Prevalence of eating disorders in trans and non-binary people
The research that has been done involving trans and non-binary individuals shows that these communities are disproportionately affected by mental health conditions, including eating disorders, compared to their cisgender peers.1
One study surveying nearly 300,000 U.S. college students revealed an elevated risk of eating disorder diagnoses and eating disorder symptoms, such as compensatory behaviors and past-month laxative use, among transgender students compared to their cisgender peers.
Nearly 16% of the trans students surveyed reported an eating disorder diagnosis within the last year. This is significant, considering approximately 1.85% of cisgender heterosexual women, 3.52% of cisgender queer women, 2.06% of cisgender queer men, and less than 1% of cisgender heterosexual men reported an eating disorder diagnosis.3
Nearly 16% of the trans students reported having an eating disorder.
Trans students also reported higher engagement in compensatory behaviors. Over 13% of trans students surveyed reported diet pill use, and 15% had used laxatives or vomiting as a compensatory behavior in the past month. Cisgender women reported less compensatory behaviors, with rates under 5.24% for past-month vomiting or laxative use and 5.11% for diet pill use.3
The prevalence of eating disorders in non-binary and trans people is only an estimate because there hasn’t been enough ED research conducted in these communities. Instead, studies often categorize all LGBTQ+ folks together, making it harder to focus on the unique struggles of the transgender and gender-diverse community.2
Non-binary and trans people and eating disorders: Why are rates so high?
Eating disorders are multifaceted and complex mental health disorders. People develop these disorders for many reasons, including genetic and environmental factors. There are some hypotheses on why trans and non-binary people seem to struggle with eating disorders at higher rates than other populations, including:3
- Trans people may engage in disordered eating behaviors to accentuate desired physical features that are more in line with their gender identity.
- Eating disorder behaviors may be used to attempt to suppress gendered features that cause gender dysphoria.
- Trans people may utilize ED behaviors to change their bodies to achieve the “ideal” body based on gender stereotypes.
Importantly, trans people experience minority stress connected to stigma, discrimination, gender-based violence, and more.3 Minority stress has been linked with patterns of disordered eating, eating disorders, and poor mental health outcomes.3
Trans people may also have a higher chance of receiving mental health care than their cisgender peers since they are often required to attend therapy to receive gender-affirming medical interventions, such as gender-affirming hormone treatment or gender-affirming surgery. If they are more likely to have contact with a provider, they may also be more likely to receive a diagnosis.2
Though not all trans people experience gender dysphoria, it can have an influence on eating disorders in the trans and non-binary communities.
Gender dysphoria refers to the psychological distress and anxiety caused by the mismatch someone may experience between their sex assigned at birth and their gender identity.4
Gender dysphoria can cause some people to experience certain kinds of body dissatisfaction and can lead to disordered eating behaviors for some people. Some trans and non-binary people may engage in eating disorder behaviors as a direct or indirect response to gender dysphoria, but this is not true for all members of this community. For other trans and non-binary people with eating disorders, the eating disorder may be completely unrelated to their gender.
It is essential not to make assumptions about eating disorders in this population or assume that everyone has the same experience.
Another major reason eating disorders may be particularly prevalent among the non-binary and trans community is the general lack of inclusive and gender-affirming care.
It's important to note that gender-affirming care has been made difficult to access in many parts of the world, leaving a shortage in the number of medical providers who are trained in best practices of gender-affirming medical care. Treatment specific to trans patients is not often covered in standard medical curricula, and many providers don’t have comprehensive knowledge and fluency.
It is also possible for non-binary and transgender patients to experience more direct discrimination in medical care.5 Many non-binary or trans people may actively decline to seek eating disorder treatment because of the fear of encountering stigma, discrimination, or incompetence within the healthcare community.5
Other commonly reported barriers to treatment for non-binary and trans eating disorders include:5
- Inadequate insurance coverage
- Financial barriers to treatment
- Lack of provider cultural competence
- Inappropriate electronic records and demographic forms
- Lack of transportation or stable housing
- Co-occurring mental health conditions
Finding help for an eating disorder
No matter your gender identity, sexual orientation, race, or age, it's vital to seek out eating disorder treatment if you think there may be a problem.
Remote care for trans and non-binary individuals
At Within Health, we prioritize inclusivity so prospective patients feel safe, comfortable, and supported throughout their treatment journey. We understand that eating disorders are very complex and that what works for one person may not work for another.
We offer specialized care for transgender and non-binary patients, as well as for queer people of all identities. Our patients can feel comfortable knowing their identities are represented on our treatment staff as we prioritize employing a diverse team of providers.
Every patient who enrolls in our program receives an extensive biopsychosocial evaluation, which our treatment team uses to create an individualized treatment plan specific to that patient’s needs and experiences. Our remote treatment program allows patients to continue their daily lives while receiving comprehensive and integrated care from a multidisciplinary team of doctors, nurses, therapists, nutrition counselors, and more.
If you or a loved one are struggling with an eating disorder, it's never too late to seek out help. Contact us today to see how we can help you get on the road to recovery.
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