Why aren’t binders a regulated medical device?

It's an interesting thought.

These are prescribed by our OTs working with children with autism at work.

www.southpaw.co.uk/sensory-integration/weight-resistance/bear-hugs-weighted-vests

They're a tight binder to provide calming deep pressure.

They're extremely explicit about the time limits the child can have. Eg, if works to calm when. In distress, only keep on for max 20 mins. It can go back on after a period of time if needed; but rarely needs to. They have strict max time limits too.

Similarly with weighted vests etc.

I've not explored whether they're medically licensed and I'm not sure if actually anyone could buy them. (Looks like they could.)

As an aside, my local LLL leader often talked about the benefits to breasts and backs with no bras; I'm not sure if she means generally or when breastfeeding, I actually think the former. I believe under wired bras aren't tonight to be good for breast tissue.

Here's the study on health effects of binding.

pubmed.ncbi.nlm.nih.gov/27300085/

It's subscriber only, though. Here's an article:

www.starobserver.com.au/news/international-news-news/landmark-chest-binding-study-reveals-medical-risks/155457

'Commercial binders were most commonly associated with negative health impacts. Respondents who wore commercial binders reported experiencing 20 out of the study’s 28 listed health impacts.

Materials like cling wrap and duct tape, commonly advised against for binding, were only associated with 13 of the 28 negative health impacts.

Researcher Sarah Peitzmeier said the data was surprising given that commercial binders are often considered the safest option.'

And this is what I find concerning:

'“Even medical professionals who know about binding aren’t really sure how to assess it clinically, what the potential health impact of binding could be, and what safer binding practices they should recommend to patients.”'

I'm sure there's a limit to DIY binding too, because of the effort to construct something. Whatever you make out of cling film and duct tape, it will have to be remade over and over. So I should imagine there would be less time spent bound up.
The thing about binding is it doesn't get rid of dysphoria around breasts, it just kicks the can down the road. At some point the binder has to be removed, and there they are. That's going to be a bigger issue psychologically than getting used to one's own body.
Using binders to avoid being looked at makes more sense, to be honest. Although there are better options than binding for that.

I don't think they're even harm reduction.

I reckon, for most teenage girls, thinking they're NB or trans is roughly equivalent to how being a goth was for my generation. An sub culture which most will grow out of once they hit adulthood.

In that context, binders are a fashion item. I suspect they're no more harmful than some of the improbable platform shoes we wore - thirty years on and I still have a slightly unpredictable ankle from those.

The difference was noone sent me down a medical pathway where I was given drugs and surgery to affirm my inner gothness.

I don't imagine something like that has any therapeutic effect. It compressed the breast area. For no real reason other than the wearer doesn't like their breasts and wishes to compress them as much as possible so that they do not look like sexually mature (or maturing) girls and women.

I used to run in a sports bra. The cups didn't allow my breasts to move very much as that would be uncomfortable. It didn't compress them, though as I imagine that would also be uncomfortable. The sports bra wasn't too tight around my ribs/ diaphragm either; as that could affect my ability to expand and contract my diaphragm to breath effectively and without restriction. I think lung issues can occur if breathing is restricted as well.

Men = transmen,
Chest reconstruction = mastectomy.

That latter is particularly egregious, because 'chest reconstruction' would normally mean just that. Reconstructing the breasts after mastectomy. It's a woeful misuse of language to use it to mean the opposite.

Whilst I share everyone's horror at the thought of teenage girls in binders, I can't fundamentally see that they're any more medical than a push up bra or a corset. I've worn all three (I used to make costumes, don't ask) and the push up bra is the least comfortable of all. Surprisingly, a well-fitting corset is the most comfortable, although don't try to do CPR in it. Digression aside, they're all three smooshing the breast tissue into a shape its owner finds cosmetically acceptable, and I think it would be difficult to legislate between them.

Looks like you're targeting binders now to get them banned or restricted. If you succeed in getting them banned or restricted we would just go back to DIY binders, so tape, scarfs, tight tops, smaller size tops, or my fave elasticated Velcro tape. You don't see the pros but heavily focus on the cons, removing safe access to binders will cause more harm than good. You can lobby parliament to outlaw any form of chest binding with a life in jail, it won't stop binding happening.

@everythingthelighttouches even worse!
But all are body modification devices. Some are mainstream fashion (and therefore damage a great number of people, especially since that damage is normalized), some help a small minority of people to live with a body they don’t feel at home in for many reasons and prevent their mental health from tanking (and come with extensive advice on wearing them responsibly).
I know which one is more damaging…
A good quality binder worn correctly is not a health risk. If at all we need more education on how to wear them correctly, not banning them.
And yes, a good one that fits properly doesn’t hinder breathing any more than shapewear designed to for more societal accepted shapes. You shouldn’t sleep in any of them, and give your body breaks, but otherwise it’s not an issue.

Binders are perfectly safe as long as they are used appropriately.

So are explosives.

'perfectly safe' seems an odd choice of phrase for something that the NHS says this about:

'Breast binders may be worn, but this can be painful and problematic. Binders restrict breathing and may have significant physical consequences. Damage to the breast tissue is also caused, so that chest surgery may be more complicated and less successful.''

Really sounds very far from 'perfectly safe', to me. Which is why, I presume, I can't find any guidance from NICE or the NHS on the safe use of binders.

I have a suspicion that not only would the MHRA be interested in the claims made in that Amazon advert, but so would the ISO; referenced further down as having certified the thing. Because that’s not how it works.

@everythingthelighttouches

There's different types of binders though, most work by smoothing lumps and bumps more than pure compression and are no more restrictive than corsets which are considered lingerie. Over tightening them is when damage occurs. I hate them myself, but them being medically certified legitimises them

They are not perfectly safe which is why the nhs says they aren’t safe.

Binders are perfectly safe as long as they are used appropriately. If binders are regulated, so should be sports bra (only to be prescribed after being measured!), all kinds of bandages and all kinds of shapewear.
I wear binders. The only time I actually did damage to myself was wearing a too tight sports bra (very popular when binders are not available) which was bought at a high street store.
High heels should definitely be banned (self mutilation - wearers are damaging their feet and legs intentionally), so should shapewear (no fitting advice given, and you can’t approve of one sort of shape wear but disapprove of another)….

It would be very difficult to get a medical product licence for a device whose sole purpose is to damage healthy tissue. At least I hope it would, but in today’s insane world, who knows?

It would be good if, as well as any statement made about these being unable to be licensed here because of the research showing such extreme risks, if there were also a statement to follow about how dangerous they are to import for personal use also.

It’s legal to import medicine that’s just for personal use from what I understand. (Which is why it’s legal to import retin a from abroad even though it should require prescription. If you look at the sites recommended for this in style & beauty etc they have a huge list of meds that can’t be prescribed here that are legal to bring in if just for personal use, adderall for example)

So while it would be great to have NHS say they can’t be prescribed safely, I think they might need further restrictions.

That's from 'Good practice guidelines for the assessment and treatment of adults with gender dysphoria'
October 2013'

Doesn't sound like a ringing endorsement. And that's for adults.