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Nutrition for LGBTQ+ Individuals

Updated: Jun 17, 2021

Curious about how nutrition and gender identity are interrelated? Learn more about nutrition counseling for the LGBTQIA+ community here!

An appreciation for food is something most people identify with. However, when we talk about the gender identity spectrum and nutrition, there’s often more than meets the eye. What do dietitians and their clients need to know about nutrition for lesbian, gay, bisexual, and transgender (LGBTQ+) individuals?


Start with creating a safe space, and then study the challenges, barriers, and strategies of connecting LGBTQIA+ individuals with the nutrition care they need. There are certain nutritional risks and disorders that face the community. Adapting care environments so that they are more inclusive is a key part of becoming an affirming provider.


Read on for an overview of nutrition for LGBTQ+ individuals.

 

Nutrition Research for LGBTQ+ Individuals

Nutritional needs for the LGBTQ+ population go largely unacknowledged -- to the point that food scientist Dr. Taylor Wallace calls the community “An Invisible Population in Data.”


There is a large lack of research, especially for transgender individuals during transition. While these unique individuals are increasingly being recognized by nutrition professionals and organizations, research is still a step behind. It is difficult to rally a significant number of participants for studies, and even harder to receive a response that can be applied widely.


The Challenges of Conducting Research

Researchers report a lack of the following when it comes to exploring medical nutritional needs across the LGBTQ+ population:

  • The proper tools

  • Time

  • Guidance (i.e. evidence-based guidelines)

  • Funding

  • Options to select alternative aspects of sexual orientation and gender identity on national representative surveys (i.e. National Health and Nutrition Examination Survey [NHANES])


How Lack of Research Impacts the Community

Disparities among the population will go unnoticed without high-quality research and evidence-based guidelines. Research helps to establish a more comprehensive understanding of nutrition and health for a population. The LGBTQ+ population has nutritional needs that aren’t properly being addressed in the current available guidelines for dietitians.



What Does Existing LGBTQ+ Nutrition Research Say?

While current studies are limited in their application to the overall population, they do indicate the following:

  • In one study, 100% of the participants (transgender individuals) indicated an interest in additional counseling and information -- especially in regards to drug and diet interactions, weight management, and supplements. This same study reported that 100% of the respondents indicated no formal nutrition care was received during their transition.

  • Another study showed that 54.4% of trans males in the study reported food insecurity. High levels of depressive symptoms were reported by the respondents. Eating disorder self-reports were also significantly higher, with binge eating being the most frequent behavior reported. Of those respondents, only 4.3% sought treatment for an eating disorder.

  • Recent practice applications for dietetic and nutrition professionals indicate that nutritional concerns differ for subpopulations of sexual minorities within the LGBTQ+ community. In other words, a gay man and a trans man likely have different nutritional needs, necessitating a spectrum of appropriate approaches.


Nutritional Areas of Concern for LGBTQ+ People & Their Providers

There are some specific areas of concern that nutrition and healthcare providers should be aware of. Multidisciplinary teams can help work together to establish the best standard of care for individuals when a lack of evidence exists.


Here are potential problems affecting the LGBTQ+ population:

  • Body dissatisfaction, which can lead to disordered eating

  • Gender-based stigma discrimination, which can lead to disparate health outcomes

  • Lack of healthcare access

  • Food insecurity

  • Gender affirmative therapies and surgery, along with potential nutrition-related side effects of medical interventions

  • Hormone therapies, along with nutrition-related side effects

  • Mental health, including prevalent rates of depression, suicidal ideation, and harassment

  • Sexually transmitted diseases (STDs)


According to Dr. Wallace:

“Nutrition is one of the highest rated health concerns among LGBTQ+ individuals.”


Unique Nutrition Needs

LGBTQ+ populations have unique needs when it comes to nutrition. Just as with males and females who identify with their gender assigned at birth, nutritional needs change in different stages of life.


It’s important to understand that social integration and physical transition can place heavy burdens of stress on the body.


