Most calorie and macronutrient calculators ask for your sex. As a gender-diverse person, which do you pick if you’re on hormone therapy?
First off, calorie calculators are based on averages. However, you’re not an average; you’re an individual.
So, even if you were cisgender, a calculator could only give you a rough estimate of your calorie and macronutrient needs.
In addition, you’re going to adjust your calories at some point anyway, whether you’re in a massing phase or in a fat loss phase… and sometimes even if you’re aiming to simply maintain your weight!
Therefore, even if the calculator were to give you the most amazingly accurate starting point, you may have to deviate from that eventually to avoid plateaus or, if eating at maintenance, to account for an increase or decrease in your activity levels.
Moreover, it seems that the formulae that assume sex differences in metabolism, may not be very reliable.
A relatively recent study – the largest of its kind to date, in fact, with over 6000 participants – seems to show that the reason why assigned female at birth (AFAB) and assigned male at birth (AMAB) people may have different metabolic rates at the same bodyweight on average, is that they have different levels of fat-free mass, not different sexes.
Taking all of this into account, the accuracy of a calculator doesn’t matter that much.
That’s why I prefer to take the approach described here instead of using a calculator when I need to estimate the calorie and macronutrient needs of any client, whether gender-diverse or not. Since it’s more personalised, it can provide a more accurate result.
Nevertheless, if you still wanted to use a calculator, I’d recommend two options:
Option 1. Pick a calculator based on a formula that doesn’t rely on sex, such as the Cunningham equation for athletes.
By clicking here, you can download my free guide to nutrition, which includes a calculator based on the Cunningham equation that doesn’t require you to calculate your body fat percentage.
You can then adjust the original target over time based on changes in your bodyweight, pictures, and measurements. You can read more about modifying your diet and training using these metrics in this three-part article.
Option 2. In my podcast with Dr. Whitney Linsenmeyer on nutritional considerations for gender-diverse people, she recommended two different methods to estimate your caloric needs if you’re already on hormone therapy:
Method 1. Base your choice of sex on the stage of your medical transition.
The World Professional Association for Transgender Health (WPATH) provides guidelines on how long it may take for masculinising and feminising hormone therapy to begin affecting your body, and how long it may take for these effects to be maximised. You can use these timelines to make an educated guess on which sex to pick.
For example, it seems that people taking testosterone may start experiencing fat redistribution and muscle growth from hormone therapy after six to 12 months. These shifts seem to take two to five years to reach completion.
So, if you’ve been on testosterone for six to 12 months, and you’ve experienced some noticeable body composition changes, you may want to select “Male” instead of “Female” on a calorie calculator.
Method 2. Use the caloric estimation for both sexes as a range.
For instance, let’s say you want to estimate your maintenance calories. If you select “Female”, the calculator gives you 2200 calories per day; if you select “Male”, it gives you 2400 calories. You can thus set the 2200 to 2400 calorie range as your target.
Keep track of your bodyweight fluctuations for two to four weeks while being consistent with this target. If your bodyweight is maintaining within a range of a few pounds, then the average calories you’re currently eating are appropriate to help you maintain your weight.
Thanks for reading. May you make the best gains.
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