feature image photo by SEAN GLADWELL via Getty Images

Despite finishing a Master’s in Psychology — in queer healthcare access, no less — I didn’t realize I had a serious eating disorder until afterward. It makes the table a bit uncomfortable while I laugh about it.

The late realization happened to me because narratives and information about eating disorders for trans women are pretty non-existent. Even worse, I developed mine while I was living as a queer man. Men don’t receive meaningful information about eating disorders, either. Eating disorders are portrayed as a cis woman’s problem. But that’s no reason to leave queer people in the dark.

So here are some essentials about eating disorders for queer people. Straight from the mouth of a sufferer who realized it a bit late.

1. Queer people are often at higher risk of eating disorders than cisgender-heterosexual people

Depending on your sources, we either have alarmingly heightened rates of eating disorder prevalence, or generally higher rates. With some mixed numbers. We’re shockingly vulnerable to eating disorders overall, but we’ve been made into a ‘lost’ population in research and treatment.

Eating disorders rarely show up unprompted. They’re often driven by a constellation of mental distress that gradually disrupts our eating patterns. Clinical psychologist Dr. Courtney Crisp says, “because the queer community tends to be exposed to more trauma and minority stress due to discrimination, this can lead to an increased risk for eating disorders.”

The mental distress we experience due to marginalization stacks up fast. Most of us won’t develop a severe eating disorder, but I dare say any of us who have anxiety or depression can identify disrupted eating patterns in our lives.

Our heightened risk for eating disorders also mixes with a lack of treatment. Dr. Crisp writes succinctly that, “Eating disorders are often thought of as a thin, cisgender white women’s disease, which does not tell the whole story.” That image has become the ‘typical’ eating disorder sufferer, leaving a range of people and conditions (like binge-eating) behind.

Queer people aren’t adequately targeted for treatment, either. Inpatient care targets cisgender women, which leaves out men, genderqueer, and trans clients. This combination of high risk and poor treatment creates conditions that let eating disorders flourish among queer people while going untreated.

These high-level conditions in society and healthcare eventually reach individual queer people. I didn’t just spawn an eating disorder. Mine rose out of severe discomfort with my body when I lived as a dysphoric ‘man.’ I didn’t have knowledge of eating disorders and how they affect men/queer people, and it swallowed me alive for years.

2. Eating disorders interact with queerness in pretty insidious ways

Eating disorders are insidious. Like anxiety or depression, they destroy our ability to trust our own perceptions. They also reshape themselves to match our personhood so that nobody is immune. Queerness opens up interactions with eating disorders that we rarely see elsewhere.

Psychotherapist Madison Mccullough says that, “The intersection of gender dysphoria and eating disorders is one that is unique to queer folks. If someone is experiencing gender dysphoria, they might have a strong desire for part(s) of their body to be different.”

That statement was like a grand piano falling onto my head, because that’s precisely what happened to me. While gender dysphoria was mauling me in 2015, I channeled my desire for a feminine body into aggressive weight loss. For trans people, acclimating to our gender can mean visceral exposure to another set of body standards, including weight and build.

Dr. Crisp pointed out that internalized queerphobia can manifest as disordered eating. She says, “if the world tells you the way you are or the way you express yourself is not ok, it is easy to internalize those messages and take it out on yourself (and your body by extension).”

Besides the expert opinions, I’ve seen queer masculine folk align parts of their identity to their bodies. Twinks and femboys are commonly portrayed as lean, which applies pressure to look a certain way in order to maintain their personal identity. Elsewhere, trans people are keenly aware of the violence leveled at us. For many of us, aggressively pursuing a body that is read as our gender (or ‘passes’) becomes a matter of personal safety.

3. Despite it all, we’re well-positioned to do something about it

Even though we’re not in a good spot for avoiding eating disorders (NOT our fault!), I’ve always appreciated that queer people are in a good place to do something about it. Queer people have a good understanding of the complex relationship between history and health. Because we’re living it. We’re also used to talking candidly about our distress and making each other aware of mental health issues. We’re strengthened by our diversity of experiences and opinions — precisely where healthcare has failed us.

If you’ve tried working on your mental health and reflected on your experiences, you’re already ahead of people who have just started grappling with these difficulties. Despite the bad news, queer folk possess the openness and personal reflection that eating disorders are most terrified of. We’ve applied it to the social ills we face. We’ve applied it to our mental health. And it’s ready to apply to eating disorders as soon as we see them.

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