Eating Disorders in LGBTQIA+ Populations
Members of LGBTQIA+ communities are at an increased risk for developing eating disorders, and face unique barriers to treatment. However, with the right care from educated providers and support from loved ones, lasting recovery is possible for every LGBTQIA+ person struggling with an eating disorder. Studies show that eating disorder rates are higher among transgender, gender non-conforming, and queer folk than among their cisgender and heterosexual counterparts. Despite this, stereotypes about who gets eating disorders—namely cisgender, white, heterosexual girls—persist. Awareness is fortunately increasing about eating disorders within LGBTQIA+ communities, and we’re committed to doing our part to amplify this awareness, close the treatment gap, and get effective eating disorder care to every LGBTQIA+ person who needs it.

Facts and statistics about eating disorders in LGBTQIA+ populations:

  • LGBTQIA+ young people experience significantly higher rates of eating disorders, with at least one survey finding that over 50% of LGBTQ+ youth reported having an eating disorder.
  • Transgender college students report experiencing disordered eating at approximately 4 times the rate of their cisgender classmates.
  • Transgender high school students are nearly 3 times as likely to restrict eating, almost 9 times as likely to use diet pills, and 7 times as likely to use laxatives to control their weight.
  • While gay males account for an estimated 5% of the total male population, they make up 42% of males with eating disorders.
  • LGBTQ+ youth are more than twice as likely as their peers to engage in bingeing and purging behavior, beginning as early as age 12.
  • 87% of LGBTQIA+ youth reported being dissatisfied with their body, and LGBTQIA+ youth with body dissatisfaction were twice as likely to report a suicide attempt in the past year compared to LGBTQ+ youth without body dissatisfaction.
  • LGBTQIA+ youth who have been diagnosed with an eating disorder reported nearly 4 times greater odds of attempting suicide in the past year compared to those who never had, or suspected they had, an eating disorder.
  • 32% of transgender people report using their eating disorder to modify their body without hormone replacement therapy.
Common questions about eating disorders in LGBTQIA+ populations

Eating disorders are highly complex brain disorders that emerge out of a constellation of different factors, including genetics, biology, environment, and more. However, LGBTQIA+ folks face a variety of unique challenges that increase their likelihood of developing an eating disorder. Those challenges include:

  • Stigma and discrimination. Society often sends LGBTQIA+ people the message that their bodies and core identities are unacceptable or unimportant, which can come through as overt discrimination, subtle microaggressions, or rejection from loved ones. All of this can contribute to a feeling of alienation and lack of acceptance, and eating disorder behaviors may emerge as a way to cope with these feelings.
  • Past trauma or PTSD. Members of the LGBTQIA+ have increased rates of trauma, which is known to significantly increase the likelihood of developing an eating disorder.
  • Unrealistic body ideals. While society at large promotes unrealistic and unhealthy body ideals, this may be more pronounced within certain LGBTQIA+ communities. This may be particularly true among gay men and boys. For transgender people, there is additional, safety-related pressure to attain narrow appearance ideals.
  • Uneducated providers. Because many healthcare providers lack knowledge about eating disorders in LGBTQIA+ populations, transgender and queer folks who are struggling often go undiagnosed, allowing their eating disorder to become more entrenched.
  • Gender dysphoria. Gender dysphoria is when someone feels significant distress, discomfort, or misalignment with their body experience. To deal with gender dysphoria, some LGBTQIA+ youth may restrict food in an effort to prevent or delay the development of sexual characteristics—like chest tissue, menstruation, or body hair—that don’t align with their gender identity. Eating disorder behaviors can also emerge as a way to cope with the intense negative feelings associated with gender dysphoria, which is more likely to happen if the dysphoria goes untreated (an outcome that’s unfortunately common for trans and nonbinary people).

