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The aim of this study was to examine the lifetime use of APEDS and associations with eating disorder and muscle dysmorphia symptoms among gender minority people.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Participants were 1653 gender minority individuals (1120 gender\u2010expansive [defined as a broad range of gender identities that are generally situated outside of the woman\u2013man gender binary, e.g., genderqueer, nonbinary] people, 352 transgender men, and 181 transgender women) recruited from The Population Research in Identity and Disparities for Equality Study in 2018. Regression analyses stratified by gender identity examined associations of any APEDS use with eating disorder and muscle dysmorphia symptom scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Lifetime APEDS use was common across groups (30.7% of gender\u2010expansive people, 45.2% of transgender men, and 14.9% of transgender women). Protein supplements and creatine supplements were the most commonly used APEDS. Among gender\u2010expansive people and transgender men, lifetime use of any APEDS was significantly associated with higher eating disorder scores, dietary restraint, binge eating, compelled\/driven exercise, and muscle dysmorphia symptoms. Any APEDS use was additionally associated with laxative use among gender\u2010expansive people. Among transgender women, use of any APEDS was not significantly associated with eating disorder or muscle dysmorphia symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>APEDS use is common and associated with eating disorder and muscle dysmorphia symptoms in gender\u2010expansive people and transgender men, thus highlighting the importance of assessing for these behaviors and symptoms among these populations, particularly in clinical settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Public Significance<\/jats:title>\n                    <jats:p>This study aimed to examine APEDS use among gender minority people. We found that 30.7% of gender\u2010expansive (e.g., nonbinary) people, 45.2% of transgender men, and 14.9% of transgender women reported lifetime APEDS use, which was associated with eating disorder and muscle dysmorphia symptoms in transgender men and gender\u2010expansive people. Clinicians should assess for these behaviors in gender minority populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/eat.23708","type":"journal-article","created":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T03:29:17Z","timestamp":1648610957000},"page":"678-687","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Appearance and performance\u2010enhancing drugs and supplements, eating disorders, and muscle dysmorphia among gender minority people"],"prefix":"10.1002","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6541-0604","authenticated-orcid":false,"given":"Jason M.","family":"Nagata","sequence":"first","affiliation":[{"name":"Department of Pediatrics University of California, San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0522-2748","authenticated-orcid":false,"given":"F. Hunter","family":"McGuire","sequence":"additional","affiliation":[{"name":"The Brown School Washington University in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9853-2280","authenticated-orcid":false,"given":"Jason M.","family":"Lavender","sequence":"additional","affiliation":[{"name":"Military Cardiovascular Outcomes Research Program (MiCOR), Department of Medicine Uniformed Services University of the Health Sciences  Bethesda Maryland USA"},{"name":"The Metis Foundation  San Antonio Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7349-7228","authenticated-orcid":false,"given":"Tiffany A.","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Psychological Sciences Auburn University  Auburn Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5588-2915","authenticated-orcid":false,"given":"Stuart B.","family":"Murray","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard E.","family":"Greene","sequence":"additional","affiliation":[{"name":"Department of Medicine New York University  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6803-5950","authenticated-orcid":false,"given":"Emilio J.","family":"Compte","sequence":"additional","affiliation":[{"name":"Eating Behavior Research Center, School of Psychology Universidad Adolfo Ib\u00e1\u00f1ez  Santiago Chile"},{"name":"Research Department Comenzar de Nuevo Treatment Center  Monterrey Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annesa","family":"Flentje","sequence":"additional","affiliation":[{"name":"Department of Community Health Systems University of California, San Francisco  San Francisco California USA"},{"name":"Alliance Health Project, Department of Psychiatry and Behavioral Sciences University of California, San Francisco  San Francisco California USA"},{"name":"The PRIDE Study\/PRIDEnet Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micah E.","family":"Lubensky","sequence":"additional","affiliation":[{"name":"Department of Community Health Systems University of California, San Francisco  San Francisco California USA"},{"name":"The PRIDE Study\/PRIDEnet Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juno","family":"Obedin\u2010Maliver","sequence":"additional","affiliation":[{"name":"The PRIDE Study\/PRIDEnet Stanford University School of Medicine  Stanford California USA"},{"name":"Department of Obstetrics and Gynecology Stanford University School of Medicine  Stanford California USA"},{"name":"Department of Epidemiology and Population Health Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell R.","family":"Lunn","sequence":"additional","affiliation":[{"name":"The PRIDE Study\/PRIDEnet Stanford University School of Medicine  Stanford California USA"},{"name":"Department of Epidemiology and Population Health Stanford University School of Medicine  Stanford California USA"},{"name":"Division of Nephrology, Department of Medicine Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,3,30]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/13691058.2020.1814968"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2016.303566"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-2768"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/15532739.2011.700873"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bodyim.2020.10.006"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2015.03.003"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-0095"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/703490"},{"issue":"4","key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"e01508","DOI":"10.1016\/j.heliyon.2019.e01508","article-title":"Protein supplement consumption is linked to time spent exercising and high\u2010protein content foods: A multicentric observational study","volume":"5","author":"Ewan T.","year":"2019","journal-title":"Heliyon"},{"key":"e_1_2_10_11_1","first-page":"309","volume-title":"Cognitive behavior therapy and eating disorders","author":"Fairburn C. 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