• Gender-Affirming Items Request Form

    [MASSACHUSETTS RESIDENTS ONLY] Below is a list of gender-affirming items that our center offers. If you prefer to pick up the item at our center, please specify what time and date (at least 2 weeks from your completion of this form) in the "suggestions & comments" box at the bottom of this page. [2 ITEMS ONLY]
  • Please make sure to enter the information for the person whom you are completing this form, including the address they want the items shipped to.

  • Date of Birth*
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  • Item Selection

    Please choose UP TO TWO (2) ITEMS in total.
  • Binders

  • These binders are completely customizable and therefore have more specifications to fill out than the other options listed above. If you choose this option, please contact our center and we will walk you through the process.

  • Binding Tape

  • This warning appeared because you have chosen a selection from "Binding Tape." BINDING WITH CLING WRAP, BANDAGES OR TAPE CAN DAMAGE TISSUE AND BREAK RIBS. If you still want to choose this item, please AGREE to acknowledge you are informed on the possible harms of binding tape and will not hold ELYSARC or Rebel Cause, Inc. accountable if any issues arise from the use of this binding tape. (Please follow the binding instructions that will be inserted into your package).*
  • Boxers and Briefs

  • Packers & STP Devices

  • Pack Gear

  • Makeup and Skincare

  • Wigs/Extensions/Hair

  • Please copy and paste the link with your specifications listed in paranthesis (after the link). Make sure the item you choose is less than $80.00 after tax. 

  • Gaffs and Tucking Underwear/Tape

  • Bra
  • Breast Forms, Bra Inserts and Body "Enhancers"

  • Should be Empty: