Inequalities, eating practices and beliefs among transgender women in Colombia: Mixed approaches in research

This study aimed to describe and categorize the eating practices and beliefs of trans women using a mixed-methods approach. Conducted in Cali, Colombia, the study included 33 trans women aged 18 years or older who voluntarily participated in August 2021. Food consumption and eating practices were assessed through structured questionnaires, and the data were analyzed using a Bayesian statistical approach and the Healthy Eating Practices Index (HEPI). In addition, discussion groups were conducted to explore participants' experiences and food-related beliefs. The results showed that 55% of the trans women presented low levels of healthy eating practices, characterized by limited dietary diversity in recommended food groups and a higher frequency of consumption of less recommended foods. Being under 30 years of age, belonging to a middle socioeconomic level, having lower levels of education and income, living with a partner, and regularly having a salt shaker on the table were factors individually associated with a higher likelihood of unhealthy eating practices. The multiple inequalities faced by the transgender population generate structural barriers that shape food practices within the community as adaptive responses to their living conditions, perpetuating unfavorable dietary patterns. These findings highlight the need for primary health care strategies with a gender-sensitive and trans-affirmative approach, in which nutrition and food practices are addressed through the lens of the social determinants of health. Transforming hegemonic social imaginaries is essential for building inclusive health environments that respect and reflect human diversity.