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Sánchez Amador L, Becerra Fernández A, Aguilar Vilas MV, Rodríguez Torres R, Alonso Rodríguez MC. Body composition and risk for sarcopenia in transgender women. Nutrition 2024; 123:112398. [PMID: 38521048 DOI: 10.1016/j.nut.2024.112398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/18/2024] [Accepted: 02/13/2024] [Indexed: 03/25/2024]
Abstract
OBJECTIVES Body composition and strength of cisgender (cis) individuals are well established. However, those for transgender women (trans women) undergoing gender-affirming hormone therapy remain unclear. This study aimed to detect possible body composition and strength variations related to sarcopenia. METHODS This was a cross-sectional comparative study of 37 trans women, 34 cis men, and 34 cis women. Body composition was measured in all individuals by bioelectrical impedance analysis; prehensile strength by dynamometry was studied in trans women. RESULTS In this study, trans women had higher body mass index values than cis individuals (P < 0.01). Fat mass was 41% higher for trans women than cis men. Muscle mass (MM) was lower in trans women than cis men (-10%), and higher than cis women (24%). Bone mass was lower in trans women than cis men and higher in cis women (P < 0.01). Trans women's prehensile strengths were 25.26 kg for the right hand and 24.8 kg for the left. Appendicular skeletal muscle mass was 23.63 kg, and appendicular skeletal muscle mass index was 8.14 kg. CONCLUSION Trans women undergoing gender-affirming hormone therapy show a tendency to adapt body compartments to those of cis women with increased fat mass and reduced muscle mass. Prehensile strength in trans women was close to the cutoff points for sarcopenia risk. Nutrition, physical activity, strength, and body composition are important to avoid the possible risk for sarcopenia. More studies along these lines are necessary, especially in older adults.
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Affiliation(s)
- Laura Sánchez Amador
- Food, Nutrition and Public Health Strategies Research Group, University of Alcala, Alcalá de Henares, Madrid, Spain.
| | - Antonio Becerra Fernández
- Food, Nutrition and Public Health Strategies Research Group, University of Alcala, Alcalá de Henares, Madrid, Spain; Department of Biomedical Sciences, Faculty of Pharmacy, University of Alcala, Alcalá de Henares, Madrid, Spain
| | - María Victorina Aguilar Vilas
- Food, Nutrition and Public Health Strategies Research Group, University of Alcala, Alcalá de Henares, Madrid, Spain; Department of Biomedical Sciences, Faculty of Pharmacy, University of Alcala, Alcalá de Henares, Madrid, Spain
| | - Rosa Rodríguez Torres
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcala, Alcalá de Henares, Madrid, Spain
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Fleming J, Grasso C, Mayer KH, Reisner SL, Potter J, Streed CG. Gender-Affirming Hormone Therapy and Cervical Cancer Screening Rates in Transgender Men and Nonbinary People: A Cross-Sectional Study from a Boston Community Health Center. LGBT Health 2024. [PMID: 38669119 DOI: 10.1089/lgbt.2023.0418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024] Open
Abstract
Purpose: Clinical monitoring for patients receiving gender-affirming hormone therapy (GAHT) has the potential to facilitate their receipt of preventive health services. We aimed to determine whether GAHT is associated with increased utilization of cervical cancer screening among transgender men (TM) and nonbinary persons assigned female at birth (NB-AFAB). Methods: We conducted a cross-sectional observational study of a single community health center in Boston. Persons of all gender identities eligible for cervical cancer screening during 2008-2019 were assessed. The outcome of interest was receipt of cervical cancer screening based on U.S. Preventive Services Task Force recommendations. We compared the proportion of persons who received cervical cancer screening by prescription of GAHT. Results: We identified 13,267 eligible persons. This cohort included 10,547 (79.5%) cisgender women, 1547 (11.7%) TM, and 1173 (8.8%) NB-AFAB persons. Among all persons eligible for cervical cancer screening, TM and NB-AFAB persons were less likely to receive screening than cisgender women (56.2% and 56.1% vs. 60.5% respectively; odds ratio [OR] = 0.84; 95% confidence interval [CI] = 0.75-0.93; OR = 0.84; 95% CI = 0.74-0.94, respectively). Among TM, those prescribed testosterone were more likely to receive cervical cancer screening than those not prescribed testosterone (57.9% vs. 48.2%, OR = 1.47; 95% CI = 1.14-1.92). Among NB-AFAB adults, those prescribed testosterone were more likely to receive cervical cancer screening than those not prescribed testosterone (61.9% vs. 51.5%, OR = 1.53; 95% CI = 1.21-1.93). Conclusions: The benefits of engagement in care to access GAHT may extend beyond the hormonal intervention to preventive health services.
