Northern California Institute for Research; Department of Veterans Affairs, San Francisco; University of California, San Francisco; San José State University.
Community Health Systems and Department of Psychiatry and Behavioral Sciences, University of California, San Francisco.
Behav Ther. 2022 Sep;53(5):869-886. doi: 10.1016/j.beth.2022.02.006. Epub 2022 Feb 28.
Transgender and gender-expansive (TGE) people, including transgender and nonbinary individuals, experience elevated rates of body dissatisfaction and disordered eating compared to cisgender individuals, but little is known about why. To address this research gap, we compared the ability of TGE-specific factors as proposed in the gender minority stress and resilience (GMSR) model, general psychological factors contained in the tripartite influence (TI) model, and an integration of these frameworks to explain body dissatisfaction and disordered eating among TGE individuals. Regression analyses were conducted to test the models' abilities to explain experiences reported in a survey of 93 U.S. TGE adults, including 43 transgender women respondents (46.2%) and 31 transgender men respondents (33.3%). Participants were diverse with regard to age (M = 34.19, SD = 12.02) and ethnoracial background (e.g., 29.0% Hispanic/Latinx, 17.2% Black/African American, 6.5% American Indian/Alaska Native; 5.4% multiracial). Results demonstrated both models' abilities to explain body dissatisfaction and disordered eating independently, except for the relationship between body dissatisfaction and the thinness-oriented TI model. An integration of the models better explained body dissatisfaction and disordered eating compared to either model alone. Notably, some findings did not align with the two frameworks, suggesting existing models may not adequately describe pathways through which disordered eating emerges in TGE populations. Specifically, body dissatisfaction showed no significant relationship with disordered eating and was not well explained by the TI model, and higher gender identity pride was related to greater disordered eating symptoms. Implications for clinical care and future research are discussed.
跨性别和性别扩展（TGE）人群，包括跨性别者和非二元性别者，与顺性别者相比，他们的身体不满和饮食失调的发生率更高，但为什么会这样，人们知之甚少。为了解决这一研究空白，我们比较了性别少数群体压力和韧性（GMSR）模型中提出的 TGE 特定因素、三因素影响（TI）模型中包含的一般心理因素，以及这些框架的整合，以解释 TGE 个体的身体不满和饮食失调。回归分析用于测试这些模型解释美国 93 名 TGE 成年人调查中报告的经验的能力，其中包括 43 名跨性别女性受访者（46.2%）和 31 名跨性别男性受访者（33.3%）。参与者在年龄（M=34.19，SD=12.02）和民族背景（例如，29.0%西班牙裔/拉丁裔，17.2%黑人/非裔美国人，6.5%美洲原住民/阿拉斯加原住民；5.4%多种族）方面存在多样性。结果表明，这两个模型都能够独立地解释身体不满和饮食失调，除了身体不满与瘦身为导向的 TI 模型之间的关系。与单独使用任何一个模型相比，模型的整合更好地解释了身体不满和饮食失调。值得注意的是，一些发现与这两个框架不一致，这表明现有的模型可能无法充分描述饮食失调在 TGE 人群中出现的途径。具体来说，身体不满与饮食失调没有显著关系，并且与 TI 模型不太相关，而更高的性别认同自豪感与更大的饮食失调症状有关。讨论了临床护理和未来研究的意义。
