Packers and Stand-to-Pee Devices for Trans-Masculine Patients

Transgender and nonbinary individuals may choose to engage in various gender-affirming practices to reduce gender dysphoria or present in a way that is more congruent with their gender identity. Trans-masculine and nonbinary individuals may practice “packing”–using a purchased or homemade device to create a masculine-appearing bulge suggestive of male genitals. This population may also use devices that allow them to urinate standing up, known as stand-to-pee devices (STPs), which may double as packers. As a health care provider, being familiar with these devices can assist in counseling transgender and nonbinary patients.

Packers and stand-to-pee devices: safe for patients?

Both packers and STPs are generally safe for daily use, according to Dr. Christopher Lewis, co-director of Pediatric Transgender Health at Washington University School of Medicine in St. Louis.

Dr. Lewis describes infection as the major health concern associated with these devices, as urinary tract and skin infections can result if patients fail to properly clean their packer or STP after each use. Most commercially available products are easily cleaned with soap and water, and homemade packers made from socks or nylons can be washed in a washing machine. Skin irritation can also result from patients using packing or STP devices if these devices are reused after washing without allowing them to dry completely.

Both packers and STPs are generally safe for daily use.

Most commercial products are made of silicone, so allergies to packing or STP devices are generally not a concern. However, if a patient has a latex allergy, it is important to counsel them to avoid devices that do not clearly state the material used.

According to Dr. Lewis, it is safe to wear packers or STPs during exercise as long as the devices are cleaned and dried afterwards. Commercial products can also be worn in the pool, as silicone will not degrade when exposed to chlorine.

Securing and using stand-to-pee devices

Most experts recommend patients practice with stand-to-pee devices at home before using them in public, as these devices can be difficult to use at first. This precaution is helpful to share with patients who want to use an STP in order to help patients avoid an embarrassing and potentially dysphoric situation in a public restroom.

Some of the difficulty of using STPs can also be alleviated by specially-designed underwear that holds the STP in place and is equipped with an opening in the front to allow for easier use in the restroom. There are also straps designed to hold packers and STPs in place, which is useful for patients who prefer boxers or other looser-fitting underwear.

Many online resources detail how to make DIY packers and STPs, which can be useful for patients who are unable to afford one of these devices or who don’t feel safe having such a device delivered due to lack of familial support.

Resources

Below are resources for making a packer or STP as well as reputable vendors from which patients can purchase packers, STPs, and packing underwear.

• DIY and commercial STP overview: An informative overview of a range of types of STPs, from DIY solutions to commercially available models. This is a great starting place to direct patients, as it discusses the pros and cons of a variety of STPs and links to several different vendors. Prices range from $10 to more than $100.
• DIY packer video: Ash Hardell, a nonbinary trans activist, describes how to make a DIY packer using nylons and discusses commercially available packing and STP products.
• Packer straps and packer/STP underwear: FtM Essentials sells packers and STPs as well as undergarments specifically designed to hold these prosthetics. Prices range from $12 to $80.
• Packer and STP underwear: Rodeoh is another vendor that sells underwear specifically to be worn with packers. Prices range from $25 to $100.