Making PCOS and Nutrition Care More Gender Inclusive
Women's health has been underserved for far too long. Pain is dismissed, symptoms are minimized, and getting a diagnosis often means fighting to be believed. This is compounded by the broader systemic and social barriers that come with navigating life as a woman. So it's genuinely encouraging to see PMOS (PCOS) finally getting the research, resources, and public conversation it deserves as a women's health issue.
That said, what about the people who have PMOS (PCOS) but don't identify as women like trans men and nonbinary folks? How can they receive care that validates and reflects their experience?
We spoke with Craig Pacheco, a registered dietitian and founder of Queerly Nutrition, a practice supporting LGBTQ2S+ folks with inclusive, affirming and evidence-based nutrition care, about what it actually looks like to make endocrine and nutrition care more gender inclusive.
What Does It Mean to Practice From an Intersectional Perspective?
Intersectionality, a term coined by scholars like Dr. Kimberlé Crenshaw, describes how different parts of a person's identity, such as ethnicity, gender, age, and ability, don't exist in isolation. They overlap and interact, shaping how systems either support or work against a person.
In nutrition care, practicing from an intersectional lens means considering culture, age, ability, neurodiversity, gender, and sexuality together, rather than treating any one of them as the whole picture. It also means recognizing lived experience as real, valuable data, especially in areas of health where formal research is still limited.
An example: a non-binary person with PCOS is also on testosterone as part of their gender-affirming care. They're also low-income. Does the provider understand how testosterone affects insulin resistance and cholesterol? How does hormone therapy impact someone with PMOS who may already have higher levels? Does this impact their metabolic health? What treatment approach needs to change? What food can this person actually afford? Do they have a mental health provider they trust to refer to? Can they afford transportation to their appointments?
Why Women's Health Needs to Expand
There's a significant research gap when it comes to how PMOS (PCOS) is experienced by people who don't identify as women, including trans and non-binary individuals. The first step toward more inclusive care is simply acknowledging that gap exists in research, best practices and clinical recommendations.
[Updated since the podcast recording] That said, more research is starting to come on gender-diverse experiences with PMOS (PCOS). A recent study analyzing community discussions found something that pushes back on the typical narrative: while illness is usually described in research as disruptive to a person's sense of self, trans and nonbinary participants often described their experience of PMOS (PCOS) in positive terms. PMOS (PCOS) was even seen as a catalyst for self-discovery.
Expanding what "women's health" research and care covers isn't about taking anything away from women; it's about closing a gap that's left real people without care that fits them.
Small Language Shifts That Make a Big Difference
Craig’s tips for healthcare professionals: One of the most practical tools for gender-inclusive care is mirroring language. If a client refers to a body part or a relationship in a specific way, reflecting that same language back, rather than defaulting to clinical or assumed terms, signals genuine respect.
If someone refers to their "bottom parts" instead of using anatomical terms, or uses "partner" instead of "husband" or "wife," using their language back shows them they're seen and heard.
This applies whether you're working one-on-one with a client or designing a group program, an intake form, or public health messaging. At its core, it comes down to client-centred care: not assuming based on appearance or cultural norms, and letting the person lead both the conversation and the language used to describe their own body and life.
Language matters too. A small but meaningful shift is talking about "people with PMOS (PCOS)" rather than exclusively "women with PMOS (PCOS)." This isn't about erasing the experiences of women; it's an additive approach that makes space for everyone who actually lives with the condition.
How Eating Disorders Intersect With Gender and Sexuality
Craig: There's a common misconception that eating disorders primarily affect thin, white, affluent women, but LGBTQ2S+ communities experience disordered eating at meaningfully high rates. Trauma and experiences of oppression are strongly linked to the development of eating disorders, which partly explains this pattern.
There's also a real lack of representation in eating disorder treatment spaces. Many rehabilitation programs are rooted in religious institutions, which can feel unwelcoming or unsafe for people who don't have a positive relationship with organized religion.
And within LGBTQ2S+ communities specifically, there can be intense pressure around body image, for example, some gay men face significant pressure toward a specific level of muscularity or leanness.
It's also worth remembering that the LGBTQ2S+ community isn't a monolith. Experiences differ widely depending on someone's specific identity, and intersectionality applies here too. The most helpful thing anyone outside a particular community can do is create space to listen rather than assume.
How Patients Can Advocate for More Inclusive Care
If you're looking for more gender-inclusive care, here are a few places to start:
Ask your community for referrals to providers others have had good experiences with.
Look for directories built specifically for finding inclusive providers, such as Rainbow Health Ontario, if you're located in Ontario.
Consider virtual care if inclusive providers aren't available in your immediate area.
Advocate directly with your current healthcare provider by explaining your needs clearly.
Above all, safety comes first. If disclosing part of your identity to a provider doesn't feel safe, it's okay to hold that information back. Leaning on your community and chosen family for support is valid and valuable, especially in places where access to specifically trained providers is limited.
A huge thanks to Craig Pacheco and Queerly Nutrition
Craig Pacheco is a Registered Dietitian and the founder of Queerly Nutrition, a practice supporting LGBTQ2S+ folks with inclusive, evidence-based nutrition care. If you're looking for gender-affirming nutrition support specifically, you can learn more about his work at Queerly Nutrition.
Want Support With Inclusive PMOS (PCOS) Care?
Working through this on your own can feel overwhelming, especially when there's so much conflicting information out there. At Nest & Nurture Health, our team of Registered Dietitians provides personalized, evidence-based support to help you build a plan that actually fits your life.
Book a free consultation to learn more about how we can support you.
References
McGhee, A., & Arthur, A. (2026). Biographical Discovery, Affirmation, and Disruption: Trans and Nonbinary Peoples' Experiences Negotiating Gender and Polycystic Ovary Syndrome. Sociology of health & illness, 48(4), e70191. https://doi.org/10.1111/1467-9566.70191
