BACKGROUND: Higher levels of body image dissatisfaction play a crucial role in the development and maintenance of eating disorders. Among different age groups, adolescents tend to focus more on their body image. However, there is limited data available on body image satisfaction in transfeminine youth. This study aimed to investigate body image satisfaction among transfeminine youth compared to cisgender female youth and to identify factors associated with body image satisfaction in transfeminine youth. Factors such as exercise and hormone intake were examined for their potential influence on body image satisfaction. METHODS: We developed a self-administered questionnaire to survey a sample of 600 youth (212 transfeminine and 388 cisgender female), aged 12-25 years, between 2021 and 2022. Body image satisfaction was assessed using the Body Image Concern Inventory Score (BICI), with a higher BICI score indicating greater body image dissatisfaction. RESULTS: A total of 209 transfeminine youth and 378 cisgender female youth participated in the study. The results showed that transfeminine youth reported higher levels of body image dissatisfaction than cisgender female youth, with mean ± SD scores of 59.3 ± 15.8 and 50.2 ± 15.9, respectively. Notably, regular exercise was associated with greater body image satisfaction (adjusted b = -7.53 [95% CI -14.78 to -0.27]
p-value = 0.04), while gender-affirming hormone intake did not show a significant association with body image satisfaction. CONCLUSIONS: These findings emphasize the importance of evaluating body image among transfeminine youth and suggest that promoting regular exercise may be an effective strategy to reduce body image dissatisfaction in this population.