Longitudinal Associations among Peer Victimization, Gender Congruence, Body Image, and Disordered Eating in Transgender and Gender Diverse Adolescents

Transgender and gender diverse (TGD) adolescents face disproportionately elevated rates of body image concerns and disordered eating. For TGD youth, body esteem is closely tied to gender congruence, the alignment between one’s body and gender identity. Peer victimization may disrupt both constructs and contribute to disordered eating. The current study used multivariate latent growth curve models (MLGCMs) and random-intercept cross-lagged panel models (RI-CLPMs) to examine (1) how body esteem, gender congruence, and disordered eating co-develop over time, and (2) whether peer victimization prospectively predicts changes in these outcomes. TGD adolescents (N = 1,700; Mage = 15.75 years; 55.41% nonbinary assigned female at birth) completed anonymous online surveys at three timepoints separated by three months. Disordered eating was examined across two dimensions: caloric restriction and muscle-building. Body esteem and gender congruence increased over time; caloric restriction and muscle-building showed no average change. Increases in body esteem and gender congruence were each associated with decreases in caloric restriction. Chronic peer victimization was associated with worse body esteem and higher disordered eating at the between-person level. At the within-person level, however, fluctuations in peer victimization did not prospectively predict any outcome. Instead, higher-than-usual gender congruence prospectively predicted lower-than-usual peer victimization at the subsequent timepoint. Body esteem and gender congruence were reciprocally reinforcing over time. Findings suggest that body esteem and gender congruence may represent two facets of the same underlying experience of gender embodiment. Peer victimization functioned more as a chronic burden than an acute stressor, and gender congruence emerged as a potential protective factor against victimization itself. Affirming environments and interventions that foster gender congruence may represent a promising path to resilience for this underserved population.