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Why Weight Is an Unspoken Problem in the Transgender Community

My own story about weight and transness is atypical. I have been chubby as far back as I can remember, but my weight was rarely an issue, in terms of body image. My parents occasionally might have suggested I try a diet, but whenever I would, I would stop within a week because it left me feeling hungry and deprived.

But there was an additional aspect that I couldn’t really voice at the time as a teenager. I wasn’t very motivated to lose weight in the first place because there were parts of being fat that I really liked. Namely, that it gave me breasts of a sort. I might have gotten made fun of for them, but having any sac of fat on my chest was incredibly helpful during periods of dysphoria, when the mismatch between what my mind expected my body to be and what my body actually was could often be unbearable.

Sure, being fat might have meant that I wasn’t considered attractive — but I was a devoted nerd with my head constantly in a book, and so my weight was never my biggest problem. Plus, much higher on the list of aspects of myself that made me uncomfortable were byproducts of puberty, like changes in my voice and new, coarser body hair.

Vintage yellow bathroom scale
Image: GraphicaArtis/Getty Images

More: Gender Identity 101: A Guide to Understanding Transgender Issues

The science of transgender health is very new. Most of what we know comes from one of two traditions: the first, a surgical and endocrinological tradition dating back more than a century on adapting and changing our bodies in order to lessen the feelings of dysphoria. The second, more recent area takes a public health lens and grew out of the AIDS crisis in the 1980s and the need to address the fact that transgender people were at high risk of contracting HIV.

While both of these are necessary, the fact that the science of transgender health has largely grown from these acute needs means that more prosaic health concerns have been largely ignored. What we know definitively about weight has to do with hormone therapy, which has many effects on body physiology.

In his book, The Psychobiology of Transsexualism and Transgenderism, Dr. Thomas Bevan, a biopsychologist, breaks down the effects of hormone therapy. Transgender women who take estrogen often find themselves gaining weight and losing muscle mass, and the body fat redistributes into a more typical female pattern. Transgender men taking testosterone may find their muscle mass increasing and their fat redistributing into a typical male pattern.

Cover of book Trans Bodies, Trans Selves
Image: Trans Bodies, Trans Selves

Trans Bodies, Trans Selves, a book about transgender health written by and for transgender people, offers some general recommendations for healthy exercise and a helpful note about eating disorders in the trans community: “[T]here are limited data regarding eating disorders in the trans community. Unfortunately, most eating disorder programs are segregated by gender and few eating disorder programs address the specific needs of our communities.”

More: 7 Things You Need to Know About the Transgender Population in the U.S.

The scientific perspective on transgender weight, clearly, is pretty thin. In order to get more of a perspective, I asked some transgender people about issues surrounding weight.

Mallory, a trans woman, says that she occasionally gets dysphoric from working out “because it’s a ‘manly thing,’ which will screw up my eating because I feel like I haven’t earned food.”

Mallory’s comments about being dysphoric from working out resonated with me; I have had a similar experience with exercise — it’s so male-coded that it can be difficult to summon the energy to do it. And, of course, it is more difficult for transgender women to gain and maintain muscle mass once we have begun hormone therapy because we suppress testosterone, which is a steroid.

Stack of weights in gym

Image: Mubariz Khan / EyeEm

Chris, a trans man, feels very dysphoric about his body, which he describes as an “hourglass figure.” This, however, has improved by starting testosterone. “I have definitely felt a massive reduction in dysphoria between the changes brought about by testosterone and the admittedly fairly minor changes brought about by exercise,” he tells me.

Like Mallory, Chris also has difficulties with certain kinds of exercise.

“There are many kinds of exercise I feel that I cannot do due to being transgender and trying to live stealth in a fairly conservative area… I know I can never [go] swimming,” Chris says.

While there is a gym across the road from him, Chris is too anxious to use it, saying that he doesn’t want to “[risk his] safety using public changing rooms [and] showers.”

Clearly, people in the trans community face unique challenges with managing their weight in addition to the normal anxieties everyone has — but you wouldn’t know this from public transgender figures. Laverne Cox and Janet Mock are some of the biggest transgender celebrities, and both are thin. Caitlyn Jenner is a former Olympian, and even though she is pushing 70, she still looks like she could effortlessly run a decathlon.

Out of all the famous trans people, the only one who has issues with weight is Chaz Bono, who didn’t become famous in his own right, but was the child of a celebrity couple. So why is it that transgender celebrities tend to be thin if not athletic?

“I think [trans celebrities] are generally thin because it makes them more easily acceptable,” Mallory suggests. In other words, to be famous, trans people have to be thin, because to be thin is to be attractive, and trans people’s acceptance often hinges on their being conventionally attractive.

More: My 5-Year-Old’s Friend Is Transgender, and He’s Doing Just Fine, Thanks

“[By being trans and thin] they are only breaking the mold in one way, and generally that’s all that they are allowed if they want to be accepted publicly,” Mallory explains.

Laverne Cox at 2017 Grammys
Image: Kevork Djansezian/Getty Images

Transgender celebrities don’t reflect the true diversity of body types and experiences with food in the trans community. The scientific community has rarely deigned to conduct research into this area of trans health, preferring instead to address the more urgent health needs of trans people, such as hormones and HIV.

While that’s understandable, it does mean that much is unknown about this huge area of life. Whatever the reason, a conversation about general health in trans people is long overdue, and the conversation about weight is an important part of that.

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