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Kamody RC, Yonkers K, Pluhar EI, Olezeski CL. Disordered Eating Among Trans-Masculine Youth: Considerations Through a Developmental Lens. LGBT Health 2020; 7:170-173. [PMID: 32380892 DOI: 10.1089/lgbt.2019.0354] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
As with male populations more generally, eating disorder symptom expression among trans-masculine youth is understudied. Gender minority individuals are at increased risk for eating disorders; however, culturally responsive and developmentally tailored research is limited. Although all gender minority individuals may experience elevated risk for developing eating disorders, the focus of this article is trans-masculine youth. We provide a theoretical conceptualization of eating disorder symptom expression among this understudied group, and propose novel directions for research, particularly for youth at pubertal onset. Adolescence as a critical developmental period for intervention is highlighted.
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Affiliation(s)
- Rebecca C Kamody
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.,Yale Medicine Pediatric Gender Program, Yale New Haven Hospital, New Haven, Connecticut, USA
| | - Kimberly Yonkers
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.,Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA
| | - Emily I Pluhar
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Christy L Olezeski
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.,Yale Medicine Pediatric Gender Program, Yale New Haven Hospital, New Haven, Connecticut, USA
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52
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Community norms for the Eating Disorder Examination Questionnaire (EDE-Q) among transgender men and women. Eat Behav 2020; 37:101381. [PMID: 32416588 PMCID: PMC7447532 DOI: 10.1016/j.eatbeh.2020.101381] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 03/24/2020] [Accepted: 03/24/2020] [Indexed: 11/21/2022]
Abstract
Transgender men and women may be at risk for eating disorders, but prior community norms of the Eating Disorders Examination Questionnaire (EDE-Q) are based on presumed cisgender men and woman and have not intentionally included transgender people. The objective of this study was to develop community norms for eating disorder attitudes and disordered eating behaviors in transgender men and women using the EDE-Q. Participants were 312 transgender men and 172 transgender women participants in The PRIDE Study, an existing cohort study of sexual and gender minority people. We present mean scores, standard deviations, and percentile ranks for the Global score and four subscale scores of the EDE-Q in transgender men and women. Transgender men and women reported any occurrence (≥1/week) of dietary restraint (25.0% and 27.9%), objective binge episodes (11.2% and 12.8%), excessive exercise (8.0% and 8.1%), self-induced vomiting (1.6% and 1.7%), and laxative misuse (.3% and .6%), respectively. Compared to a prior study of presumed cisgender men 18-26 years (Lavender, De Young, & Anderson, 2010), our age-matched subsample of transgender men reported lower rates of objective binge episodes and excessive exercise. Compared to a prior study of presumed cisgender women 18-42 years (Mond, Hay, Rodgers, & Owen, 2006), we found that an age-matched sample of transgender women reported higher rates of dietary restraint but lower rates of excessive exercise. These norms should aid clinicians in applying and researchers in investigating and interpreting the EDE-Q scores of transgender men and women.
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Teti M, Bauerband LA, Rolbiecki A, Young C. Physical activity and body image: Intertwined health priorities identified by transmasculine young people in a non-metropolitan area. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2020; 21:209-219. [PMID: 33015670 PMCID: PMC7430460 DOI: 10.1080/26895269.2020.1719950] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Background: A dearth of research exists about the health behaviors of transgender young people (TYP). As we seek to learn more about transgender (trans) health, community-based participatory research (CBPR) approaches are crucial for incorporating TYP's needs into the formulation of research questions and development of health behavior programing. Aim: Explore body image and exercise as priorities among TYP. Methods: Trans masculine young adults (N = 16) in a small city in the Midwest took part in semi-structured interviews about their health behaviors and priorities. Theme analysis was used to capture key patterns in participants' responses. Specific analysis steps included initial and more specific coding, analytical memos, organizational matrices and reports, and discussion about results with participants. Results: Participants identified exercise and body image as connected primary health concerns. They discussed these issues in terms of three themes: Body shape as motivation for exercise; Poor body image, stigma and fear as exercise barriers, and; Exercise or lack of, as destructive. Participants wanted to exercise to achieve a certain body shape, not for health or as stress relief. They cited gyms as unwelcoming, however. They also worried about discrimination and did not feel sufficiently comfortable with their bodies to exercise. When they could not exercise, they used harmful behaviors, like restricted eating, to achieve a specific male shape. Conclusions: Using participatory methods allowed us to understand the priorities of a group of Transmasculine young people. Our findings suggest that it is important to continue to explore TYP's body-related motivations for exercise and understand the balance between exercise as a positive health behavior, and a potentially harmful one, in light of TYP's complex body image concerns. Trans friendly gyms and gym policies could promote safe exercise and continued anti trans discrimination work and policy advocacy can promote the safety of TYP in all spaces.
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Affiliation(s)
- Michelle Teti
- Department of Health Sciences, University of Missouri, Columbia, Missouri, USA
| | - L. A. Bauerband
- Department of Health Sciences, University of Missouri, Columbia, Missouri, USA
| | | | - Cole Young
- Department of Health Sciences, University of Missouri, Columbia, Missouri, USA
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54
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Pistella J, Ioverno S, Rodgers MA, Russell ST. The contribution of school safety to weight-related health behaviors for transgender youth. J Adolesc 2020; 78:33-42. [DOI: 10.1016/j.adolescence.2019.12.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 11/26/2019] [Accepted: 12/01/2019] [Indexed: 10/25/2022]
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55
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Lee H, Tomita KK, Habarth JM, Operario D, Yi H, Choo S, Kim SS. Internalized transphobia and mental health among transgender adults: A nationwide cross-sectional survey in South Korea. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2020; 21:182-193. [PMID: 33015668 PMCID: PMC7430457 DOI: 10.1080/26895269.2020.1745113] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Introduction: Transgender people are stigmatized in South Korea (hereafter Korea), where cultural expectations of a biologically-based, binary sex and gender system present fundamental challenges to those whose gender identity does not align with their birth-assigned sex. A growing international body of literature implicates gender minority stress as a key contributor to transgender mental health disparities, but little research has been conducted on this topic in Korea. As in other cultural settings, depression and suicidality are urgent public health concerns for transgender people in Korea, primarily for those who have not initiated gender affirming medical treatment (GAMT), such as cross-sex hormone therapy. In the current study, an international and interdisciplinary team of authors apply the lens of gender minority stress to elucidate the relationships between a key facet of gender minority stress, internalized transphobia (ITP), and outcomes of depressive symptoms and suicidality. Methods: Based on a cross-sectional survey of 207 Korean transgender adults, the current study evaluates the relationships between ITP and depressive symptoms, suicidal ideation, and suicide attempts. ITP was measured with an eight-item, Korean-language questionnaire adapted from the Gender Minority Stress and Resilience Measure through a translation and back-translation process. Results: Korean trans women and trans men mean (mean age = 26.4) were included in the analysis, most of whom had at least one experience of any GAMT. The findings of this study show that Korean transgender adults face similar public health concerns such as high prevalence of depressive symptoms, suicidal ideation, and suicide attempts. As predicted, ITP was significantly related to depressive symptoms, suicidal ideation, and suicide attempts. Conclusion: The authors suggest potential clinical, policy, and research applications, including institutional interventions, to address structural and cultural barriers to optimal mental health and GAMT as well as mental health interventions to reduce Korean transgender people's internalized negative beliefs about their gender identity.
