Variability in eating disorder risk and diagnosis in transgender and gender diverse college students

To examine differences in elevated eating disorder risk and self-reported eating disorder diagnosis across subgroups of transgender and gender diverse (TGD) college students.

Data from 5057 TGD college students participating in the national Healthy Minds Study between 2014 and 2019 were analyzed. Chi-square tests and logistic regression analyses examined heterogeneity in prevalence and odds of elevated eating disorder risk, as measured by the SCOFF, and self-reported eating disorder diagnosis by gender, as well as by intersecting gender and sexual orientation identities.

Genderqueer and/or non-conforming college students reported the highest prevalence of elevated eating disorder risk (38.8%) relative to gender expansive students. Genderqueer and/or non-conforming (11.1%), gender expansive (12.3%), and trans men and/or transmasculine students (10.5%) reported higher prevalence of a self-reported eating disorder diagnosis relative to trans women and/or transfeminine students (6.3%). Heterosexual or straight trans men had lower odds of eating disorder risk and self-reported diagnosis relative to trans men with a minoritized sexual orientation.

Genderqueer and/or non-conforming college students may be at heightened eating disorder risk. Moreover, a heterosexual and/or straight sexual orientation was associated with lower odds of elevated eating disorder risk and self-reported eating disorder diagnoses among trans men and genderqueer and/or non-conforming college students, but this finding did not hold for other groups. College campuses should aim to reduce eating disorder risk among TGD students.