Exploring transgender adolescents’ body image concerns and disordered eating: Semi-structured interviews with nine gender minority youth

• Published in: Body image 2021-06, Vol.37, p.50-62
• Main Authors: Romito, Madelaine, Salk, Rachel H., Roberts, Savannah R., Thoma, Brian C., Levine, Michele D., Choukas-Bradley, Sophia
• Format: Article
• Language: English
• Subjects: Adolescence; Adolescent; Body Dissatisfaction - psychology; Body image; Body Image - psychology; Disordered eating; Feeding and Eating Disorders - epidemiology; Female; Gender Identity; Gender minority; Humans; Male; Qualitative; Qualitative Research; Sexual and Gender Minorities - psychology; Sexual and Gender Minorities - statistics & numerical data; Transgender Persons - psychology; Transgender Persons - statistics & numerical data; Young Adult
• ISSN: 1740-1445; 1873-6807
• DOI: 10.1016/j.bodyim.2021.01.008

•Semi-structured interviews were conducted with 9 transgender adolescents (TGAs).•Qualitative analysis explored TGAs’ gender identity, body image, disordered eating.•All TGAs reported at least one behavior to change their weight or shape.•Disordered eating was related to both transgender-specific and broader factors.•Developmental and social context affected transition, body image, disordered eating. Transgender adolescents (TGAs) face many of the same sociocultural and biological influences on body dissatisfaction and disordered eating as cisgender peers. Additionally, TGAs experience unique body- and gender-related concerns. The purpose of this study is to explore the nuances of gender identity, gender transitioning, body image, and disordered eating among TGAs. Case summaries and a synthesis of key themes are presented from interviews with nine TGAs aged 16–20 (Mage = 17). All participants reported engaging in at least one behavior to change their weight or shape. Consistent with a theoretical biopsychosociocultural model we proposed, TGAs described body dissatisfaction and disordered eating related to transgender-specific factors (e.g., behaviors aimed at minimizing secondary sex characteristics) and broader developmental and sociocultural factors. Some participants reported improvements in body image and disordered eating following gender transition. The interviews highlight complex associations among gender identity, gender transitioning, body image, and disordered eating during adolescence, suggesting that disentangling transgender-specific factors from other individual factors is difficult. These findings may guide future research on the prevalence and functions of disordered eating among TGAs and point to a unique set of needs for effective detection and treatment of concurrent gender incongruence, body dissatisfaction, and disordered eating.