(PS7-7) Associations Between Distal and Proximal Minority Stressors and Eating Pathology in Transgender and Gender Non-conforming Adults

Eating disorders (EDs) disproportionately affect transgender and gender-non-conforming (TGNC) individuals, with prevalence rates up to four times greater than their cisgender peers (Roberts et. al, 2020; Diemer et al., 2015). One reason for this may be the use of ED behaviors as a two-fold response to gender-based body dissatisfaction and external experiences of victimization and non-affirmation (Romito et al., 2021). However, limited research has addressed the role of distal and proximal minority stressors unique to TGNC populations on eating pathology outcomes. The current study aimed to explore links between proximal risk (negative expectations for future, non-disclosure), distal risk (gender-related discrimination, rejection, and victimization, internalized transphobia, non-affirmation of gender identity) and resilience factors (community connectedness, pride) on specific ED behaviors. Participants (n=209, 33.4% transgender women, 33.4% transgender men, and 33.2% gender non-conforming people) were recruited across the U.S. via Prolific Academic. All participants completed the Transgender Congruence Scale, the Gender Minority Stress and Resilience Measure, and the Eating Pathology Symptoms Inventory. Results showed that lower appearance congruence (B = -.31, p < .001) and greater negative expectations of rejection (B = .19, p = .01) were associated with overall greater body dissatisfaction in TGNC participants. Additionally, higher rates of gender-related victimization (B = .14, p = .04) as well as greater rates of negative expectations of rejection (B = .19, p = .04) were associated with binge eating. Lower identity acceptance (B = -.24, p < .001) and higher rates of gender-related victimization (B = .28, p < .001) were associated with greater purging symptoms. Greater victimization (B = .19, p = .02) and higher rates of non-affirmation of gender identity (B = .17, p = .03) were significantly associated with restriction. These results emphasize the importance of understanding the role of gender minority stressors on eating pathology in TGNC individuals. Notably, the results highlight a robust association between gender-related victimization and ED behaviors. Consistent with prior work in TGNC and broader samples, this study supports the role of appearance congruence and fear of negative evaluation on body dissatisfaction. Future work could address the strength of minority stressors on ED symptoms in subgroups of TGNC individuals longitudinally, as well as in TGNC individuals holding multiple marginalized identities.