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Affiliation(s)
- Hyemin Lee
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
| | - Kevin K. Tomita
- Counseling and Student Development Center, University of Hawai'i at Mānoa, Honolulu, HI, USA
| | | | - Don Operario
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Horim Yi
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
| | - Sungsub Choo
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
| | - Seung-Sup Kim
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- CONTACT Seung-Sup Kim Department of Public Health Sciences, Graduate School of Korea University, Anam-ro 145, Seongbuk-gu, Seoul 02841, Republic of Korea.
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56
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Parker LL, Harriger JA. Eating disorders and disordered eating behaviors in the LGBT population: a review of the literature. J Eat Disord 2020; 8:51. [PMID: 33088566 PMCID: PMC7566158 DOI: 10.1186/s40337-020-00327-y] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 09/22/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND According to past research, lesbian, gay, bisexual, and transgender (LGBT) individuals experience a higher prevalence of psychopathology, which is attributable to the increased stress (i.e., stigma and prejudice) that they experience, as detailed by the minority stress model (MSM). MAIN This current literature review examined the empirical literature regarding the rates and types of, and risk factors for eating disorders and disordered eating behaviors in LGBT adults and adolescents, in addition to each individual subgroup (i.e., lesbians, gay males, bisexuals, transgender and gender-nonconforming individuals). CONCLUSION LGBT adults and adolescents experience greater incidence of eating disorders and disordered eating behaviors than their heterosexual and cisgender counterparts. Additionally, gay, bisexual, and transgender adults and adolescents were all at increased risk for eating disorders and disordered eating behaviors. Mixed results were found for lesbian adults and adolescents. Results are discussed within the framework of the MSM.
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Affiliation(s)
- Lacie L Parker
- Department of Psychology, Loma Linda University, 11130 Anderson Street, Suite 106, Loma Linda, CA 92350 USA
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57
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Mofradidoost R, Abolghasemi A. Body Image Concern and Gender Identities between Transgender and Cisgender Persons from Iran. JOURNAL OF SEX & MARITAL THERAPY 2019; 46:260-268. [PMID: 31690230 DOI: 10.1080/0092623x.2019.1683665] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The aim was to compare body image concern and gender identities between post-operative transgender and cisgender persons. Participants included 48 transgender persons (25 trans men, 23 trans women) and 48 cisgender persons (24 cismen, 24 ciswomen). The data were collected with Littleton's Body Image Concern Inventory and the Singapore Androgyny Inventory. Results showed that body image concern was significantly higher in transgender participants compared to cisgender participants, and these scores were especially higher in trans women compared to other groups. Furthermore, trans women scored higher in the femininity subscale compared to ciswomen. Body image concern was also higher in participants with feminine gender identity compared to participants with masculine gender identity (whether they were transgender or not). Moreover, transgender persons with traditional gender identity had higher scores in body image concern in comparison to those who had nontraditional identities, as well as trans men had more Androgynous or undifferentiated identities than trans women. We also found a significant correlation between feminine subscale and body image concern. Based on our results, it seems hormonal and surgical treatments in transgender persons only can eliminate body dissatisfaction to a certain extent. The higher scores of trans women, both in body image concern and femininity, indicate that it may be harder for trans women to believe they are perceived as female by others and their bodies are adequate. Changing cultural beliefs, social values, and increasing social acceptance with the help of the media may play an important role in improving body image in the future.
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Affiliation(s)
| | - Abbas Abolghasemi
- Professor Department of Psychology, University of Guilan, Rasht, Iran
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58
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Witcomb GL, Claes L, Bouman WP, Nixon E, Motmans J, Arcelus J. Experiences and Psychological Wellbeing Outcomes Associated with Bullying in Treatment-Seeking Transgender and Gender-Diverse Youth. LGBT Health 2019; 6:216-226. [DOI: 10.1089/lgbt.2018.0179] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Gemma L. Witcomb
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | | | - Elena Nixon
- Faculty of Medicine and Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Joz Motmans
- Centre for Sexology and Gender, Ghent University Hospital, Ghent, Belgium
| | - Jon Arcelus
- The Nottingham Centre for Transgender Health, Nottingham, United Kingdom
- Faculty of Medicine and Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
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59
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Dharma C, Scheim AI, Bauer GR. Exploratory Factor Analysis of Two Sexual Health Scales for Transgender People: Trans-Specific Condom/Barrier Negotiation Self-Efficacy (T-Barrier) and Trans-Specific Sexual Body Image Worries (T-Worries). ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:1563-1572. [PMID: 31172396 DOI: 10.1007/s10508-018-1383-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 12/14/2018] [Accepted: 12/15/2018] [Indexed: 05/28/2023]
Abstract
Few sexual health measures have been validated for transgender (trans) populations. Condom/barrier self-efficacy and sexual body image worries are interrelated constructs that may contribute to enhanced and poor sexual health, respectively. We report on the development and initial validation of trans-specific scales designed to measure these constructs. Trans people in Ontario, Canada, who had ever had sex completed these scales as a part of a larger Trans PULSE survey (n = 323). Using exploratory factor analysis, a one-factor solution fit the 8-item Condom/Barrier Negotiation Self-Efficacy Scale (T-Barrier). Two factors were identified for the 7-item Sexual Body Image Worries Scale (T-Worries): "general body image worries" and "trans-related image worries," while two items were recommended for deletion. The scales demonstrated convergent validity with measures such as self-esteem, sexual anxiety, sexual satisfaction, sexual fear, and experiences of transphobia. Further evaluation to confirm these structures within an independent trans sample would be valuable. We recommend the use of these scales for studies of sexual health within trans populations, to enhance our ability to better understand and promote sexual health within trans communities.
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Affiliation(s)
- Christoffer Dharma
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, N6A 5C1, Canada
| | - Ayden I Scheim
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, N6A 5C1, Canada
| | - Greta R Bauer
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, N6A 5C1, Canada.
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60
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Ristori J, Fisher AD, Castellini G, Sensi C, Cipriani A, Ricca V, Maggi M. Gender Dysphoria and Anorexia Nervosa Symptoms in Two Adolescents. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:1625-1631. [PMID: 30815831 DOI: 10.1007/s10508-019-1396-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 01/05/2019] [Accepted: 01/07/2019] [Indexed: 05/28/2023]
Abstract
The co-occurrence of gender dysphoria and anorexia nervosa has been described in the scientific literature. This paper presents two adolescents with gender dysphoria and pathological eating behaviors and questions with longitudinal observations the clinical meaning of anorexia nervosa symptoms (e.g., restricting eating behaviors and fear of gaining weight) in adolescents with gender dysphoria. Both received psychological evaluations at different times: at first admission to the gender dysphoria clinic (T0) and 6 months after starting treatment with gonadotropin-releasing analogues (GnRHa; T1). In both cases, treatment with GnRHa not only improved psychological functioning, but also resolved pathological eating behaviors. In fact, both adolescents reported quick restoring of healthy food habits with restricting eating behaviors as well as intensive exercise no longer needed after treatment with GnRHa. Therefore, pathological eating behaviors (e.g., food avoidance and weight loss) could be assessed as a dysfunctional coping strategy adopted to gain control over a body developing in an unwanted direction and to block irreversible physical pubertal changes. This psychopathological conceptualization of pathological eating behaviors in adolescents with gender dysphoria stresses the importance of providing, in selected cases, early medical intervention such as pubertal suppression with GnRHa. Mental health professionals should therefore perform a specific and detailed assessment on gender identity within the evaluation of apparent eating disorders in adolescents. Restrictive eating behaviors as well as the intense fear of gaining weight or of becoming fat may, in fact, be considered secondary to a gender dysphoria diagnosis instead of anorexia nervosa symptoms.
