(P24-115-23) “Sometimes Your Bones Are Just Bones, They Don't Care What Society Thinks”: A Mixed Methods Study of the Nutrition-Related Experiences of Transgender and Gender Diverse Youth

Objectives: Emerging data indicate that transgender and gender diverse (TGD) youth are nutritionally at-risk and have unique nutrition concerns. The aim of this community-engaged mixed-methods study was to describe the nutrition-related lived experiences of TGD youth residing in central Ohio.

Methods: A parallel convergent design was employed and informed by the health equity promotion framework and a community advisory board. A purposive sample was recruited through community partners in central Ohio. Participants were 13-24 years old and self-identified as gender diverse. Survey data were collected, including demographics, food security (9-item USDA), and eating patterns (EDE-A). Descriptive statistics [mean (SD); n (%)] were analyzed. In-depth semi-structured interviews with TGD youth were conducted and analyzed using reflexive thematic analysis. Intercoder reliability and member checks were used to improve the rigor of the analysis. Quantitative and qualitative datasets were integrated.

Results: Sixteen participants enrolled in the study. Mean age was 18.1±3.4 years. Participants identified as transgender man (n=8), transgender woman (n=1), nonbinary (n=5), and/or genderqueer (n=4). Most (81.3%) reported low or very low food security. The majority (68.8%) reported being markedly uncomfortable seeing their own body. Qualitative themes captured gender-specific experiences, including interest in learning about health behaviors that facilitate gender affirmation, the intersection between gender and relationship with food, social undermining (e.g. weight stigma, fragmented family support), concerns about food access, and individual and community-based assets (e.g. intolerance for body shaming).

Conclusions: Integrated findings demonstrate that food security, disordered eating, body shaming, and lack of access to tailored nutrition information are concerns among TGD youth. Individual awareness and queer community support are apparent assets that should be leveraged to improve health equity. Findings offer a deeper understanding of the nutritional concerns, priorities, and experiences of TGD youth and will inform future research and intervention development.

Funding Sources: The [BLINDED INSTITUTION] Human Nutrition Vivian Endowment Fund, The [BLINDED INSTITUTION] College of Nursing [BLINDED CENTER]