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Transgend Health. 2018 Jan 1;3(1):17-23. doi: 10.1089/trgh.2017.0043. eCollection 2018.

Beyond the Binary: Differences in Eating Disorder Prevalence by Gender Identity in a Transgender Sample.

Author information

1
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
2
The Fenway Institute, Fenway Health, Boston, Massachusetts.
3
Yale School of Public Health, New Haven, Connecticut.
4
Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts.
5
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
6
Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts.
7
Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.

Abstract

Purpose: To investigate whether the prevalence of eating disorders (EDs) differs across diverse gender identity groups in a transgender sample. Methods: Secondary analysis of data from Project VOICE, a cross-sectional study of stress and health among 452 transgender adults (ages 18-75 years) residing in Massachusetts. Age-adjusted logistic regression models were fit to compare the prevalence of self-reported lifetime EDs in female-to-male (FTM), male-to-female (MTF), and gender-nonconforming participants assigned male at birth (MBGNC) to gender-nonconforming participants assigned female at birth (FBGNC; referent). Results: The age-adjusted odds of self-reported ED in MTF participants were 0.14 times the odds of self-reported ED in FBGNC participants (p=0.022). In FTM participants, the age-adjusted odds of self-reported ED were 0.46 times the odds of self-reported ED in FBGNC participants, a marginally significant finding (p=0.068). No statistically significant differences in ED prevalence were found for MBGNC individuals. Conclusions: Gender nonconforming individuals assigned a female sex at birth appear to have heightened lifetime risk of EDs relative to MTF participants. Further research into specific biologic and psychosocial ED risk factors and gender-responsive intervention strategies are urgently needed. Training clinical providers and ensuring competency of treatment services beyond the gender binary will be vital to addressing this disparity.

KEYWORDS:

eating disorders; gender; mental disorders; transgender

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