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Disordered Weight Management Behaviors, Nonprescription Steroid Use, and Weight Perception in Transgender Youth
Open accessAbstract
Purpose Disordered weight management behaviors are prevalent among youth; recent case reports suggested that these behaviors might also be common in transgender youth. We studied associations of gender identity with disordered weight management behaviors, nonprescription steroid use, and weight perception among transgender and cisgender (nontransgender) high-school students in Massachusetts.Methods Data were analyzed from the 2013 Massachusetts Youth Health Survey, an anonymous survey in a random sample of Massachusetts public high schools. Respondents were divided into three groups: transgender (n = 67), cisgender male (n = 1,117), and cisgender female (n = 1,289). Fisher's exact tests and multivariable logistic regression models were used to examine unhealthy weight management behaviors in the past 30 days: fasting >24 hours, vomiting, diet pill use, and laxative use; nonprescription steroid use; and self-perceived weight status. Analyses controlled for age, race/ethnicity, and body mass index.Results Compared with cisgender males, transgender adolescents had higher odds of fasting >24 hours (adjusted odds ratio [AOR] = 2.9, confidence interval [CI] = 1.1-7.8), using diet pills (AOR = 8.9, 95% CI = 2.3-35.2) and taking laxatives (AOR = 7.2, 95% CI = 1.4-38.4). Transgender youth had higher odds of lifetime use of steroids without a prescription than male cisgender respondents (AOR = 26.6, 95% CI = 3.5-200.1). Compared with cisgender females, transgender respondents had higher odds of perceiving themselves as healthy weight/underweight when they were overweight/obese (AOR = 2.4, 95% CI = 1.5-4.1).Conclusions Transgender youth disproportionately self-reported unsafe weight management behaviors and nonprescription steroid use compared with cisgender youth. Clinicians should be aware of this increased risk among transgender youth. Research is needed to further understand these disparities and to inform future interventions.
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In the citing paper
“Extant literature provides support for TGAs being at increased risk for disordered eating.”
From Exploring transgender adolescents’ body image concerns and disordered eating: Semi-structured interviews with nine gender minority youth (2021) · cites this paper as Guss et al., 2017
In the citing paper
“The majority of TGAs feel their biological body does not align with their felt sense of gender identity (Guss et al., 2017; McClain & Peebles, 2016).”
From Exploring transgender adolescents’ body image concerns and disordered eating: Semi-structured interviews with nine gender minority youth (2021) · cites this paper as Guss et al., 2017
In the citing paper
“Transmasculine adolescents—those assigned female at birth and who currently identify with a male gender identity—may engage in muscle-building behaviors aimed at achieving the muscular male ideal (Guss et al., 2017; McGuire et al., 2016).”
From Exploring transgender adolescents’ body image concerns and disordered eating: Semi-structured interviews with nine gender minority youth (2021) · cites this paper as Guss et al., 2017
In the citing paper
“In a representative sample of U.S. high school students, TGAs reported equal rates of diet pill and laxative abuse as cisgender females, long thought to be the most at-risk population for disordered eating (Guss et al., 2017).”
From Exploring transgender adolescents’ body image concerns and disordered eating: Semi-structured interviews with nine gender minority youth (2021) · cites this paper as Guss et al., 2017
In the citing paper
“For example, transfeminine adolescents—those who were assigned male at birth and currently identify with a female gender identity—may engage in restrictive behaviors to align with beauty standards for women (Gordon et al., 2016; Guss et al., 2017; McGuire et al., 2016).”
From Exploring transgender adolescents’ body image concerns and disordered eating: Semi-structured interviews with nine gender minority youth (2021) · cites this paper as Guss et al., 2017
In the citing paper
“A key overarching theme from this qualitative study is that it is often difficult to disentangle gender minority-specific from broader factors underlying TGAs’ body dissatisfaction and disordered eating (Gordon et al., 2016; Guss et al., 2017).”
From Exploring transgender adolescents’ body image concerns and disordered eating: Semi-structured interviews with nine gender minority youth (2021) · cites this paper as Guss et al., 2017
In the citing paper
“The body dissatisfaction and disordered eating experienced as a result of dissonance between their physical bodies and their felt sense of gender is consistent with evidence of TGAs being a high-risk population (Guss et al., 2017; Watson et al., 2017).”
From Exploring transgender adolescents’ body image concerns and disordered eating: Semi-structured interviews with nine gender minority youth (2021) · cites this paper as Guss et al., 2017
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Metadata
- Authors
- Guss, C. E., Williams, D. N., Reisner, S. L., Austin, S. B., & Katz-Wise, S. L.
- Affiliations
- Boston Children's Hospital (US)
- Corresponding author
- Guss, Carly E.
- Venue
- Journal of Adolescent Health
- Publisher
- Elsevier BV
- Published
- 2017-01
- Volume
- 60
- Issue
- 1
- Pages
- 17-22
- ISSN
- 1054-139X (ISSN-L)
- PMC
- PMC8091135
- OpenAlex
- W2540941017
- Cited by
- 153
- References
- 37
- Citations by year
- 2026: 12 · 2025: 17 · 2024: 17 · 2023: 24 · 2022: 14 · 2021: 18 · 2020: 21 · 2019: 13 · 2018: 11 · 2017: 5
- FWCI
- 13.39
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Adolescent Health (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
- National Institutes of Health (R01 HD 066963, K99HD082340, R01 HD057368)
- Maternal and Child Health Bureau (T76-MC00001)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- transgender youth, weight perception, gender identity, fasting, vomiting, laxative use, weight loss pills, eating disorders, adolescent obesity
- MeSH terms
- Drug Misuse, Adolescent, Adolescent Behavior, Body Image, Fasting, Female, Humans, Male, Massachusetts, Obesity, Risk-Taking, Vomiting, Testosterone Congeners, Laxatives, Transgender Persons
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