{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T08:28:20Z","timestamp":1787128100152,"version":"build-2736575974"},"reference-count":61,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behav. Sci.","Behavioral Sciences"],"abstract":"<jats:p>Orthorexic tendencies and their measurement remain understudied in transgender adults. This cross-sectional study conducted a preliminary psychometric evaluation of the Turkish ORTO-11 and examined psychological correlates of orthorexic tendencies in a clinically recruited sample of transgender adults undergoing psychiatric evaluation before gender-affirming hormonal or surgical treatment. Eighty participants completed the ORTO-11, Health Anxiety Inventory, Psychache Scale, Self-Compassion Scale, and Multidimensional Scale of Perceived Social Support. Internal consistency analyses, confirmatory factor analysis, Spearman correlations, robust regression, and indirect-effect analysis were conducted. The ORTO-11 showed good internal consistency (Cronbach\u2019s \u03b1 = 0.88; McDonald\u2019s \u03c9 = 0.89), and confirmatory factor analysis supported a unidimensional structure with acceptable model fit indices. Lower ORTO-11 scores, indicating greater orthorexic tendencies, were associated with higher health anxiety and psychological pain and with lower self-compassion and perceived social support. In multivariable analysis, psychological pain was the only significant independent correlate of ORTO-11 scores. Bootstrap analysis suggested that psychological pain statistically accounted for part of the association between health anxiety and orthorexic tendencies. These findings provide preliminary support for the Turkish ORTO-11 as a self-report measure of orthorexic tendencies in this clinically recruited transgender sample, but the scale should not be interpreted as a diagnostic instrument for orthorexia nervosa.<\/jats:p>","DOI":"10.3390\/bs16081423","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T07:58:23Z","timestamp":1787126303000},"page":"1423","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Psychometric Validation of the Turkish ORTO-11 and Psychological Correlates of Orthorexic Tendencies in Transgender Adults Before Gender-Affirming Treatment"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9997-351X","authenticated-orcid":false,"given":"Caner","family":"Ye\u015filo\u011flu","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine, \u00c7ukurova University, 01330 Adana, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6989-0975","authenticated-orcid":false,"given":"Ali Meri\u00e7","family":"Kurt","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Gaziantep Nizip State Hospital, 27700 Gaziantep, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9750-7531","authenticated-orcid":false,"given":"Lut","family":"Tamam","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine, \u00c7ukurova University, 01330 Adana, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3965-7360","authenticated-orcid":false,"given":"Mehmet Emin","family":"Demirkol","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine, \u00c7ukurova University, 01330 Adana, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8954-5901","authenticated-orcid":false,"given":"Zeynep","family":"Naml\u0131","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine, \u00c7ukurova University, 01330 Adana, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmut Onur","family":"Karaytu\u011f","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine, \u00c7ukurova University, 01330 Adana, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9536-2335","authenticated-orcid":false,"given":"Sinem","family":"\u00c7etin Demirta\u015f","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine, \u00c7ukurova University, 01330 Adana, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1521\/jscp.2007.26.10.1120","article-title":"Promoting self-compassionate attitudes toward eating among restrictive and guilty eaters","volume":"26","author":"Adams","year":"2007","journal-title":"Journal of Social and Clinical Psychology"},{"key":"ref_2","first-page":"1","article-title":"Self-compassion scale: The study of validity and reliability","volume":"33","year":"2007","journal-title":"Hacettepe University Journal of Education"},{"key":"ref_3","first-page":"283","article-title":"Ortoreksiya nervoza ve ORTO-11\u2032in T\u00fcrk\u00e7eye uyarlama \u00e7al\u0131\u015fmas\u0131 [Orthorexia nervosa and adaptation of ORTO-11 into Turkish]","volume":"19","author":"Merdol","year":"2008","journal-title":"T\u00fcrk Psikiyatri Dergisi"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Awad, E., Salameh, P., Sacre, H., Malaeb, D., Hallit, S., and Obeid, S. 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