EATING disorders, such as anorexia and bulimia, in transgender people can be treated with cross-sex hormone therapy (CHT), according to researchers from the University of Nottingham, Nottingham, and Loughborough University, Loughborough, UK. The team found that such disorders in transgender people were heavily linked to mental health issues resulting from body dissatisfaction, such as anxiety and depression, that can be alleviated with CHT.
The study comprised a cohort of 560 patients over the age of 17 years who attended an assessment at a UK-based national transgender health service between 2012 and 2015. In just under 25% of the participants, hormone treatment had begun prior to the assessment. All of the patients completed questionnaires on areas such as depression, anxiety, and body dissatisfaction.
Benefits of Hormone Treatment
It was found that patients who were not on hormone treatment were significantly more likely to report bulimic behaviours and a need to be thin. These conditions were heavily associated with body dissatisfaction, a preoccupation with perfectionism, depression and anxiety, and experience of trust issues in personal relationships. The team believe these results show that CHT could provide an effective therapy for eating disorders in transgender people.
One of the lead authors, Prof Jon Arcelus, University of Nottingham, commented: “These findings help to clarify the mechanisms through which hormone treatment might be able to improve eating disorder symptoms in this population. They suggest that hormones primarily improve body dissatisfaction, which in turn reduces levels of perfectionism and symptoms of anxiety, and increases self-esteem. In combination, these factors then appear to alleviate disorder symptoms. This is the first study with transgender people that has been able to indicate how cross-sex hormones alleviate eating disorder symptoms, although this finding needs to be replicated with more longitudinal research.”
Provision of Specialist Transgender Services
Due to these results, the researchers argue that patients with eating disorders should be assessed for gender identity issues and offered access to specialist transgender services where they can be evaluated for CHT. However, they acknowledge that further studies that include those people who identify outside the binary gender system, such as gender neutral, are required.
James Coker, Reporter
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