“I have to constantly prove to myself, to people, that I fit the bill”: Perspectives on weight and shape control behaviors among low-income, ethnically diverse young transgender women
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The impact of societal femininity ideals on disordered eating behaviors in non-transgender women has been well described, but scant research has explored these processes among transgender women. The present study explored weight and shape control behaviors among low-income, ethnically diverse young transgender women at high risk for HIV or living with HIV in a Northeastern metropolitan area. Semi-structured in-depth interviews were conducted with 21 participants (ages 18-31 years; mean annual income <$10,000; ethnic identity: Multiracial [n = 8], Black [n = 4], Latina [n = 4], White [n = 4], Asian [n = 1]). Interviews were transcribed and double-coded using a template organizing method, guided by ecosocial theory and a gender affirmation framework. Of 21 participants, 16 reported engaging in past-year disordered eating or weight and shape control behaviors, including binge eating, fasting, vomiting, and laxative use. Study participants described using a variety of strategies to address body image concerns in the context of gender-related and other discriminatory experiences, which shaped participants' access to social and material resources as well as stress and coping behaviors. Disordered weight and shape control behaviors were discussed in relation to four emergent themes: (1) gender socialization and the development of femininity ideals, (2) experiences of stigma and discrimination, (3) biological processes, and (4) multi-level sources of strength and resilience. This formative study provides insight into disordered eating and weight and shape control behaviors among at-risk transgender women, illuminating avenues for future research, treatment, and public health intervention.
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Transfeminine adolescents may engage in restrictive behaviors to align with beauty standards for women.
“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 Gordon et al., 2016
Previous case studies have also found TGAs restricting intake to conform to gender norms as well as to minimize secondary sex characteristics.
“Previous case studies have also found TGAs restricting intake to conform to gender norms (Gordon et al., 2016) as well as to minimize secondary sex characteristics (Couturier et al., 2015; Strandjord et al., 2015).”
From Exploring transgender adolescents’ body image concerns and disordered eating: Semi-structured interviews with nine gender minority youth (2021) · cites this paper as Gordon et al., 2016
Both case studies and quantitative literature have found purging behaviors to be prevalent among TGAs.
“Furthermore, both case studies and quantitative literature have found purging behaviors to be prevalent among TGAs (Diemer et al., 2015; Watson et al., 2017; Gordon 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 Gordon et al., 2016
It is often difficult to disentangle gender minority-specific from broader factors underlying TGAs' body dissatisfaction and disordered eating.
“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 Gordon et al., 2016
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- Authors
- Gordon, A. R., Austin, S. B., Krieger, N., White Hughto, J. M., & Reisner, S. L.
- Affiliations
- Boston Children's Hospital (US)
- Harvard University (US)
- Corresponding author
- Gordon, Allegra R.
- Venue
- Social Science & Medicine
- Publisher
- Elsevier BV
- Published
- 2016-09
- Volume
- 165
- Pages
- 141-149
- ISSN
- 0277-9536 (ISSN-L)
- PMC
- PMC5241136
- OpenAlex
- W2479786860
- Cited by
- 97
- References
- 52
- Citations by year
- 2026: 9 · 2025: 11 · 2024: 7 · 2023: 21 · 2022: 10 · 2021: 13 · 2020: 11 · 2019: 5 · 2018: 7 · 2017: 3
- FWCI
- 6.69
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- www.elsevier.com/legal/tdmrep-license (tdm)
- www.elsevier.com/open-access/userlicense/1.0/ (am, 359 d)
- doi.org/10.15223/policy-017 (stm-asf)
- doi.org/10.15223/policy-037 (stm-asf)
- doi.org/10.15223/policy-012 (stm-asf)
- doi.org/10.15223/policy-029 (stm-asf)
- doi.org/10.15223/policy-004 (stm-asf)
- Locations
- Social Science & Medicine (acceptedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Funders
- Harvard T.H. Chan School of Public Health
- Harvard University Open Gate Foundation
- Kate and Murray Seiden and Frank Denny Fund for Children Scholarship
- Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services (T71-MC-00009, T76-MC-00001)
- Fenway Institute at Fenway Health in Boston, MA
- LifeSkills Boston team
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- transgender women, disordered eating, body image, ideal femininity, gender socialization, stigma and discrimination, HIV risk, low-income young adults, ethnic diversity, resilience, ecosocial theory, gender affirmation, binge eating, laxative use
- MeSH terms
- Adolescent, Adult, Black or African American, Body Image, Body Weight, Boston, Bulimia, Ethnicity, Fasting, Feeding Behavior, Female, Hispanic or Latino, Humans, Male, Perception, Poverty, Urban Population, HIV Infections, Black People, White People, Asian People, Laxatives, Transgender Persons
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