Are There Nutritional Guidelines for Transgender People?

Transgender people are individuals whose biological sex does not match up with their gender identity. There are no centralized, official nutritional guidelines for transgender people.

If you’re searching for nutrition information to guide your dietary choices as a transgender person, you may notice a binary trend in food guidelines. You may read about how men need a certain number of protein, carbohydrates, or calories per day, while women need a different number. How does transgender nutrition fit into this binary, and will the official guidelines ever answer transgender people’s nutritional concerns?

At present, transgender people have little official guidance upon which to rely when it comes to nutrition that is specific to transgender bodies. For example, do nutritional needs change during a person’s gender transition period? How does hormone replacement therapy affect nutrition, if at all? Learn more about nutritional guidelines for transgender people and gain a better understanding of when it may be time to talk to a nutritionist for individualized advice.

Transgender people are individuals whose biological sex does not match up with their gender identity (a term that refers to whether people perceive themselves to be male, female, a combination of genders, or no gender at all). The terms transgender, gender nonconforming, and nonbinary are often tossed around in casual conversation, and as we learn more about the science behind sex and gender, the more people have an opportunity to identify with different labels. Around 1.4 million adults in the United States are transgender.

Many, but not all, transgender people choose to undergo a medical gender transition. Some transgender people do not wish to go through hormonal therapy, while others wish to have gender-affirming surgery.

Whether a transgender person has decided to undergo hormonal therapy may affect their nutritional needs. Hormone therapy is a concern as it may put transgender individuals at risk for osteoporosis and glucose intolerance. Try not to make any drastic dietary changes during your transition unless you have first talked to a doctor or nutritionist. 

General nutritional advice

There are no centralized, official nutritional guidelines for transgender people. Dietary advice is given on a case-by-case basis by a qualified doctor who has experience treating transgender patients, but there are a few generalized guidelines that the majority of transgender people can follow.

You will likely need the same number of calories a day as you did before your transition unless you gain or lose a lot of weight during the process. If you choose to have gender-affirming surgery, it’s important to talk to your doctor about whether you might need additional calories to speed up the healing process after surgery.

Transgender women

Transgender women and transgender men often experience weight gain during hormone therapy, but bodily changes, as well as the differences between where transgender women and men gain weight, can look drastically different. Transgender women may take hormones that make their bodies more feminine. In this process, their bodies may gain weight in fat and lose muscle mass. If you want to lose weight during your gender transition, take into account that your hormones may be driving your specific type of weight gain.

Transgender men

When transgender men undergo hormone therapy, they may gain muscle mass and lose extra body fat. They might also lose bone mass when given testosterone for a long period of time and therefore have a higher risk of developing osteoporosis. Work with your doctor to determine how to change your diet to speed up muscle gain and boost bone health over time.

While official nutritional guidelines for transgender men and women have not yet been created, it’s safe to say that sticking to an overall healthy eating plan is still solid advice. Focus on choosing good-quality foods whenever possible and skipping fast or processed foods. Your diet should include mostly high-nutrient fruits, vegetables, proteins, and unsaturated fats — and you should try to limit added sugar and sodium when possible. Beyond these directions, it is important to pay attention to the following two considerations if you are transgender:

Eating disorders and gender dysphoria

Some transgender people experience gender dysphoria, which is a sense of being uncomfortable in your body due to unwanted genitalia or secondary sex characteristics such as body and facial hair, breasts, and a voice that is too high or too low. 

Gender dysphoria is complex, and while it is not necessarily a precursor to transitioning, it may put transgender people at higher risk for eating disorders if it is severe. Disordered eating is not restricted to well-known diagnoses such as anorexia and bulimia: You may have an eating disorder if you avoid certain foods, binge eat without vomiting, and adopt seemingly healthy dietary patterns such as fasting to an extreme degree.

The LGBT population, and specifically nonbinary and transgender adolescents, have a much higher rate of binge eating and fasting than the cisgender population. Eating disorders, in turn, are a major risk factor for poor nutrition, this is a factor that should be carefully considered if you are transgender and experience dysphoria that interferes with your mental health.

Mental illness and nutrition

While being transgender or gender non-conforming is not a mental illness, there are several issues such as restricted access to healthcare, discrimination, and judgment from others that combine to create poor mental health for transgender men and women. If you are struggling with your mental health, transgender or not, you may neglect your nutritional needs and stop taking care of your body. 

In addition to facing discrimination, transgender people are also at higher risk for psychiatric issues such as the following disorders:

• Anxiety
• Depression
• Post-traumatic stress disorder (PTSD)
• Bipolar disorder
• Schizophrenia
• Obsessive-compulsive disorder

If you are a transgender person and you struggle with mild to significant mental illness, speak to your doctor about how you can manage your mental health as you address your nutritional needs. A doctor may advise you to work with counselors or specialists who can help you create the best plan for yourself.