Rates of Nutritional Risk in the LGBTQ+ Community

Beyond mental health disorders as a main concern for this population, the LGBTQ+ community also experiences elevated rates of the following:

  • Cancer

  • Human Immunodeficiency Virus (HIV)

  • Acquired Immunodeficiency Syndrome (AIDS)

  • Limited access to healthcare


Dietitians Acting As Affirming Providers

Affirming an LGBTQ+ individual does not require you to agree with them. It simply means you acknowledge their experience and challenges as unique and individual.


Recent practice applications for dietetic and nutrition professionals state:


“RDNs are in a position to provide appropriate, patient-centered, and compassionate care for this health-disparate population.”


Addressing the Needs of the LGBTQ+ Individual, Subpopulations, and Population

Remember, while there may be a lack of research available, there are many ways to engage as a multidisciplinary healthcare team. Work with the following individuals to better understand the needs of the individual, subpopulations, and population:

  • Health organizations

  • Policy-makers

  • Professional practice organizations

Transgender & Transitioning Individuals

Transitioning individuals should be treated with a full integrative health care team. The following resource from the Journal of the Academy of Nutrition and Dietetics can be helpful in navigating key terms in the community, research, and more.



Gender-Affirming Medical Interventions (Hormone Therapy)

Undergoing hormone therapy is an intense process. It has clinical and psychosocial considerations that dietary therapy may be able to support.


Potential gender-affirming medical interventions include:

  • Masculinizing hormone therapy

  • Feminizing hormone therapy

  • Surgical reassignment

Adolescents

Adolescents have a unique set of nutritional needs, Transgender pediatric patients have additional tranistion considerations. Suppression of puberty may possibly play a role in therapy.


It’s important to be familiar with the scope of practice (SOP) for dietitians in this situation. In certain cases, side effects of hormonal therapy may fall within the scope of practice, including:

  • Weight gain

  • Changes in body composition

  • Altered lipid profiles

  • Changes in bone composition

  • Other metabolic factors

Other Subpopulations

Recent research reports the following:

“...emerging research has indicated distinct nutrition-related considerations for sexual minorities of the LGBTQ population...significant variations in health risk behaviors within each subcategory of sexual orientation, indicating a need to investigate the dietary considerations of sexual minorities that have historically been grouped into one category.”


Improving the Future for LGBTQ+ Communities

Dietitians can help advocate for advances in healthcare for LGBTQ+ individuals. Particularly, focus can be devoted to the following areas:

  • Effective prevention of nutrition-related problems

  • Effective treatment strategies for nutrition-related problems

  • Increasing specialized care for LGBTQ+ subpopulations (within the community)

  • Advancements in legal equality, particularly as related to health and nutrition care

  • Contributing to cultural acceptance (i.e. increased media visibility)

  • Improving access to the internet

  • Increasing support for community resources

  • Reducing stigma

From the Academy

Becoming an affirming provider starts with education! For continuing education, you can access the following resource:



In Summary on Nutrition & the LGBTQ+ Community

Nutrition for LGBTQ+ communities starts simply by connecting with the individual and understanding their nutritional needs. Continual awareness and advocation efforts makes advances in health and nutrition care possible. Future research should aim at exploring subpopulations of sexual minorities so that dietitians and other professionals have evidence-based guidelines to work with.

 

References


Abate C, Miknis A, Pryczynski J, Jurczak J, Portwood S, et al. Nutrition Education for Transgender Individuals During Transition (P04-001-19). Current Developments in Nutrition. 2019;3(1):04-001-19.


Arikawa AY, Ross J, Wright L, Elmore M, Gonzalez AM, et al. Results of an Online Survey about Food Insecurity and Eating Disorder Behaviors Administered to a Volunteer Sample of Self-Described LGBTQ+ Young Adults Aged 18 to 35 Years. J Acad Nutr Diet. 2020. DOI: https://doi.org/10.1016/j.jand.2020.09.032


Rahman R, Linsenmeyer WR. Caring for Transgender Patients and Clients: Nutrition-Related Clinical and Psychosocial Considerations. J Acad Nutr Diet. 2018;119(5):727-732.


Wallace, T. LGBTQ+ Nutrition. Drtaylorwallace.com. Accessed June 2021.


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