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Affiliation(s)
- Julia Fleming
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Chris Grasso
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Kenneth H Mayer
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Sari L Reisner
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Jennifer Potter
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Carl G Streed
- Department of Medicine, Section of General Internal Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
- GenderCare Center, Boston Medical Center, Boston, Massachusetts, USA
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3
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Waters J, Linsenmeyer W. The impact of gender-affirming hormone therapy on nutrition-relevant biochemical measures. Front Nutr 2024; 11:1339311. [PMID: 38646103 PMCID: PMC11026707 DOI: 10.3389/fnut.2024.1339311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 03/21/2024] [Indexed: 04/23/2024] Open
Abstract
Gender-affirming hormone therapy carries the potential risk for shifts in biochemical markers that may impact cardiometabolic, hematologic, hepatic, and renal health. The critical evaluation of biochemical data is an integral part of a comprehensive nutrition assessment; therefore, nutrition professionals should be aware of shifts that are expected during the course of masculinizing and feminizing hormone therapy. Changes in important biochemical values along with binary sex-specific standards for interpreting laboratory data can pose significant challenges for nutrition professionals working with transgender and gender-diverse patients who receive gender-affirming hormone therapy. Overall, research on the biochemical impact of masculinizing and feminizing hormone therapy is nascent and limited. Methodologies and outcomes measured are heterogenous across studies, introducing complexities that impede researchers from drawing definitive conclusions. In light of these limitations, this narrative review aims to describe the potential implications of masculinizing and feminizing hormone therapy regimens on biochemical measures that may influence nutrition strategies and interventions to promote optimal health.
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Affiliation(s)
- Jennifer Waters
- School of Health Studies, Northern Illinois University, Dekalb, IL, United States
| | - Whitney Linsenmeyer
- Department of Nutrition and Dietetics, Saint Louis University, Saint Louis, MO, United States
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4
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Baranowski M, Webb N, Slater J. What's the big IDEA? Incorporating inclusion, diversity, equity, and access (IDEA) in population health nutrition research and practice. Appl Physiol Nutr Metab 2024; 49:560-565. [PMID: 38318810 DOI: 10.1139/apnm-2023-0215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Historically, the constructs of inclusion, diversity, equity, and access (IDEA) have not been sufficiently considered or included in population health nutrition research and practice. Consequently, current nutrition assessment benchmarks and knowledge translation tools may not accurately or adequately reflect diversity in the Canadian population or produce meaningful dietary guidance. The purpose of this current opinion paper is to introduce the population health nutrition research and practice framework and explore the current application of IDEA within this framework. Recommendations are offered to incorporate the constructs of IDEA along the continuum of future nutrition research and services to improve population nutritional health.
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Affiliation(s)
- Maria Baranowski
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Nikki Webb
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Joyce Slater
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada
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5
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Yesildemir O, Akbulut G. Gender-Affirming Nutrition: An Overview of Eating Disorders in the Transgender Population. Curr Nutr Rep 2023; 12:877-892. [PMID: 37864747 DOI: 10.1007/s13668-023-00504-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2023] [Indexed: 10/23/2023]
Abstract
PURPOSE OF REVIEW Transgender individuals are vulnerable to many nutrition-related conditions, especially eating disorders due to gender dysphoria. This review aims to summarize the current literature on eating disorders in transgender individuals. The issues that should be considered in nutrition care for the transgender population are discussed regarding public health. RECENT FINDINGS Transgender individuals can exhibit disordered eating behaviors to overcome the stress they experience due to stigma, discrimination, social exclusion, and abuse. Recent studies showed that disordered eating and clinical eating disorders are more prevalent among transgender than cisgender people. It is very important for a multidisciplinary team working in the clinic to understand the epidemiology, etiology, diagnostic criteria, and treatment of eating disorders in the transgender population. However, multidisciplinary nutritional care is limited due to the lack of transgender-specific nutrition guidelines. It is safe to say that adhering to a generally healthy nutritional pattern and using standardized nutrition guidelines. We recommend that health professionals working with patients/clients with eating disorders receive continuing education in transgender health, be empowering and inclusive, address patients/clients with their gender identity nouns and pronouns, and develop nutritional treatment plans that are not gender-specific. Eating disorders are a significant public health problem in the transgender population. Therefore, clinical screening and early intervention are necessary to identify and treat eating disorders in transgender people. Eating disorders in the transgender population should be monitored routinely, and gender-affirming care should be provided as well as treatment of eating disorders.
