The impact of gender affirming care on eating disorder symptoms and body dissatisfaction: A systematic review and meta-analysis amongst transgender and gender diverse populations
Abstract
Body dissatisfaction (BD) and eating disorders (EDs) occur frequently among transgender and gender diverse (TGD) people. Tailored, empirically-based support for this cohort of TGD people is critical. This paper examined impacts of gender affirming care on BD and ED symptoms among TGD people. A systematic review and meta-analysis of existing literature (K = 24) was analysed through a random effects model, with separate analyses for gender (transgender men, transgender women and combined TGD) and type of gender affirming care (hormones and surgery). An exploratory narrative review (K = 45) examined impacts of gender affirming care on EDs by gender and type of gender affirming care separately. Hormonal treatment was associated with lowered BD for combined TGD samples (g = -0.462, p < .001) and transgender men (g = -0.609, p = .011). Surgery was associated with lowered body dissatisfaction for combined TGD samples (g = -0.991, p < .001) and transgender men (g = -0.926, p < .001,). Combined gender affirming care was associated with lowered BD for transgender women (g = -0.714, p < .001). Heterogeneity estimates suggest caution in generalising estimates for TM and for hormonal treatment, but broadly the meta-analyses suggest beneficial relationships with body image. Exploratory narrative review findings highlighted themes of alleviated EDs, though gender affirming care impacts were influenced by side effects such as weight gain, highlighting the need for further research on…
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