Prevention and Early Detection of Eating Disorders in Trans-Affirming Primary Care: Two Vignettes of Transgender Patients

Transgender and gender-diverse (trans) people report disordered eating behaviors at disproportionately high rates compared to their cisgender peers. Although disordered eating can drastically reduce quality of life and lead to early mortality, trans-affirming primary care providers are not typically taught to identify disordered eating behaviors or provide support for eating disorder recovery. A scarcity of trans-competent eating disorder treatment for trans people combined with a lack of training and capacity in trans-affirming primary care leads to substantial barriers to accessing care for disordered eating. Engaging a structural competency approach, we employ two theoretical case vignettes to integrate insights from our clinical experience with existing research and practice. We use these cases to illustrate the application of our recommendations for prevention and early detection of disordered eating in trans-affirming primary care settings, offer suggestions for future research, and explain policy-level implications.