Policy implications for nutritional health and food security among transgender and gender-diverse individuals in the United States

Abstract

Introduction: In 2021, an executive order from the Biden Ad­ministration declared a policy promoting respect, dignity, and freedom from discrimination for all individuals, regardless of gender identity or sexual orientation. The order directed agencies to review and, if necessary, revise existing policies to align with this principle, emphasizing the enforce­ment of laws prohibiting sex discrimination (Exec. Order No. 13988, 2021). Despite this, as of June 2023, more than 540 bills affecting the LGBTQIA+ community have been proposed in various states throughout the U.S. Among these, 220 bills spe­cifically focus on transgender, gender-diverse, and gender-nonconforming individuals (TGD). Nota­bly, over 125 of these bills seek to impede or re­strict access to essential gender-affirming health­care services, including interven­tions like puberty suppressants, hormone therapy, and surgical procedures (U.S. Department of Agri­culture Food and Nutrition Service [USDA FNS], 2022). These policies are expected to have far-reaching effects on health, which in turn have sig­nificant implica­tions for nutrition outcomes, such as disordered eating patterns and food insecurity (Lessard et al., 2021). This commentary informs nutrition pro­fessionals, including dietitians, public health nutri­tionists, healthcare providers, and poli­cymakers, who work with diverse populations, including TGD individuals. It explores the down­stream implications of existing and proposed poli­cies on the nutritional health and food security of TGD individuals. Furthermore, it explores oppor­tunities for action and advocates for inclusive pol­icy reforms and improved access to resources.