Eating and exercise motivation and behaviors in trans and gender diverse adults: A mixed methods study.

Eating disorder (ED) rates in trans and gender diverse people range between 2% and 22%, with rates of disordered eating and exercise behaviors likely to be higher.Although several mechanisms have been proposed, including gender affirmation processes and minority stress, the specific pathways contributing to this heightened risk remain underexplored.Using a mixed methods approach, we investigated eating and exercise motivations and behaviors in trans and gender diverse adults.Participants completed an online survey including key demographics, Behavioral Regulation in Exercise Questionnaire, Compulsive Exercise Test, Eating Disorder Examination Questionnaire Short Form, and open-ended short answer questions related to exercise and eating experiences, and their gender.A total of 158 participants (M age 5 22.8 6 4.6 years) completed the survey, with the majority identifying as nonbinary (75.9%).Of the sample, 37.3% indicated self-reported an ED diagnosis, and 32.3% indicated current clinical symptoms on the Eating Disorder Examination Questionnaire Short Form.Descriptives for each of the scales and subscales, along with symptomatic classifications based on cut-points, Cronbach's a, chi-square tests, and Spearman's correlation, were used to explore the quantitative data.Qualitative analysis identified four themes via a data-driven, reflexive thematic approach: (a) gender and drivers of behavior, (b) environment and safety considerations, (c) challenges and opportunities of life stages, and (d) perceived norms and social desirability.This study highlights the complex interplay between gender diversity, identity, eating, and exercise behaviors in trans and gender diverse adults, revealing that thoseStephanie Budge served as action editor.