Exploring the differences in body image concerns and eating disorder symptoms between cisgender and transgender individuals: A meta-analysis
Abstract
Transgender and gender diverse (TGD) individuals are at elevated risk of eating disorders (EDs), disordered eating (DE), and body image concerns (BIC) compared to cisgender people. This study investigated the differences in EDs, DE, and BIC between cisgender and TGD individuals, as well as examine disparities in EDs, DE, and BIC between TGD groups, with the goal of identifying high-risk groups. It was hypothesised that ED and DE pathology, and BIC would be higher in transgender people than cisgender people. Differences between TGD groups were also explored. Sixty studies were examined using meta-analyses, with sixteen random-effects meta-analyses conducted. Results revealed that TGD individuals were more likely to exhibit elevated levels of EDs, DE, and BIC compared to cisgender individuals. Fewer differences in EDs, DE, and BIC between TGD groups emerged, although transgender men/transmasculine people had higher levels of restriction (vs. non-binary and gender diverse people) and compensatory behaviours (vs. transgender women/transfeminine people). Binary transgender people reported higher BIC than non-binary/gender diverse people. Study heterogeneity and prediction intervals limit inferences to the broader population, and few studies were high quality. The emerging evidence suggests that TGD people are at elevated risk of ED pathology, DE, and BIC compared with cisgender people.
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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