Compiled for Beat by: Dr Kai Thomas, Grace Williams, Luka White, and Max Keith. School of Psychology, Cardiff University. Department of Health and Social Sciences, University of Edinburgh.
Transgender and non-binary (TNB) people are those whose gender is different from the sex they were assumed to be at birth. This includes trans men, trans women, nonbinary, agender, intersex, genderqueer and genderfluid people, as well as people with traditional or Indigenous gender identities.
In the UK, at least 0.5% of people identify as TNB (Office for National Statistics, 2023). Most research on eating disorders has focused on cisgender people – those whose gender matches the sex they were assumed to be at birth. However, in the last decade, more attention has been given to understanding eating disorders among TNB people.
This research shows that TNB people may face a higher risk of developing eating disorders. This can be due to many overlapping reasons, including the distress some people feel when their body does not reflect their gender (known as gender dysphoria), experiences of discrimination, and societal pressure to look or behave a certain way.
A gender-inclusive approach means considering the needs and experiences of people of all genders – including both TNB people and cisgender people. When treatment is designed with everyone in mind, support becomes more inclusive, fair, and effective. This summary shares what research has found about eating disorders in TNB people. It covers:
We use “TNB” as an umbrella term, but we understand that not everyone identifies with this label and that language around gender is always evolving. Sometimes different researchers use different words to describe the same topic or idea (for example, some people might say “sex assigned at birth” instead of “sex assumed at birth”). In this summary, we also use the original words from the research studies we mention, even if the terminology differs slightly between studies.
Also note: Gender and sexuality can be misinterpreted as the same thing; however, gender refers to one’s own identity, whereas sexuality refers to who someone is attracted to. Like anyone else, TNB people can identify with any sexual orientation (i.e., straight, gay, lesbian, bisexual, asexual, pansexual, etc).
TNB adults and young people are more likely to experience an eating disorder or disordered eating than cisgender people:
Some groups within the TNB community are more at risk of an eating disorder than others (Romano & Lipson, 2022):
TNB people who were presumed female at birth tend to face a higher risk of an eating disorder than those presumed male at birth (Diemer et al., 2018; Feder et al., 2017). There could be a variety of reasons for this including puberty and changes to the body throughout development, as well as societal expectations. The table below shows the rates of eating disorders in different TNB groups. Gender non-conforming people presumed female at birth had the highest rates of diagnosed and self-reported eating disorders, followed by trans men, trans women, and finally gender non-conforming people presumed male at birth reporting the lowest rates (Diemer et al., 2018).
Table 1.
Rates of diagnosed eating disorders (EDs) and self-reported EDs in gender non-conforming people presumed female and male at birth, transgender men, and transgender women as reported in Diemer et al., 2018.
TNB people can experience a wide range of eating disorders. Research shows that TNB people are more likely to be diagnosed with Other Specified Feeding or Eating Disorder (OSFED) rather than anorexia nervosa, bulimia nervosa, or binge eating disorder (Chaphekar et al. (2022) This might be because the definitions of eating disorders that are used for diagnosis were based mostly on the experiences of cisgender people. As a result, some TNB people’s symptoms might not fit those narrow definitions, even though their difficulties are just as real.
There are many reasons why TNB people might develop an eating disorder, and they can be different for everyone. TNB people may share some of the same risk factors as cisgender people, such as trying to cope with strong emotions and feelings, seeking control, or facing pressure from others to look or eat a certain way. However, TNB people may also develop an eating disorder for unique reasons which we’ll explore below.
Gender dysphoria is a feeling of distress that can happen when someone’s body doesn’t match how they see themselves or how they want others to see them based on their gender. So far, research has mainly focussed on how gender dysphoria and body image concerns in TNB people might play a role in developing eating disorders. Some TNB people may use restrictive eating behaviours to try to change their body and feel more comfortable (Jones et al., 2016).
For example, some trans men and trans masculine people might restrict what they eat to reduce their curves or stop their periods, or they might exercise a lot to build muscle (Amodeo et al., 2022). Some trans women and trans feminine people might use disordered eating to lose body fat and change their shape, as thinness is often linked with femininity (Gordon et al., 2016). Nonbinary people might also try to appear more androgynous (a look that isn’t strongly masculine or feminine) (Cusack & Galupo, 2021).
During puberty, some TNB young people might use disordered eating as a way to try and delay changes to their body, like breast development or a deeper voice. However, it’s really important to remember that not all TNB people experience gender dysphoria, and not everyone with an eating disorder links it to how they feel about their body. While body dissatisfaction and gender dysphoria can be important features of eating disorders for some TNB people, there are many other factors – like social pressures, discrimination, or lack of access to gender-affirming care – that can also affect why someone might develop an eating disorder.
Similarly to cisgender people, TNB people might not always realise that their eating behaviours are related to how they feel about their body - and these feelings and goals can change over time.
