Tucking can be really important for young patients with dysphoria around their genitals or the silhouette. 

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

• Do you tuck?

• What do you tuck with?

• If using a gaff:

• How did you pick the size?
• Do you wear more than one at a time?
• Do you have more than one?

• If using tape:

• What kind of tape?
• How often do you tuck?
• How long do you tuck?
• Do you sleep tucked?
• Are you having any side effects from tucking (pain, urinary issues, etc)?

While we have very limited research and EBM on tucking best practices, general advice now is to avoid sleeping tucked to help minimize side effects. Also, non-evidence based recommendations, are to tuck no more than 8 hours a day and to try and take breaks if having discomfort. Only the youth can weigh the physical symptoms against any possible mental anguish of being untucked. Explore this with them. Focus on harm-reduction strategies and individualized care. 

At QueerDoc, we keep an active list of quality tuckining options available on our Gender Expression Resource page. This includes gaffs and tuck kits tape. Taping can be accomplished with surgical tape as well- generally tapes that are gentle on skin are best. Duct tape can cause significant skin damage. TransTape has a great guide on how to tape. Unclockable is a tuck kit made by a transwoman. GenderGear has some great educational content on several gender expression tools including gaffs. Carmen Liu even makes tucking underware for young people. Several clinics have made fabulous patient handouts on safer binding practices:

• Callen-Lorde
• OHSU
• Seattle Children’s

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.