LGBTQ+ Month

In honor of LGBTQIA+ History Month, I wanted to spread awareness of the unique experiences and increased risk of eating disorders in the LGBTQIA+ community. While I am a registered dietitian that specializes in eating disorders and strives to always support clients of all gender identities and sexual orientations, I am a cisgendered female; because of this, I’d also like to lift up the works of those who have lived experience as well. Eating disorder awareness and education are vital to decreasing barriers to appropriate care for our LGBTQIA+ community, but it is with lived experience that we gain a truer understanding of the complexity and nuance that exists in this space.

Did you know that transgender individuals are reported to be 4 times as likely to experience a diagnosed eating disorder compared to minority identified women; 7 times more likely to experience an eating disorder compared to cisgender minority identified men; and 12-15 times more likely compared to cisgender heterosexual men, and women (Diemer, et al, 2015)? Unfortunately, the statistics don’t stop there; some studies estimate that almost 50% of LGBTQ+ individuals were diagnosed with an eating disorder or suspected to have an eating disorder, along with an increased attempted suicide risk compared to the general population (The Trevor Project, 2022).

Why is the LGBTQIA+ community uniquely impacted by eating disorders you may ask? Well, several researchers postulate that it can be explained via the minority stress model (Meyer, 2003). Minority groups experience unique and difficult stressors due to their gender identity and sexual orientation that can include bullying, discrimination, internalized stigma and more. (Parker & Harriger, 2020). Experiencing this stress and discrimination can impact eating behaviors as a means to cope. If you are someone that resonates with these statistics and is a part of the LGBTQIA+ community, know that you aren’t alone.

Lived Experience Perspectives

Whether you are an individual wanting to learn more about the lived experiences of queer individuals in the eating disorder space, or are a clinician expanding your knowledge in this area, reading and listening to the following works can be a great place to start:

– ThirdWheelED was founded by two queer individuals that offer their perspectives on eating disorder recovery. Check out this podcast to listen to Jamie (OJ) Bushell (they/them/theirs) and Jamie Dannenberg, MS, RDN, LDN (she/they) discuss how eating disorders and other mental health conditions disproportionately impact LGBTQIA+ communities. – The book, Reclaiming Body Trust: A Path to Healing & Liberation by Hilary Kinavey (she/her/hers), MS, LPC and Dana Sturtevant (she/her), MS, RD share not only the lived experiences of queer individuals in the eating disorder space, but offer decades of experience, techniques, and questions to consider. – Aubrey Gordon (she/her/hers) is a writer, journalist, and popular cohost of the podcast Maintenance Phase where she offers insight into her lived experience as a queer woman with a history of eating disorders.

– Dr. Sand Chang (they/them) is a nonbinary trauma therapist that specializes in the treatment of trans health, eating disorders and body liberation while also sharing her story via their book and via other media platforms. – PFLAG is the largest organization in the US dedicated to supporting LGBTQ+ individuals be providing peer support, education and advocacy, while also sharing stories and experiences of its LGBTQ+ members.

This is in no way a comprehensive list, but a suggested starting place to learn more.

How to Improve Care for LGBTQ+ Community

Are you a clinician at a hospital, outpatient center, community organization, or in private practice and working with LGBTQIA+ individuals & wondering if you can improve the care you offer? Consider:

1. Reading about the lived experiences of LGBTQIA+ individuals and their experiences with eating disorders. Lift up the stories and voices of those with lived experiences and those that might have their voice heard less often.

2. Include your pronouns during introductions with clients and with colleagues. Ask your clients and colleagues what their pronouns are. Information is important, and when we have information on others’ pronouns, we can start to check any assumptions or biases we may have.

3. Consider including signage such as decals, flags, markers, and more to show others and clients that areas are gender-neutral and safe spaces to occupy.

4. Seek professional trainings and supervision when necessary. This supports growing inclusive settings. By seeking out education and information, you can improve your personal understanding and begin developing cultural humility.

References

1. Strother, E., Lemberg, R., Stanford, S. C., & Turberville, D. (2012). Eating Disorders in Men: Underdiagnosed, Undertreated, and Misunderstood. Eating Disorders, 20(5), 346-355. doi:10.1080/10640266.2012.715512
2. Ray, Nicholas. 2007. Gay, Lesbian, Bisexual and Transgender Youth: An Epidemic of Homelessness. National Gay and Lesbian Task Force and National Coalition for the Homeless.
3. The Trevor Project. (2023). Retrieved from https://www.thetrevorproject.org
4. Meyer, I. H. (2003). Prejudice, social stress, and mental helath in lesbian, gay and bisexual populations: conceptual issues and research evidence. Psychological Bulletin, 129(5), 674-697.
5. Parker, L. L., & Harriger, J. A. (2020). Eating disorders and disordered eating behaviors, in the LGBT population: a review of the literature. Journal of Eating Disorders, 8(1), 1-20.
6. Diemer, E. W., Grant, J. D., Munn-Chernoff, M. A., Patterson, D. A., & and Duncan, A. E. (2015). Gender identity, sexual orientation, and eating-related pathology in a national sample of college students. The Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 57(2), 144–149.

Social Media stats:

1. High school students who Identify as lesbian, gay or bisexual are more than 4 times as likely to have attempted suicide compared to their heterosexual peers (source: NAMI)

2. Gay males are thought to only represent 5% of the total male population but among males who have eating disorders, 42% identify as gay (source: Strother, et al, 2012)

3. Lesbian, bisexual or mostly heterosexual females were about twice as likely to report binge eating at least once per month in the last year (source: Nicholas, 2007)