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Affiliation(s)
- Jiska Ristori
- Sexual Medicine and Andrology Unit, Department of Experimental, Clinical, and Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy
| | - Alessandra D Fisher
- Sexual Medicine and Andrology Unit, Department of Experimental, Clinical, and Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy
| | - Giovanni Castellini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Carolina Sensi
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Agnese Cipriani
- Sexual Medicine and Andrology Unit, Department of Experimental, Clinical, and Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy
| | - Valdo Ricca
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Mario Maggi
- Sexual Medicine and Andrology Unit, Department of Experimental, Clinical, and Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy.
- Endocrinology Unit, Department of Experimental, Clinical, and Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy.
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61
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Jones BA, Pierre Bouman W, Haycraft E, Arcelus J. Gender congruence and body satisfaction in nonbinary transgender people: A case control study. INT J TRANSGENDERISM 2019; 20:263-274. [PMID: 32999612 PMCID: PMC6830978 DOI: 10.1080/15532739.2018.1538840] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Binary transgender people access gender affirming medical interventions to alleviate gender incongruence and increase body satisfaction. Despite the increase in nonbinary transgender people, this population are less likely to access transgender health services compared to binary transgender people. No research has yet understood why by exploring levels of gender congruence and body satisfaction in nonbinary transgender people. Objective: The aim of this study was to compare levels of gender congruence and body satisfaction in nonbinary transgender people to controls [binary transgender people and cisgender (nontrans) people]. Method: In total, 526 people from a community sample in the UK took part in the study (97 nonbinary, 91 binary, and 338 cisgender identifying people). Participants were asked to complete an online survey about gender congruence and body satisfaction. Results: There were differences in gender congruence and body satisfaction between nonbinary and binary transgender people. On sex-specific parts of the body (i.e., chest, genitalia, and secondary sex characteristics), nonbinary transgender people reported significantly higher levels of gender and body satisfaction compared to binary transgender people. However, there was no difference in congruence and satisfaction with social gender role between the two transgender groups (nonbinary and binary). Cisgender people reported significantly higher levels of gender congruence and body satisfaction compared to transgender people (nonbinary and binary). Conclusions: There are differences in gender congruence and body satisfaction between nonbinary and binary transgender people. Nonbinary individuals may be less likely to access transgender health services due to experiencing less gender incongruence and more body satisfaction compared to binary transgender people. Transgender health services need to be more inclusive of nonbinary transgender people and their support and treatment needs, which may differ from those who identify within the binary gender system.
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Affiliation(s)
- Bethany A. Jones
- Nottingham Centre for Transgender Health, Nottingham, UK
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK
| | | | - Emma Haycraft
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK
| | - Jon Arcelus
- Nottingham Centre for Transgender Health, Nottingham, UK
- Division of Psychiatry and Applied Psychology, Faculty of Medicine & Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
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Goldhammer HB, Maston ED, Keuroghlian AS. Addressing Eating Disorders and Body Dissatisfaction in Sexual and Gender Minority Youth. Am J Prev Med 2019; 56:318-322. [PMID: 30554976 DOI: 10.1016/j.amepre.2018.09.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 09/19/2018] [Accepted: 09/20/2018] [Indexed: 11/16/2022]
Affiliation(s)
- Hilary B Goldhammer
- National LGBT Health Education Center at The Fenway Institute, Fenway Health, Boston, Massachusetts
| | - Essence D Maston
- National LGBT Health Education Center at The Fenway Institute, Fenway Health, Boston, Massachusetts
| | - Alex S Keuroghlian
- National LGBT Health Education Center at The Fenway Institute, Fenway Health, Boston, Massachusetts; Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
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63
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Komarnicky T, Skakoon-Sparling S, Milhausen RR, Breuer R. Genital Self-Image: Associations with Other Domains of Body Image and Sexual Response. JOURNAL OF SEX & MARITAL THERAPY 2019; 45:524-537. [PMID: 30836857 DOI: 10.1080/0092623x.2019.1586018] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Genital self-image is an emerging aspect of body image relevant to sexual functioning and sexual satisfaction. The aims of the present study were to (1) examine the association between body image and genital self-image with a broad range of sexuality-related outcomes; (2) explore whether genital self-image is a more salient influence on sexual satisfaction and functioning than body image and (3) determine whether this would hold true for both men and women. The analytic sample (6,228 cis-gendered, heterosexual men and women between the ages of 18 and 40) was recruited from reddit.com online communities. Participants completed a survey that assessed genital self-image, body image, sexual satisfaction, and sexual functioning. Among women and men, positive genital self-image was associated with positive feelings about one's body overall and reduced body-related concerns specific to sexual encounters (e.g., sexual performance). In female respondents, as genital self-image increased, so did sexual satisfaction. Although genital self-image did not significantly predict sexual satisfaction among men, exploratory analysis indicated a mediating relationship with body image concerns. Findings from the current study may inform interventions to facilitate the development of a healthy sexual self-concept as well as a more positive outlook on genital appearance among men and women.
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Affiliation(s)
- Tina Komarnicky
- a Department of Family Relations and Applied Nutrition , University of Guelph , Guelph , Ontario , Canada
| | - Shayna Skakoon-Sparling
- a Department of Family Relations and Applied Nutrition , University of Guelph , Guelph , Ontario , Canada
| | - Robin R Milhausen
- b University of Guelph , Family Relations and Applied Nutrition, Macdonald Institute , Guelph , Ontario , Canada
| | - Rebecca Breuer
- a Department of Family Relations and Applied Nutrition , University of Guelph , Guelph , Ontario , Canada
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64
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Brocksmith VM, Alradadi RS, Chen M, Eugster EA. Baseline characteristics of gender dysphoric youth. J Pediatr Endocrinol Metab 2018; 31:1367-1369. [PMID: 30433874 DOI: 10.1515/jpem-2018-0250] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 10/22/2018] [Indexed: 01/06/2023]
Abstract
Background Limited information is available regarding baseline characteristics of children and adolescents with gender dysphoria (GD). The purpose of this retrospective study was to describe baseline characteristics of pediatric patients referred for GD. Methods A retrospective chart review of pediatric patients with GD referred to the pediatric endocrine clinic between 2002 and 2017 was conducted. Body mass index (BMI) percentiles and z-scores were calculated based on height and weight at the initial visit. Results Seventy-eight patients aged 14.9±2.37 years were identified. Of these, affirmed gender was more often male than female (63% vs. 37%, p=0.024). Although no difference was seen in average BMI z-scores between female to male (FTM) and male to female (MTF) patients, approximately 50% were overweight or obese. A higher incidence of anxiety was present in FTM compared with MTF youth (p=0.05). Fifty-six patients were referred in January 2014 or later, of whom 27% had a history of early expression of GD compared with 55% of those seen prior to 2014 (p=0.061). Conclusions The high prevalence of overweight in TG youth at baseline represents a potential risk for adverse health consequences. There appears to be a change in the age of first manifestation of GD over time.
