Eating disorders affect a significant portion of the population, and new research highlights that LGBTQIA+ individuals face disproportionately higher risks of developing these serious mental health conditions. While stereotypes often depict eating disorders as affecting only thin, teenage girls, the reality is far more diverse, impacting people of all ages, body sizes, cultures, races, sexes, genders, and sexualities. In 2023, approximately 1.1 million Australians, or about 4.5% of the population, were living with an eating disorder, but a growing body of evidence suggests that LGBTQIA+ people are particularly vulnerable, necessitating a deeper understanding of these disparities.
Eating disorders are complex mental health conditions characterized by abnormal eating behaviors that can severely impact both physical and mental well-being. While anorexia nervosa and bulimia nervosa are widely recognized, binge eating disorder and avoidant/restrictive food intake disorder are actually more common. These conditions can lead to severe damage to vital organs, bones, fertility, and brain function, with individuals experiencing eating disorders facing up to a fivefold increase in early mortality compared to the general population.
Featured snippet paragraph: LGBTQIA+ people are significantly more likely to experience eating disorders than non-LGBTQIA+ individuals. For instance, research indicates that lesbian, gay, and bisexual individuals are more than twice as likely to have an eating disorder, intersex people are nearly four times as likely, and transgender individuals are almost eleven times more likely to experience these conditions.
Research consistently shows that LGBTQIA+ individuals experience substantially higher rates of eating disorders when compared to their non-LGBTQIA+ counterparts. In the United States, for example, while an estimated 9% of the general population will encounter an eating disorder in their lifetime, a 2018 survey revealed that among LGBTQ young people, this figure surged dramatically. The survey found that 54% reported a formal eating disorder diagnosis, with an additional 21% believing they had an eating disorder but had not received a diagnosis.
Within the broader LGBTQIA+ community, these risks are not uniform. Studies indicate that lesbian, gay, and bisexual individuals are more than twice as likely to develop an eating disorder compared to heterosexual individuals. The risk is even more pronounced for intersex people, who are nearly four times more likely to be affected than endosex (non-intersex) individuals. Transgender individuals face the highest risk, being almost eleven times more likely to experience an eating disorder than cisgender people.
While data for asexual individuals is less extensive, studies do indicate that asexual people often report poorer body image compared to their non-asexual peers, suggesting a potential for higher rates of eating disorders within this group as well.
It is crucial to understand that identifying as LGBTQIA+ is not inherently a mental illness, nor is there evidence of a biological predisposition to eating disorders within this community. Instead, the elevated risk is largely driven by external factors, primarily minority stress and gender dysphoria.
Minority stress refers to the chronic stress experienced by members of stigmatized minority groups due to discrimination, prejudice, and social stigma. For LGBTQIA+ individuals, this constant exposure to negative societal attitudes can lead to feelings of shame, anxiety, and depression, which can, in turn, trigger or exacerbate disordered eating behaviors as a coping mechanism.
In the case of intersex individuals, medically unnecessary surgeries performed in childhood with the aim of “normalizing” their bodies can result in significant trauma and a pervasive sense of shame, further increasing their vulnerability to eating disorders.
Gender dysphoria, a distress or discomfort that arises from a mismatch between a person’s gender identity and their physical body or how they are perceived by others, is another significant contributing factor, particularly for transgender individuals. For many transgender people, disordered eating can become an attempt to alleviate or manage this dysphoria.
In transgender adolescents, eating disorders frequently emerge as a strategy to delay or prevent puberty when access to vital puberty-blocking medications is limited. For instance, restricting food intake might be employed to reduce the development of secondary sex characteristics, such as breast tissue, or to suppress menstruation.
Traditional eating disorder treatment typically involves a multidisciplinary team comprising doctors, mental health professionals, and dietitians. While effective for many, this approach was not originally designed with the unique needs of LGBTQIA+ individuals in mind and can sometimes inadvertently cause harm. LGBTQIA+ individuals have reported more negative experiences with standard treatment protocols compared to the general population.
For example, mirror exposure exercises, a common therapeutic technique aimed at reducing body image distress, can unfortunately exacerbate gender dysphoria for some transgender individuals. This highlights the critical need for treatment to be adapted and made inclusive.
To ensure effective treatment for LGBTQIA+ individuals, several adaptations are necessary. This includes consistently using correct names and pronouns, employing inclusive language and gender options on all documentation, and clearly displaying statements that affirm the welcome and safety of LGBTQIA+ individuals within the service. Integrating gender-affirming medical care into eating disorder treatment plans is also vital.
Furthermore, addressing minority stress in a trauma-informed manner is essential. This involves validating an individual’s experiences, acknowledging the impact of discrimination and stigma, and collaboratively developing healthier coping strategies and strengthening support systems. If this article has raised any concerns for you or someone you know, please reach out to the Butterfly Foundation on 1800 33 4673 or QLife at 1800 184 527 for support.