TNB people face high levels of discrimination in the UK (TransActual, 2021). This can have a serious impact on their mental health and wellbeing, and increase their chances of struggling with body image and eating disorders. The relationship between discrimination and disordered eating is complicated. Sometimes it’s direct, for example, a TNB person might use disordered eating to change their body so that it looks more like what they think is expected of their gender, to ‘pass’ as cisgender and avoid discrimination (McGregor et al., 2023). Other times, the connection is less obvious. Discrimination can cause stress, low self-esteem, or emotional pain, and some TNB people might turn to disordered eating as a way to cope with these feelings (Brewster et al., 2019; Brokjøb & Cornelissen, 2022; Tabaac et al., 2018).
Discrimination is also known to contribute to mental health difficulties like depression, anxiety, and posttraumatic stress disorder (Klemmer et al., 2018; Reisner et al., 2016), which are all risk factors for eating disorders (Barakat et al., 2023).
TNB people who face more than one kind of discrimination, like sexism, racism or homophobia, may be at even greater risk of developing eating disorders (Egbert et al., 2024; Gordon et al., 2024; Simone et al., 2022).
Discrimination can also be present in healthcare. Many TNB people avoid accessing healthcare because they fear or expect discrimination (Drabish & Theeke, 2022). This means they might not get support for disordered eating (Duffy et al., 2016). TNB people of colour are especially likely to avoid healthcare (Kcomt et al., 2020), possibly because they face more barriers and more frequent discrimination when trying to access help.
Eating disorders are often linked to body image ideals, which are ideas about how people “should” look. These ideals can come from friends, family, or the media (Thompson et al., 1999). In the UK, there’s a strong focus on being thin or muscular, and this can affect how people feel about their bodies.
There has not been much research specifically looking at body image ideals within the TNB community, but we do know that TNB people are influenced by the same body image ideals as cisgender people and often take these images on in similar ways (Jones et al., 2016; Strübel et al., 2020).
There are also body image ideals within the TNB community itself. For example, some TNB people describe an androgynous body image ideal – having a body that’s thin, flat-chested, and with short hair (Burstall et al., 2024). For some, having a body that doesn’t clearly look ‘male’ or ‘female’ helps them feel more comfortable in themselves (Galupo et al., 2021). More gender-inclusive research is needed to better understand how these body image ideals affect the risk of eating disorders in TNB people.
Many TNB people are also neurodivergent, meaning they might be more likely to be Autistic or have ADHD than people who are not TNB (Cooper et al., 2018; Strang et al., 2014; Warrier et al., 2020). Studies show that people who have more autistic traits, ADHD traits, and gender diverse traits also tend to experience more eating disorder symptoms (Thomas et al., 2025a). Research has also found avoidant/restrictive food intake disorder (ARFID) symptoms may be more common in TNB people with more autistic and ADHD traits (Thomas et al., 2025b). ARFID involves very limited eating that isn’t driven by concerns around weight, but instead by things like sensory sensitivities (e.g., textures, smells, or tastes of food). We don’t yet fully understand why TNB people who are also Autistic or have ADHD are at higher risk of developing eating disorder symptoms. However, research in Autistic people who are not TNB shows that sensory issues, differences in thinking, and social differences can all play a role (Brede et al., 2020; Levin & Rawana, 2016; Nimbley et al., 2022). For TNB people, these factors might combine with experiences of gender dysphoria and differences in planning or managing daily tasks (called executive functioning). To better support TNB people who are also neurodivergent, we need more research to understand how all these factors interact, and what kinds of support work best.
TNB people, like everyone else, can have things in their lives that protect them from developing eating disorders. These are called protective factors. Some are similar to those seen in people who are cisgender (not TNB). For example, having support from family and friends is linked to fewer eating disorder symptoms in TNB people, just like in the general population (Watson et al., 2017).
TNB people may also have some unique protective factors. One of these is access to gender-affirming medical care (such as hormone therapy and surgeries), which can help reduce body dissatisfaction, ease anxiety, and boost self-esteem (Becker et al., 2018; Fisher et al., 2014; Jones et al., 2018; Nowaskie et al., 2021; Owen-Smith et al., 2018; Rasmussen et al., 2023; Testa et al., 2017; Turan et al., 2018; van de Grift et al., 2017; van de Grift et al., 2018). All of these things can lower the chances of developing an eating disorder, and support the recovery of one[ES1] .
However, not all TNB people choose medical treatments as part of their transition. Some people prefer to socially transition, such as changing their name, pronouns, clothes, and/or hairstyle, without using hormones or having surgery (Rafferty et al., 2020). What [ES2] really seems to matter most is being accepted and affirmed – both by others and by ourselves. Whether a TNB person chooses medical transition, social transition, or something else entirely, feeling supported and seen for who they are can play a big role in protecting their mental health and lowering the risk of eating disorders.
