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We Need to Talk About the LGBTQ+ Community and Eating Disorders

  • lovassandoruk
  • Jan 9
  • 5 min read

Breaking the Stereotype

The media portrayal of eating disorders has long perpetuated a specific image: the affluent, young, thin, white, cisgender woman. If you don’t fit that image—if you’re queer, trans, older, or a person of color—you might feel invisible when it comes to eating disorder conversations. But here’s the truth: you’re not alone. A growing body of research shows that LGBTQ+ folks, many of whom do not fit this profile, face a higher risk of eating disorders, disordered eating behaviors, and body dissatisfaction.

Body image concerns and eating disorders affect people of all genders and sexual orientations, but LGBTQ+ individuals—particularly transgender and nonbinary people—experience disproportionately high rates. This isn’t because being queer or trans is a risk factor. It’s about the stress of living in a world that can be hostile, with stigma, discrimination, bullying, violence, and barriers to affirming healthcare.

Eating disorder behaviors in LGBTQ+ communities are often a response to minority stress. That means higher rates of mental health struggles aren’t caused by identity itself—they come from living in a society that produces chronic stress through rejection, discrimination, and fear of harm.




The risk isn’t the identity—it’s the environment. Research shows LGBTQ+ adults who face discrimination for who they are are five times more likely to develop an eating disorder. For many, disordered eating becomes a way of coping with things like unstable housing, workplace discrimination, or family rejection. When the world feels uncontrollable, the body can become the only thing left to control. This was true for me once, and I know many people reading this will feel that sentence hit close to home.

Gender Dysphoria as a Catalyst

For many transgender and nonbinary people, eating disorders act as a “tool” to bridge the gap between the body they were assigned at birth and the one they identify with.

  • Trans-masculine individuals may restrict to stop periods, prevent breast growth, or minimize hip and thigh curves.

  • Trans-feminine individuals may restrict to appear more “delicate” or slender, fitting traditional feminine ideals.

  • Non-binary individuals may feel pressure to become extremely thin to be read as truly androgynous, because society often interprets curvier or more muscular bodies through a binary lens.

Dysphoria can feel so overwhelming that bingeing becomes a way to numb emotional pain, while purging is used to “undo” feared changes in the body. Some engage in compulsive exercise or restriction to delay puberty or suppress secondary sex characteristics.

At the same time, not all transgender people experience gender dysphoria, and not all eating disorders in trans or nonbinary individuals are connected to gender identity. Eating disorders are complicated and can be influenced by trauma, genetics, neurodivergence, family dynamics, anti-fat bias, and cultural pressures.

Passing, Safety, and Survival

For many trans people, “passing” is not just about affirmation—it’s about staying safe. Looking a certain way can shield someone from harassment, discrimination, and even physical violence. In this context, weight gain isn’t just about appearance—it can feel like a real threat to personal safety.

For some, an eating disorder becomes a way to feel in control of that safety. If you’ve ever felt that pressure—the fear of being ‘clocked’ in public—you know it’s not about vanity; it’s about survival.

The Thin and Muscular Ideal

Pressure around appearance can feel different depending on your sexual orientation and the communities you’re part of.

  • Gay and bisexual men, who make up about 5% of the male population, represent an estimated 42% of men with eating disorders. Many feel intense pressure to be lean, muscular, and visibly fit, which can lead to compulsive exercise, restrictive eating, or muscle dysmorphia.

  • Lesbian and bisexual women show mixed patterns. Some studies suggest partial protection from traditional beauty standards, while others show equal or higher rates of body dissatisfaction and binge eating compared to straight women.

  • Bisexual and questioning individuals across genders often report high levels of distress, likely reflecting identity invalidation and marginalization from multiple directions.

These pressures are reinforced through dating culture, social media, and community norms, where bodies are often treated as currency for belonging, visibility, and safety. It can feel like everywhere you look, your body is being scored, judged, and compared—and that constant evaluation is exhausting.

Why Help Is Hard to Find

Despite greater need, LGBTQ+ people often face barriers to eating disorder care. Reports from TransHub, Within Health, and other organizations highlight a crisis of clinician competency.

Some common issues include:

  • Deadnaming and Misgendering: Using a patient’s old name or wrong pronouns in a clinic erases identity and can make someone stop seeking care. Imagine going to a doctor for help, only to have your identity erased in the room where you’re supposed to feel safe. For me, that alone would stop me from returning.

  • Trans Broken Arm Syndrome: When doctors attribute any health concern to a person’s trans identity, even something unrelated, it can feel dismissive. For eating disorders, this can look like assuming a trans person’s struggles exist only because they’re trans, ignoring trauma, genetics, or neurodivergence.

  • The Screening Gap: Many diagnostic tools are designed around cisgender norms. Asking about menstrual cycles as a criterion for anorexia excludes men and many trans people. Because clinicians often aren’t looking for eating disorders in gender-diverse patients, many go undiagnosed until a crisis occurs.

BMI is another barrier. It was meant for population-level stats, not individual health, and it doesn’t reflect muscle, fat distribution, or how hormone therapy can change the body. Yet it’s often used to gatekeep care, delaying treatment and gender-affirming support. This hits trans people especially hard - these shortcomings are amplified because hormone therapy significantly alters fat, muscle, and bone in ways BMI cannot capture.

Gender-Affirming Care Is Eating Disorder Care


Access to gender-affirming care can reduce eating disorder symptoms. For trans-masculine people, starting testosterone often lowers anxiety and the urge to restrict. Feeling at home in your body can change how you relate to food and weight—and that relief isn’t abstract; it can be life-changing.

Gender-affirming care doesn’t replace eating disorder treatment, but it can remove a major barrier to recovery when combined with nutritional and psychological care.

Recovery That Sees the Whole You

Eating disorder recovery for LGBTQ+ people works best when it is:

  • Trauma-informed: Recognizing the stress of living in a homophobic or transphobic society.

  • Affirming: Using correct names and pronouns, and offering safe, gender-neutral spaces.

  • Holistic: Going beyond food logs to focus on body image, identity-based safety, and even gender euphoria—moments of pride and joy in your body and identity.

Social support, community connection, self-compassion, and body-neutral approaches help protect those whose bodies have been targeted by stigma.

For readers: If you are struggling, know this—your identity is not the problem. You deserve recovery that respects your name, your pronouns, your body, and your story. You deserve care that sees the whole you.

For providers: It’s time to move past tolerance to active advocacy. Update intake forms. Train staff in LGBTQ+ competency. Understand that for many patients, body image is deeply tied to identity-based safety. Affirming care isn’t optional—it can be lifesaving.

Eating disorders don’t happen in a vacuum, and neither do LGBTQ+ lives. Recovery is possible when care is inclusive, affirming, and grounded in dignity, respect, and evidence—not stereotypes.

If you’ve ever felt invisible because your experience didn’t fit the typical eating disorder story, know this: your story matters. Recovery can—and should—honor it.


References / Further Reading

 
 
 

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