Table 1 Qualitative synthesis
From: Eating disorder symptomatology among transgender individuals: a systematic review and meta-analysis
References | Country | Group (n) | Population | Mean age (SD) | Eating disorder measures | Mean (SD) EDE-Q global score | Transition status | Results | Quality |
|---|---|---|---|---|---|---|---|---|---|
Arikawa et al. [53] | USA | Transgender men (59) Male (presumed cisgender) (29) Female (presumed cisgender) (93) | Community sample recruited from universities and local businesses | EAT-26 EDE-Q | 2.2 (1.5) 1.8 (1.0) 2.3 (1.3) | GAHT (81,8%) | Transgender men had higher levels of ED than (presumed cisgender) males | 5 | |
Cella et al. [45] | Italy | Transgender women (15) | Community sample recruited from associations and universities | 44.60 | EDI-2 DSM-VI | None had GAS | Transgender women reported higher levels of ED than cisgender individuals | 5 | |
Duffy et al. [49] | USA | Transgender women (19) Transgender men (22) | Community sample recruited from community organizations and transgender organizations | EDE-QS | Transgender women had higher ED scores than transgender men | 5 | |||
Gómez-Gil et al. [56] | Spain | Transgender women (159) Transgender men (71) | Clinical sample of patients with gender dysphoria complaints recruited at a hospital | M.I.N.I | All had applyed for GAHT or GAS GAHT (104) transgender women and (10) transgender men | Low prevalence of ED | 5 | ||
Hepp et al. [57] | Switzerland | Transgender women (20) Transgender men (11) | Clinical sample of outpatients undergoing treatment for GAS | 33.2 (10.3)1 | SCID-I DSM-VI | GAHT (10) GAS (7) | Low prevalence of ED | 3 | |
Jones et al. [18] | UK | Transgender individuals (563) | Clinical sample recruited from national transgender health service | 29.49 (13.67) | EDI-2 | GAHT (139) Not in GAHT (416) | Transgender individuals in GAHT had significantly lower ED symptoms than individuals not in GAHT | 5 | |
Khoosal et al. [6] | UK | Transgender women (40) | Clinical sample from gender identity clinic | 41.8 | EDI-2 | All transgender women received GAS and GAHT | Transgender women did not report higher levels of ED before or after GAS compared to comparison group | 6a | |
Linsenmeyer et al. [52] | USA | Transgender men (128) Transgender women (28) | Clinical sample recruited from a gender identity clinic | SCOFF | The majority were in GAHT (78.4%) | 28% of the sample screened positive for an ED | 5 | ||
Lipson et al. [58] | USA | Transgender individuals (330) Cisgender individuals (63,994) | Community sample based on students recruited from institutions | SCOFF | Transgender individuals had significantly higher ED scores compared to cisgender individuals | 5 | |||
Mitchell et al. [51] | USA | Transgender men (42) Transgender women (41) | Community sample recruited from community websites, blogs and snowball sampling | 28.26 (9.9) 36.68 (18.1) | EDE-Q (Restraint subscala) | 1.55 (1.5) 1.95 (1.9) | Misgendering was associated with decreased dietary restraint in transgender men | 5 | |
Mustanski et al. [8] | USA | Transgender women (12) Transgender men (8) Male (presumed cisgender) (107) Female (presumed cisgender) (119) | Community sample recruited via multiple methods and living in the Chicargo area | 18.31(1.32)2 | DISC DSM-VI | No prevalence of ED in transgender individuals | 5 | ||
Nowaskie et al. [54] | USA | Transgender men (79) Transgender women (87) | Clinical sample recruited from an outpatient gender health program | 27.18 (10.19) 34.69 (14.34) | EDE-Q | 1.30 (1.11) 1.62 (1.28) | GAHT (84) GAHT and GAS (30) | Transgender women and transgender men had EDs above cutoff, 13.8% and 10.1%, respectively Transgender individuals who had recieved GAHT and GAS had lower levels of ED than transgender individuals not in GAHT | 5 |
Nagata et al. [43] | USA | Transgender men (312) Transgender women (172) | Community sample recruited from a national cohort study collected through a web-based platform | 30.5 (9.7), 41.2 (14.9) | EDE-Q | 1.76 (1.36) 1.83 (1.28) | Transgender individuals had significantly higher rates of ED compared to cisgender individuals | 5 | |
