The Doernbecher Children's Hospital in Portland provides an instructional guide to boys on how to tuck their genitals. The hospital – which bills itself as "Oregon's top ranked children’s hospital" – states, "Tucking can reduce any concerns you have about your body, how your clothes fit and how safe you feel in public."

The guidance from the "Gender Clinic" of the children's hospital states, "Tucking is moving the penis, testicles, or both out of the way. This makes the genital area look smoother and flatter."

Despite the guidance being directed to males with male genitalia, the hospital asserts, "People of all genders can tuck."

The children's hospital warns readers, "This information uses the words 'penis,' 'scrotum,' and 'testicles.' We know you may not use those terms or identify with them. We use them here to refer to body parts that people with tucking needs have, while understanding those words are not for everyone."

Regarding tucking, the children's hospital encourages boys to "try it out at home."

"It is best to tuck for the first time when you are planning to be at home," the recommendation explains. "This keeps you from stressing about having to get it right the first time. It is also easier to learn what your body needs to be comfortable when you tuck."

The document from the children's hospital says that boys can use tape to tuck their genitals but adds, "You might find that simply wearing tight underwear smooths things out enough." The children's hospital notes that taping genitals is "more secure," and "less likely to come undone." However, the tucking instruction manual for boys cautions that using tape presents a "higher risk of skin irritation" and makes it "harder to use the bathroom because you need to take off the tape and then reapply it."

For boys not using tape for tucking their genitals, the hospital recommends children to wear "Spanx or other shapewear" or "top pantyhose or tights, with the legs cut off to your desired length." The children's hospital suggests that boys could wear a gaff – "a special type of underwear made specifically for tucking."

"If you would like things to look a little smoother, wearing a pantyliner can help," the guide proposes.

The Doernbecher Children's Hospital provides links to where boys can purchase "underwear designed for tucking."

The handout from the children's hospital endorses an online store that sells "customized and handmade line of swimwear, lingerie, and more for folks of all genders" and "offers people of any size, shape, age, ability and gender expression a safe way to have customized items that meet their needs." The children's hospital promotes the store by saying, "They have been featured in Planned Parenthood guides for people seeking gender-affirming treatment."

The children's hospital also advises boys to shop at an Etsy retailer which offers "affordable gaffs and underwear for tucking."

"They have positive reviews from trans feminine folks," the children's hospital says of the Etsy shop. "They also make products that are designed specifically for children with tucking needs."

In the guidance, the children's hospital also directs minors to a "sex-positive shop in Portland."

"There is no one-size-fits-all approach to sex education or pleasure," the sex toy store says on its website. "She Bop fosters an affirming, inclusive space where everyone can be themselves. All bodies are celebrated here. We fight for equity in the adult industry. We are working to decenter whiteness — in our hiring practices, education program, product selection, and beyond. We recognize there is more to equity than dildo skin tones. This is ongoing work, and Team Bop is dedicated to it."

The sex toy store offers "virtual offerings" that provide: "Fun and interactive sex toy chat + Q&A facilitated by one of our sex toy experts." The sex toy store also offers online classes about sexual activities, including "BJs to BDSM and more!"

The children's hospital admits, "The shop is for people age 18 and older, but they offer appointments before or after hours for younger shoppers."

The children's hospital gives step-by-step instructions for boys on how to tuck their genitals:

1. Lie down with your underwear halfway up your legs. Lying down helps you avoid losing your balance during the final step. You are now ready to tuck your testicles up inside your body.
2. You have two spaces inside your belly called the inguinal canals. Your testicles go here naturally when it is very cold. Getting in a tub of cold water can help you find the inguinal canals, as your testicles will naturally be drawn towards them.
3. Press gently on your testicles with two or three fingers, and try to guide them into the inguinal canals. This can feel strange at first, possibly even uncomfortable. You should not feel faint or nauseated or have extreme pain. If you do, take a break and try again later.
4. Once the testicles are tucked, pull the penis back between your legs. If you find yourself getting aroused, take a break and try again later. An erection will make it impossible to tuck.
5. Holding the penis in place, slide your underwear up so that it holds the tuck. You may need to do some adjustment for comfort.

The children's hospital acknowledges, "Some discomfort is normal, though not all people have it. Most people’s bodies get used to tucking this way."

The children's hospital provides boys with illustrations on "safe tucking."

Doernbecher CHILDREN\u2019S hospital in Portland has a detailed guide on \u2018tucking\u2019 for kids. At the end, they also refer children to a sex toy shop for gender affirming items.pic.twitter.com/gqb44moeNt

— Libs of Tik Tok (@Libs of Tik Tok) 1647450797

There's also detailed instruction on how boys can use tape to try to hide their genitals:

1. Carefully remove any hair from the scrotum or surrounding area. This makes pulling the tape off much more comfortable. Also, the tape does not pull hairs as you move around.
2. Tuck the testicles out of the way, using the method above.
3. Wrap toilet paper around the penis and scrotum, if you would like. This helps keep the tape from touching your skin.
4. Gently wrap the penis and scrotum in tape. Pull the penis back, using a piece of tape down the middle or two pieces of tape on either side. The tape holds the penis in the center of your body and pulled back.
5. Finish by putting on a pair of tight-fitting underwear.

The Doernbecher Children's Hospital admits, "Tucking does have some risks."

"These include urinary tract infections, problems with urine flow and twisting or inflammation in the testicles," the guidance states. "If you have any of these problems, stop tucking until you can talk with your doctor."

"Be careful not to wrap the tape around the penis and scrotum too tightly," the children's hospital warns boys. "It can cut off blood circulation. If you feel any numbness in the penis or scrotum area, untuck for a while!"

The Doernbecher Children's Hospital also provides a handout to girls about "chest binding."

"Chest binding is wrapping something around your chest to flatten your breasts," the children's hospital states. "You can do this by wearing a tight-fitting piece of clothing called a 'binder,' or in other ways. Chest binding can help people of any gender feel more comfortable with the way their chest looks and feels."

The guide for chest binding directs girls to the sex toy store to buy clothing to hide their breasts.

The children's hospital offers a handout about puberty blockers for "people with testicles" and "people with ovaries."

"Going through puberty that does not match your gender identity may cause stress and concern," the guidance from the children's hospital asserts. "This can be severe for some people. Taking puberty blockers can stop the process."

"This can give you time to think about making more permanent decisions about your body," the children's hospital says of puberty blockers. "We sometimes say that taking these medications is like 'pushing the pause button on puberty.'"

"If you use puberty blockers early in puberty, you may need less treatment or surgery later," the guide from the children's hospital reads. "For example, if puberty blockers keep your breasts from developing, you would not need surgery to remove them later."

In regard to "when to start taking puberty blockers," the guide recommends that they be taken after puberty begins, which the children's hospital defines as: "For bodies with testicles, this is when your testicles start getting larger and your penis grows" and "for bodies with ovaries, this is when you start to develop breasts."

The children's hospital admits, "Researchers have not finished studying how safe puberty blockers are in the long term. So, there might be some risks that doctors do not yet know about."

The guide warns that puberty blockers can negatively affect bone health, fertility, and mental health.

The children's hospital also supplies instructions for minors to change their name.

The Doernbecher Children's Hospital is part of the Oregon Health & Science University (OHSU) medical network which offers a "Transgender Health Program" that "provides support, information, and advocacy" for "gender-diverse patients of all ages."