Trans and nonbinary bodies

This page is for trans guys, trans mascs, nonbinary people and anyone questioning who was assigned female at birth. It covers binding, testosterone, what the rules are for under-18s, and how to make check-ups easier.

It doesn't assume anything. Some people bind and some don't. Some take testosterone, some never will, and some aren't sure yet. All of that is fine. Read whatever is useful and skip the rest.

Gender dysphoria is distress or discomfort that lasts a long time because someone's gender identity is different from the sex they were registered with at birth.¹ Not everyone who is trans or nonbinary feels it.² If it's heavy right now, the help page has people to talk to.

Verified with: NHS, Healthdirect Australia, Mayo Clinic

Binding safely

Binding means pressing down breast tissue so it looks flatter.² It isn't a medical treatment and it can be undone. It may help ease distress about the chest.² Young people who bind say it brings benefits, like feeling more comfortable, feeling safer, and being misgendered less.²

Source: WPATH, Culture, Health & Sexuality

WPATH (the World Professional Association for Transgender Health) suggests that doctors talk with trans and nonbinary teens about binding, including the benefits and the risks.² So it's okay to bring it up at an appointment.

Source: WPATH

Safer binding

• Use a binder made for binding.² Even these can cause problems, so the tips below still apply.

  Source: Culture, Health & Sexuality, International Journal of Transgender Health, WPATH

• Never bind with duct tape, elastic bandages or plastic wrap. They can restrict blood flow, damage skin and make it hard to breathe.²

  Source: WPATH

• Get the right size. A binder that's too small can damage skin and ribs, and cause shortness of breath, chest pain, back pain and overheating.³

  Source: International Journal of Sexual Health

• No major health body has set firm limits for binding. This is practical advice, not a tested rule.

  Not confirmed by a medical institution

• Common advice is to keep it under eight hours a day, and take regular breaks.⁴

  Source: International Journal of Sexual Health

• Common advice is also not to sleep in a binder, and to take it off for hard exercise.⁴

  Not confirmed by a medical institution

• Binding generally shouldn't hurt.³ If there's pain or trouble breathing, take the binder off straight away. If that doesn't make it go away, get to a doctor or hospital as soon as possible.⁵ Trouble breathing that doesn't settle is a reason to call the local emergency number.⁶

  Source: Culture, Health & Sexuality, MedlinePlus

• Keep an eye out for problems like pain or shortness of breath, and change how you bind if problems come up. If the problems keep happening, get checked by a doctor.⁴²

  Verified with: Culture, Health & Sexuality, WPATH

What binding can do to the body

The most common problems for young people who bind are back or chest pain, shortness of breath and overheating.² More serious problems, like skin infections, respiratory infections and broken ribs, are uncommon. They've been linked to binding in adults.²

Source: WPATH, Transgender Health, Pediatrics

Binding restricts breathing while the binder is on, and this goes back to normal afterwards. From what's known so far, it doesn't seem to cause lasting harm to lung function in trans and gender-diverse young people.⁴

Source: Journal of Adolescent Health

Ideally, problems from binding are looked at by a doctor who has experience with trans and nonbinary young people.² See when to see a doctor for help asking.

Source: WPATH

Testosterone and the body

This part is for anyone curious about testosterone (T), whatever you decide. It doesn't cover doses, routines or how to get it. Those belong in a conversation with a doctor who knows trans care.

WPATH recommends that care for nonbinary people fits the person, and affirms how they experience their gender.² Hormones aren't a requirement for being trans or nonbinary.

Verified with: WPATH, Healthdirect Australia

Testosterone therapy means taking the hormone testosterone. It lowers how much oestrogen the ovaries make.⁷ Research has found it can be safe and effective when it's given by a healthcare professional with expertise in trans care.⁷ For under-18s, this is exactly where experts disagree: see below.

Source: Mayo Clinic

What may change

These changes are likely, and they happen slowly, over months to years: periods stopping, a deeper voice, more facial and body hair, body fat moving to different places, the clitoris getting bigger, the vaginal lining getting thinner and drier, and more muscle and strength.⁷

Verified with: Mayo Clinic, NHS, WPATH

Some changes can go back if testosterone is stopped. Others can't: a deeper voice, a bigger clitoris, and more body and facial hair stay.⁷

Source: Mayo Clinic, NHS

What may not change

• Periods don't always stop. Periods stopping is a common and wanted effect. In one study, though, some people still had periods more than 6 months after starting.⁸ If bleeding hasn't stopped after several months, a doctor might suggest medicine to stop it.⁷ More on the periods page.

  Verified with: International Journal of Transgender Health, Mayo Clinic, NHS, WPATH, Therapeutic Advances in Reproductive Health

• Pregnancy is still possible. Testosterone might lower fertility, but pregnancy can still happen for someone who has a uterus and ovaries and has sex with a person who makes sperm. Anyone who doesn't want to get pregnant should always use birth control.⁷ WPATH says testosterone should not be counted on as contraception.² Periods stopping doesn't change that. Testosterone can also carry risks for a baby if pregnancy happens while taking it.⁹ If that might be the case, it is worth telling a doctor straight away. The sexual health page covers the options.

