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Eating disorders affect people of all ages, races, sexual orientations, and genders, including members of the transgender community. Unfortunately, when it comes to eating disorders in transgender individuals, there are often barriers to treatment not experienced by their cisgender peers, such as gender-specific programs that do not have trans-inclusive options.
Still, with the right kind of care, support, and treatment, it's possible for anyone to overcome these conditions. Transgender and gender-diverse programs can make a big difference in getting people the help they need to achieve long-term recovery.
Reliable information on eating disorders and transgender individuals can be hard to come by. Most studies explore these conditions through a binary gender lens and only relatively recently has research begun examining eating disorders in transgender individuals specifically. However, some general trends and patterns have been identified in the research that has been done.
Transgender people experience heightened rates of gender dysphoria, which is the psychological distress associated with a disparity between one's assigned gender at birth and their gender identity. Some may develop an eating disorder connected to these conflicting feelings or as an attempt to make their physical body resemble their gender identity.
Many transgender people with disordered eating also have underlying mental health conditions such as depression, which can also be connected to experiencing stigma and social alienation. Sadly, over 88% of transgender people have reported having suicidal thoughts, with over 40% attempting to end their lives.1,4
Transgender college students are more likely to receive an eating disorder diagnosis compared to their cisgender classmates.3 Transgender youth are even more susceptible to developing eating disorders. According to a survey conducted by the National Eating Disorder Association (NEDA), over half of LGBTQ+ youths struggle with disordered eating behaviors.1
Barriers to treatment for eating disorders in transgender people
Members of the transgender community often face discrimination due to their gender identity. Experiencing this type of stigma can make it difficult to speak out about eating disorder symptoms or seek out appropriate care.
Sadly, this discrimination can even come from healthcare providers like doctors or mental health professionals. This can come from a conscious bias or unconscious blindspots to the problems facing transgender individuals due to the lack of established medical research or guidelines on eating disorders and transgender patients.
Additionally, many transgender people, particularly transgender youth, do not have a safe, stable home environment where they can find care and support for their recovery. It is estimated that 40-60% of all homeless youth are part of the LGBTQIA community, and when they try to find a home, 1 in 5 transgender people report experiencing discrimination, including eviction, due to their gender identity.5,6
Discrimination against trans people can come from healthcare providers like doctors or mental health professionals.
There is, therefore, a need for increased support, education, and anti-discrimination efforts for the transgender community, especially when it comes to eating disorders and other mental health concerns.2 By raising awareness, those who cope with an eating disorder and the people who love them can access resources to get the support they need and deserve.1
Treating transgender people with eating disorders
It's essential to show understanding and empathy when treating transgender people who struggle with disordered eating. At Within, we recommend all treatment specialists, nutritionists, and healthcare professionals educate themselves on the specific needs of transgender patients and understand the importance of gender-affirming medical interventions and other gender-diverse treatment programs.
Eating disorder prevalence among transgender individuals seems to be large. Many experience disordered eating that is connected to concerns about their physical body and/or other complex dynamics associated with co-occurring mental health disorders like depression and post-traumatic stress disorder (PTSD). It's important to keep all of these considerations in mind when treating eating disorders in transgender people.
Specialized doctors
Transgender individuals may be more successful in their treatment if they receive care from doctors who specialize in gender-affirming care. This type of care aims to help the patient feel accepted and create a space of belonging where healing can occur. Thankfully, many clinicians who work in eating disorder prevention and screening or treatment programs have started including gender identity-affirmation measures in their practices.
Programs addressing gender-related triggers
Treatment protocols for transgender people may vary or include additional types of programs to address gender-related triggers, but much of the eating disorder treatment will be the same. Close attention should be paid to the complex bio-psycho-social variables faced by transgender individuals that can deepen the pain of discrimination and social alienation and make recovery a more challenging process.
Feel safe while in treatment
At Within, we welcome everybody without bias or discrimination. If you're transgender and in need of treatment for an eating disorder, call us today—we offer a safe place for you to recover.
Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.
Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.
Do all transgender people struggle with their body image?
No. Body image is not the same as gender dysphoria, or the experience of feeling one's gender assigned at birth conflicts with one's gender identity. Someone may have issues with their body image, regardless of their gender identity. Many people of all genders, races, ages, and ethnicities struggle with body image issues at some point in their lives.
What causes an eating disorder?
There is no one cause of eating disorders. They are complex mental health conditions developed by a number of interconnecting biological, psychological, and environmental factors. Some issues that commonly contribute to eating disorders include struggles with anxiety and depression, a history of trauma, and growing up in a household that emphasizes dieting behaviors or appearance as a marker of self-worth.
How can I help a person struggling with an eating disorder?
Eating disorders are very serious and should be addressed with professional help. Furthermore, it is critical not to enable the behavior by normalizing unhealthy eating patterns or encouraging others to engage in restrictive eating diet-culture-driven eating behaviors. The Within Health team can help answer any questions or concerns you may have regarding disordered eating. Call our helpline today to get started.
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