Addressing eating disorders (EDs) within trans and nonbinary (TNB) populations is a growing concern, as TNB individuals are two to four times more likely to experience EDs than cisgender women. This study explored the lived experiences of TNB people with atypical anorexia by examining how gender identity impacted experiences of ED illness and (potential) recovery. Nine TNB adults with atypical anorexia were followed for one year and completed semi-structured, in-depth, longitudinal qualitative interviews at baseline, 6 months, and 12 months. Interviews were coded using Braun and Clark’s thematic analysis procedures. Four themes, along with subthemes, emerged regarding the intersection of gender identity and ED experiences: (1) Conforming, (2) Coping, (3) Connecting, and (4) Critiquing. In Conforming, participants highlighted how societal pressures around gender contributed to ED vulnerability. In Coping, participants explained that their EDs represented attempts to cope with the overlapping influences of body dissatisfaction, gender dysphoria, and body disconnection. In Connecting, participants described ED recovery as a process of connecting to self, others, and communities that welcomed and affirmed their diverse identities. In Critiquing, participants described how current ED treatment settings were often unwelcoming of or unprepared for non-cisgender patients. Overall, participants viewed their EDs as intricately linked to their gender identity and experiences of social pressure and discrimination. This study suggests the need for targeted ED prevention and intervention efforts within TNB communities, and the ethical imperative to meaningfully address the needs of TNB patients in ED treatment settings.

Young people experience a variety of mental health concerns, including depression, non-suicidal self-injury, and suicidal ideation. These issues are at even higher rates among transgender and gender-diverse (TGD) young people, due to the additional burden of having to navigate a world in which transphobia impacts them at the individual, organizational, and policy levels. However, much of the extant research focuses only on comparing TGD youth to cisgender counterparts. This study explores the nuance within the TDG youth population regarding mental health, examining how gender, race/ethnicity, and sexual orientation change the likelihood of experiencing each of these mental health concerns. Among a sample of over 400 young people, findings indicate that those TGD young people who do not identify themselves within the masculine/feminine binary and those with marginalized sexual orientations were two to three times more likely to experience adverse mental health outcomes, as compared to their peers who are questioning their gender, and who are heterosexual. The implications for mental health professionals and others who work with young people are to recognize that mental health is not a one-size-fits all model for young TGD people, and that the intersection of multiple marginalized identities, must be addressed in order to improve the mental health of this group of young people. Findings can also be used to better understand issues of stigma, discrimination, and victimization in education, health care, and beyond.

Although gender-affirming health care improves the well-being of transgender (trans) individuals (ie, transgender, nonbinary, those with culturally specific identities, and others), trans patients continue to report frequent discriminatory and unskilled treatment in health care spaces.^1-9 These experiences are associated with suicidality, substance use, and other negative outcomes.^10-13 Consequently, trans patients sometimes withhold gender-related information to avoid discrimination.¹⁴ Furthermore, discriminatory policies creating barriers to health care access for trans people are in flux across the US.¹⁵ Multiply marginalized (eg, Black individuals, Indigenous individuals, members of other racial or ethnic minority groups, disabled individuals, people with lower socioeconomic status) trans people are already more likely to use emergency departments for primary care, which is associated with worse health outcomes compared with visiting primary care physicians.^16,17 Although these experiences are increasingly well documented, there is a dearth of scholarship investigating specific aspects of gender-affirming health care practices. Given these challenges, we posed the following research questions: (1) What influences patients’ decision-making regarding sharing gender-related information with health care providers (clinicians, health care organizations, health care systems)? (2) How do patients want to be asked gender-related questions? (3) How does provider understanding of gender impact patients’ health care experiences?

The human papillomavirus (HPV) carries a significant health risk for people with a cervix. Among transgender and nonbinary people, however, testing and treatment for HPV can pose difficulties and even be traumatic at times. This study is part of a larger mixed-methods study conducted in Michigan in 2020, and it explores the experiences of transmasculine and nonbinary people with at-home self-swabbing HPV test kits and knowledge of HPV transmission/screenings. Phenomenological qualitative methods were used by conducting virtual qualitative interviews with ten transmasculine and nonbinary individuals with cervixes, ages 23–59. Interviews were independently coded by members of the research team and a tabletop theming method was used. Four themes were generated from the data: (1) multilevel barriers; (2) “get it done, so I know that I am safe”; (3) contrasting preferences for care; and (4) community calls for change. The discussion focuses on the implications of these findings for improving sexual health care for the transgender and nonbinary community, along with directions for further research.