Eating Disorders and the Transgender Community

With the recent political focus on transgender rights, as well as it being National Eating Disorders Awareness Week, I thought it important to highlight that past research has indicated transgender people may have a higher risk of eating disorders than any of their peers.

In 2015, the Journal of Adolescent Health, determined that “rates of past-year [self-reported eating disorder] diagnosis and past-month use of diet pills and vomiting or laxatives were highest among transgender students.”(1) More specifically, “[a]bout 16 percent of trans respondents reported that they had been diagnosed with an eating disorder in the past year.” That’s five times more than the next highest group which was “men who were unsure of their sexuality, who reported rates at 3.66 percent.”(2)

This is an alarming study in and of itself, but there are two things that have really stuck with me since. Firstly, the study was done via a survey of 289,024 students across some 200 university campuses. So while this is just a small sample size, one must also take into account that there may have been even more students than reported who a) were, in fact, struggling with an eating disorder but hadn’t been “diagnosed” and/or b) did not want to divulge that he/she/they had been diagnosed.

The second is that this survey was done two years ago. Rendering such an alarming result I would have hoped other studies would have popped up in my research, but any article I found only referred to the aforementioned survey in the Journal of Adolescent Health. I could not find any other study. And with eating disorders at such a high occurrence rate ("The National Association of Anorexia Nervosa and Associated Disorders states that approximately eight million people in the U.S. have anorexia nervosa, bulimia, and related eating disorders."(3)), more research is absolutely vital in understanding these mental illnesses (yes, eating disorders are a mental illness), especially within the transgender community.

Now, I am cisgender, so I cannot—and will not—speak to this personally. I do feel, however, that every single person’s story and his/her/their experience with an eating disorder is vital for so many reasons. One being a stark indication of how much more attention and research must be given to eating disorders and, two, the more voices we have, the more people can start to understand that eating disorders affect everyone regardless of their race, gender, sexual orientation, body size, age, etc.

Now, a number of articles I read surmised possible reasons transgender people struggle with eating disorders. I’m not going to do that because I, of course, don’t know. And, also, because I do know—first hand—how individualistic eating disorders actually are. The reason(s) for one transgender person who struggles can be completely different from another, and it is not ‘always’ or ‘automatically’ related to being trans.

Dan Maldonaldo, who works at T-FFED (Trans Folx Fighting Eating Disorders), cautioned against lumping trans folx into these growing ‘theories’, “I think when we report eating disorders in our community to medical professionals, a lot of times there's this arrogance or conflation of gender dysphoria with body dysmorphia." Dan says. "People think that once you're able to transition that your eating disorder will disappear. This is not the case. There's a lot of reasons why eating disorders are prevalent in the transgender community, but it doesn't necessarily have to do with the fact that we are trans and we have bodily issues that have to do with our gender."(4)

In short, this is an extremely important topic which must be explored and researched further. And, specifically, one to which we all need to listen. Eating disorders affect everyone in so many different ways and for so many different reasons, we need to give everyone's story a place in which it can be told. 

Eating While Transgender by Jamey Hampton

Finding Me: Looking Past the Surface to Discover My Transgender Identity by Ryan Sallan

(My blog is, by no means, a hotbed of internet traffic, but if you would like to add your voice/story to this, please don’t hesitate to email me. Additionally, I encourage you to check out Trans Folx Fighting Eating Disorders for further resources, information, and support.) 

<3
s.e.c

 

  1. "Gender Identity, Sexual Orientation, and Eating-Related Pathology in a National Sample of College Students". Diemer, Elizabeth W. et al. Journal of Adolescent Health, Volume 57, Issue 2, 144 - 149.
  2. Ford, Zack. “Eating Disorders Significantly More Prevalent Among Transgender People, Study Finds”. ThinkProgress, ThinkProgress. 4 Aug 2015.  Web. 28 Feb 2016.
  3. "Statistics: How Many People Have Eating Disorders?" ANRED, 2 Mar 2016. https://www.anred.com/stats.html
  4. McNeilly, Claudia. “Trans Youth Are Significantly More Likely to Have an Eating Disorder”. Health, Broadly. 1 Dec 2015. Web. 28 Feb 2016.

Eating Disorders are an Invisible Illness

Only recently have I realized that not many people understand that eating disorders are, in fact, an invisible illness.

Image borrowed from  Screen Relish

Image borrowed from Screen Relish

So I'm going to say this louder for the people in the back because it's very, very important:

you can't tell if someone has an eating disorder just by looking at them.

It's kind of like you can't tell if someone has diabetes just by his/her appearance. Sure, some may need a insulin pump just like some disorders may cause the person to be very frail, but eating disorders do not discriminate. No matter how much you weigh, what you look like, your socioeconomic status, your gender, your race, your religion, your age, your sexual orientation... eating disorders can, and do, affect everyone.

I have no doubt this misunderstanding has been perpetuated by the media's often macabre focus on anorexia—blasting their articles with shocking "before and after" photos and bold headlines that state the person's extreme low weight. And while talking about the deadliest mental illness is important, there is so much being overlooked and left out, and that is far more damaging than people may realize.