Peterson et al. [44] | USA | Transgender women (69) Transgender men (180) | Clinical sample recruited from a gender identity clinic | 17.04 (2.88) | EDE-Q | 1.63 (1.40) 1.61 (1.33) | GAHT (28%) | Transgender individuals had significantly higher ED scores compared to cisgender individuals | 5 |
Rabito-Alcón et al. [7] | Spain | Transgender individuals (61) Comparison group (40) | Clinical sample recruited from a gender identity clinic | 27.28 (6.60) 21.85 (2.24) | EAT-26 EDI-2 (Body dissattisfaction subscale) | All in assessment phase at gender identity clinic | No significant difference between transgender individuals and the comparison group | 5 | |
Roberts et al. [50] | USA | Transgender male (635) Transgender female (64) Cisgender male (231) Cisgender female (688) | Community sample recruited from social media through advertisement | 16.0 (1.2) 16.2 (1.2) 15.9 (1.1) 15.8 (1.1) | EPSI | Transgender individuals had significantly higher rates of ED compared to cisgender individuals | 5 | ||
Romano and Lipson et al. [55] | USA | Transgender men (679) Transgender women (278) | Community sample recruited from student populations at institutions | 21.49 (4.99) 22.28 (5.96) | SCOFF | 32.57% of the transgender men and 34.23% of the transgender women reported positive for an ED on the SCOFF | 5 | ||
Schvey et al. [48] | USA | Transgender males (95) Transgender females (87) | Community sample recruited through ilitary installation and social media | 36.84 (15.29) 30.17 (11.27) | EDE-Q | 0.97 (1.0) 2.2 (1.5) | The majority were in GAT | Transgender individuals had higher ED scores than cisgender men | 5 |
Testa et al. [19] | USA | Transgender women (154) Transgender men (288) | Community sample recruited online through advertisments directed at transgender organisations | 24.59 (4.90) 22.70 (3.50) | EAT-26 | Transgender individuals who either wanted or had accessed GAT | 23% of the transgender women and 22% of the transgender men reported ED GAT was associated with decreased ED symptoms | 5 | |
Turan et al. [46] | Turkey | Transgender women (37) Comparison group of (presumed cisgender) women (40) | Clinical sample recruited from a hospital based on individual who had applied for GAT | 24.59 (4.90) 22.70 (3.50) | EAT-40 | All transgender men were in GAHT | No significant difference between transgender men and the comparison group and no significant difference before/after GAHT | 8a | |
Vocks et al. [47] | Germany | Transgender women (88) Transgender men (43) Comparison group of (presumed cisgender) men (56) and women (107) | Participants were recruited from self-help groups, counseling center and gender identity clinics | 37.27 (11.18) 34.95 (7.99) 34.77 (12.91) 32.80 (13.22) | EDE-Q EDI-2 | 1.82 (0.71) 1.63 (0.69) | GAHT: 57% of transgender women and 61% of trangender men GAS: 18% of transgender women and 33% of trangender men | Transgender individuals showed significantly higher ED scores compared to the comparison group No significant correlations were found for the number of transition stages | 4 |
Witcomb et al. [20] | UK | Transgender individuals (200) Comparison group of cisgender individuals (200) | Clinical sampel recruited from a gender identity clinic | 29.45 (6.70) 35.20 (12.10) | EDI-2 | GAHT 15 (10.7%) | Transgender individuals scored significantly higher on BD than cisgender individuals | 4 | |
Ålgars et al. [10] | Finland | Transgender men (11) Transgender women (9) | Community sample recruited from transgender support service | 42.22 (13.82) 29.45 (6.70) | EDI-3 | All but 4 participants had undergone or were currently undergoing GAT | ED scores were higher than in samples of (presumed cisgender) males | 7b | |
Ålgars et al. [4] | Finland | Transgender individuals (571) Comparison group (571) | Population based sample recruited from the Finnish registry | 25.15 (4.47)3 | EAT-26 | Transgender men showed sigificantly higher levels of ED symptoms than the comparison group of (presumed cisgender) females | 4 |