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Affiliation(s)
- Ozge Yesildemir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Bursa Uludag University, Bursa, 16059, Turkey.
| | - Gamze Akbulut
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Istanbul Kent University, Istanbul, 34433, Turkey
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Castellanos-López I, González-Rodríguez LG, Bermejo LM, Cuadrado-Soto E, López-Sobaler AM. [Nutritional problems in cis and trans women]. NUTR HOSP 2023; 40:33-36. [PMID: 37929906 DOI: 10.20960/nh.04952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
Introduction Women deserve special attention due to the different requirements they have in comparison with men. In the same way, transgender women need individualized attention. Transgender women are at greater risk of suffering heart attacks or ischemic accidents, among other diseases, and are also at greater risk of developing eating disorders, poorer weight control and poorer perception of their image. Hormone therapy for gender reaffirmation in trans women modifies their body composition, and may also increase the risk of suffering from some pathologies. The nutritional needs of cisgender women are different from those of men, and trans women also have special needs, which may depend on whether or not they follow hormone therapy. Dietary studies, although scarce, suggest that transgender women have poor dietary habits and lifestyle. It is necessary to deepen the study of the nutritional situation of the female group, considering its diversity, and to develop standards and references appropriate to each case that allow better attention to the needs of these groups.
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Affiliation(s)
- Isabel Castellanos-López
- Departamento de Nutrición y Ciencia de los Alimentos. Facultad de Farmacia. Universidad Complutense de Madrid
| | | | - Laura M Bermejo
- Departamento de Nutrición y Ciencia de los Alimentos. Facultad de Farmacia. Universidad Complutense de Madrid. Grupo de Investigación VALORNUT-UCM (920030). IdISSC
| | | | - Ana M López-Sobaler
- Departamento de Nutrición y Ciencia de los Alimentos. Facultad de Farmacia. Universidad Complutense de Madrid. Grupo de Investigación VALORNUT-UCM (920030). IdISSC
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7
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Ferrero EM, Yunker AG, Cuffe S, Gautam S, Mendoza K, Bhupathiraju SN, Mattei J. Nutrition and Health in the Lesbian, Gay, Bisexual, Transgender, Queer/Questioning Community: A Narrative Review. Adv Nutr 2023; 14:1297-1306. [PMID: 37536566 PMCID: PMC10721458 DOI: 10.1016/j.advnut.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 07/16/2023] [Accepted: 07/31/2023] [Indexed: 08/05/2023] Open
Abstract
Sexual and gender minorities have a higher risk for health and nutrition-related disparities across the life course compared to the heterosexual or cisgender population. Experiences of stigmatization and discrimination are associated with diminished mental health quality and psychological distress, which are risk factors for developing various eating disorders. Other nutrition disparities include increased risk for food insecurity, body dissatisfaction, and weight complications, such as those experienced by the transgender population in association with gender-affirming hormone therapies. Despite the need for tailored nutrition recommendations that address the unique needs of the lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ+) community, there are currently no such guidelines in North America. The purpose of this review is to summarize major LGBTQ+ nutrition disparities and highlight the need for tailored recommendations. We examine the evidence on mental health and social disparities in this group, including vulnerabilities to disordered eating, food insecurity, and healthcare provider discrimination. Importantly, we identify a scarcity of literature on dietary concerns and nutrition care guidelines for LGBTQ+ groups, including studies that address intersectionality and differences among specific gender and sexual orientations. These gaps underline the urgency of prioritizing nutrition for LGBTQ+ health needs and for developing tailored public health nutrition recommendations for this underserved population. Our review suggests that future LGBTQ+ health and nutrition research agendas should include personalized and precision nutrition, social determinants of health, diet quality, body image, and healthcare provider cultural competency and responsiveness. Moreover, the current evidence on LGBTQ+ nutrition and health will be strengthened when research studies (including clinical trials) with robust methodologies amplify inclusion and representation of this community to elucidate health and nutrition disparities in sexual and gender minorities.
