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

Abstract

Background Transgender and nonbinary (TGNB) adolescents and young adults are underrepresented in the literature on eating disorders and body image-related problems, despite increased mental health disparities and emerging research showing high associations between gender dysphoria, body image, and eating disorders among TGNB youth. Aims The scoping review was designed to critically examine the research on TGNB adolescents and young adults who experience eating and body image related problems as well as clinical studies on treatment approaches and effectiveness. Method Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used for reporting this scoping review. The electronic databases of MEDLINE and PsychInfo were used for searching subject terms. Inclusion criteria for studies required the quantitative measurement or qualitative exploration of body image or eating for transgender minor children, adolescents, or young adult samples (18 to 25 years old) and address differences in eating/body-related problems by age. The relevant data was extracted and narratively summarized. Results 49 studies were identified, data extracted, and analyzed. Increased prevalence of eating disorders and body image problems were identified for TGNB youth. Body-gender congruence through gender affirming social and medical interventions (e.g., hormone therapy) were noted as significant for alleviating body image problems and facilitating eating disorder treatment. Family and social factors were not well understood in the literature and a need for increased study of TGNB youth from varied racial/ethnic, neurodiverse, and within specific identities (e.g., nonbinary) and families and cultural contexts is still needed. Conclusions Future research should consider the use of developmental and family theories for guiding inclusion of salient social factors influencing eating patterns, body image, and treatment outcomes. In addition, more studies are needed with those from minoritized racial and ethnic groups, neurodiversity, and varied gender identities (e.g., nonbinary and gender queer) for identifying important differences.

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

“…First, studies were separated by age to create youth (children to young adult where young adults were analyzed as unique developmental stage) and adult (adult-only samples, 18 years old and older with broad age ranges and analyzed together as an all-adult sample) tables for separate analysis. Again, this manuscript will only report on the adult samples and the youth and young adult articles are summarized in a separate scoping review manuscript (Heiden-Rootes et al [24]).…”

Improving Adult Inpatient Eating Disorder Treatment: Perspectives of a Sample of Canadians with Lived Experience

“…For example, Participant Eight was denied the privilege of spirituality support while in treatment due to their identity as a Moroccan Jew despite evidence that suggests spiritual health to be integral and powerful in the success of some patients' ED recovery [44]. Research has found that Transgender and gender non-binary populations experience EDs and ED recovery in unique ways; changes to body size and shape facilitate gender dysphoria and increase the complexity of recovery, yet gender was excluded from treatment entirely, creating challenges for Participants Eight and Eleven [45]. Participant Ten, who experienced housing instability while in treatment, felt unsupported due to the stigma that suggests housing instability cannot coexist maintaining recovery [46].…”