Community norms of the Eating Pathology Symptoms Inventory (EPSI) in transgender and gender-diverse adults

Jason M. Nagata*, Christopher D. Otmar, Christopher M. Lee, Emilio J. Compte, Jason M. Lavender, Tiffany A. Brown, Kelsie T. Forbush, Annesa Flentje, Micah E. Lubensky, Mitchell R. Lunn, Juno Obedin-Maliver

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Transgender and gender-diverse (TGD) individuals are at a higher risk for eating disorders, yet existing community norms for many eating disorder measures predominantly derive from cisgender populations. This study aimed to establish community norms for the Eating Pathology Symptoms Inventory (EPSI) among TGD adults (Forbush et al., 2013). The sample included 1206 gender-diverse people, 599 transgender men, and 293 transgender women from The PRIDE Study, a national longitudinal cohort of sexual and gender minority adults in the United States. We report mean scores, standard deviations, medians, interquartile ranges, and percentile ranks for the eight EPSI scales within TGD populations. Transgender women exhibited significantly higher scores on the Cognitive Restraint, Excessive Exercise, and Negative Attitudes Toward Obesity scales compared to transgender men and gender-diverse people. Conversely, transgender men showed significantly higher scores on the Muscle Building scale relative to transgender women and gender-diverse people. These findings suggest distinct patterns of eating pathology symptoms among TGD individuals and emphasize the need for clinicians to consider gender identity when assessing eating disorder symptoms.

Original languageEnglish
Article number101993
JournalEating Behaviors
Volume58
DOIs
StatePublished - Aug 2025
Externally publishedYes

Keywords

  • Eating disorders
  • Gender-diverse individuals
  • LGBTQ+
  • Norms
  • Transgender and gender-diverse health
  • Transgender health

Cite this