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Affiliation(s)
- Elisabetta M Ferrero
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Alexandra G Yunker
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Sherri Cuffe
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Saloni Gautam
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Kenny Mendoza
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Shilpa N Bhupathiraju
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
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Buonaiuto K, Dodge E, Aboul-Enein BH. Registered Dietitian Nutritionists' Knowledge, Attitudes, and Beliefs Regarding Nutrition for the Transgender Population in Three New England States: A Cross-Sectional Study. J Immigr Minor Health 2023:10.1007/s10903-023-01484-3. [PMID: 37084019 DOI: 10.1007/s10903-023-01484-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2023] [Indexed: 04/22/2023]
Abstract
This Study examined the knowledge, attitudes, and beliefs of Registered Dietitian Nutritionists (RDN's) practicing in Maine, New Hampshire, and Vermont, regarding the transgender population. 196 RDN's from the Commission of Dietetics Registration registry located in the tri-state area responded to an anonymous online survey. The survey used the Transgender Knowledge, Attitudes and Beliefs (T-KAB) Scale and nine true/false clinically-focused questions. Descriptive statistics and chi-square analysis were used to identify trends and associations in RDN's knowledge, attitudes, and beliefs regarding the transgender population. Political views (p < 0.0001), years practicing (p = 0.0454), and religious commitment (p = 0.0429) were negatively associated, and health disparities awareness (p < 0.0002) was positively associated, with total T-KAB Score. RDN's surveyed had positive attitudes and beliefs, but a low level of knowledge. Future research should focus on training and education of RDN's, and use of the T-KAB scale to evaluate pre/post-education modules regarding nutrition care for transgender patients.
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Affiliation(s)
- Kimberly Buonaiuto
- College of Graduate & Professional Studies, University of New England, 716 Stevens Ave, Portland, ME, 04103, USA
| | - Elizabeth Dodge
- College of Graduate & Professional Studies, University of New England, 716 Stevens Ave, Portland, ME, 04103, USA
| | - Basil H Aboul-Enein
- College of Health & Wellness, Department of Health Science, Johnson & Wales University, 8 Abbott Park Place, Providence, RI, 02903, USA.
- London School of Hygiene & Tropical Medicine, Faculty of Public Health and Policy, 15-17 Tavistock Place, London, WC1H 9SH, UK.
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9
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Morgan-Bathke M, Raynor HA, Baxter SD, Halliday TM, Lynch A, Malik N, Garay JL, Rozga M. Medical Nutrition Therapy Interventions Provided by Dietitians for Adult Overweight and Obesity Management: An Academy of Nutrition and Dietetics Evidence-Based Practice Guideline. J Acad Nutr Diet 2023; 123:520-545.e10. [PMID: 36462613 DOI: 10.1016/j.jand.2022.11.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 11/27/2022] [Indexed: 12/03/2022]
Abstract
Overweight and obesity affect most adults living in the United States and are causally linked to several adverse health outcomes. Registered dietitian nutritionists or international equivalents (dietitians) collaborate with each client and other health care professionals to meet client-centered goals, informed by the best available evidence, and translated through a lens of clinical expertise and client circumstances and preferences. Since the last iteration of the Academy of Nutrition and Dietetics guideline on adult weight management in 2014, considerable research has been conducted and circumstances confronting dietitians have evolved. Thus, updated guidance is needed. The objective of this evidence-based practice guideline is to provide recommendations for dietitians who deliver medical nutrition therapy behavioral interventions for adults (18 years and older) with overweight and obesity to improve cardiometabolic outcomes, quality of life, and weight outcomes, when appropriate for and desired by the client. Recommendations in this guideline highlight the importance of considering complex contributors to overweight and obesity and individualizing interventions to client-centered goals based on specific needs and preferences and shared decision making. The described recommendations have the potential to increase access to care and decrease costs through utilization of telehealth and group counseling as effective delivery methods, and to address other barriers to overweight and obesity management interventions. It is essential for dietitians to collaborate with clients and interprofessional health care teams to provide high-quality medical nutrition therapy interventions using the nutrition care process to promote attainment of client-centered outcomes for adults with overweight or obesity.