  Source: Mayo Clinic, NHS, WPATH

• Fertility can change, and maybe for good. Mayo Clinic says testosterone may lower fertility by getting in the way of ovulation, and the chance of this being permanent may go up with long-term use.⁷ A local NHS leaflet is stronger: infertility is likely, and it may last even after stopping.⁹ That still doesn't make testosterone birth control.⁷² WPATH says fertility may come back after stopping.² Anyone who might want biological children one day should think about storing eggs first, and that's worth raising with a doctor.⁹

  Source: Mayo Clinic, NHS, WPATH

Side effects and check-ins

Possible complications include weight gain, acne, hair loss on the scalp, sleep apnea, changes in cholesterol, high blood pressure, making too many red blood cells, dryness and thinning of the vaginal lining, pelvic pain, and blood clots.⁷ That's why people on testosterone see their healthcare professional regularly, to keep track of changes and to have blood tests for things like cholesterol, blood sugar, blood count and the liver.⁷

Source: Mayo Clinic, WPATH, NHS

Never DIY hormones

Hormones that weren't prescribed, whether bought online or passed on by someone else, carry real risks:¹¹⁰

Verified with: NHS, WPATH, FDA

• The NHS strongly recommends not using or buying treatment that hasn't been prescribed for the person taking it.¹

  Source: NHS

• Websites that sell medicines without a prescription often sell fake or unsafe ones. They can have too much or too little of the active ingredient, the wrong ingredient, or other harmful substances.¹⁰

  Verified with: FDA, WHO

• Certain synthetic androgens, like anabolic steroids, can hurt the liver. Mayo Clinic says not to use them.⁷

  Verified with: Mayo Clinic, MedlinePlus

Anyone already taking hormones that weren't prescribed can speak to a doctor about it. WPATH recommends a harm-reduction approach: helping people connect with providers who can prescribe safe, monitored hormones.¹²

Verified with: NHS, WPATH

Under 18: what the rules are

This is where it gets complicated. Experts disagree, and what's available depends a lot on where someone lives. Here is what the main voices say, as plainly as possible.

Verified with: Archives of Disease in Childhood, Healthdirect Australia

What WPATH says

WPATH's guidance is one of two international guidelines that most other guidance for young people's gender care is based on.¹¹ What follows comes from its Standards of Care, version 8.

Source: Archives of Disease in Childhood

For teens, WPATH recommends a full, supportive assessment first, and medical treatment only when a set of conditions is met.² It recommends involving parents or carers in the assessment in almost all situations, unless that would harm the teen or isn't possible.² WPATH says the quality of the evidence is a key challenge in this area. It also says the evidence so far points to a general improvement in the lives of trans teens who get medical treatment after careful assessment.²

Source: WPATH

What the NHS in England does

In 2024, a review of children's gender care, the Cass Review, warned that "extreme caution" should be taken with hormones for under-18s.¹² After it, NHS England's policy allows hormones only in restricted cases, for 16- and 17-year-olds with persistent signs of gender dysphoria.¹² Later in 2024, puberty blockers, medicines used to delay puberty going further, were banned indefinitely in the UK for under-18s, for gender incongruence or dysphoria.¹²²

Verified with: UK Department of Health and Social Care, NHS (UK only)

In a consultation that ran from 9 March to 7 June 2026, NHS England proposed that masculinising and feminising hormones shouldn't be a routine treatment for under-18s, saying there wasn't enough evidence on their safety and effectiveness.¹³¹² It proposed that 16- and 17-year-olds who already have NHS prescriptions may continue, under case-by-case review.¹³ NHS England says it will consider all responses and publish a final policy.¹³ The Pharmaceutical Journal reported a pause on new referrals during the consultation.¹² As of 30 October 2026, Kindbody couldn't confirm the details of that pause, whether it still applies, or the outcome, so a GP or gender service can say what applies now.

Source: NHS

The NHS website says that for people aged 17 or under, treatment will usually include talking therapy and counselling.¹ A GP can refer someone 17 or under to a children's doctor or to young people's mental health services, who can refer on to the NHS children and young people's gender service.¹ Waits to be assessed at a gender clinic are currently very long. Anyone struggling with their mental health about their gender identity can speak to a GP about support while they wait.¹ Anyone aged 17 or under can get support from children and young people's mental health services.¹

Verified with: NHS (England only)

Everywhere else

A 2024 review looked at 23 guidelines from countries, regions and international groups. It found no agreement on when psychological or hormonal treatments should be offered to under-18s, or on what basis.¹⁴ So guidance differs between countries.

Source: Archives of Disease in Childhood

None of this changes who anyone is. If it feels like a lot, the help page lists helplines and services that can help.

