Gender Identity, Sexual Orientation, Body Image, Eating, and Weight

  • Massimo Cuzzolaro
  • Walter Milano


Gender incongruence, gender dysphoria, and many eating and weight disorders share a troubling body uneasiness. Gender nonconformities were considered to be diseases, in particular, mental disorders, till the last decades of the twentieth century. In this chapter the new DSM-5 diagnostic category gender dysphoria is discussed together with some recent changes in terminology and medical classifications concerning gender identity and sexual orientation.The rates of psychiatric disorders are higher among transgender patients attending specialized services than in cisgender people, with higher levels of body dissatisfaction and suicidal risk. Psychiatric morbidity tends to improve after gender confirmation treatments, often but not always. Therefore, an expert multi-disciplinary team including mental health professionals should manage the assessment and intervention procedures before and after hormone and surgical treatments. The risk of disordered eating and weight control behaviors is increased among sexual minorities, maybe more among MtF (male-to-female) transgenders and homosexual men. Transgender persons may develop unhealthy eating behaviors to accentuate the physical features of their gender identity. Stigma and violence exposure are significant risk factors, while social support is a significant protective factor. The effects of medical and surgical treatments of gender incongruence on eating and weight-related disorders are mostly unknown.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Massimo Cuzzolaro
    • 1
  • Walter Milano
    • 2
    • 3
  1. 1.Formerly Medical Pathophysiology Department, Eating Disorders and Obesity UnitSapienza University of RomeRomeItaly
  2. 2.ASL Napoli 1NapoliItaly
  3. 3.Mental Disorders Department, Eating Disorders UnitNapoliItaly

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