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Affiliation(s)
- Maria Morgan-Bathke
- Department of Nutrition and Dietetics, Viterbo University, La Crosse, Wisconsin
| | - Hollie A Raynor
- College of Education, Health, and Human Sciences, University of Tennessee, Knoxville, Tennessee
| | | | - Tanya M Halliday
- Department of Health and Kinesiology, University of Utah, Salt Lake City, Utah
| | - Amanda Lynch
- Department of Interdisciplinary Health Sciences, Oakland University, Rochester, MI
| | - Neal Malik
- Department of Health Science and Human Ecology, California State University, San Bernardino, San Bernardino, California
| | - Jessica L Garay
- Department of Nutrition and Food Studies, Syracuse University, Syracuse
| | - Mary Rozga
- Academy of Nutrition and Dietetics, Chicago, Illinois.
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Guy AA, Surace A, Zelaya DG, Flynn R, Opalo C, Keuroghlian AS, Mayer KH, Monti PM, Kahler CW. Transgender and gender diverse adults' reflections on alcohol counseling and recommendations for providers. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2023; 93:166-175. [PMID: 36745080 PMCID: PMC10037948 DOI: 10.1037/ort0000663] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Transgender and gender diverse (TGD) populations experience health disparities due to societal stigma that increases TGD individuals' sources of stress and decreases access to health protective resources. Research has linked experiences of stigma to risky alcohol use, yet there remains a dearth of culturally sensitive alcohol use interventions that meet the needs of TGD people. The present study was conducted to inform modifications to the content and delivery of an existing brief, telehealth, motivational intervention to decrease at-risk alcohol use among TGD adults. Individual semi-structured in-depth qualitative interviews were conducted with TGD adults who reported recent alcohol use (n = 18) to explore factors that facilitate positive interactions with health care providers and identify relevant information for alcohol use disorder treatment. Participants were recruited from an LGBTQ +-focused health center in Los Angeles, California. Two major themes and recommendations emerged: (a) A multicultural orientation of humility is important to develop productive therapeutic relationships with TGD clients when delivering motivational interviewing; (b) Due to insufficient appropriate data on alcohol use and health in TGD populations, feedback used in motivational alcohol counseling needs to be modified to better serve TGD clients. These findings show that counselors' philosophy and behavior, as well as session content, need to be considered when working with TGD populations within the context of alcohol counseling. These findings also have implications for intervention development, clinical treatment, and future research. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Arryn A. Guy
- Alcohol Research Center on HIV, Center for Alcohol and Addiction Studies, Brown University School of Public Health
- Department of Psychiatry and Human Behavior, Alpert Medical School at Brown University
- Department of Behavioral and Social Sciences, Brown University School of Public Health
| | - Anthony Surace
- Department of Behavioral and Social Sciences, Brown University School of Public Health
| | - David G. Zelaya
- Alcohol Research Center on HIV, Center for Alcohol and Addiction Studies, Brown University School of Public Health
- Department of Behavioral and Social Sciences, Brown University School of Public Health
- Harvard Medical School
| | | | | | | | - Kenneth H. Mayer
- Harvard Medical School
- The Fenway Institute, Fenway Health
- Beth Israel Deaconess Medical Center
| | - Peter M. Monti
- Alcohol Research Center on HIV, Center for Alcohol and Addiction Studies, Brown University School of Public Health
- Department of Behavioral and Social Sciences, Brown University School of Public Health
| | - Christopher W. Kahler
- Alcohol Research Center on HIV, Center for Alcohol and Addiction Studies, Brown University School of Public Health
- Department of Behavioral and Social Sciences, Brown University School of Public Health
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11
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Schier HE, Gunther C, Landry MJ, Ohlhorst SD, Linsenmeyer W. Sex and Gender Data Collection in Nutrition Research: Considerations through an Inclusion, Diversity, Equity, and Access Lens. J Acad Nutr Diet 2023; 123:247-252. [PMID: 36116772 DOI: 10.1016/j.jand.2022.09.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 09/09/2022] [Accepted: 09/12/2022] [Indexed: 01/25/2023]
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12
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Gunaydin D, Burchell D, Hickens N, Joy P. Not Just Checklists and Rainbows: Exploring Canadian Dietitians' Beliefs, Values, and Knowledge of Transgender Nutritional Care. Transgend Health 2022. [PMID: 37525835 PMCID: PMC10387146 DOI: 10.1089/trgh.2021.0107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Purpose Many transgender (short form: trans) people are experiencing disparities within Canadian health care systems, including nutritional and dietetic health care systems. This research explores the views, beliefs, and experiences of Canadian dietitians about trans nutritional care and seeks to understand how dietitians can better address the nutritional needs of trans individuals. Methods Semistructured online interviews were conducted with 16 Canadian dietitians. Interviews were transcribed and the data were analyzed thematically. Results Three main themes were created; (1) There's an Unjust System, (2) We've Come a Long Way, and (3) Not Just Checklists and Rainbows. The participants explored the historic nature of the Canadian dietetic profession and noted the connection between cis-normativity and the erasure of trans identities. They also explored how dietitians could better address the health needs of trans people, including moving beyond the acknowledgement of trans identities to changing the way gender is viewed in the profession. Conclusion The dietetic profession must move beyond surface-level activities and rethink gender. Recommendations include adding trans-focused care training into the profession, creating safer spaces for trans individuals, advocacy and allyship, and recruiting trans people to the profession.
