Nutrition for the Transgender Community

Transgender people, and the issues their community faces, are under-studied. This is due to the fact that national surveys of the general population fail to inquire if respondents are transgender or not.

Around 0.3% of U.S. adults identify as transgender and the population seems to be increasing. Trans folks still face discrimination and disparities in healthcare, even as of 2022. The lack of training and knowledge on treating and counseling transgender patients is to blame for this issue. To provide the right treatment, it is important to educate health professionals and patients alike of the issues of the trans community.

Regardless of your gender identity, it’s important to exercise and consume a balanced diet in accordance with the Dietary Guidelines for Americans. The U.S. Department of Agriculture provides many resources on building a healthy diet through the ChooseMyPlate.gov website.

Common nutrition issues in the transgender community

Weight and body image issues are prevalent among the transgender community. It’s also common for transgender men and women to face different nutritional challenges.

Transgender men who have not had breast-removal may consume more calories to mask their upper body appearance. Transgender women may restrict calories and protein to maintain a thinner, less muscular structure. Both overweight and underweight lifestyles can have detrimental long-term health consequences, like increased risk of disease and premature mortality. Regardless of a person’s gender identity, as health professionals, we need to take this into consideration.

Until administering them hormone suppressants, children will have similar nutritional requirements. Although that may impact bone growth and optimal development. The National Osteoporosis Foundation recommends that all kids and teenagers get enough calcium, vitamin D (preferably in the form of dairy) and physical activity daily to ensure strong bones.

The impact of hormone therapy

Estrogen and sex hormone therapy (sometimes called HRT) may alter one’s nutritional needs. Transgender females face unique challenges, especially when receiving hormone therapy.

Estrogens can cause weight gain and may elevate triglycerides. While there is no consensus transgender or MtF diet, there are some possible foods to avoid to reduce this risk. For example, cutting out refined carbohydrates (e.g., added sugars, white bread/rice, etc.) may help offset a spike in triglycerides. 

Some transgender women needing support in lowering testosterone may improve their hormone balance by eating foods high in soy phytosterols such as tofu or edamame. Just be sure to check with your doctor about any medication interactions first.

Iron requirements stay the same after full transition. The best vitamins for trans women and those in MtF transition contain less than 8mg of iron per daily dose; a standard women’s multivitamin is not appropriate.

Trans men also face unique challenges. Sex steroid therapy may increase bad cholesterol levels in their blood. Minimizing saturated fats and increasing dietary fiber may may help to avoid future heart health issues.

Sex steroid therapy has been shown to increase visceral fat (i.e., the harmful fat), thus a healthy diet that is balanced in calories and exercise is important. It may also lead to bone loss, particularly among middle-age to older transgender men. So again, getting calcium and vitamin D through low or nonfat dairy consumption is key.  

Once menstruation has ceased, iron requirements fall from 18 mg to 8 mg per day (i.e., avoid a standard women’s multivitamin). Transgender men may also be prescribed diuretics that require a diet lower in potassium rich foods such as bananas and coconut water.

For more information on transgender health visit the University of California, San Francisco’s Center for Excellence for Transgender Health. Additionally, head over to my Amazon page to check out my personal list of recommended supplements to support and increase your health and wellbeing.