by Maria Bez is a registered Nutritional Therapist and Kinesiologist, mother of a transgender son, and health professional. Helping transgender people stay healthy or address specific physical or emotional symptoms through an MTF diet or FTM diet and lifestyle is something very close to her heart.
Everyone can benefit physically from making healthy food choices, including those on a MTF or FTM diet. Buying locally grown fruit and vegetables doesn’t have to cost a fortune and it can help you feel good too.
Please note that we use terminology like AMAB (assigned male at birth), MtF (male to female), and transfeminine interchangeably to understand across all age groups, cultures, genders, and identities. For more information, check out our glossary of terms.
Benefits of a proper FTM and MTF diet include:
- Achieving your ideal hormone balance
- Reduced body dysphoria
- To give you a sense of control in life
- Address other health problems
- Improving the appearance and fit of clothing
- Elevate your mood, energy and self-esteem
- Help with sleep
- Reduce depression and anxiety
As a transitioner on an MTF or FTM diet, you will have different nutritional needs depending on the hormones you take and your overall health. Below I have outlined some general tips and considerations. These guidelines are not a substitute for advice from a medical practitioner.
Let’s start with the basics: in general, our diets consist of protein, carbohydrate and fat. The diversity of these key elements determines how healthy our overall diet is. Too much in one direction or the other can lead to an unbalanced, unhealthy diet. My healthy eating plate graphic shows what proportion of fats, protein, etcetera you need.
Getting the Nutritional Balance Right in Your MTF or FTM Diet
Protein
Protein is found in meat, fish, nuts, seeds, tofu, eggs. There are no specific protein recommendations for transgender people. However, a slightly higher protein intake may be beneficial in the context of weight gain, if you are a transgender man also trying to build muscle. Protein is also useful if you are a transgender female trying to maintain a healthy weight as it helps regulate insulin also known as the ‘fat storage hormone’.
As a guide, I usually tell my clients that a palm-sized piece of meat or fish is enough for a meal. In the case of transgender men, I want to be careful when you go to extremes and have too much protein – for example in protein shakes, to build muscle, because this can cause kidney problems. My advice to those looking to bulk up is to have moderate amounts of protein and weight bearing exercises.
Fat
Fats are an essential component of any healthy, balanced MTF or FTM diet. They can be divided into good and bad fats. Here we will focus on the good fats.
Hormones are made from fat, so it’s important to eat good fats to help hormone development. Fat is also essential because it coats your nerve cells which help you cope with stress and stay emotionally balanced.
Good fats include avocado, olive oil, nuts, seeds and oily fish. Be aware of products marketed as healthy products. For example, did you know that ‘healthy pages’ are gray in colour, before the manufacturer bleaches them to look like butter! Who wants to eat that?! Food is best eaten in its most natural form (ie a bit of butter spread on your toast is healthier than gray mush)!
Saturated fats (bad fats) can lead to increased blood fats (triglycerides) and unhealthy cholesterol. Bad fats include items like cheese as well as the processed fats found in deep fried food and crisps etc.
Carbohydrates
Carbohydrates are mainly sugars and starches that the body breaks down into glucose for energy. They include potatoes, rice, pasta, grains, and sugars. These foods make it harder to lose fat, because your body uses these for energy before it uses fat.
Eating too many refined carbs will raise blood sugar, which can encourage fat storage rather than fat burning. It also triggers high cortisol, which can make any anxiety feel worse. When insulin and cortisol rise too high, they work to reduce testosterone.
Ideally, you should include carbohydrates in your MTF or FTM diet to help increase your energy levels, but try to choose healthier unrefined versions: eg. whole grain rice, pasta, cottage cheese, cereals and starchy vegetables (potatoes, carrots, parsnips).
Other healthy food choices include unprocessed fruit, vegetables, whole grains, pulses, nuts and seeds. Products high in animal fat should be avoided.
It’s also important to make sure you get enough fiber through vegetables.
What Does a Healthy Eating Plate Look Like?
Please see my healthy food plate diagram outlining the ideal portions. Colorful vegetables are very important because they provide protective phytonutrients. Peppers, beets, carrots, tomatoes, squash have been shown to protect against disease and aging.
Specific MTF and FTM Dietary Guidelines for Transgender People
Lowering Testosterone for Transgender Women
- Reduce meat but make sure you have protein from other sources like nuts, seeds, eggs
- Reduce cholesterol by cutting back on saturated fats, processed food, and deep fried food (crisp, fish and chips)
- Increase soy from tofu, miso, soy sauce, edamame beans
- Eat organic food
Lowering Estrogen for Transgender Men
- Increase fiber from vegetables
- Increase flaxseed
- Sulphur-increasing foods: eggs, meat, fish, nuts, seeds
- Increase in organic food
- Reduce caffeine
- Reduce processed food
Get the care you need today
Should You be Counting Calories?
Counting calories will not encourage healthier eating. If you count calories and that’s it, you’d think an avocado and a donut are equal (an avocado has 250 calories and a jam donut has 252 calories). But they are not.
Avocados:
- Burns at a higher rate than other types of fats
- Increase the rate at which fat is burned
- noticed the body to burn more calories after eating
- Decrease appetite and reduce the desire to eat after a meal.
A donut does none of the above!
Example of a Daily Menu for a Transgender Man (FTM diet)
Breakfast
- Scrambled eggs, avocado and tomato on sourdough toast
Lunch
- Chicken or tuna salad with lots of colored foods (tomatoes, beets, pepper, lettuce, sweet potatoes, flaxseeds)
Dinner
- Meat or fish with half your plate covered with vegetables
Snacks
- Nuts and seeds with a piece of fruit
Treat
Example of a Daily Menu for a Transgender Woman (MTF diet)
Breakfast
- Eggs with tomato, avocado or soya yoghurt sprinkled with nuts and seeds)
Lunch
- Meat, fish or eggs with salad (tomatoes, beetroot, pepper, lettuce, sweet potatoes, flaxseeds)
Dinner
- Meat or fish with half your plate covered with vegetables
Treat
I like to make a large frittata (basically a thick omelet) using 10 eggs and loads of vegetables. I then keep it in the fridge and have a slice for breakfast, lunch or dinner. It’s a quick way to add something healthy to your diet and helps control blood sugar. It can last up to four days in the fridge.
The Importance of Hydration
Water is vital to our health. It helps to regulate our blood pressure, it helps with concentration and detoxification. Aim to drink between one and two liters of water throughout the day.
Alcohol can affect blood sugar and hormone levels and make depression worse. Always moderate alcohol and try to keep it to less than seven units per week.
References:
- Bedell, Sarah. (2014). The pros and cons of plant estrogens for menopause. The pros and cons of plant estrogens for menopause. 139 (10), Pages 225-236.
- Gomes, S., Jacob, M., Rocha, C., Medeiros, M., Lyra, C., & Noro, L. (2021). Expanding the boundaries of sexuality: A systematic review of food and nutrition in transgender populations. Public Health Promotion, 1-14. doi: 10.1017/S1368980021001671
- Linsenmeyer, W., Drallmeier, T. & Thomure, M. Towards a gender-affirming nutritional assessment: a case series of adult transgender men with unique nutritional circumstances. Nur J 19, 74 (2020). https://doi.org/10.1186/s12937-020-00590-4
