There is a stereotype that those with eating disorders are primarily young, thin, cisgender white women. Here at Veritas Collaborative, we know this stereotype is untrue and potentially harmful. Eating disorders affect people of any race, gender, sexuality, age, socioeconomic status, or size. In fact, studies show that the LGBTQIA+ community experiences eating disorders just as much, if not more than their non-LGBTQIA+ peers. LGBTQIA+ is an umbrella term that includes several sexual and gender identities. We will be speaking about this group generally, but we know that it encompasses a diverse mix of identities and experiences.
In this blog, we will discuss eating disorders in the LGBTQIA+ community, including unique challenges, barriers to treatment, and ways healthcare providers and treatment centers can create an inclusive environment.
Eating Disorders and the LGBTQIA+ Community
Although all individuals in the LGBTQIA+ community have an elevated risk for the development of eating disorders, certain segments, such as transgender individuals, are at a greater risk. In a 2015 study in the Journal of Adolescent Health, transgender college students reported experiencing disordered eating at approximately four times the rate of their cisgender classmates. According to a 2007 study on lesbian, gay, and bisexual individuals, it was found that among males who have an eating disorder, 42% of them identify as gay. With gay males thought to represent 5% of the total male population, one can see just how disproportionately gay men are affected by eating disorders in comparison to their straight male counterparts.
Unique Challenges the Community Faces
Any person with a marginalized identity has an elevated risk for mental health issues because of the added stressors of prejudice and discrimination. Internalized homophobia, as well as social and structural barriers in our society, are just some factors that contribute to the heightened eating disorder risk in the LGBTQIA+ population. Below are some examples of unique challenges the LGBTQIA+ community can face that increase the risk of an eating disorder:
- Experiencing or fearing rejection from family, friends, and peers
- Dissonance between one’s biological sex and gender identity
- Internalized negative messages about oneself due to sexual orientation or gender identity
- Substance use and misuse
- Discrimination based on sexual orientation or gender identity
- Bullying from loved ones or peers based on sexual orientation or gender identity
- Experiences that result in PTSD
- Heightened anxiety and depression
- Pressure to fit a certain body ideal within some LGBTQIA+ cultural contexts
Barriers to Treatment
In addition to the unique challenges that increase the risk of eating disorders in the LGBTQIA+ community, they may also experience challenges when seeking treatment. Common barriers can include lack of culturally competent care, absence of support from family and friends, and inadequate eating disorders education among LGBTQIA+ resource providers. Feeling connected to the LGBTQIA+ community has been shown to result in fewer eating disorders. This suggests that feeling connected to an understanding and supportive community may have a protective effect against eating disorders.
The number of LGBTQIA+ youth drop-in centers, gay-straight alliances, LGBTQIA+ community centers, and LGBTQIA+ healthcare resources has gone up, but many people who need these services do not have access to them where they live. Feeling isolated from the queer community can make it more difficult to seek help.
Making Treatment Inclusive for the LGBTQIA+ Community
People in the LGBTQIA+ community may face discrimination, as well as internalized homophobia or transphobia. These factors must be considered when treating these individuals in any healthcare setting, including eating disorder treatment centers. When treating a person with an eating disorder, providers should address the complexities of a person’s identity without making any assumptions about the cause of their illness.
Everyone deserves individualized care for their eating disorder. For example, focusing exclusively on body acceptance is not always the right method for transgender individuals, who may choose to pursue medical treatments to alter their bodies to align with their gender identity. Respectful and inclusive language must also be used, including using the pronouns that the patient requests. Taking gender identity into account when making room assignments in treatment is another way to make treatment inclusive. All of these considerations are essential when treating LGBTQIA+ patients.
Check out our complimentary event, “Embodied Dignity: Considerations for Clinical Practice at the Intersections of Eating Disorders and the Dazzling Spectra of Sexuality & Gender Identity” to learn more on this topic and earn continuing education credits. This webinar will be presented by Chase Bannister, MDIV, MSW, LCSW, CEDS, on June 9. Register today!