give him a big hug, and tell him he didn’t have to torture himself, and to please, please, ask for a binder for Christmas.

It made me think about how it’s broadly assumed now that trans men have always had knowledge and access to safe chest binding. That us getting our first binder is just a stepping stone to a linear transition from binding to surgery. In reality I’m sure many other trans masculine people have had a journey with their chest and their body that was just as difficult and misguided as mine was, simply because there was no one there to tell them a safer, better way existed.

I didn’t grow up with binders, and by the time I became aware of them, my body was too damaged from my ignorance to use them. I thought about how different my teen years might have been, if I’d simply known a safe chest binding option existed.

I’ve spoken about harm reduction here, and how it helps youth experimenting with relieving distress in their bodies. I will reiterate that this equation is very simple to me: Mild discomfort while wearing a binder is infinitely less damaging than the continued and escalating self harm so many trans mascs, who didn’t have access or knowledge of safe binding methods, report.

Critics would do well to actually listen to us and our experiences. The trans male experience is not a thought experiment or a worst case scenario for your beloved daughter. It is a path that can sometimes be shrouded in ignorance, obsession, and a loss of autonomy. Organizations that provide safety, information, support and resources are a beacon of light for us.