Substantial research documents higher rates of eating disorders (EDs) in transgender and gender diverse (TGD) samples as compared to cisgender samples. The purpose of this literature review is to explore the vulnerability factors that explain poorer mental health outcomes in the TGD community and the resiliency factors that inform prevention and treatment strategies. The vulnerability factors identified include minority stress, particularly for TGD individuals with multiple nonprivileged identities; inadequate access to health care; experiences of trauma and abuse; food insecurity; co-occurring mental health disorders; and body dissatisfaction rooted in gender dysphoria. The resiliency factors identified include access to gender-affirming healthcare, community support, and family support. The implications section integrates the research on vulnerability factors and resilience factors and offers guidance for working with the TGD community in the prevention and treatment of eating disorders. These strategies include screening TGD patients for EDs with the goal of early intervention, screening ED patients for gender dysphoria, treating gender dysphoria concurrently with the ED, integrating gender issues in treatment, connecting TGD patients with community resources, supporting the families of TGD patients with EDs, and addressing access to care issues. The limitations of this body of research include the overrepresentation of privileged identities within the TGD community; complications arising from catch-all diagnostic categories; the use of instruments not designed or normed on the TGD community; insufficient statistical power of small sample sizes; discrepancies in the language; and inconsistent adherence to proposed ethical standards for conducting research about the TGD community. The lack of research on eating disorders in the TGD community means significant potential for future research. Future study is needed to determine lifetime prevalence of EDs in the TGD community, introduce or refine an assessment tool that screens for EDs in TGD samples, identify additional resiliency factors, parse out subgroup gender differences, understand intersections of privileged and nonprivileged identities, assess the effectiveness of community level interventions, and develop strategies that address access to care issues.
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/46093 |
| Date | 25 April 2023 |
| Creators | Zorc, Colleen (Leen) Elizabeth |
| Contributors | Offner, Gwynneth, Symes, Karen |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
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