Baker Jessica H, Freestone David, Cai Kelly, Silverstein Scout, Urban Bek, Steinberg Dori
Equip Health, Inc., Carlsbad, California.
Equip Health, Inc., Carlsbad, California.
J Adolesc Health. 2024 Aug;75(2):254-260. doi: 10.1016/j.jadohealth.2023.11.015. Epub 2024 Feb 4.
Current eating disorder treatment approaches for youth were developed for use with cisgender girls, which limits the understanding of effectiveness for cisgender boys and transgender and gender expansive (TGE) youth. Here, we compare treatment outcomes for cisgender boys and TGE youth with cisgender girls receiving family-based treatment for an eating disorder.
Patients were aged 6-24 and either active in treatment or discharged from September 1, 2020, to November 1, 2022 (N = 1,235). Patient exposure to treatment varied given individualized length of treatment. Outcomes include eating disorder symptoms, depression, anxiety, suicidality, caregiver burden, and parental confidence in supervising treatment. Treatment outcomes for cisgender boys and TGE youth were compared with cisgender girls.
Patients included n = 975 cisgender girls, n = 152 cisgender boys, and n = 108 TGE youth. Anorexia nervosa was the most common diagnosis. Cisgender boys reported significantly lower eating disorder (b = -2.7 [-4.1, -1.3]), anxiety (b = -1.6 [-2.2, -0.9]), and depression (b = -1.7 [-2.4, -0.9]) symptoms at admission compared with cisgender girls. TGE patients had significantly higher anxiety (b = 1.08 [0.28, 1.91]) and depression (b = 1.72 [0.78, 2.65]) symptoms compared with cisgender girls. Cisgender boys started with significantly lower suicidal ideation (b = -1.28 [-2.19, -0.43]) and TGE patients with significantly higher suicidal ideation (b = 1.63 [0.76, 2.51]) than cisgender girls. All symptoms improved during treatment and improved at similar rates over time in treatment regardless of gender identity.
Early evidence from this study supports the use of family-based treatment for cisgender boys and TGE youth with eating disorders. Further research is needed on the long-term outcomes of this approach for youth of all genders.
当前针对青少年的饮食失调治疗方法是为顺性别女孩开发的，这限制了对顺性别男孩以及跨性别和性别多样化（TGE）青少年治疗效果的理解。在此，我们比较接受饮食失调家庭治疗的顺性别男孩和TGE青少年与顺性别女孩的治疗结果。
患者年龄在6至24岁之间，于2020年9月1日至2022年11月1日期间正在接受治疗或已出院（N = 1235）。由于治疗时间因人而异，患者接受治疗的时长也各不相同。结果包括饮食失调症状、抑郁、焦虑、自杀倾向、照顾者负担以及父母对监督治疗的信心。将顺性别男孩和TGE青少年的治疗结果与顺性别女孩进行比较。
患者包括975名顺性别女孩、152名顺性别男孩和108名TGE青少年。神经性厌食是最常见的诊断。与顺性别女孩相比，顺性别男孩在入院时报告的饮食失调症状（b = -2.7 [-4.1, -1.3]）、焦虑症状（b = -1.6 [-2.2, -0.9]）和抑郁症状（b = -1.7 [-2.4, -0.9]）明显更低。与顺性别女孩相比，TGE患者的焦虑症状（b = 1.08 [0.28, 1.91]）和抑郁症状（b = 1.72 [0.78, 2.65]）明显更高。顺性别男孩开始时自杀意念明显更低（b = -1.28 [-2.19, -0.43]），而TGE患者的自杀意念明显高于顺性别女孩（b = 1.63 [0.76, 2.51]）。无论性别认同如何，所有症状在治疗期间均有所改善，且随着时间推移改善速度相似。
本研究的早期证据支持对患有饮食失调症的顺性别男孩和TGE青少年使用家庭治疗。需要对这种方法在所有性别的青少年中的长期结果进行进一步研究。
