Nutrition for the Transgender Community

Nutrition for the Transgender Community
  • Dr. Taylor Wallace
  • November 16, 2017

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. 

8 thoughts on “Nutrition for the Transgender Community

  1. As a transgender woman from Australia I’ve recently started a Keto diet. Since being on this diet I’m starting to see some positive changes, searching the internet for a suitable diet for a while now and have come across the Keto. I now look to see if this Keto diet will have any affect on my HRT, so far so good the weight is coming off nicely. Great to see a small bit of information on this that has confirmed my concerns. ☺️

  2. Im a transgender girl from greece 22 years of age. When i start the hormone therapy i was 88 kilos sudenly in few months i become 64. Almos 2 years in my hormone therapy now i m 80 kilos trying to get thiner but i cant.. its a problem in my country cause we dont have so much attention as patients

  3. My transgender daughter is 17. She has very low BMI, she is non meat and fish eater but otherwise eats healthy and varied. She is taking calcium B12 and vitamin D. She has difficulty gaining weight, which may mean she will not receive her 4th round of puberty blockers. Is there anything you can advice. She is approximately 5’8 and weighs 44kilos.Thankyou

    1. Hi there – I don’t have any experience with puberty blocking medications (suggest you talk to the endocrinologist) but most of the time sufficient calorie intake is an issue with not being able to gain weight. If you can get her to consume eggs and dairy that’s a good way increasing protein intake, which is important in this situation.

  4. Hi Dr. Wallace, my name is Michelle and I am transitioning MTF and have a few questions regarding the testosterone levels in Mucuna Pruriens, particulary the Sunpotion Dopamine Bean powder.

    I have read several testimonies from people who have taken a 1/2 tsp of this ground up bean and they felt very productive. I would like to try it for myself but I am afraid that the testosterone levels will cause hair growth, increase muscle mass, lower my voice, and destroy the fat that I actually want to keep. Could you please let me know anything you can about this ingredient?

    I am not taking any hormones at the moment.

    Thanks very much,
    Michelle

    1. There’s not too many foods that influence these two hormones (to my knowledge). You may want to talk with a medical doctor about soy phytosterols (just talk to the doc to make sure there aren’t any nutrient-drug interactions first). Hope this helps!

  5. Hi Dr Taylor, i have been on hormones for 5months now, am on Androcur 50mg and Progynova 6mg but my arms are still bulkier, I have been on NO protein intake for 15days now, am craving chicken like bad, I feel sick already, but I want my muscle mass to go down, I want to be able to wear sleeveless clothes, am 27 y.o
    Am really sad that I have to stop eating mos of my fav foods for this but I don’t know what else to do. Please help

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