Interest in improving eating disorder treatment for TNB people is growing. But right now, there are no official guidelines explaining how best to support TNB people, and we still don’t have enough research to know what works best in practice. As TNB people often experience eating disorders differently from cisgender people, support needs to be personalised and inclusive for people of all gender identities.
For some TNB people, their eating disorder is closely tied to how they feel about their body, especially if they experience gender dysphoria (distress linked to a mismatch between their body and gender). Talking about gender during treatment can be helpful in these cases (Cusack et al., 2022; Duffy et al., 2016). However, not every TNB person’s eating disorder is related to their gender. For others, it may be more connected to things like anxiety, stress, or trauma. In those cases, focussing too much on gender might be unhelpful for their recovery (Cusack et al., 2022; Duffy et al., 2016). Many TNB people say they want to be treated as a ‘whole person’, not just seen through the lens of their eating disorder or gender identity (Smith & Harrop, 2024). This means treatment should be tailored to each person, recognising their unique needs and experiences.
TNB people often face extra challenges when seeking eating disorder care. Some say it is hard to get a diagnosis (Hartman-Munick et al., 2021), or that their medical needs like support with gender-affirming care are not taken seriously (Riddle & Safer, 2022). Many also feel that clinicians do not understand their body image struggles. For example, being encouraged to love your body (through “body positivity” approaches) may not feel right for someone who experiences gender dysphoria and is seeking gender-affirming changes (Duffy et al., 2016; McGregor et al., 2023). Instead, some clinicians now recommend “body neutrality” - focusing on what the body can do, rather than how it looks – as a more inclusive approach (Perry et al., 2019).
Unfortunately, many TNB people say their clinicians do not understand gender diversity well[ES1] . This can lead people to hide who they are in treatment, or feel like they have to educate their clinicans about being TNB (Duffy et al., 2016; Ferrucci et al., 2023). That’s likely because there’s very little training or guidance on how to best support TNB people with eating disorders (Ferrucci et al., 2023). The good news is, many clinicians are recognising this gap and are taking steps to learn more and make their care more inclusive (Ferrucci et al., 2024). Eating disorder services are being encouraged to use gender-affirming practices, like inclusive language, correct names and pronouns, offering inclusive facilities, and creating safer environments, so that TNB people feel seen and supported in treatment (Cusack et al., 2022).
Recovery itself can also be complicated for TNB people. For some, weight changes can bring back body changes they find distressing, like wider hips or a different chest size, which can increase feelings of gender dysphoria (Harrop et al., 2023). On top of that, some gender-affirming treatments, like surgery, are only available to people of certain weights, or whose weight falls within a specific BMI bracket. This pressure to lose or gain weight can increase risk of eating disorder symptoms (Brownstone et al., 2021). [ES2] Because of all of this, experts are calling for more joined up care, where eating disorder treatment and gender-affirming healthcare work together, so that TNB people get the holistic support they truly need (Coleman et al., 2022; Donaldson et al., 2018; Yesildemir and Akbulut (2023).
Future research needs to include TNB people with lived experience of eating disorders right from the start (Papastavrou Brooks et al., 2023). Involving TNB people in designing and carrying out research helps make sure that the research reflects their real experiences, needs, and priorities. It is also important that future studies look at the different parts of people’s identities – not just gender. For example, someone might be TNB and also be a person of colour, part of the LGBQ+ community, or from a working class background. These different identities can all affect how someone experiences an eating disorder and whether they can access support. Research has shown that people of colour, LGBQ+ people and people from lower-income backgrounds are more likely to develop eating disorders (Austin et al., 2012; Burke et al., 2023; Burke et al., 2020; Calzo et al., 2017; Diemer et al., 2015; Egbert et al., 2024; Gordon et al., 2024), but we don’t yet know enough about how those experiences combine with being TNB or neurodivergent (like being Autistic or having ADHD). We need research that explores how all of these parts of a person’s identity interact, so we can better understand eating disorders in TNB communities and offer the right kind of support.
We asked two people with lived experience what this research means to them. Read what they said below.
Person 1:
"My eating disorder (ED) developed as a way to help me cope with the effects of puberty on my body, combined with sensory and social eating difficulties that increased at secondary school. I delayed seeking help for my eating disorder for a long time because I didn’t think my eating difficulties fit the into any of the eating disorder boxes and there were no descriptions of EDs occurring in the context of gender dysphoria. I used to exercise excessively as a way to help manage my dysphoria, because it helped me feel stronger, but it was always misinterpreted as an ED behaviour.
Once I sought help, it felt like services were all aimed at cis women and I didn’t feel able to talk about my gender identity, and the times I tried, I felt it made my therapist uncomfortable.
I recovered briefly at times, but that meant returning to a more feminine body that felt wrong and alien to me. I’ve finally been able to sustain recovery for a longer period of time now that I’m also receiving gender-affirming medical care.
