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J Adolesc Health. 2015 Aug;57(2):144-9. doi: 10.1016/j.jadohealth.2015.03.003. Epub 2015 Apr 28.

Gender Identity, Sexual Orientation, and Eating-Related Pathology in a National Sample of College Students.

Author information

1
Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.
2
Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri; Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, Missouri.
3
George Warren Brown School of Social Work, Washington University, St. Louis, Missouri.
4
Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri; Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, Missouri; George Warren Brown School of Social Work, Washington University, St. Louis, Missouri. Electronic address: aduncan@wustl.edu.

Abstract

PURPOSE:

This study examined associations of gender identity and sexual orientation with self-reported eating disorder (SR-ED) diagnosis and compensatory behaviors in transgender and cisgender college students.

METHODS:

Data came from 289,024 students from 223 U.S. universities participating in the American College Health Association-National College Health Assessment II (median age, 20 years). Rates of past-year SR-ED diagnosis and past-month use of diet pills and vomiting or laxatives were compared among transgender students (n = 479) and cisgender sexual minority (SM) male (n = 5,977) and female (n = 9,445), unsure male (n = 1,662) and female (n = 3,395), and heterosexual male (n = 91,599) and female (n = 176,467) students using chi-square tests. Logistic regression models were used to estimate the odds of eating-related pathology outcomes after adjusting for covariates.

RESULTS:

Rates of past-year SR-ED diagnosis and past-month use of diet pills and vomiting or laxatives were highest among transgender students and lowest among cisgender heterosexual men. Compared to cisgender heterosexual women, transgender students had greater odds of past-year SR-ED diagnosis (odds ratio [OR], 4.62; 95% confidence interval [CI], 3.41-6.26) and past-month use of diet pills (OR, 2.05; 95% CI, 1.48-2.83) and vomiting or laxatives (OR, 2.46; 95% CI, 1.83-3.30). Although cisgender SM men and unsure men and women also had elevated rates of SR-ED diagnosis than heterosexual women, the magnitudes of these associations were lower than those for transgender individuals (ORs; 1.40-1.54).

CONCLUSIONS:

Transgender and cisgender SM young adults have elevated rates of compensatory behavior and SR-ED diagnosis. Appropriate interventions for these populations are urgently needed.

KEYWORDS:

College students; Compensatory behaviors; Eating disorders; Gender identity; Sexual orientation

PMID:
25937471
PMCID:
PMC4545276
DOI:
10.1016/j.jadohealth.2015.03.003
[Indexed for MEDLINE]
Free PMC Article

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