Objective

Research examining the prevalence and severity of eating-related psychopathology in transgender and gender nonbinary individuals is limited. This study examined how identity development and minority stress relate to the presence of disordered eating behaviors and cognitions in transgender and gender nonbinary individuals, and improvement at one-year follow-up.

Methods

Data come from a multi-site, longitudinal study of transgender and gender nonbinary individuals (n = 287) and includes assessment of transgender congruence, receipt of gender-affirming care, minority stress, and disordered eating symptoms. Hierarchical multivariable logistic regression was used to test for associations between identity development, minority stress, and eating-related psychopathology.

Results

Eighty-three participants (28.9%) met criteria for current eating-related psychopathology. Loss of control eating was the most commonly endorsed behavior, followed by laxative, diuretic, or other medication use, and compulsive exercise. Higher transgender congruence was associated with lower odds of disordered eating symptoms (OR = 0.72, 95% CI 0.55–0.94), whereas increased internalized transphobia was associated with greater odds of disordered eating symptoms (OR = 1.41, 95% CI = 1.04–1.91). Participants with eating-related psychopathology had greater odds of having received gender-affirming psychotherapy in the year prior to assessment (OR = 2.33, 95% CI = 1.32–4.14).

Conclusions

Results suggest that gender identity development and internalized transphobia are associated with eating-related psychopathology in transgender and gender nonbinary individuals. Mental health providers should consider assessing all transgender and gender nonbinary individuals for eating-related psychopathology and unique risk factors associated with disordered eating, including low transgender congruence and internalized transphobia.

中文翻译：

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跨性别和非二元性别个体饮食相关精神病理学的预测因子

客观的

研究跨性别和非二元性别个体中与饮食相关的精神病理学的患病率和严重程度是有限的。本研究探讨了身份发展和少数族裔压力如何与跨性别和非二元性别个体的饮食行为和认知障碍以及一年随访的改善相关。

方法

数据来自对跨性别和非二元性别个体 ( n  = 287) 的多站点纵向研究，包括对跨性别一致性、接受性别肯定护理、少数压力和饮食失调症状的评估。分层多变量逻辑回归用于测试身份发展、少数族裔压力和与饮食相关的精神病理学之间的关联。

结果

83 名参与者 (28.9%) 符合当前饮食相关精神病理学的标准。饮食失控是最常见的行为，其次是泻药、利尿剂或其他药物的使用，以及强迫性运动。较高的跨性别一致性与较低的饮食失调症状的几率相关（OR = 0.72, 95% CI 0.55-0.94），而内化的跨性别恐惧症的增加与较高的饮食失调症状的几率相关（OR = 1.41, 95% CI = 1.04-1.91 ）。患有与饮食相关的精神病理学的参与者在评估前一年接受性别肯定心理治疗的几率更大（OR = 2.33, 95% CI = 1.32-4.14）。

结论

结果表明，性别认同的发展和内化的跨性别恐惧症与跨性别和非二元性别个体的饮食相关精神病理学有关。心理健康提供者应考虑评估所有跨性别和非二元性别个体的饮食相关精神病理学和与饮食失调相关的独特风险因素，包括跨性别一致性低和内化的跨性别恐惧症。