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Affiliation(s)
- Victoria M Brocksmith
- University of Wisconsin - Madison, American Family Children's Hospital, Department of Pediatrics, 600 Highland Avenue H4/455 CSC, Madison, WI 53792, USA
| | - Rasha S Alradadi
- Riley Hospital for Children, Department of Pediatric Endocrinology, Indianapolis, IN, USA
| | - Melinda Chen
- Children's Hospital and Medical Center, Department of Pediatric Endocrinology, Omaha, NE, USA
| | - Erica A Eugster
- Riley Hospital for Children, Department of Pediatric Endocrinology, Indianapolis, IN, USA
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Becker I, Auer M, Barkmann C, Fuss J, Möller B, Nieder TO, Fahrenkrug S, Hildebrandt T, Richter-Appelt H. A Cross-Sectional Multicenter Study of Multidimensional Body Image in Adolescents and Adults with Gender Dysphoria Before and After Transition-Related Medical Interventions. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:2335-2347. [PMID: 30088234 DOI: 10.1007/s10508-018-1278-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 03/15/2018] [Accepted: 07/15/2018] [Indexed: 05/28/2023]
Abstract
Persistent feelings of gender dysphoria (GD) are accompanied by distress and body dissatisfaction in most clinically referred adolescents and adults. Transition-related medical interventions (e.g., puberty suppression, hormones, or surgery) may alleviate body dissatisfaction. The aim of the present cross-sectional study was to compare multidimensional body image across clinically referred adolescents and adults undergoing different transition-related medical interventions. Two clinical samples of adolescents (n = 82) and adults (n = 120) referred to specialized departments of four different transgender health services in Germany participated in the study. In total, 202 individuals from the female-to-male (FtM individuals) and male-to-female (MtF individuals) spectrum aged 14-74 years were included at different stages of their transition. Four scales assessing multidimensional aspects of body image (measured by the Body Image Assessment Questionnaire, FBeK) were compared across three groups: sample, gender, and medical interventions (while controlling for age and treatment duration). The results indicated less favorable body image scores compared with the norm in both adolescents and adults with GD. Individuals who had undergone transition-related medical interventions presented a significantly better body image on two of the four scales. Differences according to gender and age were also present. These findings suggest that medical interventions, especially gender-affirming hormones and surgery, are generally beneficial to the body image in individuals with GD. However, not all of the less favorable outcomes in multidimensional body image were positively influenced by the treatment conditions and may thus benefit from additional integrative counseling before and during transition.
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Affiliation(s)
- Inga Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraße 52, W29, 20246, Hamburg, Germany.
- Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Matthias Auer
- RG Clinical Neuroendocrinology, Max Planck Institute for Psychiatry, Munich, Germany
| | - Claus Barkmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraße 52, W29, 20246, Hamburg, Germany
| | - Johannes Fuss
- Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Birgit Möller
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraße 52, W29, 20246, Hamburg, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Medical Center Münster, Münster, Germany
| | - Timo O Nieder
- Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Saskia Fahrenkrug
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraße 52, W29, 20246, Hamburg, Germany
| | - Thomas Hildebrandt
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Erlangen, Germany
| | - Hertha Richter-Appelt
- Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Turan Ş, Aksoy Poyraz C, Usta Sağlam NG, Demirel ÖF, Haliloğlu Ö, Kadıoğlu P, Duran A. Alterations in Body Uneasiness, Eating Attitudes, and Psychopathology Before and After Cross-Sex Hormonal Treatment in Patients with Female-to-Male Gender Dysphoria. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:2349-2361. [PMID: 29594702 DOI: 10.1007/s10508-018-1189-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 02/28/2018] [Accepted: 03/02/2018] [Indexed: 05/28/2023]
Abstract
Body dissatisfaction plays an important role in the development of psychiatric problems such as eating disorders as well as gender dysphoria (GD). Cross-sex hormonal treatment (CHT) alleviates the dissatisfaction by making various changes in the body. We examined the alteration of body uneasiness, eating attitudes and behaviors, and psychological symptoms longitudinally in Turkish participants with female-to-male gender dysphoria (FtM GD) after CHT. Thirty-seven participants with FtM GD and 40 female controls were asked to complete the Body Uneasiness Test to explore different areas of body-related psychopathology, the Eating Attitudes Test to assess eating disturbances, and the Symptom Checklist-90 Revised to measure psychological state, both before CHT and after 6 months of CHT administration. The baseline mean body weight, BMI scores, body uneasiness scores, and general psychopathological symptoms of participants with FtM GD were significantly higher than female controls, whereas baseline eating attitudes and behaviors were not significantly different. Over time, FtM GD participants' mean body weight and BMI scores increased, body uneasiness and general psychopathological symptoms decreased, and eating attitudes and behaviors had not changed at 24th weeks following CHT administration compared to baseline. CHT may have a positive impact on body uneasiness and general psychopathological symptoms in participants with FtM GD. However, CHT does not have an impact on eating attitudes and behaviors.
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Affiliation(s)
- Şenol Turan
- Department of Psychiatry, Cerrahpaşa School of Medicine, Istanbul University, 34303, Kocamustafapaşa-Fatih/Istanbul, Turkey.
| | - Cana Aksoy Poyraz
- Department of Psychiatry, Cerrahpaşa School of Medicine, Istanbul University, 34303, Kocamustafapaşa-Fatih/Istanbul, Turkey
| | - Nazife Gamze Usta Sağlam
- Department of Psychiatry, Cerrahpaşa School of Medicine, Istanbul University, 34303, Kocamustafapaşa-Fatih/Istanbul, Turkey
| | - Ömer Faruk Demirel
- Department of Psychiatry, Cerrahpaşa School of Medicine, Istanbul University, 34303, Kocamustafapaşa-Fatih/Istanbul, Turkey
| | - Özlem Haliloğlu
- Department of Endocrinology and Metabolism, Cerrahpaşa School of Medicine, Istanbul University, 34303, Kocamustafapaşa-Fatih/Istanbul, Turkey
| | - Pınar Kadıoğlu
- Department of Endocrinology and Metabolism, Cerrahpaşa School of Medicine, Istanbul University, 34303, Kocamustafapaşa-Fatih/Istanbul, Turkey
| | - Alaattin Duran
- Department of Psychiatry, Cerrahpaşa School of Medicine, Istanbul University, 34303, Kocamustafapaşa-Fatih/Istanbul, Turkey
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67
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Nobili A, Glazebrook C, Arcelus J. Quality of life of treatment-seeking transgender adults: A systematic review and meta-analysis. Rev Endocr Metab Disord 2018; 19:199-220. [PMID: 30121881 PMCID: PMC6223813 DOI: 10.1007/s11154-018-9459-y] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The study aims to systematically extract and analyse data about Quality of Life (QoL) in the transgender population. A systematic literature search and meta-analysis were conducted using the MEDLINE, EMBASE, PubMed, and PsycINFO databases, up to July 2017. Only English language quantitative studies, in adults, which reported the means for validated QoL measures were included. Random-effect meta-analysis was adopted to pool data and estimate the 95% Confidence Intervals (CI). From 94 potentially relevant articles, 29 studies were included within the review and data extraction for meta-analysis was available in 14 studies. The majority of the studies were cross-sectional, lacked controls and displayed moderate risk of bias. Findings from the systematic review suggested that transgender people display poor QoL, independent of the domain investigated. Pooling across studies showed that transgender people report poorer mental health QoL compared to the general population (-0.78, 95% CI = -1.08 to -0.48, 14 studies). However, meta-analysis in a subgroup of studies looking at QoL in participants who were exclusively post-CHT found no difference in mental health QoL between groups (-0.42, 95% CI = -1.15 to 0.31; 7 studies). There was insufficient data for a pre-treatment subgroup. Evidence suggests that transgender people have lower QoL than the general population. Some evidence suggests that QoL improves post-treatment. Better quality studies that include clearly defined transgender populations, divided by stage of gender affirming treatment and with appropriate matched control groups are needed to draw firmer conclusions.
