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Health & Wellness

MTF DIET: Common Concerns and Solutions

Megan P.

The health and well-being of the transgender community remain majorly understudied. This is due to most national surveys and research programs focusing on gender-specific aspects of health and nutrition.

These programs often fail to inquire whether an individual is transgender, leading to misclassification bias when establishing estimates as health guidelines.

Members of the transgender community still face substantial discrimination in healthcare. Most health care professionals are not adequately educated on health matters regarding transgender people.

This is a very urgent concern as transgender women and men have very distinct nutrition considerations that need to be considered. Adequate support from medical care to help members of the trans community maintain a healthy lifestyle is a topic that pressingly needs to be addressed.

A balanced diet and regular exercise are necessary for everyone, regardless of gender identity. Still, there are undeniably certain factors to consider in planning a diet for transgender people.

Body image is a significant contributor to gender dysphoria. Certain societal constructs still limit transgender people from becoming the best version of themselves. It is, for example, common for transgender individuals to avoid going to the gym out of fear of judgment.

Trans men often consume more calories to mask their upper body area had they decided not to remove their breasts.

Trans women, on the other hand, often restrict their calorie consumption to an unhealthy extreme to lose weight and appear thinner and less muscular.

Being underweight is just as dangerous as being underweight. Therefore, any person should always keep close tabs on their body weight to ensure persistent good health and reduce their risk of developing a disease and body dysphoria.

Mtf Diet

Transgender Nutrition

Hormone replacement therapy changes significantly impact a person’s nutrition status. Therefore, to avoid malnutrition of any kind, a transgender person’s diet need to be adjusted according to what their body needs and can effectively utilize.

Transgender females, in particular, face distinct nutritional challenges because of the effects of estrogen on the body. Estrogen often causes weight gain and an increase in triglycerides in the body.

Although there aren’t really MTF diets tailored to their specific needs, some proper dietary guidelines will aid in disease control. An MTF diet may include reducing intake of refined carbohydrates such as sugar, rice, and bread to alleviate the spike of triglycerides.

When transgender women need help lowering their testosterone levels, ingesting foods high in soy phytosterols may be beneficial. All transgender people must see a doctor to conduct a proper nutrition assessment based on their current diet. This will help the doctor create a better diet plan for the patient.

Iron requirements for people in MTF transition will become less than 8mg daily, much lower than the typical cisgender female values that average around 18mg of iron daily.

Transgender males face their own set of challenges as testosterone therapy can cause an increase in LDL cholesterol, increasing their risk for heart disease. However, lowering the intake of saturated fats and consuming more dietary fiber can decrease this risk.

Cross-sex hormone therapy in transgender males can also increase visceral fat. Therefore, a healthy diet and exercise are especially applicable to this population. In addition, bone loss is another very real threat to transgender men, adding to the importance of calcium and vitamin D intake.

When menstruation ceases, iron requirements drop substantially from 18 to 8mg per day. If a transgender man has received a transcription for diuretics, they will require a diet of lower potassium-rich foods.

Mtf Diet

Addressing MTF Diet Concerns

Weight Gain

As a transgender woman receiving hormone therapy, you will be treated with estrogen and progesterone. One benefit that estrogen has is its protective effect on bone health.

The downside is the almost inevitable increase in total body weight. As a hormone that encourages energy storage, estrogen is commonly associated with weight gain and increased body fat.

Although you should embrace and appreciate all aspects of womanhood, it is essential to maintain a healthy weight for your feminine body type and keep your body mass in check. This is simply a precaution to ensure overall health, not necessarily to lose fat to a needless extent.

Do not fixate too much on the weight you initially gain. Instead, realize that it is a natural part of the medical transition. There can always be healthy incentives in weight loss later down the line.

It is common for existing eating disorders to be triggered during this stage. However, something to remember when you start to gain weight is that it is just temporary. Following a proper diet and exercise will whip you back into shape in no time.

Because disordered eating is so prevalent among transgender women, it may be helpful to analyze the typical nutritional requirements for a woman of your age, height, and body structure.

