Nowaskie DZ, Filipowicz AT, Choi Y, et al. - This study was carried out to assess the relationship between gender identity, gender-affirming interventions such as gender-affirming hormones (GAH) and gender-affirming surgeries (GAS), and eating disorder (ED) symptomatology. At a primary care outpatient gender health program in the United States, transgender patients completed a survey consisting of demographics, medical history, and clinical variables, including the Eating Disorder Examination Questionnaire (EDE‐Q). Researchers performed multivariate analyses of covariance to compare EDE‐Q scores across gender identity and gender affirmation. In this study, transgender women (n = 87) reported higher EDE‐Q scores and significantly higher Eating Concern in comparison with transgender men (n = 79). High levels of ED symptomatology were reported in transgender patients. Furthermore, there are subtle, yet important, differences in ED between gender identities and gender affirmations. The data demonstrate that the high ED prevalence may result from the dual pathways of sociocultural pressures as well as gender dysphoria. The findings revealed that both GAH and GAS may be effective interventions to support gender affirmation and thereby alleviate ED symptomatology. The effects of GAH are less clear, while the potential positive benefits of GAS on ED are more apparent.