In ED treatment, I felt that I needed to explain a lot about how gender identity intersects with my eating disorder. I didn’t mind, because the therapist made it a safe space to explore those topics, but there definitely needs to be better understanding of gender diversity within ED services and the competency to explore this if relevant. More joined up care between ED services and gender services is also really important – a lot of my time in ED treatment was overshadowed by uncertainty around my transition and my future, which often held me back from making more positive changes, and could have been resolved with better communication and information sharing between the two services.
This research summary really highlights the positive work being done but also the gaps that may lead to missed opportunities for TNB people with eating disorders to get timely, appropriate care and treatment."
Person 2:
"Although I didn’t realise it at the time, my gender identity and dysphoria played a substantial role in both the development and maintenance of my eating disorder. It was also one of the hardest barriers to navigate in recovery. I think if there had been a better awareness of the overlap between these experiences and more representation in the voices that were being platformed to talk about their recovery, I might have found the words sooner to better understand and articulate my experiences.
My complicated relationship with gender also impacted the various encounters I had with eating disorder services and treatment. For example, I know that for a lot of people, the environment provided by group therapy and being able to hear similar experiences can be incredibly helpful. But for many people from underserved groups, which can all uniquely influence their experience of an eating disorder, a group dynamic has the potential, if not sensitively facilitated, to feel even more alienating. Not having your experiences recognised or addressed, and to hear those around you bonding over shared experiences you can't fully relate to, can in fact further feelings of invalidation, isolation, and shame. When I did actually try to articulate dysphoria-related body dissatisfaction in an individual therapy session, it was clear that this was neither understood nor recognised as important.
So, for me, this feels important because it will hopefully contribute to greater inclusivity, both within healthcare settings and in the wider public discourse around eating disorders. To address many of the harmful assumptions and stereotypes, the diversity in experiences of people with eating disorders, and how this can present differently, needs to be better understood. Hopefully this will be a step in the right direction! Being able to talk to other gender diverse people has been something I have found so healing. Feeling understood and hearing people say the things I couldn’t previously put into words has enabled me to speak to myself with a bit more kindness."
UK’s leading eating disorder charity offering information and support on eating disorders for members of the public and professionals.
Organisation sharing information about trans rights, UK law, NHS healthcare and transphobia – for trans people, allies and professionals.
Charity providing information and support on mental health problems.
They have specific information pages on eating problems and LGBTQ+ mental health.
Offering support and information about eating disorders no matter where you are in your journey. Helplines are open 3PM– 8PM, Monday to Friday.
England: 0808 801 0677
Scotland: 0808 801 0432
Wales: 0808 801 0433
Northern Ireland: 0808 801 0434
Offering support and information about eating disorders via email.
England: help@beateatingdisorders.org.uk
Scotland: Scotlandhelp@beateatingdisorders.org.uk
Wales: Waleshelp@beateatingdisorders.org.uk
Northern Ireland: NIhelp@beateatingdisorders.org.uk
Direct support through email, WhatsApp, or phone, for people waiting for gender-affirmative healthcare. Not eating disorder specific.
Phone: 0800 640 8046, WhatsApp: 07592 650 496
Support for trans young people and their loved ones (cis and trans). Not eating disorder specific.
Phone: 0808 801 0400, Webchat: Open from 1pm – 8.30pm Monday to Friday
Comprehensive resource for people in the UK searching for support in the transgender community, via online or in person support groups. Not eating disorder specific.
Amodeo, A. L., Esposito, C., Antuoni, S., Saracco, G., & Bacchini, D. (2022). Muscle dysmorphia: what about transgender people? Culture, Health & Sexuality, 24(1), 63-78. https://doi.org/10.1080/13691058.2020.1814968
Austin, S. B., Nelson, L. A., Birkett, M. A., Calzo, J. P., & Everett, B. (2012). Eating Disorder Symptoms and Obesity at the Intersections of Gender, Ethnicity, and Sexual Orientation in US High School Students. American Journal of Public Health, 103(2), e16-e22. https://doi.org/10.2105/AJPH.2012.301150
Barakat, S., McLean, S.A., Bryant, E., Le, A., Marks, P., National Eating Disorder Research Consortium, Touyz, S., & Maguire, S. (2023). Risk factors for eating disorders: findings from a rapid review. Journal of Eating Disorders, 11(8). https://doi.org/10.1186/s40337-022-00717-4
Becker, I., Auer, M., Barkmann, C., Fuss, J., Möller, B., Nieder, T. O., Fahrenkrug, S., Hildebrandt, T., & Richter-Appelt, H. (2018). A Cross-Sectional Multicenter Study of Multidimensional Body Image in Adolescents and Adults with Gender Dysphoria Before and After Transition-Related Medical Interventions. Archives of Sexual Behavior, 47(8), 2335-2347. https://doi.org/10.1007/s10508-018-1278-4
Brewster, M. E., Velez, B. L., Breslow, A. S., & Geiger, E. F. (2019). Unpacking body image concerns and disordered eating for transgender women: The roles of sexual objectification and minority stress. Journal of Counseling Psychology, 66(2), 131-142. https://doi.org/10.1037/cou0000333
Brokjøb, L. G., & Cornelissen, K. K. (2022). Internalizing minority stress: Gender dysphoria, minority stress, and psychopathology in a norwegian transgender population. Psychology of Sexual Orientation and Gender Diversity, 9(3), 272-286. https://doi.org/10.1037/sgd0000480
Brede, J., Babb, C., Jones, C., Elliott, M., Zanker, C., Tchanturia, K., ... & Mandy, W. (2020). “For me, the anorexia is just a symptom, and the cause is the autism”: Investigating restrictive eating disorders in autistic women. Journal of autism and developmental disorders, 50, 4280-4296.
