"It's Just Not Comfortable to Exist in a Body": Transgender/Gender Nonbinary Individuals' Experiences of Body and Eating Distress During the COVID-19 Pandemic

The collective trauma of COVID-19 has had a negative impact on people's experiences of their bodies and eating, as demonstrated by studies showing increased disordered eating and body dissatisfaction during this time. The pandemic has also been shown to have had a unique and disproportionate impact on transgender and gender nonbinary (TGNB) individuals (e.g., lost gender affirming care access, elevated levels of job loss). Given that TGNB individuals already face increased risk of body distress and disordered eating compared to cisgender individuals in a nonpandemic context and have been disproportionately impacted by contextual changes with COVID-19, it is likely that the pandemic has had a distinct impact on TGNB individuals' experiences of body and eating distress. The present study aims to understand these impacts through an inductive, reflexive thematic qualitative approach. Participants were 13 TGNB individuals (10/13 gender nonbinary/gender queer; 8/13 White). They completed semistructured audio interviews about their broad experiences of body and eating during COVID-19, as well as how they understood changes across domains of family, community, access to resources, and intersectional identities interacting with these experiences. Themes included (a) Losing Affirming Spaces and Security, (b) Gaining Affirming and Supportive Spaces Online, (c) Reflecting on Embodied Gender and Identities, (d) Realizing New Connections and Insights, and (e) Considering the Self in Social Context. Notably, each of these themes interacted with participants' self-reported experiences of body and eating distress and, in some cases, healing. Our results illuminate risk and resilience factors and areas requiring innovation during and after COVID-19. Public Significance Statement The current study highlights complex impacts of COVID-19 on Transgender and Nonbinary (TGNB) individuals' experiences of body and eating distress. Most participants reported increased disordered eating during COVID-19, tying these struggles to lost affirming community and financial security and increased time alone noticing gender dysphoria. Some participants reported improved disordered eating corresponding to finding affirming online spaces. Many also found time to reflect on and, in some cases, realize gender.