Aungkawattanapong Nadvadee, Suteerojntrakool Orapa, Prownpuntu Thitaporn, Bongsebandhu-Phubhakdi Chansuda
Department of Pediatrics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Center of Excellence in Transgender Health (CETH), Chulalongkorn University, Bangkok, Thailand.
J Eat Disord. 2024 Nov 14;12(1):176. doi: 10.1186/s40337-024-01135-4.
Adolescents, particularly vulnerable during puberty, often face heightened concerns about dieting and body image. Transfeminine youth, especially in Asian cultures, are understudied in this context. This study investigates eating disorder risks among Thai transfeminine youth and compares to cisgender females, focusing on the association with body dissatisfaction. This study aims to explore 3 objectives: (1) to assess and compare the prevalence of eating disorder risks between Thai transfeminine youth and cisgender females; (2) to examine the link between body dissatisfaction and eating disorder risks; (3) to identify risk factors associated with abnormal eating disorder screening outcomes.
This is a cross-sectional comparative study conducted between September 2021 and October 2022. The study questionnaire includes Thai version of the Eating Attitude Test-26 (EAT-26) to assess the risks of eating disorders and Thai version of the Body Image Concern Inventory (BICI) to assess body dissatisfaction. The questionnaire was distributed through social media platforms to transfeminine and cisgender females, aged 12-25 years. The correlation between eating disorder risks and body dissatisfaction was analyzed with linear regression, while the comparisons between transfeminine individuals and cisgender female groups were analyzed with Wilcoxon rank-sum test.
The study included 241 transfeminine individuals and 388 cisgender females, median age 19.0 years (interquartile range [IQR] 18-21) and 18 years (IQR 16-20), respectively. Ninety (37.3%) transfeminine individuals had an EAT-26 score ≥ 20, suggesting concerns for dieting and eating behaviors, compared to 70 (18%) cisgender females (p < 0.001). Risk factors for EDs included obesity (odds ratio [OR] 3.22, confidence interval [CI] 1.36-7.6) and low income (OR 3.66, CI 1.59-8.4). Protective factors were negligible exercise (OR 0.24, CI 0.09-0.66), gender identity disclosure (OR 0.27, CI 0.1-0.77), and high levels of happiness (OR 0.85, CI 0.73-0.98). There is a significant correlation between the positive eating behavior screening and the body dissatisfaction scores.
Transfeminine youths show significantly higher concerns about dieting, body weight, and eating behaviors than their cisgender females, highlighting the unique challenges they face. These results emphasize the needs for targeted screening, health care access for treatment and support for eating disorders in transfeminine youths.
青少年在青春期特别容易受到影响，常常对节食和身体形象更为关注。在这种背景下，跨性别女性青少年，尤其是在亚洲文化背景下，研究较少。本研究调查泰国跨性别女性青少年中的饮食失调风险，并与顺性别女性进行比较，重点关注与身体不满的关联。本研究旨在探讨三个目标：（1）评估和比较泰国跨性别女性青少年和顺性别女性之间饮食失调风险的患病率；（2）研究身体不满与饮食失调风险之间的联系；（3）确定与异常饮食失调筛查结果相关的风险因素。
这是一项于2021年9月至2022年10月进行的横断面比较研究。研究问卷包括泰语版的饮食态度测试-26（EAT-26）以评估饮食失调风险，以及泰语版的身体形象关注量表（BICI）以评估身体不满。问卷通过社交媒体平台分发给年龄在12-25岁的跨性别女性和顺性别女性。饮食失调风险与身体不满之间的相关性采用线性回归分析，而跨性别个体和顺性别女性组之间的比较采用Wilcoxon秩和检验。
该研究纳入了241名跨性别个体和388名顺性别女性，中位年龄分别为19.0岁（四分位间距[IQR] 18-21）和18岁（IQR 16-20）。90名（37.3%）跨性别个体的EAT-26得分≥20，表明对节食和饮食行为存在担忧，相比之下，70名（18%）顺性别女性有此情况（p<0.001）。饮食失调的风险因素包括肥胖（比值比[OR] 3.22，置信区间[CI] 1.36-7.6）和低收入（OR 3.66，CI 1.59-8.4）。保护因素是运动量可忽略不计（OR 0.24，CI 0.09-0.66）、性别认同披露（OR 0.27，CI 0.1-0.77）和高幸福感（OR 0.85，CI 0.73-0.98）。积极的饮食行为筛查与身体不满得分之间存在显著相关性。
跨性别女性青少年对节食、体重和饮食行为的担忧明显高于她们的顺性别女性同龄人，凸显了她们面临的独特挑战。这些结果强调了对跨性别女性青少年进行针对性筛查、提供饮食失调治疗和支持的医疗保健服务的必要性。
