Development and validation of the Trans Disordered Eating Scale: a novel measure of disordered eating among trans and gender diverse adults.

Abstract

Transgender, nonbinary, and gender diverse (TGD) individuals experience stressors and risk factors related to disordered eating that are unique from cisgender counterparts. To account for these factors in symptom measurement, three studies were completed to develop and validate a new, community-specific scale for use with TGD adults. A total of 908 community-based TGD adults with a variety of intersecting identities completed surveys across three studies to test an initial pool of items, establish and validate the scale's factor structure, and assess the scale's convergent and predictive validity and test-retest reliability. Exploratory factor analyses resulted in a four-factor solution that accounted for 70.06% of variance. Confirmatory factor analyses supported a second-order hierarchical model with four latent factors that load onto a general "Gender Related Disordered Eating" factor, χ2(86)=249.81 (p < .001), RMSEA = 0.09, SRMR = 0.07, NFI = .90, CFI = .92. The final scale includes 18 items, including three clinical indicator items that differentiate body dissatisfaction associated with weight versus gender dysphoria. The scale showed strong convergent, predictive, and incremental validity and test-retest reliability. The measure appears to perform well with community-based TGD adults and offers unique insight into the factors underlying disordered eating among TGD individuals. With further validation and development, this scale may improve measurement in both clinical and research settings.