Brownstone, L. M., DeRieux, J., Kelly, D. A., Sumlin, L. J., & Gaudiani, J. L. (2021). Body mass index requirements for gender-affirming surgeries are not empirically based. Transgender Health, 6(3), 121-124.
Burke, N. L., Hazzard, V. M., Schaefer, L. M., Simone, M., O'Flynn, J. L., & Rodgers, R. F. (2023). Socioeconomic status and eating disorder prevalence: at the intersections of gender identity, sexual orientation, and race/ethnicity. Psychological medicine, 53(9), 4255-4265. https://doi.org/10.1017/S0033291722001015
Burke, N. L., Schaefer, L. M., Hazzard, V. M., & Rodgers, R. F. (2020). Where identities converge: The importance of intersectionality in eating disorders research. International Journal of Eating Disorders, 53(10), 1605-1609. https://doi.org/https://doi.org/10.1002/eat.23371
Burstall, J., Tan, K. J., de la Piedad Garcia, X., & Anderson, J. R. (2024). Experiences of body image in the gender non-binary community: a qualitative analysis. Body Image, 51, 101762. https://doi.org/10.1016/j.bodyim.2024.101762
Calzo, J. P., Blashill, A. J., Brown, T. A., & Argenal, R. L. (2017). Eating Disorders and Disordered Weight and Shape Control Behaviors in Sexual Minority Populations. Current psychiatry reports, 19(8), 49. https://doi.org/10.1007/s11920-017-0801-y
Chaphekar, A. V., Vance, S. R., Garber, A. K., Buckelew, S., Ganson, K. T., Downey, A., & Nagata, J. M. (2022). Transgender and other gender diverse adolescents with eating disorders requiring medical stabilization. Journal of eating disorders, 10(1), 199. https://doi.org/10.1186/s40337-022-00722-7
Coleman, E., Radix, A. E., Bouman, W. P., Brown, G. R., De Vries, A. L., Deutsch, M. B., ... & Arcelus, J. (2022). Standards of care for the health of transgender and gender diverse people, version 8. International journal of transgender health, 23(sup1), S1-S259.
Cooper, K., Smith, L. G. E., & Russell, A. J. (2018). Gender Identity in Autism: Sex Differences in Social Affiliation with Gender Groups. Journal of Autism and Developmental Disorders, 48(12), 3995-4006. https://doi.org/10.1007/s10803-018-3590-1
Cusack, C. E., & Galupo, M. P. (2021). Body checking behaviors and eating disorder pathology among nonbinary individuals with androgynous appearance ideals. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 26(6), 1915-1925. https://doi.org/10.1007/s40519-020-01040-0
Cusack, C. E., Levenson, N. H., & Galupo, M. P. (2022). “Anorexia wants to kill me, dysphoria wants me to live”: Centering transgender and nonbinary experiences in eating disorder treatment. Journal of LGBTQ Issues in Counseling, 16(3), 265-284.
Diemer, E. W., Grant, J. D., Munn-Chernoff, M. A., Patterson, D. A., & Duncan, A. E. (2015). Gender Identity, Sexual Orientation, and Eating-Related Pathology in a National Sample of College Students. J Adolesc Health, 57(2), 144-149. https://doi.org/10.1016/j.jadohealth.2015.03.003
Diemer, E. W., White Hughto, J. M., Gordon, A. R., Guss, C., Austin, S. B., & Reisner, S. L. (2018). Beyond the Binary: Differences in Eating Disorder Prevalence by Gender Identity in a Transgender Sample. Transgender Health, 3(1), 17-23. https://doi.org/10.1089/trgh.2017.0043
Donaldson, A. A., Hall, A., Neukirch, J., Kasper, V., Simones, S., Gagnon, S., ... & Forcier, M. (2018). Multidisciplinary care considerations for gender nonconforming adolescents with eating disorders: A case series. International Journal of Eating Disorders, 51(5), 475-479.
