ABSTRACT
Measuring a patient’s body size and shape is a perfunctory component of a registered dietitian’s nutrition assessment. With those values, we then provide labels such as underweight, normal, overweight, or obese, and often recommendations on how to achieve a “normal” body weight. In this chapter, we illustrate the limitations and cisnormativity of nutrition assessment methods related to body size and shape using narrative inquiry design. The chapter features my (Melik) personal narrative as a 35-year-old, African American, transgender male, and my experience with weight gain after starting hormone therapy, which was in part due to a genuine desire to have a larger body size. As a cisgender registered dietitian and ally to the transgender community, I (Whitney) also share my personal reflections on the biases I have internalized from my training, such as the assumption that all people want to be in the “normal” range for body mass index. We close by discussing how registered dietitians can confront their own biases, foster more nuanced conversations with their transgender and gender-diverse patients regarding their goals for body size and shape, and ultimately provide better nutrition care for the transgender community.
