Towards gender-affirming nutrition assessment: a case series of adult transgender men with distinct nutrition considerations

Abstract

No guidelines exist regarding nutrition assessment for transgender or gender non-conforming patients. Multiple nutrition assessment methods utilize gender-specific values that provide distinct recommendations for males and females. This clinical case series depicts the food and nutrition considerations of ten adult transgender men using anthropometric, survey, and dietary recall data. Male reference values were used to analyze patient data, though multiple approaches to nutrition assessment in the transgender population are discussed. Major nutrition-related concerns were obesity, low fruit and vegetable intake and high sodium intake; disordered eating was not a prominent concern. Further research is needed to inform nutrition care for the transgender and gender nonconforming populations.

Item Generation in the Development of an Interactive Nutrition Specific Physical Exam Competency Tool (INSPECT): A Qualitative Study Utilizing Technology-Based Focus Groups in the United States

“…As transgender individuals may opt to transition from one gender to the other using hormonal therapy and/or through gender-affirming surgeries, these practices may have a marked impact on their nutritional status, weight, and body habitus, which in turn, may impact the NFPE performed on these individuals [ 47 , 48 , 49 ]. Nonetheless, gender identification differences were not discussed during the expert focus group discussions, suggesting that this may be a relatively new area for the RDNs.…”

Expanding the limits of sex: a systematic review concerning food and nutrition in transgender populations

“…First, the contemporary public health demands challenge classic nutritional assessment methods and dietary recommendations to include the transgender population. Studies concerning recommendations for anthropometric measures and Dietary Reference Intake consider a binary division of the sexes (male and female) (10) . However, the studies we gathered demonstrate the effects of HRT and GAS on lipid profile, body composition, eating disorder development and behaviour in the transgender population and the need to consider such processes in their health assessments.…”

“…The first study included in the review was published in 2009 (21) and the vast majority of such studies were published since 2015 (10, . Of the thirty-seven studies, five concerned food and nutritional security (25,29,37,38,48) , twenty-five concerned body image and weight control (21,23,24,(26)(27)(28)(32)(33)(34)36,(40)(41)(42)(43)(44)(45)(46)(47)49,50,(52)(53)(54)(55) , five concerned nutritional status (10,22,30,31,56) , one concerned nutritional health care (51) and one involved emic views of healthy eating (39) . The most frequent study designs were cross-sectional (n 22), followed by case reports (n 5), case-controls (n 4), cohort studies (n 4) and one ethnographic study (n 1) (see Table 1).…”

“…Yet, there are no nutritional recommendations that are appropriate to the context of the transgender population (30) . This is true even though certain alternatives are indeed presented during nutritional therapy, such as male and female-based reference values for the related stage of the individual's hormonal transition (i.e., hormonal composition), and the references for the desired gender (10) .…”

“…Consolidated surveys provide a basis for anthropometric and food consumption parameters and present specific recommendations based on gender. However, though important for orienting populations around the world, such recommendations do not address individuals who are transgender (10) . To promote genderbased nutritional and food care, we need to know what nutritional and food research informs us about transgender communities.…”