Drabish, K., & Theeke, L. A. (2022). Health Impact of Stigma, Discrimination, Prejudice, and Bias Experienced by Transgender People: A Systematic Review of Quantitative Studies. Issues in Mental Health Nursing, 43(2), 111-118. https://doi.org/10.1080/01612840.2021.1961330
Duffy, M. E., Henkel, K. E., & Earnshaw, V. A. (2016). Transgender Clients’ Experiences of Eating Disorder Treatment. Journal of LGBT Issues in Counseling, 10(3), 136-149. https://doi.org/10.1080/15538605.2016.1177806
Duffy, M. E., Henkel, K. E., & Joiner, T. E. (2019). Prevalence of Self-Injurious Thoughts and Behaviors in Transgender Individuals With Eating Disorders: A National Study. Journal of Adolescent Health, 64(4), 461-466. https://doi.org/https://doi.org/10.1016/j.jadohealth.2018.07.016
Egbert, J., Luke, A., & Qeadan, F. (2024). Intersectionality of demographic characteristics in self-reported anorexia nervosa, bulimia nervosa, and probable eating disorders among college students. International Journal of Eating Disorders, 57(1), 132-145. https://doi.org/https://doi.org/10.1002/eat.24090
Feder, S., Isserlin, L., Seale, E., Hammond, N., & Norris, M. L. (2017). Exploring the association between eating disorders and gender dysphoria in youth. Eating Disorders, 25(4), 310-317. https://doi.org/10.1080/10640266.2017.1297112
Ferrucci, K. A., Lapane, K. L., Jesdale, B. M., McPhillips, E., & Dubé, C. E. (2024). Eating disorder specialist views on gender competency and education for treating gender minority patients. The Journal of Behavioral Health Services & Research, 51(2), 232-249. https://doi.org/10.1007/s11414-023-09864-1
Ferrucci, K. A., McPhillips, E., Lapane, K. L., Jesdale, B. M., & Dubé, C. E. (2023). Provider perceptions of barriers and facilitators to care in eating disorder treatment for transgender and gender diverse patients: A qualitative study. Journal of eating disorders, 11(1), 36. https://doi.org/10.1186/s40337-023-00760-9
Fisher, A. D., Castellini, G., Bandini, E., Casale, H., Fanni, E., Benni, L., Ferruccio, N., Meriggiola, M. C., Manieri, C., Gualerzi, A., Jannini, E., Oppo, A., Ricca, V., Maggi, M., & Rellini, A. H. (2014). Cross‐sex hormonal treatment and body uneasiness in individuals with gender dysphoria. The Journal of Sexual Medicine, 11(3), 709-719. https://doi.org/10.1111/jsm.12413
Galupo, M. P., Cusack, C. E., & Morris, E. R. (2021). “Having a non-normative body for me is about survival”: Androgynous body ideal among trans and nonbinary individuals. Body Image, 39, 68-76. https://doi.org/10.1016/j.bodyim.2021.06.003
Gordon, A. R., Austin, S., Krieger, N., White Hughto, J. M., & Reisner, S. L. (2016). "I have to constantly prove to myself, to people, that I fit the bill": Perspectives on weight and shape control behaviors among low-income, ethnically diverse young transgender women. Social Science & Medicine, 165, 141-149. https://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=psyc15&AN=2016-42585-016
Gordon, A. R., Beccia, A. L., Egan, N., & Lipson, S. K. (2024). Intersecting gender identity and racial/ethnic inequities in eating disorder risk factors, symptoms, and diagnosis among U.S. college students: An intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy. International Journal of Eating Disorders, 57(1), 146-161. https://doi.org/https://doi.org/10.1002/eat.24089
Hartman-Munick, S. M., Silverstein, S., Guss, C. E., Lopez, E., Calzo, J. P., & Gordon, A. R. (2021). Eating disorder screening and treatment experiences in transgender and gender diverse young adults. Eating Behaviors, 41, 101517. https://doi.org/https://doi.org/10.1016/j.eatbeh.2021.101517
Harrop, E. N., Hecht, H. K., Harner, V., Call, J., & Holloway, B. T. (2023). “How do I exist in this body… That’s outside of the norm?” Trans and nonbinary experiences of conformity, coping, and connection in atypical anorexia. International Journal of Environmental Research and Public Health, 20(2), 1156.
Jones, B. A., Haycraft, E., Bouman, W. P., Brewin, N., Claes, L., & Arcelus, J. (2018). Risk factors for eating disorder psychopathology within the treatment seeking transgender population: The role of cross-sex hormone treatment. European Eating Disorders Review, 26(2), 120-128. https://doi.org/https://doi.org/10.1002/erv.2576
Jones, B. A., Haycraft, E., Murjan, S., & Arcelus, J. (2016). Body dissatisfaction and disordered eating in trans people: A systematic review of the literature. Int Rev Psychiatry, 28(1), 81-94. https://doi.org/10.3109/09540261.2015.1089217
Kcomt, L., Gorey, K. M., Barrett, B. J., & McCabe, S. E. (2020). Healthcare avoidance due to anticipated discrimination among transgender people: A call to create trans-affirmative environments. SSM - Population Health, 11, 100608. https://doi.org/https://doi.org/10.1016/j.ssmph.2020.100608
Klemmer, C. L., Arayasirikul, S., & Raymond, H. F. (2018). Transphobia-Based Violence, Depression, and Anxiety in Transgender Women: The Role of Body Satisfaction. Journal of Interpersonal Violence, 36(5-6), 2633-2655. https://doi.org/10.1177/0886260518760015
Levin, R. L., & Rawana, J. S. (2016). Attention-deficit/hyperactivity disorder and eating disorders across the lifespan: a systematic review of the literature. Clinical psychology review, 50, 22-36.
