Purpose: The purpose of this study was to describe the prevalence of and relationships among disordered eating, food insecurity, and weight status among transgender and gender nonbinary youth and young adults. Methods: This cross-sectional study involved a screening protocol to assess disordered eating and food insecurity risk from September to December of 2019 at a gender clinic using five validated measures: (1) previous eating disorder diagnosis (yes/no); (2) Sick, Control, One Stone, Fat, Food Questionnaire (SCOFF); (3) Adolescent Binge Eating Disorder Questionnaire (ADO-BED); (4) Nine-Item Avoidant/Restrictive Food Intake Disorder Screen (NIAS); and (5) Hunger Vital Sign. Age, assigned sex at birth, gender identity, stage of medical transition, and body mass index were collected. Pearson's r correlation coefficients, between-groups t-tests, one-way analysis of variance tests, and Tukey's honest significant difference test were used to characterize the relationships between variables. Results: A total of 164 participants ages 12-23 years completed the screener. Using assigned sex at birth, 1.8% were underweight, 53% were a healthy weight, 17.1% were overweight, and 28.0% were obese. An estimated 8.7% reported a previous eating disorder diagnosis, 28.0% screened positive on the SCOFF, 9.1% on the ADO-BED, 75.0% on the NIAS, and 21.2% on the Hunger Vital Sign. Transgender males scored higher on the NIAS than transgender females ( p = 0.03). Those with a previous eating disorder diagnosis scored significantly higher on the Hunger Vital Sign ( p < 0.05). Conclusion: Gender clinics should routinely screen for disordered eating, food insecurity, overweight, and obesity to identify patients in need of further evaluation and referral.
No guidelines exist regarding nutrition assessment for transgender or gender non-conforming patients. Multiple nutrition assessment methods utilize gender-specific values that provide distinct recommendations for males and females. This clinical case series depicts the food and nutrition considerations of ten adult transgender men using anthropometric, survey, and dietary recall data. Male reference values were used to analyze patient data, though multiple approaches to nutrition assessment in the transgender population are discussed. Major nutrition-related concerns were obesity, low fruit and vegetable intake and high sodium intake; disordered eating was not a prominent concern. Further research is needed to inform nutrition care for the transgender and gender nonconforming populations.
The Continuing Professional Education (CPE) quiz for this article is available for free to Academy members through the MyCDRGo app (available for iOS and Android devices) and through www. jandonline.org (click on "CPE" in the menu and then "Academy Journal CPE Articles"). Log in with your Academy of Nutrition and Dietetics or Commission on Dietetic Registration username and password, click "Journal Article Quiz" on the next page, then click the "Additional Journal CPE quizzes" button to view a list of available quizzes. Non-members may take CPE quizzes by sending a request to journal@ eatright.org. There is a fee of $45 per quiz (includes quiz and copy of article) for non-member Journal CPE. CPE quizzes are valid for 1 year after the issue date in which the articles are published.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.