Eating Disorders Within the Transgender Community
Identifying as transgender comes with its own unique set of challenges; stigma, discrimination, hate crimes, lack of access to adequate care, mental illness, and trauma, among others. What is not known, or perhaps not acknowledged, is the high rates of disordered eating within the transgender community, particularly amongst those who do not have access to gender-affirming care.
By: D Belinsky
As a member of the transgender community myself, I know how accepted it is within the community to restrict, binge, purge, or engage in other behaviors to manipulate your body to ease gender dysphoria and make your body look more like the body of the gender you identify with. Because of this acceptance within the community and lack of proper access to healthcare, many transgender individuals end up developing very serious eating disorders that often result in very serious damage to their bodies.
Transgender people who do enter eating disorder treatment when their behaviors spiral out of control are often subjected to the same treatment practices as their cisgender counterparts, which can often be ineffective. One prime example of this is surrounding body image and how most body image groups are run, with the goal of body acceptance and body love. This concept can be very difficult for a transgender person to embody as it is their bodies that pose the problem and, as a result, body acceptance wouldn’t necessarily be the best course of treatment for these individuals.
Unfortunately, there is a lack of research on effective treatment for transgender individuals with eating disorders or disordered eating. Much of the research that has been done focuses on getting these individuals into gender-affirming treatment and started on hormones and gender-affirming surgeries. And although there is some benefit in this course of treatment, for many of these individuals, particularly those who have developed clinically diagnosable eating disorders, gender-affirming health care is insufficient in dealing with their eating disorders.
There needs to be more research done into what kind of treatments are the most effective for transgender individuals with eating disorders, and perhaps creating treatment programs that are exclusively for transgender individuals with eating disorders. Several studies have revealed that transgender individuals have a difficult time connecting with their cisgender counterparts and often didn’t feel integrated within their programs as they experienced microaggressions, such as incorrect pronoun or name usage for those who had not legally changed their names.
Within the clinical community, those clinicians that do work with transgender individuals need to do the work to educate themselves on how the motivations for the behaviors involved with eating disorders may differ in transgender individuals and how to lessen the harm that they may be causing themselves in being uneducated in working with transgender individuals and all the intersectionality that comes with it. This work needs to come from clinicians themselves, it should not be the job of transgender individuals who are in treatment to provide education to their clinicians on how to properly address and treat them without causing more trauma and harm. In addition to these actions, real work needs to be done in recognizing and not accepting eating disorders as the norm within the transgender community.
BALANCE eating disorder treatment center™ is dedicated to the treatment of members of the LBGTQ+ community with eating disorders including anorexia, bulimia, and binge eating disorder as well as disordered eating and body image concerns through our programs and services.
Additionally, our center has responded to the needs of the LGBTQ+ community with the creation of a group specifically for those struggling with eating disorders and body image concerns. Our LGBTQ+ Eating Disorder Recovery Group offers a safe space for clients to process issues related to recovery and body image and is not limited to any specific eating disorder diagnosis.
This post was written by BALANCE Social Work Intern, D Belinsky.
D Belinsky (they/them) is a first-year Mental Health Counseling student at Baruch College and is doing their practicum internship at BALANCE right now, and they are very excited for the opportunity. D received their Bachelor of Science in Psychology with a minor in Women’s & Gender Studies from the College of Staten Island. They have deep passions working with the eating disorder community, as well as the LGBTQ+ and personality disorder communities, specifically looking into how those three populations intersect amongst each other.
They have done a great deal of advocacy work with the LGBTQ+ community, including working on the Gender Committee for the CUNY system and the LGBTQ Student Leadership Program also within CUNY.
References
Diemer, E. E., Hughto, J. M., Gordon, A. R., Guss, C., Austin, S. B., & Reisner, S. L. (2018).
Beyond the binary: differences in eating disorder prevalence by gender identity in a transgender sample. Transgender Health, 3(1), 17-23.
Donaldson, A. a., Hall, A., Neukirch, J., Kasper, V., Simones, S., Gagnon, S., … Forcier, M.
(2018). Multidisciplinary care considerations for gender nonconforming adolescents with eating disorders: A case series. International Journal of Eating Disorders, 51(5), 475-479.
Thapliyal, P., Hay, P., & Conti, J. (2018). Role of gender in the treatment experiences of people with an eating disorder: A metasynthesis. Journal of Eating Disorders, 6(18).