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Affiliation(s)
- Anna Nobili
- Institute of Mental Health, Faculty of Medicine & Health Sciences, University of Nottingham, Room B12, B Floor, Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK
- Nottingham National Centre for Transgender Health, Nottingham, UK
| | - Cris Glazebrook
- Institute of Mental Health, Faculty of Medicine & Health Sciences, University of Nottingham, Room B12, B Floor, Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK.
| | - Jon Arcelus
- Institute of Mental Health, Faculty of Medicine & Health Sciences, University of Nottingham, Room B12, B Floor, Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK
- Nottingham National Centre for Transgender Health, Nottingham, UK
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Witcomb GL, Bouman WP, Claes L, Brewin N, Crawford JR, Arcelus J. Levels of depression in transgender people and its predictors: Results of a large matched control study with transgender people accessing clinical services. J Affect Disord 2018; 235:308-315. [PMID: 29665513 DOI: 10.1016/j.jad.2018.02.051] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 01/12/2018] [Accepted: 02/16/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND Depression is a serious disorder which significantly impacts wellbeing and quality of life. Studies exploring mental wellbeing in the transgender population are mostly limited by small, non-homogenous samples and lack of matched controls. This study aimed to address these limitations and explore depression rates in a large sample of transgender people, compared with matched controls from the general population, as well as factors predicting depression in those taking cross-sex hormone treatment (CHT) compared to those not. METHODS Transgender individuals (n = 913) completed a measure of depression, measures which predict psychopathology (self-esteem, victimization, social support, interpersonal problems), and information regarding CHT use. Participants were matched by age and experienced gender with adults from the general population who had completed the measure of depression. RESULTS Individuals were categorized as having no, possible or probable depressive disorder. Transgender individuals not on CHT had a nearly four-fold increased risk of probable depressive disorder, compared to controls. Older age, lower self-esteem, poorer interpersonal function and less social support predicted depressive disorder. Use of CHT was associated with less depression. LIMITATIONS Participants were attending a national gender identity service and therefore represent only a sub-group of transgender people. Due to the cross-sectional design, longitudinal research is required to fully confirm the finding that CHT use reduces depression. CONCLUSION This study confirms that non-treated transgender individuals have an increased risk of a depressive disorder. Interventions offered alongside gender affirming treatment to develop interpersonal skills, increase self-esteem and improve social support may reduce depression and prepare individuals for a more successful transition.
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Affiliation(s)
- Gemma L Witcomb
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Walter Pierre Bouman
- Nottingham Centre for Transgender Health, 12 Broad Street, Nottingham NG1 3AL, United Kingdom.
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
| | - Nicola Brewin
- Nottingham Centre for Transgender Health, 12 Broad Street, Nottingham NG1 3AL, United Kingdom
| | - John R Crawford
- School of Psychology, University of Aberdeen, Aberdeen, United Kingdom
| | - Jon Arcelus
- Nottingham Centre for Transgender Health, 12 Broad Street, Nottingham NG1 3AL, United Kingdom; Institute of Mental Health, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, United Kingdom
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69
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Röder M, Barkmann C, Richter-Appelt H, Schulte-Markwort M, Ravens-Sieberer U, Becker I. Health-related quality of life in transgender adolescents: Associations with body image and emotional and behavioral problems. Int J Transgend 2018. [DOI: 10.1080/15532739.2018.1425649] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Affiliation(s)
- Mieke Röder
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Claus Barkmann
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hertha Richter-Appelt
- Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Schulte-Markwort
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Inga Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Owen-Smith AA, Gerth J, Sineath RC, Barzilay J, Becerra-Culqui TA, Getahun D, Giammattei S, Hunkeler E, Lash TL, Millman A, Nash R, Quinn VP, Robinson B, Roblin D, Sanchez T, Silverberg MJ, Tangpricha V, Valentine C, Winter S, Woodyatt C, Song Y, Goodman M. Association Between Gender Confirmation Treatments and Perceived Gender Congruence, Body Image Satisfaction, and Mental Health in a Cohort of Transgender Individuals. J Sex Med 2018; 15:591-600. [PMID: 29463478 DOI: 10.1016/j.jsxm.2018.01.017] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 01/19/2018] [Accepted: 01/29/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Transgender individuals sometimes seek gender confirmation treatments (GCT), including hormone therapy (HT) and/or surgical change of the chest and genitalia ("top" and "bottom" gender confirmation surgeries). These treatments may ameliorate distress resulting from the incongruence between one's physical appearance and gender identity. AIM The aim was to examine the degree to which individuals' body-gender congruence, body image satisfaction, depression, and anxiety differed by GCT groups in cohorts of transmasculine (TM) and transfeminine (TF) individuals. METHODS The Study of Transition, Outcomes, and Gender is a cohort study of transgender individuals recruited from 3 health plans located in Georgia, Northern California, and Southern California; cohort members were recruited to complete a survey between 2015-2017. Participants were asked about: history of GCT; body-gender congruence; body image satisfaction; depression; and anxiety. Participants were categorized as having received: (1) no GCT to date; (2) HT only; (3) top surgery; (4) partial bottom surgery; and (5) definitive bottom surgery. OUTCOMES Outcomes of interest included body-gender congruence, body image satisfaction, depression, and anxiety. RESULTS Of the 2,136 individuals invited to participate, 697 subjects (33%) completed the survey, including 347 TM and 350 TF individuals. The proportion of participants with low body-gender congruence scores was significantly higher in the "no treatment" group (prevalence ratio [PR] = 3.96, 95% CI 2.72-5.75) compared to the definitive bottom surgery group. The PR for depression comparing participants who reported no treatment relative to those who had definitive surgery was 1.94 (95% CI 1.42-2.66); the corresponding PR for anxiety was 4.33 (95% CI 1.83-10.54). CLINICAL TRANSLATION Withholding or delaying GCT until depression or anxiety have been treated may not be the optimal treatment course given the benefits of reduced levels of distress after undergoing these interventions. CONCLUSIONS Strengths include the well-defined sampling frame, which allowed correcting for non-response, a sample with approximately equal numbers of TF and TM participants, and the ability to combine data on HT and gender confirmation surgeries. Limitations include the cross-sectional design and the fact that participants may not be representative of the transgender population in the United States. Body-gender congruence and body image satisfaction were higher, and depression and anxiety were lower among individuals who had more extensive GCT compared to those who received less treatment or no treatment at all. Owen-Smith AA, Gerth J, Sineath RC, et al. Association Between Gender Confirmation Treatments and Perceived Gender Congruence, Body Image Satisfaction and Mental Health in a Cohort Of Transgender Individuals. J Sex Med 2018;15:591-600.
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Affiliation(s)
- Ashli A Owen-Smith
- Department of Health Management and Policy, School of Public Health, Georgia State University, Atlanta, GA; Center for Clinical and Outcomes Research, Kaiser Permanente Georgia, Atlanta, GA.