Check-ups that are easier on dysphoria

Appointments about intimate health can be hard when they bring up dysphoria. Feeling nervous is normal, and it can help to tell the doctor.¹⁵ Here are things that are okay to ask for.

Source: ACOG

• The right name, pronouns and words. WPATH says health workers should ask trans and nonbinary people what name and pronouns to use, and which words to use for their body parts.² If nobody asks, it's okay to say it first.

  Source: WPATH

• Someone in the room. It's okay to ask for a chaperone, often a nurse, or to bring a friend, partner or family member for any part of an exam.¹⁶¹⁵

  Source: Mayo Clinic, ACOG

• Knowing what comes next. In a pelvic exam, the doctor tells the patient exactly what's being done at each step.¹⁶ Asking "what happens next?" before anything happens is always okay.

  Source: Mayo Clinic

• Stopping. If something hurts, say so straight away. The doctor can stop and talk about it. In cervical screening, the patient is in control and can ask to stop at any time.¹⁶¹⁷

  Verified with: Mayo Clinic, NHS

• Not every check needs an exam. A pelvic exam usually isn't needed at a first visit unless there are problems like unusual bleeding or pain. For someone who is having sex, many STI tests can be done with a pee sample, and some use a swab or blood.¹⁵¹⁸

  Source: ACOG, Mayo Clinic, NHS

Cervical screening, later on

WPATH recommends cervical screening for trans and nonbinary people who have a cervix, following local guidelines.² It doesn't start in the teen years: in England the first invite comes at 25, and in the US screening isn't recommended before 21.¹⁹¹⁵

Verified with: WPATH, NHS, ACOG

In England, someone with a cervix who is registered at the GP as male or indeterminate may not be invited automatically, and can ask the GP surgery, a sexual health service or a transgender health clinic to get invitations.¹⁹ Testosterone can make cervical tissue thinner, which can make test results harder to read.⁷ So it's worth mentioning at the appointment.

Source: NHS, Mayo Clinic, WPATH

The test is meant to be done in a way that keeps pain and distress low. It's okay to ask for a smaller speculum, to put it in yourself, to lie in a different position, or to bring someone along.²¹⁷ HPV swabs, including ones people take themselves, may be a useful alternative to a speculum exam.²

Verified with: WPATH, NHS, WHO

More on when to see a doctor and how to ask.

Titles are shown as each source published them, so they may use words this site doesn't.

1. NHS (UK National Health Service) — Gender dysphoria and incongruence (accessed 2026-10-30)
2. World Professional Association for Transgender Health (WPATH) — Standards of Care for the Health of Transgender and Gender Diverse People, Version 8 (SOC8) (accessed 2026-10-30)
3. Trans Lifeline — Is Binding Supposed to Hurt? (accessed 2026-10-30) community health org
4. CHEST Physician (American College of Chest Physicians) — Chest binding and respiratory health in transgender and gender-diverse patients (accessed 2026-10-30)
5. Minus18 — How to bind your chest safely and healthily (accessed 2026-10-30) community health org
6. MedlinePlus (NIH/NLM) — When to use the emergency room - adult (accessed 2026-10-30)
7. Mayo Clinic — Masculinizing hormone therapy (accessed 2026-10-30)
8. International Journal of Transgender Health (peer-reviewed; Zwickl et al., 2024) — Persistent menstruation in transgender people using testosterone gender-affirming hormone therapy (accessed 2026-10-29)
9. NHS (Nottinghamshire leaflet) — Masculinising hormones information sheet (accessed 2026-10-30)
10. U.S. Food and Drug Administration (FDA) — How to Buy Medicines Safely From an Online Pharmacy (accessed 2026-10-30)
11. Archives of Disease in Childhood (peer-reviewed; Taylor et al., 2024) — Clinical guidelines for children and adolescents experiencing gender dysphoria or incongruence: a systematic review of guideline quality (part 1) (accessed 2026-10-30)
12. The Pharmaceutical Journal (Royal College of Pharmacy) — NHS proposes removing masculinising and feminising hormones as routine treatments for under-18s (accessed 2026-10-30)
13. NHS England — Clinical policy: prescribing of masculinising and feminising hormones for children and adolescents (public consultation guide) (accessed 2026-10-30)
14. Archives of Disease in Childhood (peer-reviewed; Taylor et al., 2024) — Clinical guidelines for children and adolescents experiencing gender dysphoria or incongruence: a systematic review of recommendations (part 2) (accessed 2026-10-30)
15. American College of Obstetricians and Gynecologists (ACOG) — Your First Gynecologic Visit (FAQ) (accessed 2026-10-29)
16. Mayo Clinic — Pelvic exam (accessed 2026-10-30)
17. NHS (UK National Health Service) — What happens at your cervical screening appointment (accessed 2026-10-30)
18. NHS (UK National Health Service) — Visiting a sexual health clinic (accessed 2026-10-29)
19. NHS (UK National Health Service) — When you'll be invited for cervical screening (accessed 2026-10-30)