NutraCast: The lack of nutritional guidelines for trans people

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As transgender Americans gain visibility, a recent Pew Research survey found that 1.6% of US adults are transgender or nonbinary, meaning their gender differs from the sex they were assigned at birth. That rate is even higher for younger adults, with 5% of those under 30 identifying as trans or nonbinary. Traditionally nutrition assessments are gender-specific, with one set of guidelines for men and another for women. So what does that mean for those who are in the middle?

Taylor Wallace, PhD, CFS, FACN, a food scientist, Editor of the Journal of Dietary Supplements, Deputy Editor of the Journal of the American College of Nutrition and founder of the nutrition consulting firm Think Healthy Group, said there is a growing interest in nutritional interventions for the trans community, but the research is lacking.

“The main thing is, you've got to talk with your health professional, because the last thing you want to do is be on a medication that a certain vitamin supplement or a certain diet regimen counters. Right now, we know a lot, for instance, about the interactions of estrogen with nutrients, but we don't know a lot about, for instance, when you give a male to female transitioning individual estrogen, and what that does to their calcium requirement. So we're given a lot of guesses here. In one sense, that's a good thing because that really gets everybody fired up, that we need more evidence and it really kind of bangs the gong to our government agencies, the big non-profit scientific societies that something needs to be done here. The downside is for a while, until we have better evidence, we're not going to have the answers to many questions and we're going to rely on scientific opinion.”

Wallace said he hopes to work with LGBTQIA+ health organizations like Whitman-Walker Health, who has longitudinal data from individuals they've been treating over the last decade, to develop data in order to get funding for research.

“You can't just go to NIH and say ‘hey, I got this idea for our clinical trial.’ You need to have some idea that these millions of dollars of taxpayer money that you're using is going to work or be beneficial to society, and you have to write a proposal and have some type of preclinical data. I think that's where the lgbtqia+ communities and their nonprofit associations and advocacy groups can play a very big role in helping people like me develop that preclinical data,” said Wallace.