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Affiliation(s)
- Duygu Gunaydin
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Drew Burchell
- Department of Biology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Nicholas Hickens
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Phillip Joy
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
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Linsenmeyer W, Garwood S, Waters J. An Examination of the Sex-Specific Nature of Nutrition Assessment within the Nutrition Care Process: Considerations for Nutrition and Dietetics Practitioners Working with Transgender and Gender Diverse Clients. J Acad Nutr Diet 2022; 122:1081-1086. [DOI: 10.1016/j.jand.2022.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 12/20/2021] [Accepted: 02/23/2022] [Indexed: 10/19/2022]
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14
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Streed CG, Beach LB, Caceres BA, Dowshen NL, Moreau KL, Mukherjee M, Poteat T, Radix A, Reisner SL, Singh V. Assessing and Addressing Cardiovascular Health in People Who Are Transgender and Gender Diverse: A Scientific Statement From the American Heart Association. Circulation 2021; 144:e136-e148. [PMID: 34235936 DOI: 10.1161/cir.0000000000001003] [Citation(s) in RCA: 105] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
There is growing evidence that people who are transgender and gender diverse (TGD) are impacted by disparities across a variety of cardiovascular risk factors compared with their peers who are cisgender. Prior literature has characterized disparities in cardiovascular morbidity and mortality as a result of a higher prevalence of health risk behaviors. Mounting research has revealed that cardiovascular risk factors at the individual level likely do not fully account for increased risk in cardiovascular health disparities among people who are TGD. Excess cardiovascular morbidity and mortality is hypothesized to be driven in part by psychosocial stressors across the lifespan at multiple levels, including structural violence (eg, discrimination, affordable housing, access to health care). This American Heart Association scientific statement reviews the existing literature on the cardiovascular health of people who are TGD. When applicable, the effects of gender-affirming hormone use on individual cardiovascular risk factors are also reviewed. Informed by a conceptual model building on minority stress theory, this statement identifies research gaps and provides suggestions for improving cardiovascular research and clinical care for people who are TGD, including the role of resilience-promoting factors. Advancing the cardiovascular health of people who are TGD requires a multifaceted approach that integrates best practices into research, health promotion, and cardiovascular care for this understudied population.
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Linsenmeyer W, Waters J. Sex and gender differences in nutrition research: considerations with the transgender and gender nonconforming population. Nutr J 2021; 20:6. [PMID: 33451300 PMCID: PMC7811260 DOI: 10.1186/s12937-021-00662-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 01/11/2021] [Indexed: 12/27/2022] Open
Abstract
A sex- and gender-informed approach to study design, analysis and reporting has particular relevance to the transgender and gender nonconforming population (TGNC) where sex and gender identity differ. Notable research gaps persist related to dietary intake, validity and reliability of nutrition assessment methods, and nutrition interventions with TGNC populations. This is due in part to the conflation of sex and gender into one binary category (male or female) in many nutrition surveillance programs worldwide. Adoption of the Sex and Gender Equity In Research (SAGER) guidelines and the two-step method of querying sex and gender has the potential to exponentially increase the body of research related to TGNC health.
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Affiliation(s)
- Whitney Linsenmeyer
- Doisy College of Health Sciences, Saint Louis University, 3437 Caroline St, St. Louis, MO, 63104, USA.
| | - Jennifer Waters
- Rush Copley Medical Center, 2000 Ogden Avenue, Aurora, IL, 60504, USA
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