Alterations in Body Uneasiness, Eating Attitudes, and Psychopathology Before and After Cross-Sex Hormonal Treatment in Patients with Female-to-Male Gender Dysphoria

  • Şenol Turan
  • Cana Aksoy Poyraz
  • Nazife Gamze Usta Sağlam
  • Ömer Faruk Demirel
  • Özlem Haliloğlu
  • Pınar Kadıoğlu
  • Alaattin Duran
Original Paper


Body dissatisfaction plays an important role in the development of psychiatric problems such as eating disorders as well as gender dysphoria (GD). Cross-sex hormonal treatment (CHT) alleviates the dissatisfaction by making various changes in the body. We examined the alteration of body uneasiness, eating attitudes and behaviors, and psychological symptoms longitudinally in Turkish participants with female-to-male gender dysphoria (FtM GD) after CHT. Thirty-seven participants with FtM GD and 40 female controls were asked to complete the Body Uneasiness Test to explore different areas of body-related psychopathology, the Eating Attitudes Test to assess eating disturbances, and the Symptom Checklist-90 Revised to measure psychological state, both before CHT and after 6 months of CHT administration. The baseline mean body weight, BMI scores, body uneasiness scores, and general psychopathological symptoms of participants with FtM GD were significantly higher than female controls, whereas baseline eating attitudes and behaviors were not significantly different. Over time, FtM GD participants’ mean body weight and BMI scores increased, body uneasiness and general psychopathological symptoms decreased, and eating attitudes and behaviors had not changed at 24th weeks following CHT administration compared to baseline. CHT may have a positive impact on body uneasiness and general psychopathological symptoms in participants with FtM GD. However, CHT does not have an impact on eating attitudes and behaviors.


Body image Body uneasiness Cross-sex hormonal treatment Eating attitudes Gender dysphoria 



We would like to thank all the people who volunteered to participate in this study.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This study was approved by the ethics committee of the Cerrahpaşa Medical Faculty at Istanbul University.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Authors and Affiliations

  1. 1.Department of Psychiatry, Cerrahpaşa School of MedicineIstanbul UniversityKocamustafapaşa-Fatih/IstanbulTurkey
  2. 2.Department of Endocrinology and Metabolism, Cerrahpaşa School of MedicineIstanbul UniversityKocamustafapaşa-Fatih/IstanbulTurkey

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