Food insecurity and risk eating behaviours in gender affirming care in La Araucanía, Chile: a qualitative study

Authors

  • Rodrigo Hernán Torres Bravo Department of Public Health, Universidad de La Frontera, Temuco, Chile https://orcid.org/0000-0002-4546-1770
  • Augusto Claudio Obando Cid Departamento de Salud Pública, Universidad de La Frontera, Temuco, Chile
  • María Angélica Hernández Moreno Centro de Investigación en Género, Diversidad e Inclusión en Salud (Epu Pillan), Facultad de Medicina, Universidad de La Frontera, Temuco, Chile

DOI:

https://doi.org/10.14306/renhyd.30.4.2809

Keywords:

Food insecurity, Disordered eating behavior, Gender-affirming care, Transgender persons, Social determinants of health

Abstract

Introduction: Food and nutrition security (FNS) is a key social determinant of health. Among trans and gender-diverse (TGD) people, stigma, discrimination, and economic precarity can increase vulnerability to food insecurity (FI), a key dimension of FNS, shaping everyday eating practices. In Chile’s La Araucanía Region, marked by poverty and rurality, these dynamics intersect with growing demand for gender-affirming care in a resource-constrained public health setting. Objective: To describe how a multidisciplinary clinical team understands and addresses FNS within TGD healthcare, and how FI is articulated in relation to risk eating behaviours and eating-disorder (ED)–related clinical concerns.

Methods: Exploratory–interpretive qualitative study at the Gender Clinic of Hospital Dr. Hernán Henríquez Aravena (Temuco, Chile). Twelve professionals (medicine, psychology, midwifery, and social work) participated in in-depth semi-structured interviews. Data were audio-recorded, transcribed verbatim, and analysed using situational analysis with iterative coding and relational mapping (Atlas.ti v.23). Ethical approval and written informed consent were obtained.

Results: ED-related clinical concerns functioned as a central organising axis in clinical reasoning and interdisciplinary care. FI was approached pragmatically as immediate feasibility (“what can be eaten today”) and linked to disrupted routines, precarious income, fragile support networks, and limited local food availability. Team narratives highlighted how body image pressures and expectations around gender transition and gender-affirming hormone therapy shaped differentiated eating patterns among transfeminine and transmasculine patients. The team emphasised early identification of risk, context-sensitive nutrition education, supportive follow-up, and referrals aligned with available resources.

Conclusions: In this public service, FI and risk eating behaviours intersect with embodied expectations and material conditions, shaping care organisation. Routinised screening for FI and risk eating behaviours, territorially adapted nutrition education, and coordinated social/community support pathways may strengthen equitable TGD healthcare.

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Author Biographies

Rodrigo Hernán Torres Bravo, Department of Public Health, Universidad de La Frontera, Temuco, Chile

Academic and researcher at the Department of Public Health, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile. He holds a Bachelor’s degree in Nutrition and Dietetics, a Master’s degree in Applied Anthropology, Health and Community Development, and is a PhD candidate in Health and Development at the University of Salamanca. He is a member of the Observatory of Health Equity by Gender and Mapuche People, the Epu Pillan Research Center on Gender, Diversity and Inclusion in Health, and the Right to Food Observatory of Latin America and the Caribbean. His work focuses on public health, health equity, gender and diversity, with particular interest in food insecurity, nutrition, and healthcare for trans and gender-diverse people.

Augusto Claudio Obando Cid , Departamento de Salud Pública, Universidad de La Frontera, Temuco, Chile

Academic at the Department of Public Health, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile. He is a midwife, holds a degree in Education, a Master’s degree in Applied Social Sciences, a PhD in Social and Political Processes in Latin America, and a PhD in Social Sciences. He is Director of the Master’s Program in Community Public Health and Local Development at Universidad de La Frontera. His research interests focus on sexual and reproductive health, gender, and sexualities.

María Angélica Hernández Moreno, Centro de Investigación en Género, Diversidad e Inclusión en Salud (Epu Pillan), Facultad de Medicina, Universidad de La Frontera, Temuco, Chile

Academic at the Department of Public Health, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile. She is a nutritionist, holds a degree in Health Sciences Education, a Master’s degree in Sustainable Development Management, and a PhD in Health and Development in the Tropics from the University of Salamanca. She serves as Deputy Regional Coordinator of the Right to Food Observatory of Latin America and the Caribbean and is affiliated with the Center for the Study and Promotion of Human Rights at Universidad de La Frontera. Her research interests include food security and sovereignty, family farming, and mental health in older adults.

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Published

2026-09-10

How to Cite

Torres Bravo, R. H., Obando Cid , A. C., & Hernández Moreno, M. A. (2026). Food insecurity and risk eating behaviours in gender affirming care in La Araucanía, Chile: a qualitative study. Spanish Journal of Human Nutrition and Dietetics. https://doi.org/10.14306/renhyd.30.4.2809

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Online First

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Research articles

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Copyright (c) 2020 Rodrigo Hernán Torres Bravo, Augusto Claudio Obando Cid , María Angélica Hernández Moreno

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This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

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