Department of Psychological and Brain Sciences, University of Delaware, Newark, Delaware, USA.
Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Int J Eat Disord. 2021 Jul;54(7):1135-1146. doi: 10.1002/eat.23494. Epub 2021 Feb 27.
Adolescence is a developmental period of increased risk for disordered eating. Gender minority adolescents (GMAs), or those whose gender identity does not align with their sex assigned at birth, may experience body image concerns related to unique gender-related stressors. GMAs may use disordered eating to affirm a feminine, masculine, or nonbinary gender identity. However, little is known about differences in disordered eating between GMAs and cisgender adolescents. Therefore, this study had two primary goals: (a) to compare disordered eating between GMAs and cisgender adolescents by examining the role of gender identity and sex assigned at birth; and (b) within GMAs, to examine associations between gender identity congruence and disordered eating.
A large U.S. sample of GMAs and cisgender adolescents (n = 1,191 GMAs; 919 cisgender; M = 15.93 years) reported their disordered eating on an anonymous online survey.
A MANOVA revealed a significant interaction between gender identity and sex assigned at birth. Follow-up ANOVAs demonstrated that purging, caloric restriction, excessive exercise, and muscle building differed as a function of gender identity and sex assigned at birth. Among GMAs, a multiple multivariate regression model demonstrated that disordered eating was lower among participants who reported greater gender identity congruence.
GMAs should not be considered a homogenous group, as differences in gender identity may lead to the internalization of different appearance ideals and disparate eating disorder symptomatology. Results suggest that clinicians working with GMAs consider the unique body image concerns that could accompany a specific gender identity.
青春期是饮食失调风险增加的发展阶段。性别少数群体青少年（GMAs），即那些其性别认同与其出生时的性别不符的青少年，可能会因与独特的性别相关压力相关的身体形象问题而感到担忧。GMAs 可能会通过饮食失调来确认女性、男性或非二元性别认同。然而，对于 GMAs 和顺性别青少年之间在饮食失调方面的差异，我们知之甚少。因此，本研究有两个主要目标：（a）通过检查性别认同和出生时的性别来比较 GMAs 和顺性别青少年之间的饮食失调；（b）在 GMAs 内部，研究性别认同一致性与饮食失调之间的关联。
一项来自美国的 GMAs 和顺性别青少年的大型样本（GMAs 组 n = 1191；顺性别组 n = 919；平均年龄 15.93 岁）通过匿名在线调查报告了他们的饮食失调情况。
MANOVA 显示性别认同和出生时的性别之间存在显著的交互作用。进一步的方差分析表明，催吐、节食、过度运动和肌肉锻炼因性别认同和出生时的性别而异。在 GMAs 中，多元回归模型表明，报告性别认同一致性较高的参与者的饮食失调程度较低。
GMAs 不应被视为一个同质群体，因为性别认同的差异可能导致内化不同的外貌理想和不同的饮食障碍症状。结果表明，与 GMAs 合作的临床医生应考虑与特定性别认同相关的独特身体形象问题。
