{"id":39467,"date":"2022-04-11T06:39:00","date_gmt":"2022-04-11T06:39:00","guid":{"rendered":"https:\/\/tiller.cronometerdev.com\/blog\/?p=39467"},"modified":"2025-02-10T16:03:52","modified_gmt":"2025-02-11T00:03:52","slug":"nutrition-considerations-transgender","status":"publish","type":"post","link":"https:\/\/cronometer.com\/blog\/nutrition-considerations-transgender\/","title":{"rendered":"Nutrition Considerations For The Transgender Population"},"content":{"rendered":"\t\t
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Article independently reviewed by the Registered Dietitian team specializing in support for personalized virtual nutrition counseling at HealthStandNutrition.com.<\/h6>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Over the past several decades, vital advocacy work has increased the visibility of\u00a0transgender people in society. And while important steps toward more inclusive\u00a0healthcare have been taken, nutrition guidelines for transgender people do not\u00a0exist. However, there are several dietary implications that transgender people\u00a0should consider during and following their transition period, specifically if\u00a0masculinizing or feminizing hormone therapy is used.<\/p>

With the information and research that is available today, we’ve compiled the guide below in hopes of helping this community live their healthiest lives.<\/p><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Transgender Men (Female to Male; FtM)<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Testosterone (T) therapy can result in weight gain and changes to body composition\u00a0(increased lean mass and decreased body fat). In addition, while bone mass may\u00a0increase temporarily, long-term T therapy can result in accelerated bone loss.\u00a0Dyslipidemia (elevated LDL-cholesterol and low HDL-cholesterol) is also common\u00a0with T therapy and there is an increased risk for health conditions such as heart\u00a0disease, hypertension, and type 2 diabetes, when other factors (age, race, lifestyle\u00a0habits, etc.) are taken into consideration. Eating disorders, dangerous weight control\u00a0strategies, and body dissatisfaction are also very common in the transgender\u00a0population, particularly among transgender women (1-3).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Transgender Women (Male to Female; MtF)<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Similar nutrition and health-related issues may occur in transgender women\u00a0receiving hormone therapy. Dyslipidemia and changes to blood pressure can\u00a0increase the risk for blood clotting disorders, hypertension, and type 2 diabetes if\u00a0additional risk factors are present. However, in contrast to transgender men,\u00a0transgender women often have improved bone mineral density, especially if gender\u00a0reassignment surgery has occurred (1-3).\u00a0Eating disorders, dangerous weight control\u00a0strategies, and body dissatisfaction are also very common in the transgender\u00a0population, particularly among transgender women (1-3).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Macronutrient Considerations<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Energy<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Popular equations used to estimate energy requirements, such as Harris Benedict or\u00a0Mifflin St. Jeor, are gendered and may not accurately capture the body composition\u00a0of transgender people. A preferable method of determining energy need is indirect\u00a0calorimetry, which uses a machine to measure oxygen consumption and carbon\u00a0dioxide production to predict energy requirements. However, indirect calorimetry\u00a0can be costly and unavailable, leaving equations as the only option for energy\u00a0assessment. If an equation is used to determine energy need, it\u2019s advisable to\u00a0monitor weight status weekly.<\/p>

If you are someone who struggles with disordered eating, there are a few settings to help take the focus off of counting calories, which can be found in this blog<\/a>.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Protein<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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\n\t\t\t\t\t\t\t\t\tNo specific protein recommendations exist for transgender people, although a\u00a0slightly higher protein intake may be beneficial in the context of weight gain. A\u00a0minimum of 1 gram per kilogram of body weight is sufficient for most adults.\n\nHowever, factors such\u00a0as activity level and the presence of disease can influence protein requirements. For\u00a0individualized recommendations, it\u2019s best to work with a Registered Dietitian\u00a0familiar with transgender nutrition needs (you can find a skilled professional by\u00a0searching Cronometer\u2019s\u00a0professional directory<\/a>).\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Fat<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Transgender individuals receiving hormone therapy may develop high cholesterol levels, increasing the risk for heart disease and stroke. An eating pattern that emphasizes whole fruits and\u00a0 vegetables, whole grains, pulses, nuts, and seeds, with reduced intakes of high-fat animal products, is ideal for improving cholesterol levels.<\/p>

In addition, it\u2019s important to ensure that you are meeting minimum fibre requirements as determined on an individual basis by a Registered Dietitian and choosing heart-healthy fats, such as those found in plants and fish.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Bone Health Considerations<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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\n\t\t\t\t\t\t\t\t\tWhile bone health tends to improve for transgender women (MtF), it typically\u00a0worsens for transgender men (FtM) due to the hormonal impacts of testosterone.\u00a0Important nutrients essential for achieving optimal bone health are discussed below.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Protein<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Debate exists regarding the ideal amount of protein for bone health since high\u00a0protein diets are associated with increased urinary losses of calcium (4). However,\u00a0urinary calcium losses do not necessarily lead to a negative calcium balance or\u00a0reduced bone mass (5), and moderate protein intakes of 1.0 to 1.5 g per kg of body weight per day have been shown to be overall beneficial to bone health.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Calcium and Vitamin D<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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The role of these two nutrients in the promotion of healthy bones is well known. While all adults should aim to meet the recommended daily allowance (RDA) for calcium and vitamin D, transgender men (FtM) receiving T therapy may benefit from an intake slightly above the RDA to prevent osteoporosis.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Related Bone Health Nutrients<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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\n\t\t\t\t\t\t\t\t\tMagnesium, phosphorus, vitamin A, potassium,\u00a0zinc, vitamin B12, vitamin C, vitamin K.