| | - Joseph Gerth
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | | | - Joshua Barzilay
- Center for Clinical and Outcomes Research, Kaiser Permanente Georgia, Atlanta, GA
| | - Tracy A Becerra-Culqui
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Darios Getahun
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Shawn Giammattei
- Rockway Institute, Alliant International University, San Francisco, CA
| | - Enid Hunkeler
- Emeritus, Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Timothy L Lash
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Andrea Millman
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Rebecca Nash
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Virginia P Quinn
- Emeritus, Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Brandi Robinson
- Center for Clinical and Outcomes Research, Kaiser Permanente Georgia, Atlanta, GA
| | - Douglas Roblin
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, MD
| | - Travis Sanchez
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | | | - Vin Tangpricha
- School of Medicine, Emory University, Atlanta, GA; Atlanta US Department of Veterans Affairs Medical Center, Atlanta, GA
| | - Cadence Valentine
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Savannah Winter
- Center for Clinical and Outcomes Research, Kaiser Permanente Georgia, Atlanta, GA
| | - Cory Woodyatt
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Yongjia Song
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Michael Goodman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
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Jones BA, Haycraft E, Bouman WP, Brewin N, Claes L, Arcelus J. Risk Factors for Eating Disorder Psychopathology within the Treatment Seeking Transgender Population: The Role of Cross-Sex Hormone Treatment. EUROPEAN EATING DISORDERS REVIEW 2018; 26:120-128. [DOI: 10.1002/erv.2576] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 11/30/2017] [Accepted: 12/04/2017] [Indexed: 11/08/2022]
Affiliation(s)
- Bethany Alice Jones
- Nottingham Centre for Transgender Health; Nottingham UK
- School of Sport, Exercise, and Health Sciences; Loughborough University; UK
| | - Emma Haycraft
- School of Sport, Exercise, and Health Sciences; Loughborough University; UK
| | | | - Nicola Brewin
- Leicestershire Eating Disorder Service, Bennion Centre; Glenfield Hospital; Leicester UK
| | - Laurence Claes
- Faculty of Psychology and Education Sciences; KU Leuven; Leuven Belgium
- Faculty of Medicine and Health Sciences (CAPRI); University of Antwerp; Antwerp Belgium
| | - Jon Arcelus
- Nottingham Centre for Transgender Health; Nottingham UK
- Institute of Mental Health, School of Medicine; University of Nottingham; Nottingham UK
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Schaumberg K, Welch E, Breithaupt L, Hübel C, Baker JH, Munn-Chernoff MA, Yilmaz Z, Ehrlich S, Mustelin L, Ghaderi A, Hardaway AJ, Bulik-Sullivan EC, Hedman AM, Jangmo A, Nilsson IAK, Wiklund C, Yao S, Seidel M, Bulik CM. The Science Behind the Academy for Eating Disorders' Nine Truths About Eating Disorders. EUROPEAN EATING DISORDERS REVIEW 2017; 25:432-450. [PMID: 28967161 PMCID: PMC5711426 DOI: 10.1002/erv.2553] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 08/16/2017] [Accepted: 08/18/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE In 2015, the Academy for Eating Disorders collaborated with international patient, advocacy, and parent organizations to craft the 'Nine Truths About Eating Disorders'. This document has been translated into over 30 languages and has been distributed globally to replace outdated and erroneous stereotypes about eating disorders with factual information. In this paper, we review the state of the science supporting the 'Nine Truths'. METHODS The literature supporting each of the 'Nine Truths' was reviewed, summarized and richly annotated. RESULTS Most of the 'Nine Truths' arise from well-established foundations in the scientific literature. Additional evidence is required to further substantiate some of the assertions in the document. Future investigations are needed in all areas to deepen our understanding of eating disorders, their causes and their treatments. CONCLUSIONS The 'Nine Truths About Eating Disorders' is a guiding document to accelerate global dissemination of accurate and evidence-informed information about eating disorders. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Katherine Schaumberg
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Elisabeth Welch
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Lauren Breithaupt
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, George Mason University, Fairfax, VA, USA
| | - Christopher Hübel
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Jessica H Baker
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Zeynep Yilmaz
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Linda Mustelin
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Public Health and Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
| | - Ata Ghaderi
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Andrew J Hardaway
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Emily C Bulik-Sullivan
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Anna M Hedman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Andreas Jangmo
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ida A K Nilsson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska Hospital, Stockholm, Sweden
| | - Camilla Wiklund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Shuyang Yao
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Maria Seidel
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Peterson CM, Matthews A, Copps-Smith E, Conard LA. Suicidality, Self-Harm, and Body Dissatisfaction in Transgender Adolescents and Emerging Adults with Gender Dysphoria. Suicide Life Threat Behav 2017; 47:475-482. [PMID: 27539381 DOI: 10.1111/sltb.12289] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 06/15/2016] [Indexed: 11/30/2022]
Abstract
Prevalence of suicide attempts, self-injurious behaviors, and associated psychosocial factors were examined in a clinical sample of transgender (TG) adolescents and emerging adults (n = 96). Twenty-seven (30.3%) TG youth reported a history of at least one suicide attempt and 40 (41.8%) reported a history of self-injurious behaviors. There was a higher frequency of suicide attempts in TG youth with a desire for weight change, and more female-to-male youth reported a history of suicide attempts and self-harm behaviors than male-to-female youth. Findings indicate that this population is at a high risk for psychiatric comorbidities and life-threatening behaviors.
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Affiliation(s)
- Claire M Peterson
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Abigail Matthews
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | | | - Lee Ann Conard
- Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Feder S, Isserlin L, Seale E, Hammond N, Norris ML. Exploring the association between eating disorders and gender dysphoria in youth. Eat Disord 2017; 25:310-317. [PMID: 28281883 DOI: 10.1080/10640266.2017.1297112] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study reviews the overlap between eating disorders (EDs) and gender dysphoria (GD) in an adolescent population. A retrospective chart review was conducted on a clinical population presenting for concerns of GD. It was noted that five of the 97 patients had been found to be suffering from an ED at presentation. An additional 10 patients were noted to have ED-related symptoms. Although ED risk was elevated in trans males and females, absolute risk was higher in trans males when compared to population based prevalence rates. Our results suggest that rates of EDs and ED-related symptoms are high in patients presenting with GD, and that standard screening for these symptoms should be considered in both populations at assessment and over the course of treatment.
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Affiliation(s)
- Stephen Feder
- a Division of Adolescent Health, Department of Pediatrics, Children's Hospital of Eastern Ontario , University of Ottawa , Ottawa , Ontario , Canada.,b Children's Hospital of Eastern Ontario Research Institute , Ottawa , Ontario , Canada
| | - Leanna Isserlin
- c Department of Psychiatry, Children's Hospital of Eastern Ontario , University of Ottawa , Ottawa , Ontario , Canada
| | - Emily Seale
- b Children's Hospital of Eastern Ontario Research Institute , Ottawa , Ontario , Canada
| | - Nicole Hammond
- b Children's Hospital of Eastern Ontario Research Institute , Ottawa , Ontario , Canada
| | - Mark L Norris
- a Division of Adolescent Health, Department of Pediatrics, Children's Hospital of Eastern Ontario , University of Ottawa , Ottawa , Ontario , Canada.,b Children's Hospital of Eastern Ontario Research Institute , Ottawa , Ontario , Canada
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Watson RJ, Veale JF, Saewyc EM. Disordered eating behaviors among transgender youth: Probability profiles from risk and protective factors. Int J Eat Disord 2017; 50:515-522. [PMID: 27862124 PMCID: PMC5754211 DOI: 10.1002/eat.22627] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/22/2016] [Indexed: 11/10/2022]
Abstract
PURPOSE Research has documented high rates of disordered eating for lesbian, gay, and bisexual youth, but prevalence and patterns of disordered eating among transgender youth remain unexplored. This is despite unique challenges faced by this group, including gender-related body image and the use of hormones. We explore the relationship between disordered eating and risk and protective factors for transgender youth. METHODS An online survey of 923 transgender youth (aged 14-25) across Canada was conducted, primarily using measures from existing youth health surveys. Analyses were stratified by gender identity and included logistic regressions with probability profiles to illustrate combinations of risk and protective factors for eating disordered behaviors. RESULTS Enacted stigma (the higher rates of harassment and discrimination sexual minority youth experience) was linked to higher odds of reported past year binge eating and fasting or vomiting to lose weight, while protective factors, including family connectedness, school connectedness, caring friends, and social support, were linked to lower odds of past year disordered eating. Youth with the highest levels of enacted stigma and no protective factors had high probabilities of past year eating disordered behaviors. DISCUSSION Our study found high prevalence of disorders. Risk for these behaviors was linked to stigma and violence exposure, but offset by social supports. Health professionals should assess transgender youth for disordered eating behaviors and supportive resources. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:515-522).
