Gender Confirming Medical Interventions and Eating Disorder Symptoms Among Transgender Individuals

Objective: Studies indicate that transgender individuals may be at risk of developing eating disorder symptoms (EDS). Elevated risk may be attributed to body dissatisfaction and/or societal reactions to nonconforming gender expression, such as nonaffirmation of a person's gender identity (e.g.,...

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Bibliographic Details
Published in:Health psychology 2017-10, Vol.36 (10), p.927-936
Main Authors: Testa, Rylan J., Rider, G. Nicole, Haug, Nancy A., Balsam, Kimberly F.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Body Dissatisfaction
Body Image
Bulimia
Chest
Discontent
Eating Disorders
Feeding and Eating Disorders - etiology
Female
Gender Identity
Gender Reassignment
Genital surgery
Hair
Human
Humans
Hysterectomy
Indirect effects
Intervention
Male
Middle Aged
Pronouns
Risk Factors
Surgery
Symptoms
Thoracic surgery
Transgender persons
Transgender Persons - psychology
Young Adult
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Summary:Objective: Studies indicate that transgender individuals may be at risk of developing eating disorder symptoms (EDS). Elevated risk may be attributed to body dissatisfaction and/or societal reactions to nonconforming gender expression, such as nonaffirmation of a person's gender identity (e.g., using incorrect pronouns). Limited research suggests that gender-confirming medical interventions (GCMIs) may prevent or reduce EDS among transgender people. Method: Participants included 154 transfeminine spectrum (TFS) and 288 transmasculine spectrum (TMS) individuals who completed the Trans Health Survey. Serial multiple mediation analyses controlling for age, education, and income were used to examine whether body satisfaction and nonaffirmation mediate any found relationships between various GCMIs (genital surgery, chest surgery, hormone use, hysterectomy, and hair removal) and EDS. Results: For TFS individuals, the nonaffirmation to body satisfaction path mediated relationships between all GCMIs and EDS, although body satisfaction alone accounted for more of the indirect effects than this path for chest surgery. For TMS individuals, relationships between all GCMIs and EDS were mediated by the nonaffirmation to body satisfaction path. Conclusion: Findings support the hypothesis that GCMIs reduce experiences of nonaffirmation, which increases body satisfaction and thus decreases EDS. Among TFS participants, the relationship between chest surgery and lower levels of EDS was mediated most strongly by body satisfaction alone, suggesting that satisfaction with one's body may result in lower EDS even if affirmation from the external world is unchanged. Implications of these findings for intervention, policy, and legal efforts are discussed, and future research recommendations are provided.
ISSN:0278-6133
1930-7810
DOI:10.1037/hea0000497