Transgender and other gender diverse adolescents with eating disorders requiring medical stabilization

Journal of Eating Disorders

Research

Anita V. Chaphekar¹  Stanley R. Vance¹  Andrea K. Garber¹  Sara Buckelew¹  Jason M. Nagata¹  Amanda Downey²  Kyle T. Ganson³ 

[1] Department of Pediatrics, University of California, San Francisco, Box 0503, 550 16th Street, 94143, San Francisco, CA, USA;Department of Pediatrics, University of California, San Francisco, Box 0503, 550 16th Street, 94143, San Francisco, CA, USA;Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, Box 0503, 550 16th Street, 94143, San Francisco, CA, USA;Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St W, Toronto, ON, Canada;

关键词: Transgender;    Gender diverse;    Non-binary;    Gender identity;    Eating disorder;    Inpatient medical unit;    Treatment goal weight;    Percent median body mass index;    Growth chart;    Adolescents;   

DOI  :  10.1186/s40337-022-00722-7

 received in 2022-09-06, accepted in 2022-12-13,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundDespite the high prevalence of eating disorders in gender diverse adolescents, little is known about the characteristics of gender diverse youth with eating disorders who require inpatient medical stabilization. The primary objective of this study was to describe the medical, anthropometric, and psychiatric characteristics of gender diverse adolescents hospitalized for eating disorders and compare these characteristics to cisgender peers hospitalized for eating disorders. The secondary objective was to evaluate percent median body mass index as one marker of malnutrition and treatment goal body mass index as a recovery metric between patients’ birth-assigned sex and affirmed gender using standardized clinical growth charts.MethodsA retrospective chart review was conducted of 463 patients admitted to an inpatient eating disorders medical unit between 2012 and 2020. To compare medical, anthropometric, and psychiatric data between gender diverse and cisgender patients, chi-square/Fisher’s exact and t-tests were used. Clinical growth charts matching the patients’ birth-assigned sex and affirmed gender identity were used to assess percent of median body mass index and treatment goal body mass index.ResultsTen patients (2.2%) identified as gender diverse and were younger than cisgender patients [13.6 (1.5) years vs. 15.6 (2.7) years, p = 0.017]. Gender diverse patients were hospitalized with a higher percent median body mass index compared to cisgender peers [97.1% (14.8) vs. 87.9% (13.7), p = 0.037], yet demonstrated equally severe vital sign instability such as bradycardia [44 (8.8) beats per minute vs. 46 (10.6) beats per minute, p = 0.501], systolic hypotension [84 (7.1) mmHg vs. 84 (9.7) mmHg, p = 0.995], and diastolic hypotension [46 (5.8) mmHg vs. 45 (7.3) mmHg, p = 0.884]. Gender diverse patients had a higher prevalence of reported anxiety symptoms compared to cisgender patients (60% vs. 28%, p = 0.037).ConclusionsGender diverse patients demonstrated complications of malnutrition including vital sign instability despite presenting with a higher weight. This is consistent with a greater proportion of gender diverse patients diagnosed with atypical anorexia nervosa compared to cisgender peers. Additionally, psychiatric comorbidities were present among both groups, with a larger percentage of gender diverse patients endorsing anxiety compared to cisgender patients.

【 授权许可】

CC BY   
© The Author(s) 2022