(043) Genital Tucking Practices in Trans Individuals and Anogenital Implications
Authors: Christensen R , Ajayi B , Bachmann G 
Published: June 2023

Abstract

Introduction
Genital tucking is a practice performed by some transgender women and gender nonconforming individuals to reduce or conceal the contour of the penis and testicles. A variety of genital tucking techniques exist that are used to achieve an individual’s desired appearance. The penis and scrotum may be moved into the perineal area or between the buttocks. Some individuals may additionally reposition the testicles upward into the inguinal canals. Typically, these techniques are reinforced through the use of compression underwear, a specialized supportive undergarment termed a gaff, or adhesive tape. Despite the important role genital tucking plays in gender expression and affirmation, little, if any, research currently exists on the prevalence of tucking practices, the techniques employed, and its effects on anogenital health. Dermatological injury due to genital tucking encompasses a broad range of complications and may be largely avoidable if correct anogenital care and tucking methods are implemented.

Objectives
The purpose of this study is to present key findings generated from a review of available literature on anogenital dermatological conditions and their association with genital tucking. Data are presented on genital tucking techniques, associated health risks with emphasis on dermatological considerations, as well as suggested physician preventative counseling.

Methods
PubMed was searched for publications corresponding to the areas of interest (moisture-associated skin damage, medical adhesive-related skin injury, anogenital care techniques). Research from primary publications, consensus statements, and literature reviews were included. Findings were synthesized and applied to the context of genital tucking practices.

Results
As certain tucking practices expose the anogenital skin to excessive moisture, friction, and adhesive products, dermatological complications are a significant concern. Individuals who tuck may experience medical adhesive-related skin injury which includes mechanical injury (e.g., skin tears, blistering), dermatitis (e.g., hypersensitivity reactions), and other injuries such as maceration and folliculitis. Moreover, genital tucking may predispose individuals to intertriginous dermatitis, an inflammatory skin condition that occurs due to friction and trapped moisture within skin folds. Predisposing risk factors to skin injury that may disproportionately affect transgender individuals who tuck include dehydration, exposure to estrogen hormone therapy, and immunodeficiency. Prevention of adverse outcomes related to tucking should include counseling and regular surveillance of the anogenital area. Patients should be counseled on the selection and use of absorbent, natural fabrics as well as the safest and most effective adhesive tapes. Applying barrier and drying agents before tucking and employing proper adhesive removal techniques should be recommended to further reduce risk of anogenital skin injury and infection.

Conclusions
This review was the first of our knowledge to discuss the practice of genital tucking, the associated dermatological risk factors, and the critical role physicians play in caring for and counseling patients on tucking practices. Genital tucking preventative counseling and routine examination of the affected area may improve anogenital health of individuals who engage in this practice.

Disclosure
No.