In addition to being at a heightened risk for developing an eating disorder, LGBTQ+ people also face barriers to effective treatment. Some of the challenges they might encounter include:

  • Lack of provider education. Unfortunately, not many healthcare providers are knowledgeable about eating disorder risk in LGBTQ+ populations and the importance of gender-affirming care. This might mean that patients go undiagnosed or even face discrimination. This lack of education can be particularly harmful fortrans patients, who might come up against “trans broken arm syndrome,” which is when serious health issues (like eating disorder symptoms) are chalked up to their gender journey. Some providers might even gatekeep gender-affirming treatments because they believe that the patient’s desires are stemming from the eating disorder.
  • Lack of research. Most eating disorder research looks at white, cisgender females. And while more research is being done on eating disorders in LGBTQIA+ populations, the standards of care and the most frequently used measurement tools to assess eating disorder severity are still based on predominantly white, cisgender, and heterosexual samples.
  • A hostile legal environment. Anti-trans and anti-LGBTQ+ legislation can increase barriers to proper healthcare, including eating disorder treatment, as well as exacerbate many of the factors that increase risk of eating disorders in this population.
  • Estranged family. For some LGBTQIA+ folks, protecting their mental health means distancing themselves from their family or experiencing rejection from their family of origin. Because of that, they often lack the emotional and financial safety nets that someone living at home with their parents likely has.

Given all of these challenges, your support is crucial to any LGBTQIA+ loved one who may be struggling with an eating disorder. Here are some tangible ways to help:

  • Validate their identity. Use their pronouns and wholly embrace their gender identity and sexual orientation to send the message that they are accepted and their life is worth fighting for.
  • Be their advocate. In a healthcare environment that often sidelines their experience, vocal advocates can be a huge help to LGBTQIA+ people. That might mean advocating for them to healthcare providers, insurance carriers, or even family and friends.
  • Help them find gender-affirming care. For trans and nonbinary folks, gender-affirming treatment is non-negotiable criteria for achieving recovery. Help your loved one do the research and make the phone calls to find treatment that will validate their identity.
  • Be there. By simply showing up, you can help your loved one feel less alone, safer in their body, and more motivated to seek treatment. Make your concerns known in a curious and gentle way, and be proactive in initiating conversations and helping them seek care.

While every person has unique desires and life circumstances, the answer to this question is generally yes. Eating disorders don’t exist in a vacuum, and it’s important for treatment teams to have a comprehensive sense of what’s going on in a patient’s life, which includes their gender identity and sexual orientation.

It’s also important to discuss these topics to ensure that patients are able to access gender-affirming care. Gender-affirming care is an approach to treatment that respectfully affirms a trans patient’s gender identity, taking into account all the physical, mental, and social aspects of their well-being. Gender-affirming care often starts as a simple conversation, where a patient and their providers discuss what pronouns the patient uses and whether that differs by setting, what their gender identity means to them, and what challenges they’ve faced or are facing. By understanding a person’s whole experience and incorporating it into their treatment, providers can better support patients in moving toward recovery.

How Equip supports LGBTQIA+ populations

We know that those in LGBTQIA+ communities face specific challenges in eating disorder recovery, and our treatment is designed to help them overcome each. Nearly half of our clinicians and mentors identify as LGBTQIA+, and all our providers are trained in providing the nuanced and sensitive care this population needs. All Equip providers complete training on gender-affirming care, and we’re proud to be rolling out Gender Responsive & Affirming Care at Equip (GRACE), a detailed protocol that will serve as our guiding philosophy toward gender-affirming care. We offer two LGBTQIA+ support groups, one for youth and one for adults, as well as two transgender and gender nonconforming (TGNC) support groups, one for patients and one for caregivers of TGNC patients. We acknowledge that there is a long way to go before LGBTQIA+ populations have the same access to proper eating disorder diagnoses and evidence-based treatment as their cisgender, heterosexual counterparts. On our part, we’re committed to providing treatment that addresses these challenges with sensitivity and competence, while we work toward raising awareness and making effective eating disorder treatment available to every LGBTQIA+ person who needs it.
If you think you or an LGBTQIA+ person in your life may be struggling with an eating disorder, finding prompt treatment is vital.
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