Transgender and gender diverse (TGD) young adults have elevated risk for disordered eating, unhealthy weight control behaviors, and eating disorders (EDs). Little is known about TGD young adult experiences with ED screening and treatment; this qualitative study aimed to address this gap.

This study used data from eight asynchronous online focus groups, a dynamic online bulletin board method (N = 66). Participants posted responses to moderator-posed questions over a 4-day period. Participants were TGD young adults ages 18–30 years old, were recruited using social media and outreach to community organizations, and resided in 25 US states. We conducted inductive thematic analysis of all focus group excerpts that described experiences with ED screening or treatment (n = 32). Participants were of diverse gender identities (25% transgender woman, 41% transgender man, 28% non-binary, 6% another gender) and racial/ethnic identities (62% White, 13% Latinx, 13% Multiracial, 6% Asian, 6% Black).

Three major themes emerged from the analysis: (1) Barriers to ED screening/treatment; (2) Complexity of the relationship between EDs and gender dysphoria; (3) Need for provider education in gender affirming care practices for ED screening and treatment.

Results indicate an ongoing need for gender affirming care for TGD young adults in ED screening and treatment. Health care systems must address barriers to screening and treatment for TGD young adults, including enhancing understanding of the intersection of gender dysphoria and eating disorders as well as improvements in health care provider training.

跨性别和性别多样化 (TGD) 的年轻人出现饮食失调、不健康的体重控制行为和饮食失调 (ED) 的风险较高。关于 TGD 年轻成人在 ED 筛查和治疗方面的经验知之甚少；这项定性研究旨在解决这一差距。

本研究使用来自八个异步在线焦点小组的数据，一种动态在线公告板方法（N  = 66）。参与者在 4 天内发布了对主持人提出的问题的答复。参与者是 18-30 岁的 TGD 年轻人，他们是通过社交媒体和社区组织外展招募的，居住在美国 25 个州。我们对所有描述 ED 筛查或治疗经验的焦点小组摘录进行了归纳主题分析 ( n  = 32)。参与者具有不同的性别认同（25% 跨性别女性，41% 跨性别男性，28% 非二元性别，6% 其他性别）和种族/民族认同（62% 白人，13% 拉丁裔，13% 多种族，6% 亚裔， 6% 黑色）。

分析中出现了三个主要主题：(1) ED 筛查/治疗的障碍；(2) EDs与性别不安之间关系的复杂性；(3) 需要在 ED 筛查和治疗的性别肯定护理实践方面对提供者进行教育。

结果表明在 ED 筛查和治疗中持续需要对 TGD 年轻人进行性别肯定护理。医疗保健系统必须解决筛查和治疗 TGD 年轻人的障碍，包括加强对性别不安和饮食失调的交叉点的理解，以及改进医疗保健提供者培训。