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•Body composition and strength remain unclear in transgender women undergoing gender-affirming hormone therapy.•Transgender women tend to adapt their body composition to cis women's bodies.•Changes in strength and muscle mass of trans women could be a risk for sarcopenia.•Nutrition, exercise, or diseases related to the changes in body composition and strength in transgender women should be monitored. Body composition and strength of cisgender (cis) individuals are well established. However, those for transgender women (trans women) undergoing gender-affirming hormone therapy remain unclear. This study aimed to detect possible body composition and strength variations related to sarcopenia. This was a cross-sectional comparative study of 37 trans women, 34 cis men, and 34 cis women. Body composition was measured in all individuals by bioelectrical impedance analysis; prehensile strength by dynamometry was studied in trans women. In this study, trans women had higher body mass index values than cis individuals (P < 0.01). Fat mass was 41% higher for trans women than cis men. Muscle mass (MM) was lower in trans women than cis men (–10%), and higher than cis women (24%). Bone mass was lower in trans women than cis men and higher in cis women (P < 0.01). Trans women's prehensile strengths were 25.26 kg for the right hand and 24.8 kg for the left. Appendicular skeletal muscle mass was 23.63 kg, and appendicular skeletal muscle mass index was 8.14 kg. Trans women undergoing gender-affirming hormone therapy show a tendency to adapt body compartments to those of cis women with increased fat mass and reduced muscle mass. Prehensile strength in trans women was close to the cutoff points for sarcopenia risk. Nutrition, physical activity, strength, and body composition are important to avoid the possible risk for sarcopenia. More studies along these lines are necessary, especially in older adults. [Display omitted]

To analyze the eating habits of the transgender population throughout the transition process, evaluate the nutritional requirements associated with gender transition, and reflect on the possible dietary challenges facing the transgender population. A cross-sectional observational study was carried out with 146 individuals (58.90% transgender women [n = 86] and 41.09% transgender men [n = 60]) aged between 18 and 60 y old. Eating habits and nutritional intake were evaluated through a food consumption frequency questionnaire, 24-h dietary recall, and subsequent data entry using DIAL software. The anthropometric parameters weight and height were determined following the protocol proposed by the International Society for the Advancement of Kinathropometry and waist circumference was determined following the protocol of the World Health Organization. The study found that the diets of the studied population were unhealthy, with low fruit consumption (6.4 ± 4.39 rations in transgender men versus 11.5 ± 2.59 rations in transgender women, P = 0.758898323). Diets were high in lipids (43.62 and 44.24 in transgender women and transgender men, respectively) and protein (16.63 and 15.65 in transgender women and transgender men, respectively). Deficiencies in carbohydrates, folate, vitamin D, and minerals such as calcium, iodine, and zinc were detected along with an excess of selenium and especially phosphorus, which could affect hormone levels. Changes were detected as a result of their desire to look similar physically to the desired sex, they followed rules, ways of acting, and habits of primary socialization (learned in the family during their life). The analysis of the changes observed in our study revealed that during the transition process, eating habits changed based on information, often incorrect, obtained from the internet. Therefore, it is advisable to recommend implementing strategies that increase the consumption of fruits, vegetables and whole grains. In this study, we detected some nutritional deficiencies depending on the type of hormone treatment, so nutritional care must be individualized. Therefore, individualized nutritional interventions focused on increasing the consumption of fruits, vegetables, and whole grains should be carried out. It would be advisable to develop guidelines for nutritional advice, diagnosis, and intervention for transgender people based on scientific evidence as well as provide nutritional advice to the clinicians responsible for their follow-up. •Dietary patterns and hormonal and social factors remain unclear in transgender people undergoing gender-affirming hormone therapy.•Transgender individuals tend to adapt their dietary patterns to look similar physically to the desired sex.•Changes in dietary patterns can have adverse physiological consequences and cause late-onset chronic diseases.•Nutrition, exercise, and diseases related to changes in body composition and strength should be monitored in transgender women.

In recent years, different studies have provided estimates of the prevalence of transsexualism with very diverse results. The purpose of this study was to ascertain the prevalence, incidence, and sex ratio of transsexualism in the autonomous region of Madrid (Spain). A total of 1234 patients who attended from 2007 to the end of 2015 in the only Gender Identity Unit (GIU) in Madrid were analyzed. Sixty-three patients were excluded for various reasons; thus, 1171 could be included: 803 male-to-female (MtF) and 368 female-to-male (FtM) transsexual patients. Transsexualism was diagnosed based on the ICD-10, World Health Organization, 1992, and/or gender identity disorder based on the DSM-IV-TR, American Psychiatric Association, 2000. The demographic statistics were calculated on the basis of the population over 15 years old of Madrid. Based on healthcare demand, the prevalence of transsexualism was 22.1 in 100,000 inhabitants: 31.2 for MtF and 12.9 for FtM, making the MtF/FtM ratio approximately 2.2:1. The incidence rate was 2.5 in 100,000 inhabitants, representing an annual average of 130 demands. Although transsexualism occurs in all countries with different rates of prevalence, in our area, this prevalence was higher than reported from other European countries. We believe that two main circumstances might influence this high prevalence: the easy accessibility and the absence of a waiting list to the GIU, and the permissive social and legal climate and openness of Spain, especially in Madrid.

