(030) Troubles with a Tight Tuck - A Survey of Tucking Practices and Genitourinary Complaints

Abstract

Abstract Introduction Tucking is a common practice within the trans-female community to align gender identity with phenotype, with one study finding that 74.7% of trans-feminine respondents engaged in tucking. Tucking is found in other communities that may not identify as transgender such as drag queens and cross-dressers. Tucking involves bringing the testes up into the inguinal canal and positioning the penis towards the rectum. The manipulation of the male reproductive organs is not a benign practice. Complications include urinary tract infections, testicular pain, and issues with urinary flow. Reproductive function is affected with significantly lower total sperm per ejaculate, total motile sperm, and a change in morphology among transgender women compared to cisgender men. Research examining tucking and genitourinary complications has been sparse, and healthcare professionals may not be well informed regarding these complications. Objective To assess common tucking practices and associated genitourinary concerns. Methods An anonymous 30-question Qualtrics survey was administered on Reddit, an anonymous online forum, from Oct 2022 to Dec 2022. The survey included questions regarding demographic information, tucking procedures, and genitourinary symptoms associated with tucking. Inclusion criteria included those over 18 years who engage in tucking. This survey was posted on discussion forums that target those who practice tucking, including r/drag, r/asktransgender, r/truscum, r/crossdressing. Categorical variables were analyzed using descriptive statistics and Fisher’s Exact test. Results There were 50 responses with a 52% completion rate. The analysis included 20 surveys, and 6 surveys were excluded for not meeting the inclusion criteria. Demographic information included transgender status and age. 45% of participants identified as transgender females. 75% of participants were between 18 and 40 years old, and 25% were older than 40 years old. This cohort had significant experience tucking with 45% stating that they’ve tucked for over 5 years. 50% tucked 3 times or less per week, 15% tucked more than 3 times per week but not every day, and 30% tucked daily. When tucking, a majority (55%) tucked for 1-5 hours, 20% for 6-10 hours, 10% for 11-15 hours, 5% for 16-20 hours, and 10% for 21-24 hours. Regarding tucking materials, 5% reported using medical tape to tuck and the remaining 95% reported using a tight undergarment to tuck, such as shapewear, pantyhose, gaff, and underwear. All participants stated they did not feel uncomfortable seeking medical care. Complications included changes in ejaculation (30%), genital pain (22%), and genital numbness (17.7%). 75% of this cohort stated that they did not have any other concerns or experiences with tucking that were not mentioned in the survey. Approximately 22% stated concerns regarding fertility with tucking, and 27.8% considered fertility preservation. Conclusions This study is one of the first to investigate tucking practices and related genitourinary concerns. These respondents primarily used tight undergarments to manipulate the male reproductive organs. Most of the cohort did not have tucking-related genitourinary concerns. Of those with concerns, common concerns included future fertility and fertility preservation. More research is needed regarding fertility outcomes in tucking communities for physicians to adequately serve these communities. Disclosure No.