Male and female values differ so greatly that you may find you have to adjust every part of your diet to meet your nutritional needs as a transgender female. The daily estimated energy intake of men is substantially higher than that of women.

A helpful aid in getting used to this new diet may be replacing one meal a day with a nutritional shake. A good quality shake will help you adjust your diet if your goals include losing weight while maintaining an adequate vitamin and mineral intake.

Nutrition Assessment

Changing Nutritional Needs

A standard multivitamin complex for women is always beneficial. Trans women should, however, consult a doctor about their iron requirements.

Multivitamins’ iron requirements are often very high to account for all the lost iron during menstruation.

As a transgender female, your iron requirements won’t be nearly as high. Excessive dietary iron can be very harmful. It is worth having a doctor analyze your blood work before deciding on a vitamin supplement.

Cholesterol, Triglycerides, and Heart Disease

Biological males have a much higher risk of developing heart disease than biological females. Therefore, it was long believed that female hormones must have some kind of protective effect against such complications. However, research suggests that this is not the case at all.

The opposite is true. The combination of anti-testosterone and estrogen therapy has proven to increase blood pressure and triglycerides as well as visceral and subcutaneous fat. In addition, a decrease in insulin sensitivity has also been proven to be a consequence of estrogen therapy.

Transgender men, in contrast, have displayed a decrease in high-density lipoproteins and an increase in triglycerides.

Testosterone treatment seemed to have no effect on blood pressure, low-density lipoproteins, fat distribution, or insulin sensitivity.

When transitioning from male to female, you must take measures to protect your cardiovascular system. For example, omega-3 fatty acids found in fish oil supplements have exceptional protective properties for the heart.

Any healthcare professional would advise you to increase your eicosapentaenoic acid and docosahexaenoic acid intake. These have been proven to increase the amount of high-density lipoproteins in the body and positively affect serum lipids, platelet fatty acids, plasma, and fasting glucose concentrations.

Trans women run a much higher risk for myocardial infarctions and stroke than trans men. Therefore, an MTF diet should consist of an abundance of heart-healthy foods. Maintaining a healthy weight is also essential in preventing such diseases.

Bone Loss/Osteoporosis

There aren’t many available studies on the long-term effects of testosterone on bone health in transgender men. However, it has been hypothesized that the risk of bone diseases such as osteoporosis increases in trans men due to testosterone therapy.

Osteoporosis is an ever-growing concern and occurs when the creation of bone matter cannot keep up with the rate of bone breakdown, resulting in decreased bone mineral density.

Estrogen is known to improve bone density. Thus, transgender females have the added bonus of better bone health after receiving estrogen therapy. In addition, including vitamin D and calcium into an MTF diet can further improve bone health.

Mental Health

Mental health is not an issue that can be solved by nutrition alone, and it is undoubtedly not a trans-specific concern. There is, however, an alarming amount of evidence on the severity of mental health issues in the transgender community.

This evidence indicates an alarmingly high statistic of trans people suffering from depression and committing suicide.

Applicable to transgender women, evidence suggests a strong relationship between low testosterone levels and depression.

As your body adjusts to the low testosterone levels as a trans woman, you may experience a decline in your mental health and general happiness.

This should stabilize with time as you get accustomed to the changes in hormone levels. Support from friends and family can go a long way in helping you stay optimistic and maintain a positive attitude.

A well-balanced MTF diet can also contribute to overall happiness. This is because when our body is getting all the nutrients it needs to function optimally, it can also do a better job at sustaining all your vital organs and systems.

This includes the secretion of the right hormones at the right time, ensuring more stabilized moods.

High-quality diets have been connected to lower rates of depression and other mental health issues.

Gut Health

The enteric nervous system is incredibly elaborate and uses more than thirty different neurotransmitters in its daily functions.

Serotonin is closely related to feelings of happiness and well-being. Not surprisingly, 95% of the body’s serotonin is located in the gut. Therefore, maintaining a healthy gut contributes significantly to overall health regarding both physical and mental aspects.

An MTF diet should be primarily centered around gut health and how to improve on it.

