Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul 4;11(1):111.
doi: 10.1186/s40337-023-00828-6.

A scoping review of the research literature on eating and body image for transgender and nonbinary adults

Katie Heiden-Rootes  1 , Whitney Linsenmeyer  2 , Samantha Levine  3 , Mark Oliveras  3 , Miriam Joseph  4
Affiliations

A scoping review of the research literature on eating and body image for transgender and nonbinary adults

Katie Heiden-Rootes et al. J Eat Disord. .

Abstract

Background: Eating disorder treatment approaches and outcome studies have historically centered almost exclusively on cisgender populations. Transgender and nonbinary (TGNB) adults are underrepresented in general and intervention research despite being at increased risk for eating and body image-related problems.

Aims: This scoping review was designed to gather and examine the research with TGNB adults who experience eating and body image related problems, as well as clinical studies on the effectiveness of treatment approaches.

Method: Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used for reporting this review. MEDLINE and PsychInfo were used as electronic databases for searching subject terms. Inclusion criteria for studies required the quantitative measurement or qualitative exploration of body image or eating for TGNB adults. The relevant data were extracted and summarized based on quantitative findings and qualitative themes.

Results: After review of over 1258 articles, 59 studies met criteria and data were extracted and summarized. Factors associated with eating disorders and body image problems across studies suggests gender-affirming medical interventions are effective and emphasized treatment for an eating disorder is warranted alongside gender affirming medical care. Body image was associated with eating patterns aimed at meeting gendered ideals of body shape and size. There was variation in guiding theories and absence of consensus in the definition of transgender in the review studies. This likely demonstrates the changing language, social acceptance of TGNB people and identities, diagnostic criteria, and clinical conceptualizations of eating and body image.

Conclusions: Future research should consider the use of theory for guiding inclusion of salient social factors influencing eating patterns, body image, and treatment outcomes. In addition, future research is needed that centers on nonbinary and genderqueer populations, as well as those from minoritized racial and ethnic groups to inform culturally appropriate concerns, needs, and treatment modalities.

Keywords: Body image; Disordered eating; Eating; Transgender; Weight.

Plain language summary

Fifty-nine published research studies with transgender adults on eating patterns, body image, and associated risks and comorbidities were collected and summarized. Across studies, gender affirming medical interventions like hormone therapy and surgery were associated with decreases in eating disorder symptoms and improved body image. Studies from interviews with transgender adults found social causes for disordered eating and poor body image including rejection and discrimination. Future studies should use guiding theories for testing the causality and consider rejection and discrimination experienced by transgender adults.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA 2020 Flow Diagram of the systematic literature review process. *Note. Some samples included both youth and adults with analysis by age for obtaining separate results based on age/developmental period
See this image and copyright information in PMC

References

    1. Riddle MC, Robertson L, Blalock DV, Duffy A, Le Grange D, Mehler PS, et al. Comparing eating disorder treatment outcomes of transgender and nonbinary individuals with cisgender individuals. Int J Eat Disord. 2022;55(11):1532–1540. doi: 10.1002/eat.23812. - DOI - PubMed
    1. Nagata JM, Ganson KT, Austin SB. Emerging trends in eating disorders among sexual and gender minorities. Curr Opin Psychiatry. 2020;33(6):562. doi: 10.1097/YCO.0000000000000645. - DOI - PMC - PubMed
    1. Jones BA, Haycraft E, Murjan S, Arcelus J. Body dissatisfaction and disordered eating in trans people: a systematic review of the literature. 2016. - PubMed
    1. Brewster ME, Velez BL, Breslow AS, Geiger EF. Unpacking body image concerns and disordered eating for transgender women: The roles of sexual objectification and minority stress. J Couns Psychol. 2019;66(2):131–142. doi: 10.1037/cou0000333. - DOI - PubMed
    1. Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003;129(5):674. doi: 10.1037/0033-2909.129.5.674. - DOI - PMC - PubMed

Publication types

LinkOut - more resources