Disordered Eating in the Queer Community: Self-Esteem Issues, Resources, Support
Navigating life as a queer, transgender, or otherwise gender-diverse person can be challenging in an unwelcoming society. Disordered eating is a way to cope, so it’s not surprising that the LGBTQ+ community faces higher rates of eating disorders. The Trevor Project found that 9% of LGBTQ+ youth ages 13-24 have been diagnosed with an eating disorder and 29% suspect that they have one.
The LGBTQ+ community continues to endure trauma both on an individual level and cultural legacy level, due to a long history of oppression. To add to this, queer people often struggle with bullying, discrimination, lack of support, body dissatisfaction, and isolation, making them a high risk for developing disordered eating or an eating disorder.
Many individuals face the burdens of coping with rejection, isolation from other queer people, barriers to gender-affirming care, and body image ideals that are specific to the lesbian, gay, bisexual, and transgender communities alone. All of these stressors put queer people at a disadvantage, which is why it is critical to support them with the care they need.
Self-Esteem Issues
The stigma, prejudice, and discrimination that the queer community faces directly impact their self-esteem. At the same time, the constant reminder by the media and society of what the 'perfect physique’ is doesn't help anyone. For years, the LGBTQ community has battled discrimination by raising their concerns to be both seen and heard. There is still a lingering ‘minority stress’ that is at the root of these self-esteem issues, from years of not having a voice. Because of this, the LGBTQ community suffers more with their self-esteem by trying to reach unattainable body ideals, constantly needing to raise awareness of their community, and battling the harsh backlash from society, causing many adverse mental health problems.
Body image ideals in the queer community
There are certain stereotypes that create pressure on LGBTQ+ people to conform to beauty standards that are identity-specific:
For nonbinary folks, the stereotypical beauty standard is a thin, waifish appearance that is associated with androgyny.
Transgender women face immense pressure to be hyper-feminine, which traditionally includes a thin body. The sexualization and fetishization of transfeminine people also add to the pressure to achieve the thin ideal.
Gay and bisexual men often feel confined to two body types: muscular or very slight. These narrow ideals are reinforced by the media and the rampant fatphobia in the gay dating scene. These same beauty standards are racialized for gay men of color.
Trans men are impacted by the pressure to masculinize their appearance by gaining muscle and losing soft, “feminine” features.
Bisexual individuals in general face mental health issues at higher rates than any other group. The sexualization of bisexual women in particular leads to pressure to have a thin, “desirable” body.
Access to gender-affirming care
Gender-affirming care is eating disorder prevention because disordered eating can be a coping mechanism for gender dysphoria. Some trans individuals may turn to disordered eating in order to create an appearance that better aligns with their gender. For example, transmasculine folks may restrict their food intake in an effort to stop menstruation and reduce breast size.
Due to the pathologization of fatness in the medical field, weight can be a barrier to gender-affirming surgery. Top surgery doctors and other gender-affirming surgery providers often instruct patients to lose weight prior to the procedures in order to meet BMI requirements. These BMI requirements are not evidence-based, nor are they set by the World Professional Association for Transgender Health (WPATH). The BMI itself is a medically-irrelevant calculation based only on white, cisgender bodies.
It is common for transgender individuals to have higher BMI numbers due to hormone replacement therapy (HRT), higher risks of binge eating disorder, and a lack of access to safe, affirming exercise spaces.
Insurance companies may also refuse to cover gender-affirming surgeries for patients on the basis of weight; because insurance coverage is contingent upon “medical conditions” being “reasonably well-controlled,” and higher weights are often equated with poor health.
The prescription of weight loss for gender-affirming surgeries compounds the risk of eating disorders for trans and gender non-conforming people.
LGBTQ+/Queer Eating Disorder Resources
LGBTQ+ Affirming Providers
Find a specialized LGBTQ+ affirming therapist and non-diet dietitian who can guide you through disordered eating and body acceptance with an informed approach.
LGBTQ+-affirming dietitians:
Note: Therapists who wish to better serve their LGBTQ+ clients can enroll in continuing education with The Affirmative Couch.
Trauma-informed therapy:
An LGBTQ+-affirming trauma therapist trained in EMDR, IFS Therapy, or other trauma therapy modalities can also be a helpful resource.
LGBTQ+ Eating Disorder Support Groups:
Fed Up Collective Support Groups
Queer ED Support Groups Directory
Begin Self-Esteem Therapy in California
You deserve to recognize what an amazing individual you are. Our team would be happy to offer support from our San Francisco, CA-based practice and across the state via online therapy. You can start your therapy journey with Kindful Body by following these steps:
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Kindful Body LGBTQ Services Available
Kindful Body offers online therapy in California for all genders. We are an inclusive therapy service and are here to help with related to low self-esteem and more! If you or someone you know is struggling with anorexia, bulimia, binge eating, emotional eating, trauma, and body image, contact us today. Our registered dietitians also provide nutritional counseling to help with disordered eating. Kindful Body welcomes you with compassion and care.