As we celebrate sexual and gender diversity, sobering discriminatory legislation (240+) is being proposed (and passed) in states across the US. Policy impacts the social determinants of health and therefore has downstream nutrition implications. For example, insufficient anti-bullying policies in schools1<\/sup>, school curriculum and topic censoring, and other bans and restrictions may further alienate LGBTQIA+ individuals and promote discrimination. Social rejection, discrimination, and stigma manifest as stress, compromised mental health, suicidality, food insecurity, disordered eating patterns, increased allostatic load, inflammation, overweight\/obesity, and chronic disease2<\/sup>.<\/p>\n This is concerning when we consider the known disparities experienced by the LGBTQIA+ community. For example elevated risk of overweight and obesity among lesbian and bisexual women3,4<\/sup>, HIV among gay and bisexual men5<\/sup>, and mixed findings suggest elevated risk of some cancers4,6<\/sup> and cardiovascular disease4,7<\/sup> among LGB adults. Fewer studies have explored disparities among transgender individuals. Those that have been conducted indicate socioeconomic and health disparities persist among transgender individuals8\u201311<\/sup>. This includes elevated rates of depression, anxiety, and psychological distress10,12<\/sup>. Further, disproportionate rates of poor general health10,13<\/sup>, food insecurity14\u201316<\/sup>, and disordered eating patterns1,14,16,17<\/sup>.<\/p>\n The disparities are stark and can\u2019t be ignored. However, combatting health disparities does not stop at identifying prevalence. In alignment with the Health Equity Promotion Model18<\/sup>, identifying the strengths and pathways that promote health is equally important. The LGBTQIA+ communities have strength, resilience, persistence, adversity, and empathy. In working with<\/em> LGBTQIA+ communities to leverage those strengths we begin to elevate solutions.<\/p>\n Research that applies this model of empowerment and celebration offers the community and advocates the tools to combat these disparities through interventions and policy change.<\/p>\n These articles summarize recently published research related to nutrition considerations for LGBTQIA+ communities:<\/p>\n Sexual orientation\u2013based disparities in food security among adults in the United States: results from the 2003\u20132016 NHANES<\/a>, The American Journal of Clinical Nutrition<\/em><\/strong>, <\/em>December 2021<\/p>\n In the US, 10.5% of the general population experience food insecurity. These rates are disproportionately higher among sexual minority (e.g., lesbian, gay, bisexual, and otherwise non-heterosexual) individuals, likely a manifestation of discrimination and stigma. Data from NHANES revealed a statistically significant difference in household food security between sexual minority groups and their heterosexual counterparts. Rates and relative risk of moderate and severe food insecurity were 20-70% higher among all sexual minority groups compared to heterosexuals after adjusting for sex, race, ethnicity, and age. The highest rates were among bisexuals19<\/sup>.<\/p>\n An Examination of the Sex-Specific Nature of Nutrition Assessment within the Nutrition Care Process: Considerations for Nutrition and Dietetics Practitioners Working with Transgender and Gender Diverse Clients<\/a>, Journal of the Academy of Nutrition and Dietetics<\/strong><\/em>, <\/strong>February 2022<\/p>\n The Nutrition Care Process (NCP) directs registered dietitians (RD) when conducting nutrition assessments. Many domains of the nutrition assessment are sex-specific, posing a unique question for those serving a transgender or gender diverse (TGGD) population. Applying clinical logic, Linsenmeyer et. al., offer suggested approaches for clinicians working with TGGD patients to deliver gender affirming care. Those suggestions include: use references consistent with sex assigned at birth if the patient has not medically transitioned (e.g., hormone therapy); individualize approach based on the patient\u2019s medical transition status using the World Professional Association for Transgender Health Standards of Care<\/a>; and report data as a range between male and female references. Additionally, clinicians can affirm patients by using correct names and preferred pronouns, updating medical records to reflect the patient\u2019s gender identity, and using gender neutral terms (e.g., when describing the body). The article details hypothetical case studies for application20<\/sup>.<\/p>\n Opportunities for Action<\/strong><\/p>\n Regardless of your area of research, ASN members can take steps to celebrate and affirm sexual and gender diversity. A few opportunities for action are listed below:<\/p>\n Reference<\/strong><\/p>\n <\/p>\n\n
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*ASN Member Contributor <\/h3>\n<\/p>\n<\/div>\n