March 31 is International Transgender Day of Visibility (also referred to as TDOV or Trans Day of Visibility). The day is dedicated to celebrating transgender people and their contributions to society whilst raising awareness of the serious discrimination and threats faced by transgender people worldwide.
Founded in 2009 by transgender activist Rachel Crandall in reaction to the fact that the only other international transgender-centred day was Transgender Day of Remembrance that mourned the murders of transgender people. The day aims to celebrate those who were living, to bring trans people together and inspire hope.
Research into the experience of transgender people with eating disorders is limited.
Given that transgender/gender diverse individuals are exposed to chronic ongoing stressors due to being a severely marginalised population group, it is generally understood that for many, eating disorder behaviours manifest as a coping mechanism.
Available findings suggest transgender and gender diverse individuals are at a much greater risk of developing an eating disorder than that of cisgender people, whose gender identity matches their sex assigned at birth.
With only one major study into transgender and gender diverse patients with eating disorders, there is a gap in understanding and implementing the most effective care for these individuals while in eating disorder treatment.
Understanding sex and gender
Transgender and gender diverse people identify with a different gender to the sex they were assigned at birth, or their natal sex (biological sex). They may be binary (she/her or he/him) or a non-binary gender identity (they/them).
People often use the words sex and gender interchangeably, but these terms are different.
Sex refers to the physical and chromosomal differences between people who are male, female, or intersex. A person generally has their sex assigned at birth based on physiological characteristics such as genitalia, and possibly their chromosomal representation.
Gender is a social construct of how a person identifies. Gender includes norms, behaviours and roles associated with being a woman, man, or other gender identity. A person may identify at any point within or outside this spectrum.
When we think about why transgender and gender diverse individuals are at a much greater risk of developing eating disorders; we can identify a number of factors.
Rates of body dissatisfaction and distress are much higher compared with cisgender youth. Engaging in disordered eating behaviours may be used to alter a person’s physical characteristics in ways that align with their gender identity.
A common myth falsely presents that transgender individuals are simply ‘confused’. The facts are that confusion and uncertainty can be present, but this is a common part of the journey for many adolescents and individuals who explore their gender identity. Transgender people generally have a clear understanding of their gender identity. Hence, with the ever-present role of diet culture in our society, many use dieting as a common means to control distressing and extreme feelings about their body.
Those who engage in dieting are five times more likely to develop an eating disorder than those who do not diet.
In fact, dieting is one of the strongest factors in the contribution to the onset of eating disorders.
Transgender populations are widely misunderstood. This misunderstanding extends to health care settings. A survey released in late 2022 found 62% of participants specifically noted eating disorder treatment providers lacked understanding in transgender and gender diverse health care. This creates extraordinary barriers for transgender and gender diverse patients to receive adequate treatment.
Medical and Treatment Considerations
It is vital that unique medical and treatment based considerations are taken into account when it comes to transgender and gender diverse individuals with eating disorders.
Access to equal, inclusive care for transgender and gender diverse individuals must be upheld.
It is crucial that transgender and gender diverse individuals are seen and heard. The need to have a day of ‘visibility’ is indicative of the discrimination and oppression experienced in many, if not all, aspects of their life.
It is hoped that in time further research will help to establish specific evidence-based care for those who are transgender or gender diverse living with eating disorders.
Resources and support
There are extensive resources and support available to everyone interested in the transgender space.
Human Rights Campaign (USA) Understanding the Transgender Community
Trans Hub a digital information and resource platform for all trans and gender diverse people in NSW
Trans Hub glossary
ACT A Gender Agenda
Australian Press Council language guidelines
GLAAD ––the world’s largest Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ) media advocacy organization – transgender resources
EDFA is the only national organisation focused solely on providing support, education and advocacy to families and carers of those living with eating disorders. Our community of families and carers who have supported or are supporting a loved one with an eating disorder brings its wealth of lived-experience knowledge to all of EDFA’s activities.
We believe recovery is possible. We believe passionately in the power of hope. Together, with knowledge and support, we know hope can make a difference to those with an eating disorder as well as their families and carers. Join our community at www.edfa.org.au.