Body-Related Distress,Eating-Risk Indicators,and Minority Stress Correlates in Transgender and Gender-Diverse Adults: A Network Analysis

Abstract

Background:

Transgender and gender-diverse (TGD) individuals experience elevated body-related distress and eating-related symptoms, often in the context of minority stress and variable social support. In this population, body uneasiness may reflect not only evaluative dissatisfaction but also disturbances in embodiment. However, the conditional associations linking body uneasiness, eating-related symptom indicators, internalized transphobia, and perceived social support remain insufficiently explored in clinical TGD samples.

Aims:

To describe conditional associations among body uneasiness dimensions, eating-related symptom indicators, internalized transphobia, and perceived social support in TGD adults using a network-analytic approach.

Method:

A cross-sectional study was conducted in 134 TGD adults attending a multidisciplinary gender clinic. Participants completed the Body Uneasiness Test (BUT), an extended seven-item SCOFF screening tool, the Multidimensional Scale of Perceived Social Support (MSPSS), and the Internalized Transphobia subscale of the Gender Minority Stress and Resilience measure. A regularized Gaussian graphical model (EBICglasso, γ = .50) was estimated to examine conditional associations among variables. Network stability and accuracy were assessed via bootstrap procedures, and bridge indices were calculated to explore connections between psychosocial and symptom domains.

Results:

Body uneasiness dimensions formed a densely connected cluster, with body image concerns, weight phobia, and depersonalization showing the highest connectivity and predictability. A relatively strong association also emerged between weight phobia and eating-related symptom indicators. Demographic variables showed limited connectivity within the network. Perceived social support dimensions clustered together and were largely peripheral to the symptom domain; family support showed a weak negative association with depersonalization. Internalized transphobia exhibited modest connectivity with body uneasiness nodes.

Conclusions:

In this clinical sample of TGD adults, body uneasiness dimensions were more strongly interconnected than psychosocial variables within the estimated network. These findings provide an exploratory description of conditional associations among body-related distress, eating-related symptom indicators, and psychosocial variables in a gender-affirming clinical context. Longitudinal studies are needed to clarify temporal relationships and clinical implications.