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Epidemiology and Population Health

Filling a gap in care: addressing obesity in transgender and gender diverse patients

Abstract

Transgender and gender diverse (TGD) adults are more likely to have obesity compared to cisgender peers. Based on surveys, the TGD population experiences disparities in healthy lifestyle behaviors (e.g., physical activity, screen time) compared to reference groups. They also face significant socioeconomic and healthcare barriers to accessing affirming care and gender minority stress, potentially contributing to increased weight. Gender-affirming hormone therapy is associated with changes in body composition and increased weight, which may impact cardiometabolic risk trajectory. Obesity can also be a barrier to gender-affirming surgeries, and affirming weight management services tailored to TGD patients are an important gap in healthcare to address. This Perspective briefly reviews current literature on the unique barriers experienced by TGD people and their identified needs regarding weight management interventions. It also suggests areas for future research to best fill this gap in healthcare and research while supporting the provision of lifesaving gender-affirming care.

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Fig. 1

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Funding

Funding

JMT has no financial disclosures. SJI receives funding through a Eunice Kennedy Shriver National Institute of Child Health & Human Development grant (The Colorado Building Interdisciplinary Research Careers in Women’s Health [BIRCWH] Program; supported by 5K12HD057022, PIs: Regensteiner JG and Santoro NF).

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JMT and SJI made individual contributions to authorship. JMT wrote the first draft of the manuscript and created the figure. JMT and SJI made critical revisions to the manuscript and reviewed and approved the final version.

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Correspondence to John Michael Taormina.

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Taormina, J.M., Iwamoto, S.J. Filling a gap in care: addressing obesity in transgender and gender diverse patients. Int J Obes 47, 761–763 (2023). https://doi.org/10.1038/s41366-023-01334-0

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