Node Smith, ND

Using Cross-sex Hormone Therapy (CHT) in Transgender Patients to help with Eating Disorders and Body Dissatisfaction

A recent research article addressed the use of cross-sex hormone therapy (CHT) in transgender patients to alleviate symptoms associated with eating disorders including body dissatisfaction.1

Assessing Eating Disorder Patients for Gender Identity Issues

The research was conducted through the University of Nottingham and the University of Loughborough. The overarching message is a recommendation that physicians involved with eating disorder patients assess these individuals for gender identity issues. These patients may benefit from being referred to transgender health services to be evaluated for possible hormone therapy.

Food Restriction May be a Way to Control Puberty, Reduce Development of Breasts, or to Stop Periods

Jon Arcelus, professor at the Institute of Mental Health, based at the University of Nottingham, and at the Nottingham Centre for Transgender Health, comments: “Young transgender people may restrict their food as a way to control their puberty, stop their period or reduce the development of breasts. Eating disorder professionals should consider the gender identity of the person when assessing a person with symptoms of an eating disorders.”

Unrealistic Body Image put Forth by Western Society has Pushed Many to take Dieting to Extreme Levels

Western society’s emphasis on an unrealistic body image has pushed many individuals to use diet pills and laxatives, binging, and self-induced vomiting, as well as anorexia to manipulate natural body appearance. For transgender individuals, this dissatisfaction with body shape and weight can be even more severe. Transgender individuals may use eating behaviors, or drugs, to help achieve a more masculine or feminine body. Transgender males may even restrict food as a way of preventing the onset of menstruation.

Hormone Therapy may Actually help these Individuals

The use of hormone therapy may actually help these individuals. The research in question looked at almost 600 patients over the age of 17 who were recruited through a national transgender health service. Patients were asked to complete questionnaires on issues related to eating disorders as well as mental health symptoms. The findings showed that patients not on hormone therapy were more likely to report body dissatisfaction and participate in dysfunctional eating behavior. Other factors that were associated with transgender individuals not taking hormones were attitudes of perfectionism, trust issues within personal relationships, and anxiety and depression.

The suggestion is that hormone therapy may primarily improve body image satisfaction, which then reduces perfectionism, and symptoms of anxiety and a constant need to increase self-esteem through controlled eating.


  1. Jones BA, Haycraft E, Bouman WP, Brewin N, Claes L, Arcelus J. Risk Factors for Eating Disorder Psychopathology within the Treatment Seeking Transgender Population: The Role of Cross-Sex Hormone Treatment. Eur Eat Disord Rev. 2018
Image Copyright: <a href=’’>vadimgozhda / 123RF Stock Photo</a>

Node Smith, ND, is a naturopathic physician in Portland, OR and associate editor for NDNR. He has been instrumental in maintaining a firm connection to the philosophy and heritage of naturopathic medicine among the next generation of docs. He helped found the first multi-generational experiential retreat, which brings elders, alumni, and students together for a weekend camp-out where naturopathic medicine and medical philosophy are experienced in nature. Four years ago he helped found the non-profit, Association for Naturopathic ReVitalization (ANR), for which he serves as the board chairman. ANR has a mission to inspire health practitioners to embody the naturopathic principles through experiential education. Node also has a firm belief that the next era of naturopathic medicine will see a resurgence of in-patient facilities which use fasting, earthing, hydrotherapy and homeopathy to bring people back from chronic diseases of modern living; he is involved in numerous conversations and projects to bring about this vision.

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