Hello Kristen, back to the original question. I have asked myself that very same question. Why are we as a community not being healthy. I am no health nut my self but I do try and eat ok and exercise once in a while. My only guess at the answer to smoking and self destructive behavior by our sisters and brothers is that we are in pain and we need release. Unfortunately smoking in it self is a drug that calms you and makes you feel better. Drinks do the same. Overeating does too. Luckily exercise does too. This is no excuse however.
Personally I think fad diets are not the answer to this question. Do not get me wrong I have known plenty of people who lost weight on the Keto one and many others. Education on living healthy on HRT is a good first step, but that does not get to the root. Body dysmenorrhea goes hand in hand with gender dysmenorrhea, and it is just another step or hurdle that we as trans people have to cross. I wish dealing with this step would be added to the rest of the list like changing your name, living 1 year as a the correct gender, etc.
BTW check out the 7 Minute Woman workout app for the phone. This is my go to for the last few months. I simply love it. 💕