While all people have important nutritional needs, some folks have unique health experiences which can result in different needs relating to their nutrition. One of these groups is trans people. Throughout this section, we provide a brief overview of some unique nutritional needs which trans people might have.

Body Image and Eating Disorders

A national study of US college students which looked at eating disorders amongst sexual and gender minority young adults demonstrated that trans young adults were more likely to experience eating disorders than their cisgender or sexual minority peers.

While there are a variety of reasons people experience body image concerns or eating disorders, trans people experience unique drivers which impact how they are affected by these issues. These include:

  • Some trans people may feel the need to conform to gender norms. In an effort to conform to these norms, someone might feel pressure to try to lose or gain weight, even if they wouldn’t have planned to do so otherwise.

  • Nutrition isn’t just a physical issue. Instead, it’s also a social issue. Trans people experience higher rates of poverty, which can result in a lack of food security. This can lead to trans people experiencing challenges in accessing high quality nutritional options.

If you notice signs of disordered eating, consult a mental health care professional, doctor, or dietician before the problem gets worse. You can find more information about resources near you in our “Get Access” section.

Hormones and Nutrition

When you start testosterone, your metabolic demands and lean muscle mass may increase. This can result in your body having an increased need for calories and protein. If you’ve recently started testosterone, ensure you speak with a healthcare provider (i.e. nutritionist) if you have challenges gaining or maintaining weight. You may need to be screened for nutritional deficiencies, which could require you to modify your eating habits.

Bone Health and Osteoporosis

There has been limited long-term research which studies the impact of hormones on bone health. Therefore, it can be challenging to know whether or not more trans people experience osteoporosis than their cisgender counterparts. That said, we do know that estrogen and testosterone play a major role in maintaining healthy bones and that trans people experience a range of other general risk factors which can negatively impact bone health.

Canadian screening guidelines recommend that all postmenopausal women and men over 50 be screened for possible risk factors for osteoporosis. If two or more risk factors are present, the individual should be offered a bone density scan.

If you belong to one of the following groups, the Transgender Health Program (Vancouver Coastal Health) recommends that you be considered for a bone density scan:

Folks taking feminizing hormones:

  • If you are taking estrogen on a regular basis, only get tested if there are other risk factors.

  • If you are taking anti-androgens alone (without estrogen) for more than 5 years, get tested after age 60.

  • If your testicles have been removed and you haven’t been taking estrogen consistently, get tested after age 60.

Folks take masculinizing hormones:

  • If you’re not on testosterone and your ovaries have not been removed, get tested after age 60 (or sooner if there are other risk factors).

  • If you’ve been taking testosterone for more than 5 years, get tested after age 50 (or sooner if there are other risk factors).

  • If your ovaries have been removed and you haven’t been taking testosterone consistently, get tested no matter what your age is.

You can help prevent osteoporosis through a variety of means, including but not limited to: eating a healthy and balanced diet; increasing your intake of calcium and vitamin C; reducing smoking, alcohol, and caffeine intake; taking your testosterone and estrogen as prescribed; and participating in weight-bearing exercise.

References 

Ashbee, Olivia, and Joshua M Goldberg. “Trans People and Osteoporosis.” Rainbow Health Ontario, Vancouver Coastal Health, Transcend, and Canadian Rainbow Health Coalition, Feb. 2006, www.rainbowhealthontario.ca/wp-content/uploads/woocommerce_uploads/2014/08/Osteoporosis.pdf. 

“Calcium and Vitamin D.” Osteoporosis Canada, osteoporosis.ca/bone-health-osteoporosis/calcium-and-vitamin-d/. 

Cooper, Charlotte, et al. “LGBTQ People and Eating.” Rainbow Health Ontario, Rainbow Health Ontario, Mar. 2014, www.rainbowhealthontario.ca/wp-content/uploads/woocommerce_uploads/2018/05/RHO_FactSheet_LGBTQEATING_E.pdf. 

Diemer, Elizabeth W, et al. “Gender Identity, Sexual Orientation, and Eating-Related Pathology in a National Sample of College Students.” Journal of Adolescent Health, Society for Adolescent Health and Medicine, Aug. 2015, www.jahonline.org/article/S1054-139X(15)00087-7/fulltext.

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The QTHC is based in Amiskwaciwâskahikan (ᐊᒥᐢᑲᐧᒋᐋᐧᐢᑲᐦᐃᑲᐣ) within Treaty 6 territory, a traditional meeting ground and home of the Nêhiyaw (Cree), Denesuliné (Dene), Nahkawininiwak (Saulteaux), Niitsítapi (Blackfoot), and Îyârhe Nakoda (Nakota Sioux), as well as nations not represented by the treaty, and is located in Region 4 of the Métis Nation of Alberta. We commit to engaging in an ongoing process of decolonization, and will strive to conduct our work in an anti-oppressive and anti-racist way, working towards equity, empowerment, and inclusion for all Two Spirit, queer, trans, and non-binary people.