McGregor, K., McKenna, J.L., Barrera, E.P., Williams, C. R., Hartman-Munick, S. M., & Guss, C. E. (2023). Disordered eating and considerations for the transgender community: A review of the literature and clinical guidance for assessment and treatment. Journal of Eating Disorders, 11(75). https://doi.org/10.1186/s40337-023-00793-0
Nimbley, E., Golds, L., Sharpe, H., Gillespie‐Smith, K., & Duffy, F. (2022). Sensory processing and eating behaviours in autism: A systematic review. European Eating Disorders Review, 30(5), 538-559.
Nowaskie, D. Z., Filipowicz, A. T., Choi, Y., & Fogel, J. M. (2021). Eating disorder symptomatology in transgender patients: Differences across gender identity and gender affirmation. International Journal of Eating Disorders, 54(8), 1493-1499. https://doi.org/https://doi.org/10.1002/eat.23539
Office for National Statistics. (2023). Gender identity by age and sex, England and Wales: Census 2021. Retrieved from https://www.ons.gov.uk/peoplepopulationandcommunity/culturalidentity/genderidentity/articles/genderidentityageandsexenglandandwalescensus2021/2023-01-25
Owen-Smith, A. A., Gerth, J., Sineath, R. C., Barzilay, J., Becerra-Culqui, T. A., Getahun, D., Giammattei, S., Hunkeler, E., Lash, T. L., Millman, A., Nash, R., Quinn, V. P., Robinson, B., Roblin, D., Sanchez, T., Silverberg, M. J., Tangpricha, V., Valentine, C., Winter, S., . . . Goodman, M. (2018). Association between gender confirmation treatments and perceived gender congruence, body image satisfaction, and mental health in a cohort of transgender individuals. The Journal of Sexual Medicine, 15(4), 591-600.
Papastavrou Brooks, C., Kafle, E., Butt, N., Chawner, D., Day, A., Elsby-Pearson, C., Elson, E., Hammond, J., Herbert, P., Jenkins, C. L., Johnson, Z., Keith-Roach, S. H., Papasileka, E., Reeves, S., Stewart, N., Gilbert, N., & Startup, H. (2023). Co-producing principles to guide health research: an illustrative case study from an eating disorder research clinic. Research Involvement and Engagement, 9(1), 84. https://doi.org/10.1186/s40900-023-00460-3
Perry, M., Watson, L., Hayden, L., & Inwards-Breland, D. (2019). Using body neutrality to inform eating disorder management in a gender diverse world. The Lancet Child & Adolescent Health, 3(9), 597-598.
Rafferty, J. R., Donaldson, A. A., & Forcier, M. (2020). Primary Care Considerations for Transgender and Gender-Diverse Youth. Pediatrics In Review, 41(9), 437-454. https://doi.org/10.1542/pir.2018-0194
Rasmussen, S. M., Dalgaard, M. K., Roloff, M., Pinholt, M., Skrubbeltrang, C., Clausen, L., & Kjaersdam Telléus, G. (2023). Eating disorder symptomatology among transgender individuals: a systematic review and meta-analysis. Journal of eating disorders, 11(1), 84. https://doi.org/10.1186/s40337-023-00806-y
Reisner, S. L., White Hughto, J. M., Gamarel, K. E., Keuroghlian, A. S., Mizock, L., & Pachankis, J. E. (2016). Discriminatory experiences associated with posttraumatic stress disorder symptoms among transgender adults. Journal of Counseling Psychology, 63(5), 509–519. https://doi.org/10.1037/cou0000143
Riddle, M. C., & Safer, J. D. (2022). Medical considerations in the care of transgender and gender diverse patients with eating disorders. Journal of eating disorders, 10(1), 178.
