{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T23:19:33Z","timestamp":1793834373887,"version":"4.6.1"},"reference-count":10,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,1]]},"abstract":"\n \n <\/jats:sec>\n \n BACKGROUND AND OBJECTIVES:<\/jats:title>\n Most transgender individuals assigned female at birth use chest binding (ie, wearing a tight garment to flatten chest tissue for the purpose of gender expression), often beginning in adolescence, to explore their gender identity. Although binding is often critical for mental health, negative physical side effects, ranging from chronic pain to rib fractures, are common. Time to first onset of symptoms is unknown.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n A community-engaged, online, cross-sectional survey (\u201cThe Binding Health Project\u201d) enrolled 1800 assigned female at birth or intersex individuals who had ever used chest binding. Lifetime prevalence of 27 pain, musculoskeletal, neurologic, gastrointestinal, generalized, respiratory, and skin or soft tissue symptoms related to binding was assessed. Nonparametric likelihood estimation methods were used to estimate survival curves.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n More than one-half (56%) of participants had begun binding by age 21, and 30% had begun by age 18. In 18 of 27 symptoms, the majority of people who go on to experience the event will do so within the first binding-year, but several skin-related and rare but serious outcomes (eg, rib fracture) took longer to occur. Pain presents rapidly but continues to rise in intensity over time, peaking at &gt;5 years of binding.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n Although many symptoms emerge quickly, others can take years to develop. Individuals and their clinicians can use this information to make informed decisions on how to structure binding practices and top surgery timing while meeting goals related to gender expression and mental health. Access to puberty blockers may delay initiation of binding, preventing binding-related symptoms in youth.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/peds.2020-0728","type":"journal-article","created":{"date-parts":[[2021,2,4]],"date-time":"2021-02-04T04:35:49Z","timestamp":1612413349000},"source":"Crossref","is-referenced-by-count":46,"title":["Time to First Onset of Chest Binding\u2013Related Symptoms in Transgender Youth"],"prefix":"10.1542","volume":"147","author":[{"given":"Sarah M.","family":"Peitzmeier","sequence":"first","affiliation":[{"name":"Center for Sexuality and Health Disparities and Department of Health Behavior and Biological Sciences, School of Nursing and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Silberholz","sequence":"additional","affiliation":[{"name":"Department of Technology and Operations, Stephen M. Ross School of Business, University of Michigan, Ann Arbor, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivy H.","family":"Gardner","sequence":"additional","affiliation":[{"name":"Department of Surgery, Oregon Health and Science University, Portland, Oregon;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"Weinand","sequence":"additional","affiliation":[{"name":"Southern New Mexico Family Medicine Residency Program, Las Cruces, New Mexico; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberlynn","family":"Acevedo","sequence":"additional","affiliation":[{"name":"School of Public Health, Boston University, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2021,3,1]]},"reference":[{"issue":"1","key":"2021121014073819900_B1","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1080\/13691058.2016.1191675","article-title":"Health impact of chest binding among transgender adults: a community-engaged, cross-sectional study","volume":"19","author":"Peitzmeier","year":"2017","journal-title":"Cult Health Sex"},{"key":"2021121014073819900_B2","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-319-13829-9","volume-title":"Female-to-Male (FtM) Transgender People\u2019s Experiences in Australia: A National Study","author":"Jones","year":"2015"},{"issue":"9","key":"2021121014073819900_B3","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1080\/13691058.2018.1529335","article-title":"The binding practices of transgender and gender-diverse adults in Sydney, 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