It is all too common in society to assume the only people who suffer from eating disorders are cisgender girls and women, and that’s all. This isn’t the case, and it’s becoming increasingly clear that gender dysphoria and body dysphoria are contributing factors to disordered eating behaviors.

The need for sensitive, open-minded and trustworthy treatment for gender expansive patients suffering from eating disorders is enormous, and it does matter how you approach a patient’s gender identity, with regard to the efficacy of treatment for their eating disorder.

Gender Dysphoria and Eating Disorders

Gender Dysphoria is, in short, a person’s experience of their assigned gender being at odds with how they understand their gender. This fundamental discrepancy can lead to a person having serious issues with how their body develops, both with external appearance and internal hormone environment. They know there is a mismatch between their body and who they know themselves to be, and gender dysphoria can result. Gender determined at birth is becoming increasingly understood as not necessarily an accurate predictor of who someone actually is, and who they will be as they grow.

Body Dysmorphia and Eating Disorders

Understandably, gender dysphoria often includes a decent amount of body dysmorphia and associated disordered eating. In this case, eating disorders serve as an avenue to fulfill a need for control in someone’s out-of-control life. This sense of control is desperately desired by individuals who feel betrayed by their body’s expression of gender. How people treat them and have opinions on who they are can also feel wildly disconcerting. That feeling of control, even if it comes from a destructive path like an eating disorder, can be a band-aid for distress.

Disordered eating can alter someone’s visual appearance. Becoming extremely preoccupied with reducing or increasing muscle mass, altering fat distribution to prevent the development of gendered body shapes, reducing weight, etc., can all result from eating disorders. What’s worse, it can be all too easy to miss disordered eating in a patient who is motivated by moving away from assigned gender at birth expectations, instead of toward them, as might be expected by a cisgender person with an eating disorder.

It is critical to ask thoughtful, supportive questions when engaging with a patient who is gender-diverse and may need treatment for an eating disorder. A patient may not fit a gender-normative definition of disordered eating, but may still suffer from an eating disorder. We at THIRA Health consider it irresponsible to let patients slip through the cracks, especially socially vulnerable patients, and structure our eating disorder recovery program in Seattle to specifically avoid this.

Inclusive Mental Health Support

You may find yourself wondering how a clinician can best support gender-diverse patients in eating disorder treatment. The intersection of gender identity and disordered eating can be incredibly complex and sensitive, and the best way to help people at this crossroads is to address them, and interact with them, based on the gender identity they know is correct for themselves. Making assumptions based on appearance isn’t accurate enough; asking people who they are, and how to understand and interact with them, is the only way to know for sure you’re approaching your patient properly.

Banishing stigma in gender-diverse eating disorder treatment

To feel comfortable in eating disorder treatment, fear of how they’ll be treated with regards to their gender, and internalized shame over gender expansive expressions and feelings, are both things that a patient may have to overcome. A clinician’s job is to remove judgment and shame from the eating disorder recovery environment, through how treatment is structured and through how they engage with a patient. This will allow the gender-diverse individual to feel fully supported throughout the treatment process.

Using correct pronouns is important, as is understanding how a gender-diverse person approaches their body and their sense of self. When a patient is dealing with an eating disorder that intersects with gender dysphoria and body dysmorphia, meeting them where they are in their experiences and understanding of themselves is the only way to effectively help them.

Support through gender dysphoria and disordered eating

It requires a great deal of sensitivity to approach a patient who finds their eating disorder to be an effective way to affirm their gender, regardless of their gender identity. Patients can be attached to what they feel their eating disorder gives them, in terms of how others treat them, and in terms of how they see themselves. It is important to appreciate a patient as they are, with how they relate to their eating disorder, including when it intersects with alleviating any gender dysphoria. It may be a required secondary support to offer other ways to get relief from gender dysphoria in treatment, and it must be considered when working with gender-diverse patients.

THIRA’s Approach to Gender-Inclusive Eating Disorder Recovery in Seattle

At THIRA Health, we consider our programs best suited for “women, teen girls, and gender expansive individuals,” and we mean what we say. We aim to provide care that takes into account a whole individual and approach each person in our care as they are. We understand that eating disorder recovery treatment can take place side-by-side with a better understanding of gender identity, and we want to provide each patient with a safe, affirming environment to work through their treatment program. We want everybody to see success, and offer a variety of program structures that can meet the schedule of working professionals or those with higher care needs.

Check out our program offerings here, and contact us to learn more about how we provide care for girls, women, and gender expansive people who need support through eating disorder recovery, including when gender dysphoria plays a part in a patient’s life experience.