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Tolosa-Sola I, Gunnard K, Giménez Muniesa C, Casals L, Grau A, Farré JM. Body dissatisfaction and eating disorder symptomatology: Which factors interfere with sexuality in women with eating disorders? J Health Psychol 2017; 24:1526-1535. [PMID: 28810426 DOI: 10.1177/1359105317695425] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Body dissatisfaction is a relevant aspect in both eating disorders and sexuality. Using Stice's model, this study aimed to evaluate the relationship between these variables in eating disorder patients compared with healthy controls. Statistically significant correlations between body dissatisfaction and sexuality were found in the whole sample. The clinical group had higher rates of body dissatisfaction and sexual impairment. Within the clinical group, the participants with a greater drive for thinness showed higher sexual dysfunctions. These results suggest that sexuality should be systematically explored in eating disorders. Higher rates of drive for thinness may be associated with greater sexual impairment.
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Affiliation(s)
| | | | | | | | - Antoni Grau
- 3 Institut de Trastorns Alimentaris (ITA), Spain
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77
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Guss CE, Williams DN, Reisner SL, Austin SB, Katz-Wise SL. Disordered Weight Management Behaviors, Nonprescription Steroid Use, and Weight Perception in Transgender Youth. J Adolesc Health 2017; 60:17-22. [PMID: 28029539 PMCID: PMC8091135 DOI: 10.1016/j.jadohealth.2016.08.027] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 08/18/2016] [Accepted: 08/19/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE Disordered weight management behaviors are prevalent among youth; recent case reports suggested that these behaviors might also be common in transgender youth. We studied associations of gender identity with disordered weight management behaviors, nonprescription steroid use, and weight perception among transgender and cisgender (nontransgender) high-school students in Massachusetts. METHODS Data were analyzed from the 2013 Massachusetts Youth Health Survey, an anonymous survey in a random sample of Massachusetts public high schools. Respondents were divided into three groups: transgender (n = 67), cisgender male (n = 1,117), and cisgender female (n = 1,289). Fisher's exact tests and multivariable logistic regression models were used to examine unhealthy weight management behaviors in the past 30 days: fasting >24 hours, vomiting, diet pill use, and laxative use; nonprescription steroid use; and self-perceived weight status. Analyses controlled for age, race/ethnicity, and body mass index. RESULTS Compared with cisgender males, transgender adolescents had higher odds of fasting >24 hours (adjusted odds ratio [AOR] = 2.9, confidence interval [CI] = 1.1-7.8), using diet pills (AOR = 8.9, 95% CI = 2.3-35.2) and taking laxatives (AOR = 7.2, 95% CI = 1.4-38.4). Transgender youth had higher odds of lifetime use of steroids without a prescription than male cisgender respondents (AOR = 26.6, 95% CI = 3.5-200.1). Compared with cisgender females, transgender respondents had higher odds of perceiving themselves as healthy weight/underweight when they were overweight/obese (AOR = 2.4, 95% CI = 1.5-4.1). CONCLUSIONS Transgender youth disproportionately self-reported unsafe weight management behaviors and nonprescription steroid use compared with cisgender youth. Clinicians should be aware of this increased risk among transgender youth. Research is needed to further understand these disparities and to inform future interventions.
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Affiliation(s)
- Carly E. Guss
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - David N. Williams
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - Sari L. Reisner
- Division of General Pediatrics, Boston Children’s Hospital, Boston, Massachusetts,Department of Pediatrics, Harvard Medical School, Boston Massachusetts,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - S. Bryn Austin
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts,Department of Pediatrics, Harvard Medical School, Boston Massachusetts,Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston Massachusetts
| | - Sabra L. Katz-Wise
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts,Department of Pediatrics, Harvard Medical School, Boston Massachusetts
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78
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Millet N, Longworth J, Arcelus J. Prevalence of anxiety symptoms and disorders in the transgender population: A systematic review of the literature. Int J Transgend 2016. [DOI: 10.1080/15532739.2016.1258353] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Nessa Millet
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK
| | - Julia Longworth
- Nottinghamshire Healthcare NHS Trust, Nottingham National Centre for Transgender Health, Nottingham, UK
| | - Jon Arcelus
- Nottinghamshire Healthcare NHS Trust, Nottingham National Centre for Transgender Health, Nottingham, UK
- University of Nottingham Faculty of Medicine and Health Sciences, Institute of Mental Health, Nottingham, UK
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79
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Jones BA, Haycraft E, Murjan S, Arcelus J. Body dissatisfaction and disordered eating in trans people: A systematic review of the literature. Int Rev Psychiatry 2016; 28:81-94. [PMID: 26618239 DOI: 10.3109/09540261.2015.1089217] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Body dissatisfaction plays a prominent role in gender dysphoria. In some individuals body dissatisfaction appears to manifest disordered eating in order to suppress bodily features of natal gender and accentuate features of gender identity. To date, there has been no systematic review of the literature pertaining to body dissatisfaction and disordered eating in trans individuals. Such a review may highlight important implications for clinicians working with trans people. Therefore, the aim was to critically and systematically review the available literature examining body dissatisfaction or disordered eating in a trans population, and also the literature pertaining to how body dissatisfaction and disordered eating are related in trans people. This review found three studies that explored disordered eating in trans people, five studies that explored body image and disordered eating in trans people, and 18 studies that explored body image in trans people. The findings from this review suggest that body dissatisfaction is core to the distress trans people experience and that this dissatisfaction may also put some individuals at risk of developing disordered eating. Additionally, the findings appear to suggest that gender dysphoria treatment is successful at increasing body satisfaction and improving body image. The clinical implications are discussed.
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Affiliation(s)
- Bethany Alice Jones
- a Nottingham Centre for Gender Dysphoria , Nottingham , UK ;,b School of Sport, Exercise, and Health Sciences, Loughborough University , Loughborough , UK
| | - Emma Haycraft
- b School of Sport, Exercise, and Health Sciences, Loughborough University , Loughborough , UK
| | - Sarah Murjan
- a Nottingham Centre for Gender Dysphoria , Nottingham , UK
| | - Jon Arcelus
- a Nottingham Centre for Gender Dysphoria , Nottingham , UK ;,b School of Sport, Exercise, and Health Sciences, Loughborough University , Loughborough , UK
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80
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Gordon AR, Austin SB, Krieger N, White Hughto JM, Reisner SL. "I have to constantly prove to myself, to people, that I fit the bill": Perspectives on weight and shape control behaviors among low-income, ethnically diverse young transgender women. Soc Sci Med 2016; 165:141-149. [PMID: 27518756 PMCID: PMC5241136 DOI: 10.1016/j.socscimed.2016.07.038] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 07/22/2016] [Accepted: 07/27/2016] [Indexed: 10/21/2022]
Abstract
The impact of societal femininity ideals on disordered eating behaviors in non-transgender women has been well described, but scant research has explored these processes among transgender women. The present study explored weight and shape control behaviors among low-income, ethnically diverse young transgender women at high risk for HIV or living with HIV in a Northeastern metropolitan area. Semi-structured in-depth interviews were conducted with 21 participants (ages 18-31 years; mean annual income <$10,000; ethnic identity: Multiracial [n = 8], Black [n = 4], Latina [n = 4], White [n = 4], Asian [n = 1]). Interviews were transcribed and double-coded using a template organizing method, guided by ecosocial theory and a gender affirmation framework. Of 21 participants, 16 reported engaging in past-year disordered eating or weight and shape control behaviors, including binge eating, fasting, vomiting, and laxative use. Study participants described using a variety of strategies to address body image concerns in the context of gender-related and other discriminatory experiences, which shaped participants' access to social and material resources as well as stress and coping behaviors. Disordered weight and shape control behaviors were discussed in relation to four emergent themes: (1) gender socialization and the development of femininity ideals, (2) experiences of stigma and discrimination, (3) biological processes, and (4) multi-level sources of strength and resilience. This formative study provides insight into disordered eating and weight and shape control behaviors among at-risk transgender women, illuminating avenues for future research, treatment, and public health intervention.
