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Eating disorders are up to 10 times more common in the LGBT community. Here is an overview of the problems, and some suggestions for help.

Eating disorders are shockingly common among gay men, lesbians, and transgender or gender-nonconforming people. Survey data from Australia found that:

  • Fourteen percent of gay men, 30 percent of transgender people, and 34 percent of lesbians had been diagnosed with an eating disorder at some time in their lives.
  • Twenty-one percent of transgender people, 23 percent of gay men, and 32 percent of lesbians were so ashamed of their eating habits that they ate in secret.
  • Forty-seven percent of gay men, 62 percent of lesbians, and 69 percent of transgender people were dissatisfied with their eating habits.
  • Two percent of gay men, three percent of transgender people, and four percent of lesbians took diet pills.
  • One percent of gay men, two percent of lesbians, and three percent of transgender people used self-induced vomiting as a method of preventing weight gain.

This survey and others like it suggest that lesbians, gay men, and transgender people are prone to eating disorders and more often than not unhappy with their eating habits. Their rates of actual and potential eating disorders are much higher than those for the general population. But why should this be?

Surveys have also found that:

  • Gay men tend toward depression.
  • Lesbians have higher-than average scores for negative social interactions and anxiety than the average for the population.
  • Transgender people tend toward even greater depression and negative social interactions as well as lower self-esteem than either gay men or lesbians and also the general population.

Among trans people, negative emotions tended to snowball:

  • Anxiety and depression tended to occur together almost all the time.
  • Thwarted attempts to find belonging fueled depression.
  • And when trans people felt rejected by the people they loved, they also rejected themselves.
Non-binary youth have the highest rates of eating disorders of all the sexual minorities. They are the most likely of all sexual minorities to lose weight by fasting, to eat in binges, to lose weight by taking speed, to lose weight by taking laxatives, and to lose weight by throwing up. Nearly 75 percent of non-binary people not having reached the age of 25 engaged in one of these eating behaviors.

Eating disorders are rampant in LGBTQIA people. We could speculate why this happens. But let's look at some ways to help LGBTQIA people lead happier lives.

School connectedness (for LGBTQIA people aged 14 to 18)

Finding a school where LGBTQIA teens are accepted can make a life-changing difference for them. Feelings of belonging, engagement, and support at school greatly reduce the frequency of eating disorders in teens of all sexual orientations, but even more for LGBTQIA.

Family connectedness

Teens who recognize that their families care about their inner emotional states are better adjusted and less likely to engage in disordered eating.

Perception of friends caring

Repeated studies have found that younger LGBTQIA people who feel that their friends care have lower rates of disordered eating.

Social support

More important to young adults aged 19 to 25, social support includes tangible expression of social support, such as inclusion in social activities, positive interaction in casual contact, situationally appropriate expressions of affection, and information about life-positive activities and opportunities.

The bottom line about helping youthful sexual minority people avoid eating disorders

About half of LGBTQIA teens aged fourteen to eighteen alternate binge eating with purging through the use of methamphetamines, laxatives, or diuretics. About a third of LGBTQIA young adults continue these activities.

Supportive friends make a huge difference in the psychological health of sexual minority young people. So do supportive schools, where teachers and administrators stop the stigmatizing of sexual minority youth so they can have a more normal and happy experience of school. And more important still are supportive parents, who recognize the value and worth of their children who happen to have a different sexual orientation, and who make their homes sanctuaries free of bullying and abuse.

But at least as important as these factors is access to doctors and other healthcare providers who understand the challenges of growing up LGBTQIA. The nature of eating disorders is that they are mostly conducted in secret. Parents, siblings, friends, and teachers may not realize anything is wrong until the eating disorder requires hospitalization. Doctors, physician's assistants, and nurses who are knowledgeable of the early signs of eating disorders — which affect up to 80 percent of LGBTQIA youth at some point in their development — can encourage early intervention. They can also help sexual minority youth to find the vocabulary they need to share their experience with their world.

It is important to prevent bullying and physical abuse of LGBTQIA young people. Physical and psychological trauma fuel the anxiety and depression which so often express themselves as anorexia, bulimia, and binge-eating disorders. These potentially fatal conditions are not inevitable among sexual minority people. But it takes an engaged community to give these young people a fighting chance for a healthy life.

  • Bell K, Rieger E, Hirsch JK. Eating Disorder Symptoms and Proneness in Gay Men, Lesbian Women, and Transgender and Non-conforming Adults: Comparative Levels and a Proposed Mediational Model. Front Psychol. 2019 Jan 8.9:2692. doi: 10.3389/fpsyg.2018.02692. eCollection 2018. PMID: 30671007.
  • Clark TC, Lucassen MFG, Bullen P, et al. The health and well-being of transgender high school students: Results from the New Zealand Adolescent Health Survey. Journal of Adolescent Health. 2014.55:93–99. doi: 10.1016/j.jadohealth.2013.11.008
  • Veale JF, Saewyc EM, Frohard-Dourlent H, et al. Being safe, being me: Results of the Canadian Trans Youth Health Survey. Vancouver, BC: Stigma and Resilience Among Vulnerable Youth Centre
  • 2015. [Accessed on July 15, 2019]. from http://saravyc.sites.olt.ubc.ca/files/2015/05/SARAVYC_Trans-Youth-Health-Report_EN_Final_Print.pdf.
  • Photo courtesy of SteadyHealth

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