Romano, K. A., & Lipson, S. K. (2022). Weight misperception and thin-ideal overvaluation relative to the positive functioning and eating disorder pathology of transgender and nonbinary young adults. Psychology of Sexual Orientation and Gender Diversity, 9(4), 446-453. https://doi.org/10.1037/sgd0000524
Simone, M., Hazzard, V. M., Askew, A. J., Tebbe, E. A., Lipson, S. K., & Pisetsky, E. M. (2022). Variability in eating disorder risk and diagnosis in transgender and gender diverse college students. Annals of Epidemiology, 70, 53-60. https://doi.org/https://doi.org/10.1016/j.annepidem.2022.04.007
Smith, E. K., & Harrop, E. N. (2024). “That’s not at all what i needed” trans adults' perspectives on trans-affirming primary care and eating disorders. Social Science & Medicine, 348, 116836. https://doi.org/https://doi.org/10.1016/j.socscimed.2024.116836
Strang, J. F., Kenworthy, L., Dominska, A., Sokoloff, J., Kenealy, L. E., Berl, M., Walsh, K., Menvielle, E., Slesaransky-Poe, G., Kim, K.-E., Luong-Tran, C., Meagher, H., & Wallace, G. L. (2014). Increased Gender Variance in Autism Spectrum Disorders and Attention Deficit Hyperactivity Disorder. Archives of Sexual Behavior, 43(8), 1525-1533. https://doi.org/10.1007/s10508-014-0285-3
Strübel, J., Sabik, N. J., & Tylka, T. L. (2020). Body image and depressive symptoms among transgender and cisgender adults: Examining a model integrating the tripartite influence model and objectification theory. Body Image, 35, 53-62. https://doi.org/https://doi.org/10.1016/j.bodyim.2020.08.004
Tabaac, A., Perrin, P. B., & Benotsch, E. G. (2018). Discrimination, mental health, and body image among transgender and gender-non-binary individuals: Constructing a multiple mediational path model. Journal of Gay & Lesbian Social Services, 30(1), 1-16. https://doi.org/10.1080/10538720.2017.1408514
Testa, R. J., Rider, G. N., Haug, N. A., & Balsam, K. F. (2017). Gender confirming medical interventions and eating disorder symptoms among transgender individuals. Health Psychol, 36(10), 927-936. https://doi.org/10.1037/hea0000497
Thompson, J. K., Coovert, M. D., & Stormer, S. M. (1999). Body image, social comparison, and eating disturbance: A covariance structure modeling investigation. International Journal of Eating Disorders, 26(1), 43-51.
Thomas, K. S., Cooper, K. and Jones, C. R. G. (2025a). The intersection of autistic traits, ADHD traits, and gender diversity in disordered eating and drive for muscularity within the general population. Neurodiversity, 3 (10.1177/27546330241308649)
Thomas, K. S., Keating, J., Ross, A. A., Cooper, K. and Jones, C. R. G. (2025b). Avoidant/restrictive food intake disorder (ARFID) symptoms in gender diverse adults and their relation to autistic traits, ADHD traits, and sensory sensitivities. Journal of Eating Disorders, 13, 33. (10.1186/s40337-025-01215-z)
TransActual. (2021). Trans lives survey 2021: Enduring the UK’s hostile environment. https://transactual.org.uk/wp-content/uploads/TransLivesSurvey2021.pdf
Turan, Ş., Aksoy Poyraz, C., Usta Sağlam, N. G., Demirel, Ö. F., Haliloğlu, Ö., Kadıoğlu, P., & Duran, A. (2018). Alterations in body uneasiness, eating attitudes, and psychopathology before and after cross-sex hormonal treatment in patients with female-to-male gender dysphoria. Archives of Sexual Behavior,47(8), 2349-2361. https://doi.org/10.1007/s10508-018-1189-4
van de Grift, T. C., Elaut, E., Cerwenka, S. C., Cohen-Kettenis, P. T., De Cuypere, G., Richter-Appelt, H., & Kreukels, B. P. C. (2017). Effects of medical interventions on gender dysphoria and body image: A follow-up study. Psychosomatic Medicine, 79(7). https://journals.lww.com/psychosomaticmedicine/fulltext/2017/09000/effects_of_medical_interventions_on_gender.14.aspx
van de Grift, T. C., Elfering, L., Greijdanus, M., Smit, J. M., Bouman, M.-B., Klassen, A. F., & Mullender, M. G. (2018). Subcutaneous mastectomy improves satisfaction with body and psychosocial function in trans men: Findings of a cross-sectional study using the body-q chest module. Plastic and Reconstructive Surgery, 142(5).
Warrier, V., Greenberg, D. M., Weir, E., Buckingham, C., Smith, P., Lai, M.-C., Allison, C., & Baron-Cohen, S. (2020). Elevated rates of autism, other neurodevelopmental and psychiatric diagnoses, and autistic traits in transgender and gender-diverse individuals. Nature Communications, 11(1), 3959. https://doi.org/10.1038/s41467-020-17794-1
Watson, R. J., Veale, J. F., & Saewyc, E. M. (2017). Disordered eating behaviors among transgender youth: Probability profiles from risk and protective factors. International Journal of Eating Disorders, 50(5), 515-522. https://doi.org/https://doi.org/10.1002/eat.22627
Yesildemir, O., & Akbulut, G. (2023). Gender-affirming nutrition: An overview of eating disorders in the transgender population. Current Nutrition Reports, 12(4), 877-892. https://doi.org/10.1007/s13668-023-00504-w