Packing can be really important for young patients with dysphoria around their genitals or the silhouette. A packer, also called a ‘prosthetic’ is any object (sock, silicone, or otherwise) that allows anyone of any gender to ‘sport a package’ or present a silhouette of external genitals. An STP is a device that allows the user to Stand To Pee when urinating. 

When working with youth it is important to ask about packing:

• Do you pack? (Do you want to pack?)

• What do you pack with?

• Are you having any side effects from packing (pain, urinary issues, skin breakdown, etc)?

• Do you need any resources for packing?

• Do you want to stand to pee?

While we have very limited research and EBM on packing or STP best recommendations, general advice is to avoid anything causing pain and limit physician discomfort by repositioning a packer when present. Only the youth can weigh the physical symptoms against any possible mental anguish. Explore this with them. Focus on harm-reduction strategies and individualized care. 

At QueerDoc, we keep an active list of quality packing options available on our Gender Expression Resource page. This includes packers and STPS. GenderGear has some great educational content on several gender expression tools including STPs and packers. 

These are all resources I share regularly with patients and patient families. The QueerDoc page also has some resources for free or low cost gender expression resources for youth with non-supportive families or who can’t afford options. I do document any side effects the patient experiences as those can be used in the future to support surgery if the patient desires it. Additionally, I provide letters of medical necessity for gender expression tools as they qualify as medical treatments for the patients gender dysphoria (F64.2/F64.9). If you haven’t enrolled in QueerCME, join now to listen to the lecture on non-hormonal interventions to appear more curvy and soft to learn more.