Abstract
Transgender populations are disproportionately impacted by eating disorders and disordered eating behaviors; however, transgender clients lack access to affirming and culturally responsive mental health care and are frequently undiagnosed. In addition, conventional treatment models for eating disorders do not attend to the unique causes and manifestations of eating disorders among transgender people, which include: minority stress and gender trauma; gender dysphoria and lack of access to safe, gender-affirming treatment; safety concerns and the need for passing; cissexism and resulting disempowerment; and pervasive, harmful beauty standards coupled with hyper-scrutiny of trans bodies. This project includes a summary and analysis of the existing literature and data regarding the causes of and current treatment recommendations for eating disorders within transgender populations. It also suggests a social-work-led shift within eating disorder treatment to center the sociopolitical forces which so often lead to such diagnoses.
Highlights
Transgender populations are disproportionately impacted by eating disorders and disordered eating behaviors; transgender clients lack access to affirming and culturally responsive mental health care and are frequently undiagnosed
Research on health outcomes among transgender people and research on eating disorders are each underfunded (Feldman et al, 2016; Murray et al, 2017); few studies have been published on the intersection of the two that are generalizable at a population level
Only 30.42% of respondents to the 2015 study (Diemer et al, 2015) and 11.3% of respondents to the 2016 study (Holt et al, 2016) were people of color (POC). Of the former, only 4.5% of respondents were Black and 5.96% were Latinx; the remainder of the 30.42% were comprised of Asian American Pacific Islander (AAPI), multiracial, Native American, and “unknown” respondents (Diemer et al, 2015)
Summary
UNIQUE CAUSES AND MANIFESTATIONS OF EATING DISORDERS WITHIN TRANSGENDER POPULATIONS. Despite limited representation of transgender bodies in both popular media and a lack of attention in clinical training to transgender concerns, research over the past several decades has indicated a high prevalence of eating disorders (EDs) and disordered eating behaviors among transgender populations. Research on health outcomes among transgender people and research on eating disorders are each underfunded (Feldman et al, 2016; Murray et al, 2017); few studies have been published on the intersection of the two that are generalizable at a population level. Those which do exist have focused nearly exclusively on transgender youth. A 2015 study of gender identity, sexual orientation, and self-reported ED diagnoses among college students (N=289,024) found that trans respondents (n=479) were more likely to report disordered eating behaviors generally, and those consistent with a diagnosis of OSFED (Diemer et al, 2005). Other researchers have importantly identified that mortality rates for Eating
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