Maria Bez is a Registered Nutritional Therapist and Kinesiologist, mother of a transgender son, and a healthcare professional. Helping transgender people stay healthy or address specific physical or emotional symptoms through an MTF diet or FTM diet and lifestyle is a topic close to her heart.
Everyone can benefit physically from making healthy food choices, including those following MTF and FTM diets. Buying locally grown fruits and vegetables doesn’t have to cost you anything, and it can help you feel good, too.
Please note that we use terminology such as AMAB (assigned male at birth), MtF (male-to-female), and trans-feminine interchangeably to ensure understanding across age groups, cultures, genders, and identities. For more information, please visit our Glossary of terms.
Benefits of a good FTM and MTF diet include:
- Achieving your ideal hormone balance
- Reducing body dysphoria
- Gives you a sense of control in life
- Addressing other health issues
- Improving the look and fit of clothes
- Improves your mood, energy and self-confidence
- Help with sleeping
- Reducing depression and anxiety
As a trans person on an MTF or FTM diet, you will have different dietary needs depending on what hormones you are taking and your overall health. Below I have outlined some general tips and considerations. These guidelines are not intended to replace advice from a physician.
Let’s start with the basics: In general, our diet consists of protein, carbohydrates, and fat. The variety 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 chart outlines what ratio of fats, proteins, etc. you need.
Finding the Right Nutritional Balance in Your MTF or FTM Diet
Egg white
Protein is found in meat, fish, nuts, seeds, tofu, and 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 who also wants to build muscle. Protein is also helpful if you are a transgender woman who is trying to maintain a healthy weight, as it helps regulate insulin, also known as the “fat storage hormone.”
As a guideline, I usually tell my clients that a piece of meat or fish the size of your palm is enough for a meal. For transgender men, I would be cautious about going to extremes and eating too much protein – for example in protein shakes to build muscle, as this can lead to kidney problems. My advice for those who want to gain weight is to eat moderate amounts of protein and do weight-bearing exercises.
Fat
Fats are an essential part of any healthy, balanced MTF or FTM diet. They can be divided into good and bad fats. Here we focus on the good fats.
Hormones are made up of fat, so it is important to eat good fats to help hormone development. Fat is also essential because it coats your nerve cells, which helps you deal with stress and stay emotionally balanced.
Good fats include avocado, olive oil, nuts, seeds and oily fish. Be aware of products marketed as healthy. Did you know that ‘healthy spreads’ are grey in colour before they are bleached by the manufacturer to look like butter? Who wants to eat that?! It is best to consume food in its most natural form (i.e. a little butter on your toast is healthier than a grey mush)!
Saturated fats (bad fats) can lead to elevated blood fats (triglyerides) and unhealthy cholesterol. Bad fats include items such as cheese, but also the processed fats found in fried foods and chips etc.
Carbohydrates
Carbohydrates are primarily 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 them for energy before it uses fat.
Consuming an excessive amount of refined carbohydrates will cause blood sugar levels to rise, which can trigger fat storage instead of fat burning. It also triggers high cortisol, which can make anxiety worse. Once insulin and cortisol rise too high, they work to lower testosterone.
Ideally, you should include carbohydrates in your MTF or FTM diet to boost your energy levels, but try to choose healthier, unrefined versions: for example, wholegrain rice, pasta, wholegrain bread, cereals and starchy vegetables (potatoes, carrots, parsnips).
Other healthy food choices include unprocessed fruits, vegetables, whole grains, legumes, nuts and seeds. Products high in animal fat should be avoided.
It is also important to make sure you get enough fiber from vegetables.
What does a healthy plate look like?
Check out my healthy plate chart which shows ideal portion sizes. Colorful vegetables are very important because they provide protective phytonutrients. Peppers, beets, carrots, tomatoes, and squash have been shown to protect against disease and aging.
Specific MTF and FTM Diet Guidelines for Transgender People
Lowering Testosterone for Transgender Women
- Eat less meat, but make sure you get protein from other sources, such as nuts, seeds and eggs.
- Lower your cholesterol by eating less saturated fats, processed foods and fried foods (chips, fish and chips)
- Increase the soy from tofu, miso, soy sauce and edamame beans
- Eat organic food
Lowering Estrogen for Transgender Men
- Increase fiber from vegetables
- Increase flaxseed
- Increase your intake of foods containing sulfur: eggs, meat, fish, nuts, seeds
- Increase organic food
- Reduce caffeine
- Reduce processed foods
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Should you count calories?
Counting calories will not lead to healthier eating. If you count calories and that’s it, you think an avocado and a donut are the same (an avocado has 250 calories and a jelly donut has 252 calories). But they are not.
Avocados:
- Are burned faster than other types of fat
- Increase the rate at which fat is burned
- Ensures that the body burns more calories after eating
- Reduces appetite and the urge to eat after a meal.
A donut does none of the above!
Sample daily menu for a transgender man (FTM diet)
Breakfast
- Scrambled eggs, avocado and tomato on sourdough bread
Lunch
- Chicken or tuna salad with lots of colored foods (tomato, beetroot, bell pepper, lettuce, sweet potato, linseed)
Dinner
- Meat or fish with half of your plate covered with vegetables
Snacks
- Nuts and seeds with a piece of fruit
Treat
Sample daily menu for a transgender woman (MTF diet)
Breakfast
- Eggs with tomatoes, avocado or soy yogurt sprinkled with nuts and seeds)
Lunch
- Meat, fish or eggs with salad (tomato, beetroot, pepper, lettuce, sweet potato, linseed)
Dinner
- Meat or fish with half of your plate covered with vegetables
Treat
I like to make a big frittata (basically a thick omelette) with 10 eggs and lots of veggies. I then keep it in the fridge and have a slice for breakfast, lunch or dinner. It’s a quick way to get something healthy into your diet and helps keep your blood sugar levels in check. It will keep in the fridge for up to four days.
The importance of hydration
Water is vital to our health. It helps regulate our blood pressure, aids concentration and detoxification. Try to drink between one and two litres of water throughout the day.
Alcohol can disrupt blood sugar levels and hormones and worsen depression. Always moderate your alcohol consumption 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). Pushing the boundaries of sex: A systematic review on food and nutrition in transgender populations. Public Health Nutrition, 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 specific nutritional considerations. Nutr J 19, 74 (2020). https://doi.org/10.1186/s12937-020-00590-4