As a functional dietitian, my role is not only to optimize nutritional status but also to honor the individuality of each person I work with. Gender transition is a deeply personal, often transformative journey, encompassing emotional, physical, and physiological shifts. Nutrition can be a powerful ally during this process—supporting hormonal changes, stabilizing mood, maintaining muscle and bone health, and promoting overall well-being.
Whether someone is beginning hormone therapy, undergoing gender-affirming surgery, or simply aligning their lifestyle with their identity, here are some of the key nutritional considerations I explore in partnership with transgender and gender-diverse clients.
1. Hormone Therapy and Nutritional Shifts
Estrogen Therapy (MTF/AMAB individuals):
- Body Composition Changes: Expect a natural shift toward increased fat mass and decreased lean muscle mass. Supporting this shift nutritionally may involve adjusted protein needs (often 1.2–1.6g/kg body weight/day) and a thoughtful approach to strength training and nutrient timing.
- Cardiovascular Support: Estrogen can impact lipid profiles. Focus on omega-3s (flaxseeds, chia, fatty fish), soluble fiber (oats, legumes), and limiting trans fats and excessive added sugars.
- Bone Health: Calcium and vitamin D become even more critical. Include leafy greens, fortified plant milks, and consider a vitamin D supplement (with lab testing guidance).
Testosterone Therapy (FTM/AFAB individuals):
- Muscle Mass & Protein: Testosterone increases anabolic activity, often resulting in increased lean mass. This typically raises protein needs, especially with concurrent exercise (aim for 1.4–2.0g/kg/day).
- Insulin Sensitivity: Monitor carbohydrate intake and quality—favor whole grains, legumes, and root vegetables over refined carbs to maintain insulin balance.
- Iron & Hematocrit: Testosterone can raise red blood cell count. Routine bloodwork is key. Iron intake may need to be adjusted accordingly—especially if menstruation stops.
2. Micronutrient Monitoring
Transition can impact micronutrient needs. Some common nutrients I track include:
- Vitamin B12: Especially in those on reduced animal products or using metformin for PCOS.
- Zinc: Important for hormone metabolism and skin health.
- Magnesium: Supports mood, sleep, and muscle relaxation—essential during times of stress and change.
Lab work is essential here, and I often collaborate with physicians to monitor levels at regular intervals.
3. Mental Health & Nutrition
Nutrition profoundly influences mental well-being—a critical focus during transition. Anxiety, dysphoria, and depression may be part of the experience, and supporting neurotransmitter health through food is key:
- Omega-3 fatty acids for mood regulation (EPA & DHA are especially helpful).
- Tryptophan-rich foods (turkey, pumpkin seeds, oats) for serotonin support.
- Stable blood sugar to reduce mood swings—achieved through regular, balanced meals with protein, fat, and fiber.
Gut health also plays a major role in emotional regulation. Probiotic and prebiotic foods (like kefir, sauerkraut, garlic, and leeks) can support the gut-brain axis.
4. Post-Surgical Nutrition Support
For those undergoing gender-affirming surgeries:
- Pre-op prep: A nutrient-dense, anti-inflammatory diet can reduce surgical risk. This includes adequate protein, antioxidants (berries, greens), and hydration.
- Post-op healing: Protein, zinc, vitamin C, and arginine are crucial. I often recommend collagen or bone broth, along with targeted supplements to support tissue repair.
- Digestive tolerance: Start with easy-to-digest meals and gradually reintroduce fiber as tolerated.
5. Individualized and Affirming Support
There is no one-size-fits-all plan. As a functional dietitian, I work to understand the whole person—considering:
- Past medical history (PCOS, insulin resistance, disordered eating history, etc.)
- Relationship to food and body
- Access to safe and affirming care
- Cultural preferences and food availability
My goal is to create a safe, collaborative space where all clients—trans, nonbinary, and gender diverse—feel empowered to nourish themselves with knowledge, compassion, and pride. Nutrition during gender transition isn’t just about macro- and micronutrients. It’s about reclaiming your relationship with your body, your health, and your identity. With functional nutrition tools, lab data, and a whole-person lens, we can support this journey with care and intention. If you’re transitioning or supporting someone who is, know that you deserve affirming, evidence-based guidance that honors your unique path. And if you’re seeking a personalized plan rooted in science and compassion—I’d be honored to walk alongside you.