3 Ways to Improve How We Support the LGBTQ+ Community

Source: Photo by Kirsty Lee on Unsplash

June is Pride Month, which is a time to celebrate the LGBTQ+ community. And while there is a lot to celebrate (yay marriage equality!) we also still have a lot more work to do. So, as we close out pride month, I want to take a moment and reflect on some of the things that we as eating disorder professionals—and as helping professionals more generally—could be doing to better support the LGBTQ+ community. Here are my three, which are just a drop in the bucket of what we could be improving on.

1. Recognize that LGBTQ+ individuals are at higher risk for eating disorders.

We tend to think that eating disorders only affect thin, white, middle-upper class, cisgender women. Nope. Research suggests that the most at-risk populations actually are transgendered individuals followed by bisexual women. In fact, one study found that trans individuals have nearly 5 times the risk of eating disorder symptoms when compared to cisgender heterosexual women. Trans individuals often feel isolated in eating disorder treatment settings, likely due to the unique ways in which gender dysphoria complicates one's relationship with their body and eating—and the ways that this may not be understood by treatment professionals. In addition, a 2015 study found that bisexual women are at increased risk for eating disorders when compared with other sexual minority groups. And gay men are at increased risk when compared to straight men. While we are talking about stereotypes, we should also keep in mind that people at higher weights are at increased risk of eating disorder symptoms. So let’s stop thinking of eating disorders as a thin rich white girl problem. These misconceptions lead to missed diagnoses and poorer treatment outcomes.

2.LGBTQ+ folks are at much higher risk for homelessness and food insecurity.

The latest research shows us that members of the LGTBQ+ community are at a higher risk for being thrown out of their homes, especially trans folks. Even more troubling, trans folks often have a difficult time finding a public shelter where they feel safe. This makes one’s relationship with one’s body potentially traumatic, disrupting healthy development of body image (does that even exist anymore in our messed up culture?) and impacting food availability and eating behavior. Plus, all individuals on the LGBTQ+ spectrum are at higher risk for food insecurity, which has been linked to a higher likelihood of eating disorder development. Ask your clients where they live and if it’s safe. Do they have regular access to food? These essential questions should inform any treatment plan.

3. Pronouns Matter

A recent study found that being misgendered and other non-affirming gender experiences was associated with increased risk of eating disorder symptoms, as well as increased internalized stigma, more negative mental health outcomes, and increased risk of suicide for transgendered individuals. Ask what pronouns your patients use. Don’t assume. Cisgendered allies, we can help here by stating our pronouns when we introduce ourselves (ie. “Hi, I’m Dr. Alexis Conason, and I go by she/her.”). I love the trend of people including pronouns in their social media bios.

Bottom Line: We need a lot more research. Though there’s promising literature out there about the intersection of eating disorders, sexual orientation, and gender, we still continue to primarily study cisgendered white upper-middle class college students, believing that, because this is who we study (often a “sample of convenience” since undergrads are readily available to participate in research studies in exchange for extra credit), this is who struggles with eating disorders. In reality, it neglects marginalized populations and leads to the myth that eating disorders aren’t prevalent in these groups, when really it is just understudied. There is much more research that needs to be done!

If you identify as a member of the LGBTQ+ community and want to share what you think we could be doing better as healthcare providers, we would love to hear from you! Feel free to share in the comments below!

Alexis Conason is a clinical psychologist specializing in the treatment of overeating disorders, body image dissatisfaction, psychological issues related to bariatric surgery, and sexual issues. She is the founder of The Anti-Diet Plan (sign up for her free 30 day course). Follow her on Twitter, Instagram, and Facebook.