Eating Disorders in the LGBTQ+ Community

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Kirsten Book, FNP-BC, PMHNP-BC

For many, the thought of eating disorders may exclusively call to mind young, heterosexual, thin, white women. Unfortunately, it is a myth that eating disorders only affect a certain population of people. The reality is that eating disorders affect individuals of all ages, gender identities, sizes, races, and ethnicities. 

June is Pride Month, a time to celebrate the LGBTQ+ community and sexual and gender diversity. Members of the community unite to recognize and honor the voices of lesbian, gay, bisexual, transgender, and queer and/or questioning people. Not only is this a good month to celebrate the LGBTQ community, but also a perfect time to address the increased rate of eating disorders in LGBTQ individuals. 

Members of the LGBTQ+ community have an increased risk of developing an eating disorder compared to straight and cisgender individuals. Sadly, members of the community are also more likely to experience barriers to care than the general population, making it even more difficult for the individual to seek help.

Recent studies are attempting to explain a particular pattern of eating disorders in U.S. society. Researchers have found that more than half of young LGBTQ people between the ages of 13 and 24 have been diagnosed with an eating disorder. (The Trevor Project, 2021)

Risk Factors:

There are certain identified risk factors that may make the development of eating disorders among the LGBTQ+ population more likely. Some of these risk factors may include:

Bullied and discriminated against because of gender or sexual identity

  • Increased anxiety and stress related to a disconnect between gender identity and biological sex
  • Increased shame because of gender identity
  • Negative beliefs, thoughts, and poor body image about oneself
  • Isolated from cisgender peers leading to depression
  • Experienced violence and post traumatic stress disorder

Barriers to Treatment: 

Members of the LGBTQ community with eating disorders experience unique barriers to treatment that make them less likely to get the help they need. Particularly the lack of access to treatment programs that address the unique issues that affect the LGBTQ community. 

Not all eating disorder treatment programs are LGBTQ friendly or even educated. For many LGTBQ individuals, there is a general distrust of the medical community. Based on the findings of the 2015 U.S. Transgender Survey, which is a large-scale survey of transgender adults in the United States, 23 percent of respondents did not see a doctor when needed due to fear of being mistreated as a transgender person and 33 percent had a negative experience with a healthcare provider in the past year, such as verbal harassment or being refused treatment. 

Any distrust of the medical providers would only increase a person’s likelihood to keep any issues to themselves and thereby, continuing to keep their eating disorder a secret. Without trust in the medical system, there is little hope that a LGBTQ individual will feel comfortable to speak up about their struggles. 

Support efforts toward greater inclusion and diversity:

To be helpful is to be inclusive, non-judgmental, and culturally competent. Support is the key to recovery for people of all gender and sexual identities. There are strategies to provide support that are safe, inclusive, and affirming for LGBTQIA+ community members with eating disorders.

Here are some ways that individuals can help :

  • Create a safe place for people to share without judgment
  • Listen to the LGBTQ + community about their relationship with food and their bodies
  • Affirm identity using gender inclusive language
  • Introduce yourself with your name and pronouns and ask others for theirs
  • Practice using gender-neutral terms  (“everyone”) in place of gendered ones (“men and women”).
  • Support efforts to make all eating disorder treatment programs safe and gender affirming

LGBTQIA+ individuals face unique barriers to eating disorder treatment, and ensuring that the community has access to care is ongoing work. It is important that the LGBTQ population is included in the research that informs social and healthcare policies and education is desperately needed in all levels of care of treatment to help validate the experiences and treat the unique needs of the LGBTQ community. 

Kirsten Book, FNP-BC, PMHNP-BC, is a dual board-certified family nurse practitioner and psychiatric nurse practitioner who specializes in treating adolescents and adults struggling with eating disorders, substance use, and co-occurring disorders. Not only does Kirsten have the education and clinical experience, but she also is in recovery from an eating disorder. She uses her own personal experience to draw empathy, compassion, and humility when working with her patients. Kirsten has the unique opportunity to help improve an individual’s mental health, by not only utilizing medications and psychotherapy, but also by instilling hope, which she believes is just as powerful and effective as what any medication can do. Kirsten has an outpatient private practice in Chicago, Illinois. She also is licensed to practice in Arizona and Washington. Kirsten is also the Medical Liaison for IAEDP (International Association for Eating Disorder Professionals), and she speaks at local schools to help educate the adolescents and staff about eating disorder prevention and treatment.