ORF46-03 - Perceptions and Satisfaction Rates of Body Composition and Body Shape Changes in Transgender and Gender Diverse Adults on Gender Affirming Hormone Therapy

Objectives
To compare the perceptions and satisfaction rates of weight, muscle size, body fat, and body shape among transgender and gender diverse (TGD) adults on gender affirming hormone therapy (GAHT) for at least one year.

Background
To improve their body image and satisfaction, many TGD individuals elect GAHT to promote physical changes to their body composition and shape such as body fat redistribution and changes to muscle size. However, there is little research on the perceptions of body composition and body shape changes and satisfaction rates after starting GAHT.

Methods
This was a cross-sectional cohort study of TGD participants seen at an adult gender clinic in Boston. Participants completed paper surveys after having been on GAHT for at least one year. Data captured included patient perceptions of their weight, muscle size, body fat, and body shape changes following GAHT, as well as satisfaction with each individual change. Weight, BMI, and waist circumference were also measured.

Results
Among the 101 patients enrolled the mean age was 28 years old and 52% were AMAB. AFAB participants were more likely to report an increase in muscle size (79% vs 2%) and positive satisfaction with the changes to their muscle size (78% vs 44%) compared to those AMAB. AMAB participants were more likely to report an increase in body fat (70% vs 28%), dissatisfaction with their weight (40% vs 19%), dissatisfaction with their weight changes (25% vs 10%) and dissatisfaction with their body shape changes (21% vs 8%) compared to those AFAB. Rates of body shape satisfaction, however, were similar among AMAB (70%) and AFAB individuals (73%). The average waist circumference was 96 cm for AMAB individuals and 95 cm for AFAB individuals. As a marker of cardiometabolic risk, rates of waist circumference ≥88 cm were 63% for AMAB individuals and 67% for AFAB individuals. Rates of waist circumference ≥102 cm were 33% for AMAB individuals and 28% for AFAB individuals.

Conclusion
Satisfaction rates differed between AMAB and AFAB individuals regarding the changes to their body composition and body shape following GAHT. The findings of this study can be used to better inform the counseling of TGD patients on their expectations for GAHT and to discuss strategies to optimize the achievement of patient goals. Additional research is needed on the factors that are both positively and negatively associated with body satisfaction.