Wednesday 23/07/2025

Photo: Pexels – Luiggi Castillo

Text: Lucia Giral

EDs and Gender Diversity: Understanding Eating Disorders Beyond the Binary

Talking about eating disorders (EDs) means diving into a complex territory where body, identity and society intersect. Research and clinical care have long focused almost exclusively on cisgender women, but what happens when someone’s sense of gender doesn’t fit the traditional boxes of “man” or “woman”? We now know that trans, non-binary and gender-non-conforming people have specific experiences that deserve to be seen and understood.

The body beyond the binary

For many transgender, non-binary or gender-non-conforming individuals, the relationship with their body is inseparable from the quest to align their felt identity with outward physical traits. In this context, ED behaviours can become tools to modify, control or even neutralize sex characteristics that feel uncomfortable, or an expression of deep body dissatisfaction fuelled by social pressure and discrimination (Feder, Kraschel & Wells, 2021).

• Transmasculine examples: restrictive eating to minimise hips, chest, or other features read as feminine.
• Transfeminine examples: restrictive or purging behaviours driven by pressure to achieve thin ideals linked to femininity (Jones, Haycraft, Murjan & Arcelus, 2016).

Specific risk factors in trans and non-binary populations

• Gender-related body dysphoria that reaches beyond appearance to the lived experience of the body itself (Jones et al., 2016).
  
• Minority stress (Meyer, 2003): the mental-health impact of discrimination and stigma.
  
• Lower family and social support, which heightens isolation and psychological distress (Watson, Veale & Saewyc, 2017).
  
• Limited access to gender-affirming care (hormones, surgery), prolonging anguish and body dissatisfaction (Feder et al., 2021).

Although EDs are still most prevalent among young cis women, newer studies and social change show rising rates in cis men and across other gender identities. Yet trans and non-binary people remain under-diagnosed because many studies still use binary categories that erase their experiences.

Understanding EDs through a gender-diverse lens means looking past the binary and acknowledging that every story is unique, shaped by a web of individual, social and cultural factors. If any of this resonates with you, remember you’re not alone and that your experience deserves to be heard and validated.

References

• Feder, S., Kraschel, K., & Wells, L. (2021). Transgender Health Care: Improving Medical Student and Physician Knowledge and Addressing Barriers to Care. Yale Journal of Biology and Medicine, 94(2), 199-205.
• Jones, B. A., Haycraft, E., Murjan, S., & Arcelus, J. (2016). Eating Disorders in Transgender People: A Review of the Literature. European Eating Disorders Review, 24(2), 142-150. https://onlinelibrary.wiley.com/doi/10.1002/erv.2403
• Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674-697. https://psycnet.apa.org/doi/10.1037/0033-2909.129.5.674
• Watson, R. J., Veale, J. F., & Saewyc, E. M. (2017). Disordered eating behaviors among transgender youth: Probability profiles from risk and protective factors. International Journal of Eating Disorders, 50(5), 515-522. https://onlinelibrary.wiley.com/doi/10.1002/eat.22627
• Revista Científica de Psicología NUNA YACHAY. (2025). Risk of Eating Disorders in Adolescents at an Educational Unit in Riobamba: A Comparative Study. NUNA YACHAY, 7(13), 60-66. https://publicacionescd.uleam.edu.ec/index.php/nuna-yachay/article/view/1430