The Trans Community Lacks Good Nutrition Advice

When I began my transition in 2019, I was frustrated with the limited research and information on proper nutrition and psychological wellness. My own medical practitioners, while completely knowledgeable and supportive, could not begin to address nutrition.

When I started to do my own research, I could count on one hand the number of scientific studies or related scientific literature that dealt with nutrition for the trans community.

And good nutrition is critical for the trans community.

Whitney Linsenmeyer Ph.D., R.D., spokesperson for the Academy of Nutrition and Dietetics and Assistant Professor of Nutrition at Saint Louis University says this: “Those receiving masculinizing or feminizing hormone therapy (HT) may experience change in body weight, body composition, bone health, and cholesterol levels, among others. Nutrition can play a role in all of these factors.”

The transitioning process can require an all-encompassing physical and mental change. Everyone’s transitioning process is different, and not everyone decides to do hormone therapy, but for those that do, that can entail additional challenges.

For just one example, hormone therapy can result in modest weight gain, according to a 2020 study, but a few study participants reported a 40-pound weight gain during transitioning. These types of vast changes warrant specific dietary needs, as the body is working to adapt.

Vanessa Rissetto, M.S., R.D., C.D.N., Dietetic Internship Director of NYU, and cofounder of Culina Health echoes this: “The fact that for the LGBTQ population we have no studies to date on how their hormone treatment affects their nutritional needs is a big issue. We have no markers and I don’t see any studies being funded at the moment.”

Why? Linsenmeyer says that, “specific to registered dietitians, the reality is that training on nutrition care for the transgender population is rarely included in our formal education.”

Without an emphasis in education, may registered dietitians may be “blind” to the nutritional needs of those in transition. And then there are other confounding factors, says Linsenmeyer.

There’s breaching the fine line of cultural privacy, and researchers may feel as if they’re being too intrusive by studying the topic. There’s the potential for political pressure that may be indirectly applied to those involved in scientific research. Whatever the reason, the idea that an entire population group has no secure space to turn to for guidance is alarming.

One Personal Account

As someone with a history of disordered eating, manifesting itself by way of orthorexia and body dysmorphia, I can attest to the damage poor nutrition has on one’s health.

Since transitioning, and finding a new love for the body I exist in, I recognize that food and self-worth are two components that are irreplaceable in the transitioning process. When I was very sick, weighing around 100 pounds (I’m around 5’6), my body stopped producing hormones of any kind.

I have come a long way and am currently at a healthy weight for my height. However, I am presently facing the health-related consequences of my past, including osteoporosis beginning at the age of 25 (I am now 30, and have a limited ability to increase my bone density at this stage of life), kidney and liver damage, anemia, infertility, and several others.

There are instances when I’m simply scared, because my symptoms are not overt, and I can only go by what I feel to a certain extent. At this moment in time, I can only move forward by being as proactive as possible to prevent additional damage.

Nutrition Is More Than Just Food

Any minority group, feeling outcast, would find it a greater task to advocate for themselves. I found that as a transman, this caused me to turn inward, striking an accusatory tone in my own self-talk. I have heard similar stories from others within the LGBTQ community.

This process led me to decide I was not worth it, removing all components of pleasure from my existence, including food.

Food is a way to connect with ourselves and others, it is a personal experience that is directly tied to emotions and physical wellbeing. Food contributes to our memory, concentration, mood and can alleviate additional emotion-related behavioral patterns, such as anxiety and depression.

This is through several key factors of dietary intake, including variety, adequacy, nutrient-density, and balance. By maintaining these practices in a flexible way, my body is able to perform at its best, producing the hormones and cellular energy required to stabilize mood, blood sugar, fluid balance and additional cognitive processes and emotions.

A Call to Action

Moving forward, we must address the needs of the transgender community. “As educators we have to create a safe space for those minority groups to feel comfortable reaching our and expressing their concerns. We have to acknowledge not enough is being done, and we have to take steps toward change.” says Rissetto. “We can’t just sit around and point fingers, and we also can’t say, well I’ve done all I can.”

I couldn’t agree more with her sentiments. It’s not a conversation about who should be doing what, it’s a discussion as to what can we do now to help.

Linsemeyer agrees: “My research and clinical practice centers on nutrition care for the transgender population, but the reality is that I am cisgender and will have a different perspective than a transgender or non-binary nutrition professional.”

With this in mind, creating an educational program that connects cisgender and transgender professionals would be a great start. Establishing a specific nutritional organization that accounts for LGBTQ needs within their practice and realm of scope would be even better.

This needs to be more than a conversation.

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