Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Epidemiology and Population Health

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


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.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type



Prices may be subject to local taxes which are calculated during checkout

Fig. 1


  1. The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. The National Academies Collection: Reports funded by National Institutes of Health. Washington (DC) 2011.

  2. Brown GR, Jones KT. Mental health and medical health disparities in 5135 transgender veterans receiving healthcare in the veterans health administration: a case-control study. LGBT Health. 2016;3:122–31.

    Article  PubMed  Google Scholar 

  3. Dragon CN, Guerino P, Ewald E, Laffan AM. Transgender medicare beneficiaries and chronic conditions: exploring fee-for-service claims data. LGBT Health. 2017;4:404–11.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Nagata JM, Ganson KT, Austin SB. Emerging trends in eating disorders among sexual and gender minorities. Curr Opin Psychiatry. 2020;33:562–7.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Christian R, Mellies AA, Bui AG, Lee R, Kattari L, Gray C. Measuring the health of an invisible population: lessons from the Colorado Transgender health survey. J Gen Intern Med. 2018;33:1654–60.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Diamond LM, Alley J. Rethinking minority stress: a social safety perspective on the health effects of stigma in sexually-diverse and gender-diverse populations. Neurosci Biobehav Rev. 2022;138:104720.

    Article  PubMed  Google Scholar 

  7. VanKim NA, Erickson DJ, Eisenberg ME, Lust K, Simon Rosser BR, Laska MN. Weight-related disparities for transgender college students. Health Behav Policy Rev. 2014;1:161–71.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Newcomb ME, Hill R, Buehler K, Ryan DT, Whitton SW, Mustanski B. High burden of mental health problems, substance use, violence, and related psychosocial factors in transgender, non-binary, and gender diverse youth and young adults. Arch Sex Behav. 2020;49:645–59.

    Article  PubMed  Google Scholar 

  9. Klaver M, Dekker M, de Mutsert R, Twisk JWR, den Heijer M. Cross-sex hormone therapy in transgender persons affects total body weight, body fat and lean body mass: a meta-analysis. Andrologia. 2017;49:e12660.

    Article  Google Scholar 

  10. Kyinn M, Banks K, Leemaqz SY, Sarkodie E, Goldstein D, Irwig MS. Weight gain and obesity rates in transgender and gender-diverse adults before and during hormone therapy. Int J Obes (Lond). 2021;45:2562–9.

    Article  CAS  PubMed  Google Scholar 

  11. Bigarella LG, Ballardin AC, Couto LS, de Avila ACP, Ballotin VR, Ingracio AR, et al. The impact of obesity on plastic surgery outcomes: a systematic review and meta-analysis. Aesthet Surg J. 2022;42:795–807.

    Article  PubMed  Google Scholar 

  12. Brownstone LM, DeRieux J, Kelly DA, Sumlin LJ, Gaudiani JL. Body mass index requirements for gender-affirming surgeries are not empirically based. Transgend Health. 2021;6:121–4.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Martinson TG, Ramachandran S, Lindner R, Reisman T, Safer JD. High body mass index is a significant barrier to gender-confirmation surgery for transgender and gender-nonbinary individuals. Endocr Pract. 2020;26:6–15.

    Article  PubMed  Google Scholar 

  14. Fisher AD, Castellini G, Ristori J, Casale H, Cassioli E, Sensi C, et al. Cross-sex hormone treatment and psychobiological changes in transsexual persons: two-year follow-up data. J Clin Endocrinol Metab. 2016;101:4260–9.

    Article  CAS  PubMed  Google Scholar 

  15. Silva ED, Fighera TM, Allgayer RM, Lobato MIR, Spritzer PM. Physical and sociodemographic features associated with quality of life among transgender women and men using gender-affirming hormone therapy. Front Psychiatry. 2021;12:621075.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Kirby SR, Linde JA. Understanding the nutritional needs of transgender and gender-nonconforming students at a large public midwestern university. Transgend Health. 2020;5:33–41.

    Article  PubMed  PubMed Central  Google Scholar 

  17. van der Sluis WB, de Bruin RJM, Steensma TD, Bouman MB. Gender-affirmation surgery and bariatric surgery in transgender individuals in The Netherlands: Considerations, surgical techniques and outcomes. Int J Transgend Health. 2022;23:355–61.

    Article  PubMed  Google Scholar 

Download references



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).

Author information

Authors and Affiliations



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.

Corresponding author

Correspondence to John Michael Taormina.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

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).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


Quick links