ResumenEl tratamiento de la transexualidad es en gran medida irreversible. Por ello es necesaria una cuidadosa evaluación psicológica previa. Sin embargo, al ser un fenómeno emergente, se han desarrollado pocas pautas de evaluación. Por ello, se hace necesario tener al menos una orientación acerca de qué áreas evaluar. El objetivo de este estudio es proponer una serie de áreas a incluir en la entrevista para la evaluación psicológica de personas transexuales. Para ello se lleva a cabo una revisión de la literatura existente relacionada con el tema. Se revisan tantos las áreas de evaluación habituales en Psicología Clínica como los aspectos normalmente considerados en la evaluación de personas transexuales. Como conclusiones se proponen una serie de áreas a incluir en la entrevista para la evaluación psicológica de personas transexuales. AbstractThe treatment of the transgenderism is mainly irreversible. Therefore, a very carefully psychological assessment is needed. However, being transgenderism an emergent phenomenon there are a few guidelines. So that, it is necessary to have at least some guidance on which areas transgenderism should be evaluated.  To the aim of this study is to propose a number of areas to include in the psychological assessment of transgender people. In it are reviewed either usual assessment areas in Clinical Psychology and the aspects that are usually taken into consideration in the assessment of transgenderism.  As a result a number of areas for the psychological interview to assess transgender people is presented.

La transexualidad es un fenómeno emergente. Es necesario evaluar no solo la presencia de transexualidad sino también todas las variables de proceso. Este estudio tuvo como objetivo presentar y analizar las propiedades psicométricas de dos instrumentos de evaluación en población transexual; uno para evaluar ansiedad y otro depresión. Se llevó a cabo la construcción cualitativa de las dos escalas y se validó su contenido mediante su aplicación a 154 sujetos. Se calcularon la validez de criterio y la fiabilidad mediante el Alfa de Cronbach y se ejecutó un Análisis Factorial Exploratorio. Se obtuvieron datos de alta significación estadística para la fiabilidad de las escalas (para ESANTRA un Alfa de Cronbach de .958 y correlación entre mitades de .926 y para ESDETRA un Alfa de Cronbach de .967 y correlación entre mitades de .958) y también para todos los elementos de ambas, así como una alta validez de criterio (para ESANTRA de .782 con p< .001 con el ISRA y para ESDETRA .829 con p< .001 con el BDI). El AFE mostró un único factor explicativo en cada escala (con varianza explicada del 45.71% ESANTRA y 51.55% ESDETRA). Las escalas ESANTRA y ESDETRA parecen ser útiles para la evaluación de ansiedad y depresión en personas transexuales.

Transgenderism is an emergent phenomenon. It is necessary not only to evaluate transgenderism, but also all the variables involved in the gender transition process. The aim of the study was to present and analyze psychometric properties of two assessment tools for transgender people. One for Anxiety and the other for Depression. A qualitative construction of the two scales was carried out. Then both were content-validated, and eventually their psychometric properties were tested (Through Cronbach's Alpha, between-halves correlation, criteria validity and a Factorial Analysis). These scales were applied to 154 people. Both validity and reliability showed good outcomes (for ESANTRA Cronbach's Alpha .958 and correlation between halves .926 and for ESDETRA Cronbach's Alpha .967 and correlation between halves 0.958). Criteria validity was high (ESANTRA .782 p<.001 and ESDETRA .829 p><.001). The Exploratory Factorial Analysis only showed one factor in each scale. They had an explanatory variance of 45.71% ESANTRA and 51.55% ESDETRA. ESANTRA and ESDETRA scales seem to be useful for the assessment of anxiety and depression in transgender people. Keywords: Transsexualism, transgender, psychological assessment, anxiety, depression.>< .001 and ESDETRA .829 p<.001). The Exploratory Factorial Analysis only showed one factor in each scale. They had an explanatory variance of 45.71% ESANTRA and 51.55% ESDETRA. ESANTRA and ESDETRA scales seem to be useful for the assessment of anxiety and depression in transgender people. Keywords: Transsexualism, transgender, psychological assessment, anxiety, depression.> <.001). The Exploratory Factorial Analysis only showed one factor in each scale. They had an explanatory variance of 45.71% ESANTRA and 51.55% ESDETRA. ESANTRA and ESDETRA scales seem to be useful for the assessment of anxiety and depression in transgender people.

El tratamiento de la transexualidad es en gran medida irreversible. Por ello es necesaria una cuidadosa evaluación psicológica previa. Sin embargo, al ser un fenómeno emergente, se han desarrollado pocas pautas de evaluación. Por ello, se hace necesario tener al menos una orientación acerca de qué áreas evaluar. El objetivo de este estudio es proponer una serie de áreas a incluir en la entrevista para la evaluación psicológica de personas transexuales. Para ello se lleva a cabo una revisión de la literatura existente relacionada con el tema. Se revisan tantos las áreas de evaluación habituales en Psicología Clínica como los aspectos normalmente considerados en la evaluación de personas transexuales. Como conclusiones se proponen una serie de áreas a incluir en la entrevista para la evaluación psicológica de personas transexuales.