“I’m still not sure if the eating disorder is a result of gender dysphoria”: Trans and nonbinary individuals’ descriptions of their eating and body concerns in relation to their gender.

Abstract

Conceptualizations of eating disorders (ED) have primarily been based on the experiences of cisgender women. Yet trans and nonbinary individuals (TNB) may be at greater risk than cisgender individuals to suffer from eating disorders, disordered eating, and body image concerns. The current study takes a phenomenological approach to explore how TNB individuals conceptualize eating and/or body image issues. Qualitative data were obtained from 82 TNB participants who self-reported eating and/or body image concerns. Primary analyses focused on participants’ responses to an open-ended prompt regarding how participants understand the relationships among gender identity, gender expression, and weight and shape control behaviors. Thematic analysis identified five themes: (a) gender dysphoria, (b) puberty, (c) emotion (dys)regulation, (d) gender expression, and (e) recovery/transition. Results indicate various factors salient to gender identity and expression and eating concerns. Findings extend beyond the traditional focus on gender dysphoria by highlighting other important factors for TNB individuals, such as the function ED psychopathology serves (e.g., gender avoidance and self-punishment). This broadens the ED field’s understanding of how gender dysphoria relates to ED psychopathology, rather than focusing solely on the physical body. Distress and associated behaviors related to both gender dysphoria and eating disorder psychopathology may be reciprocal and reinforcing and, as such, should be considered in tandem in treating TNB clients experiencing EDs and body image concerns. This work may better identify ED risk and maintenance within this population and thus optimize prevention and intervention.

Effect of gender identity on the association between gender dysphoria and suicidality via appearance anxiety among transgender and gender-diverse young people: moderated mediation study

“…binary gender expression, such as masculinity or femininity. 43 Such excessive body concerns probably put them at suicide-related risk. 22 Second, a queer theory framework suggests that stereotypical gender expectations in a cultural context can exacerbate young TGD adults' worries about their appearance and may contribute to body dissatisfaction.…”

Transgender and gender diverse consumers on navigating the stigmatized process of gender affirmation in the Central Plains USA

“…In this data set, being an ethnic minority, low on socioeconomic status, overweight or older in age may pose additional challenges to the gender affirmation journey. Research has shown that these identifiers often carry with them their own stigma and otherness and, therefore, can cause additional negative stress for the TGD individual (Garthe et al , 2020; Hernandez, 2020; Lazaro and Bacio, 2021; Lee et al , 2021; Cusack et al , 2022).…”

“…and gender diverse consumers their own stigma and otherness and, therefore, can cause additional negative stress for the TGD individual (Garthe et al, 2020;Hernandez, 2020;Lazaro and Bacio, 2021;Lee et al, 2021;Cusack et al, 2022).…”

Lifetime and daily weight stigma among higher weight sexual minority women: Links to daily weight-based concerns, avoidance, and negative affect.

“…Thus, while the results from our community sample of higher weight SMW provide a helpful starting point, these findings may not necessarily generalize to clinical populations or other sexual and/or gender minority populations. For example, transgender females are likely to have unique experiences at the intersection of weight, body image, and stigma relative to cisfemale SMW (e.g., Cusack et al, 2022), and research investigating weight stigma among gender-expansive and transgender individuals is an important future direction.…”