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OT and Transfeminine Equipment: Breast Forms, Gaffs, and Tucking Oh My!

Transfeminine equipment or equipment for those with feminine gender expression among people assigned a male sex at birth, particularly transgender and gender non-conforming individuals may include: prostheses, breast forms, gaff, tape, tucking, padding.

Padding: Padding refers to the use of undergarments to create the appearance of larger breasts, hips or buttocks. Padding may also assist in minimizing dysphoria.

            Some padding-specific garments include:

–       Padded undergarments: Typically, useful for facilitating appearance of wide hips or full buttocks

–       Bras with pockets: Also known as mastectomy bras, they are designed to accommodate breast forms and other associated prostheses

–       Padded bras: May be preferable if breast growth is present but not at the desired size.

Prostheses: An artificial body part(s), typically made from plastics, lightweight metals, or composites. May be formed to represent a breasts, penis, scrotum, or other anatomy.

Breast forms: Prostheses that have the appearance of breasts. Typically made of soft silicone gel and adhere to one’s body or are placed in a bra. Can be considered a form of padding.

Tucking: Tucking is the practice of arranging and supporting external genitals between the legs, including the penis, scrotum, and testicles so they are not visible in clothing. There are many ways to tuck, such as pushing the penis and other anatomy between your legs and then pulling on a pair of undergarments, to tucking the testicles inside of you. People tuck for many different reasons. One might tuck in order to feel more at ease in their body (minimize dysphoria), to feel more comfortable in their clothing, or to facilitate affirmation as one’s gender. There is minimal research on the safety of tucking.

Gaff: compression underwear that minimizes the appearance of a penis, scrotum, and testicles.

Tape: tape may be used with or instead of a gaff to “tuck” or minimize the appearance of the penis, scrotum, and testicles.

Important gaff considerations:

o Choosing the right size gaff is like choosing the right size underwear. One can also measure the circumference of their waist, just above the hips for correct sizing.

o Safe tucking/gaff techniques mirror those of binding:

o Minimize frequency of wearing, take breaks throughout the week (although it may not be ideal, it is particularly important for involved anatomical and physiological systems). Reducing the intensity of wearing (daytime donning) can also reduce risk of negative effects, though not as significantly as reducing the frequency.

o Minimize duration of wearing, as in reducing the wear time throughout the years. Bottom surgery is an alternate to tucking, however it is important to note that not every individual that tucks will want bottom surgery, nor will all individuals have access to the procedure (cost, access to healthcare, etc.)

o Unsafe tucking can affect the circulatory system, musculoskeletal anatomy, fertility issues, sex and intimacy, and skin integrity.

Gaff/ tucking garment maintenance: First and foremost, follow the washing/care instructions on the packaging/garment. In general, hand washing is the best. Avoid using bleach and/or a dryer as they accelerate material breakdown/ reduce integrity of the material. Pay special attention to skin folds, folding in the tucking garments (gaffs), bulging skin adjacent to the gaff or selected garment, redness, skin abnormalities, and prolonged indentations. Pay extra attention to the effects of the trans affirming/generally affirming care that you provide.  

The risks and contraindications are 𝕒𝕝𝕞𝕠𝕤𝕥 𝕒𝕝𝕨𝕒𝕪𝕤 𝕒 𝕣𝕖𝕤𝕦𝕝𝕥 𝕠𝕗 𝕦𝕟𝕤𝕒𝕗𝕖 𝕥𝕦𝕔𝕜𝕚𝕟𝕘 and 𝕒 𝕣𝕖𝕤𝕦𝕝𝕥 𝕠𝕗 𝕒 𝕙𝕖𝕒𝕝𝕥𝕙 𝕤𝕪𝕤𝕥𝕖𝕞 𝕥𝕙𝕒𝕥 𝕗𝕒𝕚𝕝𝕖𝕕 𝕒𝕥 𝕞𝕖𝕖𝕥𝕚𝕟𝕘 𝕒𝕟 𝕚𝕟𝕕𝕚𝕧𝕚𝕕𝕦𝕒𝕝𝕤 𝕟𝕖𝕖𝕕𝕤. We need to have the knowledge based to educate our clients on safe tucking practices as healthcare provides and 𝕖𝕤𝕡𝕖𝕔𝕚𝕒𝕝𝕝𝕪 as occupational therapists. HELLO!! ADLS!! DRESSING!! Anotha time for the people in the back: we alllll know that our professors/we talk about dressing all of the time throughout our programs and throughout providing care 𝕒𝕔𝕣𝕠𝕤𝕤 𝕥𝕙𝕖 𝕝𝕚𝕗𝕖𝕤𝕡𝕒𝕟. That’s right peds friends, I’m calling you in on this too. You may have a child, adolescent, or young adult that is going to need 𝕪𝕠𝕦 to educate them on safe tucking practices.

By The Rainbow OT

Hey! Welcome to my blog!

My name is Devlynn and I am a traveling occupational therapist who is passionate about inclusion and representation of the LGBTQIA+ individuals in the healthcare system.

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