By Seren Thomas
Content warning - Discussion of eating disorders.
Eating disorders are becoming increasingly prevalent worldwide. But health professionals’ lack of cross-cultural understanding and education about the specific needs of underrepresented people could prolong or worsen their disorders. Current treatment models for eating disorders generally assume a thin, white, cis, heterosexual, middle-to-upper-class young woman as the typical patient. In recent years, attempts to raise awareness about eating disorders amongst men and boys have challenged assumptions that eating disorders are a ‘female’ issue. But instead of allowing for gender fluidity, these binary and cisnormative ideals of eating disorder diagnosis, treatment and recovery continue to marginalize the experiences of many queer and trans people.
I am non-binary and I am currently recovering from almost ten years of disordered eating. My eating disorder developed for many reasons, not all of them related to my transness, but some very much related. My body first began to cause me discomfort when I hit puberty - something I know now to be pretty standard for a lot of trans people, as these physical changes sometimes trigger gender dysphoria. Although it doesn’t always translate into a mental health condition, trans people often struggle with body dissatisfaction and gender dysphoria as their attempts to fit into society are hard to square with who they really want to be.
Yet when I started to receive eating disorder treatment I quickly realised it wasn’t designed for people like me. My carers told me that feeling hatred or shame towards your body is not healthy, but as a trans afab (assigned female at birth) person, watching my body change from underfed and androgenous to more stereotypically feminine was unspeakably difficult. As my eating disorder treatment did not consider trans experiences, I still sometimes find it hard to tell whether I am expressing disordered behaviour or gender dysphoria. For instance, I wish my chest was smaller. I bind and someday I want to get top surgery. I no longer make plans to shrink my chest through weight loss, but sometimes I still think about it. Is that disordered? Or is that just being trans?
When people wonder why marginalised people experience higher prevalence of eating disorders, to me it seems obvious that structural inequality plays a significant role. Just like in wider society, the experiences of marginalised people are not sufficiently provided for in the health and care sector. According to Stonewall’s 2018 report, one in four non-binary people have experienced disordered eating in the past year. This is a massive proportion of people who need care, and not just any care, but care that centres their needs and experiences. We need eating disorder services that are community based and intersectional, not just in terms of gender and sexuality, but also in terms of race, ethnicity, disability and class.
I tried to recover several times over the years, but it was only when I came out as non-binary and stopped feeling ashamed of my transness that I really started to recover. For me, being trans is healing. It is unfettered love. It is wholeness. I formed close and solid friendships, community and family. I fell in love with another trans person who loves me regardless of my body and how I feel about it. I learned to cherish and find power in my transness. Recovery is different for everyone, but for me, recognising and celebrating who I am, regardless of what people and society thinks, is what did it.
Seren took the lead on the creation of a zine highlighting LGBTQI experiences of eating disorders, which you can access here: https://www.kscopehealth.org.uk/project/highlighting-lgbtqi-experiences-of-eating-disorders/
(Originally published 6/08/20)