In recent years, there has been recognition and a growing movement to address inequities in eating disorder (ED) treatment for people in the transgender community. Treatment providers are noticing a higher occurrence of all eating disorders and related issues such as body dysmorphic disorder in trans people compared to the general population. According to one study, transgender individuals experience eating disorders at a rate 4 times higher than their cisgender peers. When planning their treatment programs, care providers should certainly include gender-affirming policies.
Understanding the challenges trans people face with body image, discrimination, and eating can help reduce EDs in the transgender community before treatment becomes necessary.
Respecting a Trans Person’s Identity Is Key
First, it needs to be noted that gender dysphoria is not the sole cause or even the leading cause of eating disorders. Eating disorder recovery specialists working with trans individuals must consider that every ED from anorexia nervosa to avoidant restrictive food intake disorder is a complex condition stemming from many possible causes.
However, transgender people still face difficulties with discrimination or ignorance, even within the medical community. Failure to respect a person’s gender identity can cause or worsen the onset of EDs. Doctors, therapists, and other mental health care providers can be slow to recognize the unique needs of transgender people. This can lead to insensitive treatment that reinforces feelings of being misunderstood or disrespected so often experienced by transgender people.
An example might be a trans woman visiting a doctor who consistently uses the wrong pronouns in her medical charts. This practice can cause the patient considerable stress and a feeling that her gender identity is not recognized and respected. Misgendering of this sort is usually not due to malicious intent or bigotry on the doctor’s part but a lack of familiarity with treating transgender individuals.
Incidence of Co-occurring Disorders
Eating disorder centers and their staff are used to treating co-occurring disorders such as post-traumatic stress disorder (PTSD) and anxiety as segments of patients’ care plans, as they are relatively common in cases of eating disorders. Transgender people are at higher risk of having these disorders. That means trans ED patients are at even greater risk for experiencing a co-occurring disorder.
These disorders are known to induce behavioral symptoms intended to relieve the negative feelings they create. Maladaptive coping behaviors can temporarily lift the person’s mood but often become dangerous, showing up as drug or alcohol abuse, self-harm (e.g., cutting, etc.), or binging and purging. Because they usually cause a release of serotonin and dopamine, these coping behaviors can become addictive in their own right and become central components of eating disorders such as bulimia nervosa and binge eating disorder.
Gender-affirming treatment can identify the presence of anxiety, depression, PTSD, OCD, or other mental health disorders that frequently coexist with eating disorders. This can assist in preventing harmful coping behaviors such as purging or food intake restrictions. In the case of an at-risk group like trans people, it can help identify and stop an oncoming ED.
Eating Disorders in the Transgender Community Can Be Prevented
Many causes of mental health disorders such as genetic factors, body dissatisfaction and dysphoria, peer pressure and other environmental influences, and biological factors can also influence the onset of EDs, often through various coping behaviors. Being at a higher risk for mental health issues and disordered eating and exercise behaviors, trans people can be more susceptible to each. This is not a reason to despair. With progressive attitudes and gender-affirming policies prevailing in ED treatment, there is always hope.
By respecting each person’s basic human dignity, preventative measures to reduce the need for ED treatment in the trans community is possible. Something as basic as respecting a client’s preferred pronouns can make all the difference for someone facing daily discrimination in large and small ways. Transgender individuals deserve the same level of compassionate mental health care cisgender people normally receive. With a more sensitive approach to treatment and respect for clients’ gender identity, eating disorders in the trans community can be reduced.
If you or someone you know experiences mental health issues, it is important to seek help from a qualified professional. Our Resource Specialist can help you find expert mental health resources to recover in your community. Contact us now for more information on this free service to our users.
ABOUT THE AUTHOR: CARRIE HUNNICUTT
With 20 years of behavioral health business development experience, Carrie combines world-class marketing, media, public relations, outreach, and business development with a deep understanding of client care and treatment. Her contributions to the world of behavioral health business development – and particularly eating disorder treatment – go beyond simple marketing; she has actively developed leaders for her organizations and for the industry at large.
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