So often, the stigmas surrounding eating disorders are attributed to cisgender, white, female populations when in reality, eating disorders are not bound to race, gender or age. Considering that one study identified that “trans individuals have nearly 5 times the risk of eating disorder symptoms when compared to cisgender heterosexual women,” it is the responsibility of the eating disorder community at large to understand and address the unique challenges associated with providing supportive, effective, and well-informed treatment to the LGBTQ+ population. As we wind down Pride Month, the team at Columbus Park felt it was pertinent to discuss and review some of these unique risk factors and the ways in which they impact the treatments we provide.
We can begin our review with a discussion around prevalence. A 2015 study found that bisexual women are at a higher risk for eating disorders when compared to other sexual minority groups and gay men are at higher risk than men who are straight. A BBC Article titled ‘How Being Gay Can Make Your Body Issues Worse writes “In 2014, the International Journal of Eating Disorders found that gay or bisexual men were three times more likely than straight men to have body image issues.” Additionally, A recent survey in Attitude Magazine reported that in a poll, 84% of respondents said they felt under intense pressure to have a good body. Only 1% considered themselves “very happy” with their appearance. Clinicians must also be aware of body image issues associated with those experiencing Gender Dysphoria within the trans population, as this unique struggle may contribute to compounded difficulties accepting one’s body and body image –a struggle reported by many individuals with eating disorders. This has been noted to contribute to feelings of isolation and discomfort in treatment centers where this confounding variable goes unaddressed.
As LGBTQ+ populations are often underrepresented in larger scale treatment studies, the experience of marginalized populations often cannot be accounted for when evaluating best practices. Considering a great number of research studies are based on college campuses where there are disproportionate numbers of Caucasian, upper-middle class cisgendered young adults involved in studies (referred to as a “sample of convenience” in a recent Psychology Today article) the LGBTQ+ population is understudied. As a result of this, the myths continue to circulate about the ‘typical’ eating disorder sufferer and awareness around the LGBTQ+ populations remains limited.
An easy way to start incorporating more sensitivity to the unique stressors of the LGBTQ+ population in your practice? Start by reading the latest research. A recent study reported that LGBTQ+ youth are at a higher risk for homelessness. Members of the LGTBQ+ community are at a higher risk for being thrown out of their homes, especially trans individuals. Be sure your intake interviews are thorough and supportive. Secondly, as clinicians, we must be mindful of utilizing the correct gender pronouns. We must simply ask our clients at the time of intake what pronouns they prefer. The improper use of pronouns is associated with an increased risk of eating disorder symptoms, along with negative mental health outcomes and feelings of being invalidated in treatment. Meeting your client where they are to understand their unique circumstances will result in more validating, effective and supportive treatment. Learn more about the unique needs of this population here.
3 Ways to Improve How We Support the LGBTQ Community. (n.d.). Retrieved July 1, 2018, from https://www.psychologytoday.com/us/blog/eating-mindfully/201806/3-ways-improve-how-we-support-the-lgbtq-community?eml