Division of Adolescent Medicine, Seattle Children's Hospital (AH Pham and KR Ahrens), Seattle, Wash.
Department of Psychological and Brain Sciences, University of Iowa (H-M Eadeh), Iowa City, Iowa.
Acad Pediatr. 2023 Aug;23(6):1247-1251. doi: 10.1016/j.acap.2022.12.013. Epub 2022 Dec 30.
We longitudinally explored frequency of disordered eating among transgender and nonbinary (TGNB) adolescents and explored trends by gender identity and gender-affirming care.
Participants completed an abbreviated version of the Eating Disorder Examination Questionnaire (EDE-Q) at baseline, 3, 6, and 12 months after establishing care in a gender clinic. We analyzed descriptive statistics and multivariate linear regression analyses.
Of the 91 TGNB adolescent participants, 61% were transmasculine, 30% transfeminine, and 7% nonbinary/gender-fluid. Among TGNB adolescents, disordered eating thoughts/behaviors were frequently endorsed with 26% of participants engaging in any occurrence of binge eating, 27% limiting the amount of food they ate, and 30% excluding foods from their diet. Forty percent of participants reported any occurrence of at least 1 disordered eating behavior and 17% at least 3 behaviors. Abbreviated EDE-Q responses did not differ significantly by sex assigned at birth, gender identity, gender-affirming medications, or time spent receiving gender-affirming care. There was a significant effect of age (P value = .003) on abbreviated EDE-Q scores.
There were no significant changes in disordered eating after initiating gender-affirming medical care, possibly due to the limited study time frame of 12 months. Given the high prevalence of disordered eating behaviors, clinicians should consider screening all TGNB adolescents for disordered eating thoughts/behaviors throughout gender-affirming care. Future longitudinal research should recruit larger samples with a diverse range of gender identities and survey disordered eating thoughts/behaviors at least one year after starting gender-affirming medications.
我们纵向探讨了跨性别和非二元性别（TGNB）青少年中饮食障碍的发生频率，并探讨了基于性别认同和性别肯定性护理的趋势。
参与者在性别诊所建立护理后，分别在基线、3、6 和 12 个月时完成了饮食障碍检查问卷（EDE-Q）的简短版本。我们进行了描述性统计和多变量线性回归分析。
在 91 名 TGNB 青少年参与者中，61%为跨男性，30%为跨女性，7%为非二元/性别流动。在 TGNB 青少年中，饮食障碍的想法/行为经常被认可，26%的参与者有暴食行为，27%的参与者限制进食量，30%的参与者从饮食中排除食物。40%的参与者报告有任何至少一种饮食障碍行为，17%的参与者有至少 3 种行为。简短 EDE-Q 反应在出生时的性别分配、性别认同、性别肯定性药物或接受性别肯定性护理的时间上没有显著差异。年龄对缩写 EDE-Q 评分有显著影响（P 值 =.003）。
在开始接受性别肯定性医疗护理后，饮食障碍没有明显变化，可能是由于研究时间框架仅为 12 个月。鉴于饮食障碍行为的高患病率，临床医生应该考虑在整个性别肯定性护理过程中对所有 TGNB 青少年进行饮食障碍想法/行为的筛查。未来的纵向研究应招募更多具有不同性别认同的样本，并在开始使用性别肯定性药物后至少一年调查饮食障碍的想法/行为。