The reason for this is partly because of the high correlation between mental health issues and the challenges transgender men and women face.

The other crucial motivation to maintain gut health is that the gut is where most nutrients and essential vitamins such as vitamin D are absorbed. Therefore, poor gut health can further contribute to malnourishment.

Mtf Diet

Diet And Exercise For Transgender People

Before Your Medical Transition

There are a few common factors that health care professionals will assess before you can be eligible for gender-affirming surgery to express your gender identity.

A common requirement in gender-affirming nutrition assessment is having a healthy body mass index within an appropriate range.

Body mass does not solely depend on your body fat. It also incorporates factors such as your height and compound body weight.

Some hormone therapy and surgery regimes require a healthy body mass index for eligibility.

The following BMI values outline the classifications of nutrition status for adults:
  • BMI below 18.5 = Underweight
  • BMI between 18.5 and 24.9 = Healthy Weight
  • BMI between 25 and 29.9 = Overweight
  • BMI above 30 = Obese

Body mass index is calculated using weight (measured in kilograms) divided by height (in meters) squared.

Mtf Diet

Transgender Patients Receiving Hormone Therapy Can Expect Changes Regarding The Following Factors:

  • Weight
  • Body Mass
  • Body Fat Redistribution
  • Height
  • Metabolism
  • Appetite
  • Muscle mass
  • Lean body mass

MTF Diet Focused On Losing Weight

Following a diet and exercise routine to lose weight shouldn’t lead to eating disorders but should instead just be a tool to become the best you and feel comfortable in your body.

The hormone therapy involved in transitioning from male to female often leads to energy storage and weight gain. So let’s look at some tips on how to get rid of that extra weight.

It’s Simple…

If you want to lose weight, you must consume fewer calories than you burn.

If you want to gain weight, you must consume more calories than you burn.

What To Drink?

Drinking lots of water is always a healthy guideline. However, consider adding low-calorie flavorings if the taste doesn’t satisfy you. You can also add some lemon or cucumber slices to give it that refreshing touch.

Caffeinated beverages are known to lower your appetite and increase your metabolism rate. Avoid adding sugar and milk to these drinks as it will only increase your calorie intake.

Try to focus on eating your calories instead of drinking them. Sugary drinks and most alcoholic drinks are known to add way too many calories to your daily intake.

Many people have a misconception about fruit juices. Sure, it is rich in vitamins, but it is also a major source of sugar and energy that you may not use in your day. This will contribute to weight gain.

Plan Your Meals

It is so easy to grab a snack or get take out when you haven’t considered what you will eat for the day.

Focus on prepping your meals and cooking at home to avoid consuming foods rich in saturated fat. Instead, go for organic food options.

Eating foods high in lean protein and low in carbs and saturated fats can help you improve your lean body mass and tone your muscle mass.

Combining a healthy diet with regular exercise will help you achieve your goals.

Count Calories

Counting the calories you consume daily will encourage weight loss a lot. However, we don’t always realize that a healthy snack may still contain more calories than we will be able to burn off in a day.

Getting educated and informed about low-calorie options can help you reach your goal weight faster and in a healthier way.

Many available apps make it easy to count calories. Consider downloading MyFitnesPal, Calorie King, SELFNutrition data or any related apps to keep track of your daily calorie intake.

Support from others in similar situations as yours can also be very helpful. Whether you suffer from an eating disorder or struggle to drop off those excess pounds, there will be a supportive community to keep you stay motivated and proactive. Some of these groups and programs include Weight Watchers, HMR, Blue Apron and Home Chef.


Following hormone therapy, trans people have been known to experience a decrease in motivation to work out. While this is entirely understandable, exercise is still a critical factor in your overall health.

Diet pills can be very dangerous to your system even when they claim to be completely safe.

Replace the need for such aids with a sustainable exercise regiment that will help you lose or maintain a healthy weight and improve your mood.

A combination of cardio and weight-bearing exercises is proven to be the most beneficial.

Sticking with a diet centered around organic food while getting sufficient exercise is sure to help you feel confident and proud of your body.

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