SUN-079 Baseline Body Satisfaction in Gender-Diverse Youth

Abstract

Background: Body dissatisfaction often contributes to the distress experienced by transgender and nonbinary individuals. However, limited data exist regarding body image in the pediatric age range. Objective: To establish baseline ratings of body satisfaction among gender-diverse youth prior to puberty blocking medication. Methods: Subjects were recruited from the gender health clinic at Riley Hospital for Children beginning in January 2018. Eligible subjects met clinical criteria for a puberty blocker, were treatment naïve, and were anticipated to be on a blocker alone for ≥ 1 year. We assessed self-reported body satisfaction at baseline using the Body Image Scale-Gender Spectrum. Subjects rated various body parts on a scale of 1 (very satisfied) to 5 (very dissatisfied). For analysis, body parts were grouped into gendered features (primary sex, secondary sex, & neutral characteristics) and also body areas (appearance/hair/voice, head & neck, musculoskeletal, hips, chest, & genitals/gonads).1 Results: Twenty subjects (mean age 12.0, range 8.4-14.0) were enrolled of whom 13 were transmasculine (TM) and 7 were transfeminine (TF). TM subjects had a mean BMI percentile of 73.7% and height z-score of 0.50, with breast Tanner stage (TS) of II (n=2), III (n= 3), IV (n=3) and V (n=4). Estradiol levels ranged from <20-120 pg/mL and testosterone levels ranged from <10-38 ng/dL. TF subjects had a mean BMI percentile of 65.3% and height Z-score of 0.58, with testicular volumes of 5 cc (n=1), 6 cc (n=2), 9 cc (n=1), 10 cc (n=1) and 15 cc (n=1). Testosterone levels ranged from <10-215 ng/dL and estradiol levels ranged from <5-31 pg/mL. Among all subjects, mean satisfaction ratings for gendered features were 4.45 (primary sex characteristics), 3.21 (secondary sex characteristics), and 2.61 (neutral characteristics). Mean satisfaction ratings for body areas were 4.45 (genitals/gonads), 3.85 (chest), 3.23 (appearance/hair/voice), 3.03 (hips), 2.83 (musculoskeletal), and 2.55 (head & neck). The only significant between-group difference in satisfaction was for the chest region, with TM subjects reporting higher dissatisfaction (4.35 vs 2.93, p <0.004). Conclusion: The gender-diverse youth in our study reported high degrees of dissatisfaction with their genitals/gonads and, for TM subjects, their chest. In contrast, they reported generally neutral feelings toward many of their other body parts. To the best of our knowledge this is the youngest cohort of gender-diverse youth in whom body satisfaction has been explored. Further studies of the effects of endocrine treatment on body image in gender-diverse youth are warranted, specifically as they relate to other measures of well-being.