\n\nBone is a complex, living tissue that requires adequate intake of many different\u00a0nutrients. However, since several of the recommended intakes for these nutrients\u00a0are gendered, it\u2019s challenging to provide guidance on ideal targets. That said, given\u00a0the increased risk of poor bone health in transgender men (FtM), a conservative\u00a0approach is to aim for the higher intake of the two gendered options for each\u00a0nutrient, being mindful not to exceed the upper limit.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Bone Breakers<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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\n\t\t\t\t\t\t\t\t\tCaffeine, alcohol, sodium.

\nWhen it comes to preserving bone health, it\u2019s also important to pay attention to the\u00a0foods and nutrients that interfere with the bone-building process and\/or contribute\u00a0to increased calcium losses. Caffeine intake in excess of 400 mg (equivalent to four\u00a08 oz. brewed coffees) can increase calcium loss, while excessive alcohol intake\u00a0interferes with bone-building activity. High dietary sodium can also reduce bone\u00a0density so keep daily intake to less than 2300 mg per day (7).\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Iron<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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One other nutrient worth mentioning for its relevance to the transgender population is iron. Transgender men (FtM) receiving hormone therapy will no longer experience menstruation and as a result, iron needs are in line with cisgender males at 8 mg per day.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Conclusion<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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\n\t\t\t\t\t\t\t\t\tAlthough significant progress has been made in medicine to enhance the lives of\u00a0transgender people, the nutritional needs of this population remain largely\u00a0unknown. Weight gain, metabolic disease, and disordered eating may all be\u00a0experienced at a higher rate in the transgender population compared to cisgenders,\u00a0which speaks to the urgent need for inclusive, evidence-based guidelines. When it\u00a0comes to choosing a sex in your Cronometer account, it may be preferable to select\u00a0the gender that has been transitioned to in order to capture the fat\/muscle\u00a0composition changes that accompany hormone therapy. Careful attention should be\u00a0paid to the bone-building nutrients (for transgender men) and regular weight and\u00a0health monitoring by a medical team is important to confirm the suitability of\u00a0nutrition targets.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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References:<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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1.\u00a0<\/span>Rahman R, Linsenmeyer WR. Caring for Transgender Patients and Clients:<\/span><\/div><\/div><\/section>
Nutrition-Related Clinical and Psychosocial Considerations. J Acad Nutr Diet. 2019<\/div>
May;119(5):727-732. Available from:<\/div>
https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/29779913<\/div>
\u00a0<\/div>
2.\u00a0Fergusson P, Greenspan N, Maitland L, Huberdeau R. Towards Providing Culturally<\/span><\/div>
Aware Nutritional Care for Transgender People: Key Issues and Considerations.<\/div>
Can J Diet Pract Res. 2018 Jun 1;79(2):74-79. Available from:<\/div>
https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/29543495<\/div>
\u00a0<\/div>
3.\u00a0Breeding Z. Nutrition Considerations for the Transgender Community. Food &<\/span><\/div>
Nutrition. 2017 Dec. Available from:<\/div>
https:\/\/foodandnutrition.org\/from-the-<\/div>
magazine\/nutrition-considerations-transgender-community\/<\/div>
\u00a0<\/div>
4.\u00a0Heaney RP, Layman DK. Amount and type of protein influences bone health. Am<\/span><\/div>
J Clin Nutr. 2008 May;87(5):1567S-1570S. Available from:<\/div>
https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/18469289<\/div>
\u00a0<\/div>
5.\u00a0Bonjour JP. Dietary protein: an essential nutrient for bone health. J Am Coll Nutr.<\/span><\/div>
2005 Dec;24(6 Suppl):526S-36S. Available from:<\/div>
https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/16373952<\/div>
\u00a0<\/div>
6.\u00a0Kerstetter JE, O’Brien KO, Insogna KL. Dietary protein, calcium metabolism, and<\/span><\/div>
skeletal homeostasis revisited. Am J Clin Nutr. 2003 Sep;78(3 Suppl):584S-592S.<\/div>
Abstract available from:<\/div>
https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/12936953<\/div>
\u00a0<\/div>
7.\u00a0Dietitians of Canada, Practice-based Evidence in Nutrition. Eating Guidelines to<\/span><\/div>
Prevent Osteoporosis: It\u2019s Never Too Late! 2018 Oct. Available through<\/div>
subscription.<\/div><\/div><\/div><\/section>
<\/section>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

Article independently reviewed by the Registered Dietitian team specializing in support for personalized virtual nutrition counseling at HealthStandNutrition.com. Over the past several decades, vital advocacy work has increased the visibility of\u00a0transgender people in society. And while important steps toward more inclusive\u00a0healthcare have been taken, nutrition guidelines for transgender people do not\u00a0exist. However, there are several […]<\/p>\n","protected":false},"author":38436,"featured_media":44721,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[7],"tags":[],"class_list":["post-39467","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-nutrition"],"_links":{"self":[{"href":"https:\/\/cronometer.com\/blog\/wp-json\/wp\/v2\/posts\/39467","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cronometer.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cronometer.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cronometer.com\/blog\/wp-json\/wp\/v2\/users\/38436"}],"replies":[{"embeddable":true,"href":"https:\/\/cronometer.com\/blog\/wp-json\/wp\/v2\/comments?post=39467"}],"version-history":[{"count":0,"href":"https:\/\/cronometer.com\/blog\/wp-json\/wp\/v2\/posts\/39467\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cronometer.com\/blog\/wp-json\/wp\/v2\/media\/44721"}],"wp:attachment":[{"href":"https:\/\/cronometer.com\/blog\/wp-json\/wp\/v2\/media?parent=39467"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cronometer.com\/blog\/wp-json\/wp\/v2\/categories?post=39467"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cronometer.com\/blog\/wp-json\/wp\/v2\/tags?post=39467"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}