Often, a big component of these illnesses is the lie that "you aren't enough". In direct relation to the eating disorder, it often becomes "you aren't sick enough to have an ED", or "you aren't thin enough to have an ED". This is continually enabled by the aforementioned articles, as well as the misunderstanding of people in general. (Not to mention medical personnel, but that's a whole other rant for me to get into another day.I cannot tell you how many people I've heard say they don't think they have an eating disorder because their BMI (which is a crap measure of health to begin with)/their weight/whatever doesn't qualify or isn't "enough". Not to mention people having said such things to them (i.e. "You weigh too much to have an eating disorder." "Men don't get eating disorders.") And with an illness as dangerous as these, when early intervention is vital, that false belief can literally mean life and death.

Besides—when it comes down to the nitty gritty—eating disorders aren't about weight anyway. It's a far more sinister internal struggle that manifests in the person's relationship with food. But, still, many people are kicked out of treatment programs when they reach a "healthy weight " even though that does not, by any means, mean they are cured of their disorder. In fact, some people have been refused treatment or insurance coverage because they don't meet a certain criteria.

Certainly doesn't help combat that falsity that "you aren't thin enough to be sick", yeah?

It's a dangerous and difficult path to wager as someone who struggles with a disorder as well as those around them who care, and I would encourage people to check out Types & Symptoms of Eating Disorders by NEDA. Listed there are ones which have a clinical diagnosis under the DSM-5. But some—like orthorexia nervosa—aren't listed and aren't in the DSM-5 (another avenue which can lead to feelings of not being "sick enough" etc.) However, all eating disorderswhether recognized in the DSM, have other variations, disordered eating, etc.are valid; there is no hierarchy.

And we, as a whole and as individuals, must start looking past the outside and start seeing the invisible.

Sarah

If I missed a disorder of any kind please let me know so I can add it; it is important to me that all are represented.

What Does National Eating Disorder Awareness Week Mean?

In addition to reflecting on what National Eating Disorder Awareness Week represents to me (awareness, of course. But also advocacy? Ending stigma?), I have been considering trying to write a blog post of some kind every day during #NEDAW (Feb. 21 - 27th). Which is a big thing considering I'm actually making a structured goal, let alone one that requires consistency.

I know all two of you must be asking, Who are you and what have you done with, Sarah?! But she's still here, as demonstrated by how I've spent the entire day thinking, "Well, do I really have anything to say about eating disorders? What if I've already said all the stuff I can speak to ?"

I have my personal experiences which are, of course, extremely important. I have ideas and opinions I've gleaned from reading, listening, learning, and reflecting. But I am not the most structured, factually focused person out there. Also, I've never really aligned myself with 'advocacy'; not because I have anything against it, but that I approach things with the viewpoint of writing what I know and if someone gets something from it, all the better! Lastly, there are many extremely intelligent people I follow on Twitter who have done their research, remembered their research, and can translate that research into something streamlined and accessible (i.e. Andrea LaMarre is brilliant!)

That's not me, though. That isn't how my mind operates. And the majority of the time I'm OK with that, but as I was reading through post after post of great information today that I am thrilled is getting out there, it was difficult not to look at my blank little blog page and think, "Well, what am I going to write about that hasn't already been written about, and written better?"

Honestly, I still don't know for sure. But I spent last week searching for people who would want to share their experiences with eating disorders. I can only speak to what I went through, but eating disorders are vast, in addition to anorexia and bulimia (which are only recently beginning to be talked about) there is EDNOS (Eating disorder not otherwise specified)/OSFED (Other specified feeding or eating disorder), BDD (body dysmorphic disorder), BED (binge eating disorder), among others. And I feel it is vital that every narrative about EDs are heard. Disordered eating included, as it is a huge stepping stone toward the previously mentioned illnesses.

The awesome Eye Still Brave contacted me to share, for which I am excited! But no one else responded. Which is completely fine, of course, but it got me wondering why that was. I know EDs thrive on isolation, guilt, shame, and silence. Speaking up, about anything, is hard—especially regarding something as personal and difficult as an eating disorder. And I understand people not being ready or not even wanting to share experiences.

But it got me thinking that even IF everything about eating disorders has already been written (unlikely) or the things I'm trying to say have been expressed better/differently (possibly (with also a nod to the fact this might be perfectionism trying to sneak in)), I probably still ought to keep shouting into the void anyway. Because I can't tell everyone else his/her/their experience is valid and worth telling (which I truly believe, through and through) if I think I've written all I can write about my experiences/thoughts about eating disorders.

So, in short, I've decided that to me National Eating Disorder Awareness Week is about speaking up. Even—especially—when I think it's already been better said. Because 1) that kinda sounds like something the ED voice in my head would want me to believe and 2) really, even if it has already been said, that doesn't mean it any less important or tru

So, we will see how this blog-a-day goal works with my here-to-there self (and the acceptance, of course, if it doesn't work!).  But in the meantime, if you're ready—and no matter what it is that might make you hesitate— speak boldly, my friends!

- Sarah

 

Also, if you want to speak up and don't have a platform, or would like to share your blog regarding eating disorder (I don't post anything with numbers), then don't hesitate to leave me a comment or shoot me a message!