Nutrition-related needs and considerations in the transgender and gender non-conforming (TGNC) population: Current gaps and future directions in research

Abstract

Transgender and gender non-conforming (TGNC) individuals face significant health disparities despite growing visibility and awareness. Nutrition-related disparities are particularly concerning, with TGNC individuals experiencing higher rates of food insecurity, eating disorders, body dissatisfaction, and overweight or obesity. Gender-affirming hormone therapy (GAHT) and other medical interventions lead to significant physiological changes that can influence nutritional needs, as well as body composition and bone mineral density, yet existing daily energy estimation equations do not account for TGNC individuals or those undergoing GAHT. Perioperative nutrition is also vital, as gender-affirming surgeries increase metabolic demands and risk of muscle loss due to immobility and catabolism. Moreover, TGNC individuals report higher rates of food insecurity, with transgender men being particularly affected, largely due to economic disparities and systemic discrimination. Eating disorders are likely under reported in this population due to limited access to competent, inclusive care. Most research combines transgender and gender non-conforming individuals, limiting insight into subgroup differences. To improve health outcomes among TGNC individuals, there is a critical need for more inclusive, longitudinal research, particularly in the areas of nutrition, metabolism, and post-surgical care. Such research could inform the development of tailored interventions, enhance healthcare provider competence, and support the creation of clinical guidelines that address the specific health and nutrition needs of TGNC individuals. Ultimately, this would help reduce disparities and promote long-term well-being for TGNC individuals.