Online Program

Weight and shape control behaviors among young transgender women: Findings from Project Body Talk

Monday, November 2, 2015

Allegra R. Gordon, MPH, ScD, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
S. Bryn Austin, ScD, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
Cassandra Okechukwu, ScD, MSN, Social and Behavioral Sciences, Harvard T.H Chan School of Public Health, Boston, MA
Nancy Krieger, PhD, Dept of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
Jaclyn White, MPH, Chronic Disease Epidemiology, Yale University, New Haven, CT
Sari Reisner, ScD, Epidemiology/ The Fenway Institute, Harvard School of Public Health/ Fenway Health, Boston, MA

Background: Despite recent research suggesting that eating disorders may be a key health concern among transgender populations, little is known about potentially harmful weight and shape control behaviors in at-risk transgender women. The present study explored weight and shape control practices among low-income, ethnically diverse young transgender women in the Boston metropolitan area.

Methods: Semi-structured in-depth interviews were conducted with 21 participants (ages 18-31 years; mean annual income<$10,000; ethnic identity: Multiracial [n=8], Black [n=4], Latina [n=4], White [n=4], Asian [n=1]). Interviews were transcribed and double-coded using a template organizing method, guided by ecosocial theory and a gender affirmation model.

Results: Study participants described using a variety of strategies to address body image concerns.  Of 21 participants, 16 reported engaging in past-year disordered eating or weight and shape control behaviors, including binge eating, fasting, vomiting, and laxative use. Participants described a social context with gender-related and other discriminatory experiences, which shaped participants’ access to social and material resources as well as stress and coping behaviors. Several participants discussed the interaction of social and biological processes, particularly in relation to gender-affirming cross-sex hormone use and its role in both body satisfaction and weight gain concerns. Individual and community-level resiliencies related to the development of positive body image included peer and family networks and receipt of gender-affirming healthcare.

Conclusion: This formative study provides insight into disordered eating and weight and shape control behaviors among at-risk transgender women, illuminating avenues for research, treatment, and public health interventions to enhance resilience factors.

Learning Areas:

Diversity and culture
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe two potential pathways via which young transgender women may be at risk of eating disorders. Discuss a gender affirmation model and its potential application to understanding and contextualizing disordered eating behaviors in young transgender women.

Keyword(s): Lesbian, Gay, Bisexual and Transgender (LGBT), Nutrition

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the co-Investigator for this study and had primary responsibility for the study's design, implementation, and analysis.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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