LGBTQ+ identified folks experience unique stressors that may contribute to the development of an eating disorder. While there is still much research to be done on the relationships between sexuality, gender identity, body image, and eating disorders, we know that eating disorders disproportionately impact some segments of the LGBTQ+ community.
RISK FACTORS
LGBTQ+ people face unique challenges that may put them at greater risk of developing an eating disorder. Research shows that, beginning as early as 12, gay, lesbian, and bisexual teens may be at higher risk of binge-eating and purging than heterosexual peers.
Potential factors that may play a role in the development of an eating disorder may include:
- Fear of rejection or experience of rejections by friends, family, and co-workers
- Internalized negative messages/beliefs about oneself due to sexual orientation, non-normative gender expressions, or transgender identity
- Experiences of violence and post-traumatic stress disorder (PTSD), which research shows sharply increases vulnerability to an eating disorder
- Discrimination due to one’s sexual orientation and/or gender identity
- Being a victim of bullying due to one’s sexual orientation and/or gender identity
- Discordance between one’s biological sex and gender identity
- Inability to meet body image ideals within some LGBTQ+ cultural contexts
LGBTQ+ youth also experience increased risks of homelessness or unsafe home environments:
- Up to 42% of homeless youth are LGBTQ+-identified
- 33% of youth who are homeless or in the care of social services experienced violent assault when they came out
BARRIERS TO SUPPORT AND TREATMENT
LGBTQ+ people, in addition to experiencing unique contributing factors, may also face challenges for accessing treatment and support. Common barriers may include a lack of culturally-competent treatment, which addresses the complexity of unique sexuality and gender identity issues, lack of support from family and friends, and insufficient eating disorders education among LGBTQ+ resource providers who are in a position to detect and intervene.
The emergence of LGBTQ+ youth drop-in centers, gay-straight alliances, LGBTQ+ community centers, and LGBTQ+ healthcare resources have created more safe spaces to access support and mental health care. However, many LGBTQ+ people still remain isolated in communities that do not offer such services/programs.
RESEARCH ON LGBTQ+ PEOPLE AND EATING DISORDERS
Research remains limited on eating disorders among LGBTQ+ populations. Existing research shows that:
- In one study, gay and bisexual boys reported being significantly more likely to have fasted, vomited, or taken laxatives or diet pills to control their weight in the last 30 days.
- Gay males are thought to only represent 5% of the total male population but among males who have eating disorders, 42% identify as gay.
- Gay males were seven times more likely to report binging and 12 times more likely to report purging than heterosexual males.
- Compared with heterosexual men, gay and bisexual men had a significantly higher prevalence of lifetime full syndrome bulimia, subclinical bulimia, and any subclinical eating disorder.
- Females identified as lesbian, bisexual, or mostly heterosexual were about twice as likely to report binge-eating at least once per month in the last year.
- Elevated rates of binge-eating and purging by vomiting or laxative abuse was found for people who identified as gay, lesbian, bisexual, or “mostly heterosexual” in comparison to their heterosexual peers.
- Black and Latinx LGBs have at least as high a prevalence of eating disorders as white LGBs.
- A sense of connectedness to the gay community was related to fewer current eating disorders, which suggests that feeling connected to the gay community may have a protective effect against eating disorders.
