Transgender people may want to adopt a healthy eating routine to support their health and well-being. Those transitioning with hormone therapy (HT) also may follow a heart-healthy diet to improve cardiovascular health and decrease disease risk. However, several questions may arise when delving into healthy eating guidelines.
Sex-specific nutrition recommendations
When exploring questions about food and nutrition, transgender people may recognize several nutrition recommendations that are sex-specific, or those that rely on the male or female sex. People who are intersex (those born with a variety of differences in their sex traits and reproductive anatomy) may have similar questions.
Especially among those who have entered data into diet tracking apps or wearable fitness devises, a common question that arises is: How can I calculate my energy needs when the equations rely on sex? It’s true that many of the equations used to estimate energy needs require users to select male or female.
In fact, several nutrition recommendations rely on sex, including those for:
- Vitamins and minerals
- Water
- Fiber
- Protein
- Carbohydrates
- Omega-3 and omega-6 fatty acids
- Alcohol
- Calories
In some instances, the recommendations do not differ for males and females. Other times, they vary widely. For example, the recommended dietary allowance (RDA) for iron is 18 milligrams per day for females and 8 milligrams per day for males during middle adulthood. However, the RDA for vitamin D for males and females during middle adulthood is the same: 600 International Units per day.
In addition, several types of data used by a registered dietitian nutritionist (RDN) to assess a person’s nutrition status are interpreted based on sex, including:
- Body fat percentage
- Waist circumference
- Waist-to-hip ratio
- Growth charts for children and adolescents
- Lab values such as hemoglobin, hematocrit and HDL-cholesterol, among others
Approaches to sex-specific nutrition recommendations
To provide an accurate nutrition assessment, an RDN will use a variety of information, such as their patient’s sex, gender, age, height, weight, body fat percentage, typical diet, food allergies and intolerances, supplement use, medical history, social history, lab values and a physical exam. An RDN also will ask about medications, which may or may not include HT.
When addressing sex-specific data, an RDN may use different approaches to individualize care, including:
- Using sex assigned at birth if not medically transitioning with HT
- Individualizing the assessment based on amount of time on HT
- Using a range with both male and female values
The chosen approach may depend on the type of data, as well as the patient’s overall health and personal goals. It’s important to note that even if an RDN is using sex assigned at birth, they can still honor a person’s gender identity in important ways such as using their correct name and pronouns.
To find an RDN near you, use the Academy’s searchable Find a Nutrition Expert tool.
Find a Nutrition Expert
Looking for credible nutrition information and recommendations? The Academy of Nutrition and Dietetics' network of credentialed food and nutrition practitioners are ready to help!