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Affiliation(s)
- Allegra R Gordon
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
| | - S Bryn Austin
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA; Department of Social & Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Nancy Krieger
- Department of Social & Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Jaclyn M White Hughto
- The Fenway Institute, Fenway Health, Boston, MA, USA; Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Sari L Reisner
- The Fenway Institute, Fenway Health, Boston, MA, USA; Division of General Pediatrics, Boston Children's Hospital, Boston, MA, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
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81
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van de Grift TC, Cohen-Kettenis PT, Elaut E, De Cuypere G, Richter-Appelt H, Haraldsen IR, Kreukels BPC. A network analysis of body satisfaction of people with gender dysphoria. Body Image 2016; 17:184-90. [PMID: 27137814 DOI: 10.1016/j.bodyim.2016.04.002] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 04/12/2016] [Accepted: 04/13/2016] [Indexed: 11/16/2022]
Abstract
In gender dysphoria (GD), much of the experienced distress results from body dissatisfaction. The current study analyzed the configuration of body satisfaction in trans men and women using network analysis. In total, 485 individuals diagnosed with GD from four European countries, applying for medical treatment, filled out the Body Image Scale for Transsexuals. A six-factor model reflecting different body areas was confirmed via confirmatory factor analysis. A further configuration of body satisfaction was modelled using correlation network analysis techniques in R. Genital dissatisfaction showed limited connection with other body areas in comparison to other subscales. Body characteristics influencing social gender recognition were most centrally involved in body (dis)satisfaction in both natal sexes. In trans women these characteristics were related mostly to voice and hair, whereas in trans men these characteristics were related to muscularity and posture. Focusing on these socially influential body characteristics may provide important targets for transgender healthcare.
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Affiliation(s)
- T C van de Grift
- Department of Medical Psychology, Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands; Department of Plastic, Reconstructive & Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - P T Cohen-Kettenis
- Department of Medical Psychology, Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands
| | - E Elaut
- Center of Sexology and Gender, Ghent University Hospital, Ghent, Belgium
| | - G De Cuypere
- Center of Sexology and Gender, Ghent University Hospital, Ghent, Belgium
| | - H Richter-Appelt
- Department of Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - I R Haraldsen
- Department of Neuropsychiatry and Psychosomatic Medicine, Division of Clinical Neuroscience, Rikshospitalet, Oslo, Norway
| | - B P C Kreukels
- Department of Medical Psychology, Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands.
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82
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Bouman WP, Davey A, Meyer C, Witcomb GL, Arcelus J. Predictors of psychological well-being among treatment seeking transgender individuals. SEXUAL AND RELATIONSHIP THERAPY 2016. [DOI: 10.1080/14681994.2016.1184754] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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83
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Bouman WP, Claes L, Marshall E, Pinner GT, Longworth J, Maddox V, Witcomb G, Jimenez-Murcia S, Fernandez-Aranda F, Arcelus J. Sociodemographic Variables, Clinical Features, and the Role of Preassessment Cross-Sex Hormones in Older Trans People. J Sex Med 2016; 13:711-9. [PMID: 26897462 DOI: 10.1016/j.jsxm.2016.01.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 01/06/2016] [Accepted: 01/16/2016] [Indexed: 10/22/2022]
Abstract
INTRODUCTION As referrals to gender identity clinics have increased dramatically over the last few years, no studies focusing on older trans people seeking treatment are available. AIMS The aim of this study was to investigate the sociodemographic and clinical characteristics of older trans people attending a national service and to investigate the influence of cross-sex hormones (CHT) on psychopathology. METHODS Individuals over the age of 50 years old referred to a national gender identity clinic during a 30-month period were invited to complete a battery of questionnaires to measure psychopathology and clinical characteristics. Individuals on cross-sex hormones prior to the assessment were compared with those not on treatment for different variables measuring psychopathology. MAIN OUTCOME MEASURES Sociodemographic and clinical variables and measures of depression and anxiety (Hospital Anxiety and Depression Scale), self-esteem (Rosenberg Self-Esteem Scale), victimization (Experiences of Transphobia Scale), social support (Multidimensional Scale of Perceived Social Support), interpersonal functioning (Inventory of Interpersonal Problems), and nonsuicidal self-injury (Self-Injury Questionnaire). RESULTS The sex ratio of trans females aged 50 years and older compared to trans males was 23.7:1. Trans males were removed for the analysis due to their small number (n = 3). Participants included 71 trans females over the age of 50, of whom the vast majority were white, employed or retired, and divorced and had children. Trans females on CHT who came out as trans and transitioned at an earlier age were significantly less anxious, reported higher levels of self-esteem, and presented with fewer socialization problems. When controlling for socialization problems, differences in levels of anxiety but not self-esteem remained. CONCLUSION The use of cross-sex hormones prior to seeking treatment is widespread among older trans females and appears to be associated with psychological benefits. Existing barriers to access CHT for older trans people may need to be re-examined.
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Affiliation(s)
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
| | - Ellen Marshall
- Nottingham Centre for Gender Dysphoria, Nottingham, United Kingdom; School of Sport, Exercise, and Health Sciences, Loughborough University, United Kingdom
| | - Gill T Pinner
- Division of Psychiatry and Applied Psychology, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Julia Longworth
- Nottingham Centre for Gender Dysphoria, Nottingham, United Kingdom
| | - Victoria Maddox
- Nottingham Centre for Gender Dysphoria, Nottingham, United Kingdom
| | - Gemma Witcomb
- Nottingham Centre for Gender Dysphoria, Nottingham, United Kingdom; School of Sport, Exercise, and Health Sciences, Loughborough University, United Kingdom
| | - Susana Jimenez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), ISCIII, Barcelona, Spain
| | - Fernando Fernandez-Aranda
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), ISCIII, Barcelona, Spain
| | - Jon Arcelus
- Nottingham Centre for Gender Dysphoria, Nottingham, United Kingdom; Division of Psychiatry and Applied Psychology, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, United Kingdom
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84
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Saitz TR, Hannan JL, Marson L, Krychman M, Hartzell-Cushanick R, Bergeron S, Dean J. Survey of the Literature December 2015. Sex Med 2015; 3:227-34. [PMID: 26797055 PMCID: PMC4721028 DOI: 10.1002/sm2.88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Theodore R Saitz
- Department of Urology Oregon Health & Science University Portland OR USA
| | - Johanna L Hannan
- Department of Physiology Brody School of Medicine East Carolina University
| | | | - Michael Krychman
- Southern California Center for Sexual Health and Survivorship Medicine
| | | | - Sophie Bergeron
- Department of Psychology University of Montreal Quebec Canada
| | - John Dean
- Department of Urology Oregon Health & Science University Portland OR USA
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