The relationship between GD and ED in adolescents seeking for medical GR

It has been suggested that adolescents presenting with gender dysphoria (GD) are at increased risk of developing eating disorders (ED) as attempts to control the undesired sex characteristics. Medical gender reassignment (GR) has been expected to resolve ED. However, these assumptions are based on research of very low quality. We analysed the prevalence of eating disorders among 2,080 adolescents seeking GR in specialized gender identity services (GIS) in Finland in 1996–2019, and their 1:8 matched controls. Of the GD subjects, 5.0% had a lifetime ED diagnosis compared to 1.6% of the controls (p < 0.001). About half were first diagnosed before and a half only after contacting GIS. ED during follow-up was best predicted by ED before the index contact. The GD subjects were equally likely to need treatment for ED during follow-up regardless of GR status. The findings are discussed in light of suggested risk factors for and psychosocial correlates of ED and GD.