Understanding Eating Disorders In The LGBTQIA+ Community
Eating disorders are complex mental health conditions that affect people across all demographics. However, members of the LGBTQIA+ community face unique challenges that can increase their vulnerability to developing and recovering from eating disorders.
Understanding these factors is crucial in addressing and supporting the mental health needs of this diverse population. This blog from Fill The Gap Counsellor Alisha Mah offers some insights.
Elevated Prevalence Among LGBTQIA+ Individuals
Research indicates that LGBTQIA+ individuals experience higher rates of disordered eating and eating disorders compared to their heterosexual and cisgender counterparts. Over half (54%) of LGBTQIA+ adolescents in the United States have been diagnosed with an eating disorder during their lifetime.
Trans and gender diverse individuals are disproportionately affected. An Australian study found that 23% of transgender young people have a current or previous eating disorder diagnosis. Trans and gender diverse individuals are also 50 times more likely to engage in disordered eating behaviours and 85 times more likely to experience Avoidant/Restrictive Food Intake Disorder (ARFID). Despite these elevated risks, only 20% of trans and gender diverse individuals who meet the clinical threshold on screening tools receive a formal diagnosis.
These statistics highlight the importance of early, inclusive, and informed support.
Additional reading:
Eating disorders and disordered eating behaviors in the LGBT population: a review of the literature
The mental health experience and care pathways of trans young people
Schweizer, K. (2025, May 27). Eating Disorders in Trans and Gender Diverse People: Towards Inclusive, Affirming Care [Professional development slides]. Perth Eating Disorder Mental Health Professionals Network, Perth, WA.
Minority Stress and Internalised Stigma
The Minority Stress Model suggests that chronic stress arising from societal stigma, discrimination, and prejudice contributes to adverse mental health outcomes in minority populations. For LGBTQIA+ individuals, this stress often manifests as internalised negative beliefs about one’s body and identity, increasing vulnerability to eating disorders. Rejection or fear of rejection by friends, family, and co-workers, as well as discrimination and bullying due to one’s sexual orientation and/or gender identity, are significant risk factors.
What you can do:
- Let your loved one know you accept and affirm their identity – every part of it.
- Be mindful of how external stressors (e.g., discrimination, misgendering) may affect their mental health and relationship with food.
- Encourage open conversations about their feelings of safety, acceptance and identity.
Concealment of Identity and Its Consequences
Concealing one’s sexual orientation or gender identity, often due to fear of discrimination or rejection, can exacerbate feelings of isolation and internal conflict. This concealment has been linked to increased symptoms of body dysmorphic disorder and disordered eating, and often contributes to chronic stress, anxiety, and depression.
What you can do:
- Create an environment where your loved one knows they can safely express their identity without fear of judgement or rejection.
- Educate yourself on LGBTQIA+ terminology so they don’t carry the emotional burden of having to explain or justify their identity.
- Avoid making assumptions about their identity – give them space to share in their own time and in their own words.
Intersectionality: The Compounding Effect of Multiple Marginalised Identities
Individuals who navigate multiple marginalised identities (such as being LGBTQIA+ and neurodivergent or LGBTQIA+ and living with a disability) face compounded stressors that further increase the risk of developing eating disorders. These intersecting identities often lead to unique experiences of discrimination and barriers to accessing appropriate care. This can develop into heightened feelings of alienation and stress, which can contribute to the development or exacerbation of an eating disorder.
The intersection of neurodivergence and gender diversity necessitates inclusive and affirming care approaches that address the unique needs of individuals navigating both identities.
What you can do:
- Acknowledge and respect all the intersecting parts of your loved one’s identity.
- Seek out culturally responsive resources and peer support groups when appropriate.
- Validate the unique barriers they may face in accessing support and be an ally in helping remove them.
Body Image, Identity, and the Quest for Belonging
In LGBTQIA+ community, physical appearance often plays a significant role in expressing identity and finding belonging. For instance, transgender individuals may engage in disordered eating behaviours to align their bodies with their gender identity, while others may feel pressure to conform to certain body ideals prevalent within LGBTQIA+ subcultures. This emphasis on body image as a marker of identity and belonging can lead to unhealthy relationships with food and body, highlighting the importance of addressing these issues in treatment and support. It is important to note that while gender-affirming care can alleviate gender dysphoria, it may not address body dysmorphia, which requires distinct therapeutic interventions.
What you can do:
- Avoid commenting on their body – even with good intentions.
- Support your loved one to find affirming clothing, haircuts, or styles that help reduce dysphoria.
- Ask what language around their body feels affirming or distressing to them, and adjust your communication accordingly.
Additional reading:
LGBTIQA+ people, eating disorders and body image
Treatment Challenges and Harms
Traditional eating disorder treatments often lack the cultural competence to address the specific needs of LGBTQIA+ individuals, particularly trans and gender diverse people. Challenges include:
- Treatment modalities that, intentionally or unintentionally, aim to change, suppress, or eliminate gender identity.
- Gendered treatment environments (e.g., addressing groups as “ladies” or “gentlemen”) that invalidate or exclude trans and non-binary individuals.
- Limited provider knowledge about gender diversity, leading to inadequate care.
- Pathologisation of trans identities, such as attributing eating disorders solely to being transgender.
- Body acceptance messaging that may feel invalidating for trans people experiencing gender dysphoria.
- Standard practices like mirror exposure therapy that may cause harm to trans and gender diverse individuals.
What you can do:
- Help your loved one find a clinician or service that affirms LGBTQIA+ identities.
- Ask service providers about their experience and training in LGBTQIA+ care.
- Accompany your loved one to appointments if they want support or help advocating for inclusive care.
Supporting Your LGBTQIA+ Loved One With An Eating Disorder
Supporting LGBTQIA+ individuals experiencing eating disorders necessitates creating environments that are affirming, inclusive, and culturally competent. Key strategies include:
- Affirm Identity: Use correct name and pronouns. Validate their experiences.
- Educate yourself: Learn about the links between identity, dysphoria, and eating disorders.
- Be an advocate: Help your loved one access inclusive and affirming treatment. Seek therapeutic approaches like Family-Based Therapy Plus (FBT+), which incorporate peer mentors for both parents and young people and centre gender-affirming care throughout the treatment process.
- Watch for signs of distress: Hidden dysphoria or identity-related stress may come out through food and body concerns.
- Create safety at home: Minimise gendered language, binary assumptions, or body talk.
- Encourage connection: Support them in building relationships with affirming peers or groups.
- Take time to reflect on your own assumptions and discomfort: It’s okay to not be perfect, as long as you’re willing to learn and grow.
- Practice self–care: Supporting someone through this is hard – seek your own support when needed.
- You don’t have to have all the answers – showing up with love, acceptance, and a willingness to learn can help your LGBTQIA+ loved one feel seen, valued and supported on their path to recovery.
If you would like to learn more about how to support your loved one who is part of the LGBTQIA+ community or explore other strategies to support your loved one’s recovery, our Fill The Gap counsellors are here to help.
EDFA’s Fill The Gap counselling service offer free, one-on-one online counselling to support carers in navigating the challenges of caring for a loved one with an eating disorder or disordered eating concerns.
Please contact Administrative Assistant Bailey Wightman on 03 9125 5670 or email bailey.wightman@edfa.org.au if you need support accessing the service.
About Eating Disorders Families Australia
Eating Disorders Families Australia (EDFA) is the only national organisation solely for carers and families of those with an eating disorder. EDFA provides support, EDucation, advocacy, and FREE online counselling services and annual membership. EDFA has a private Facebook forum, providing a safe place for eating disorder carers and family members to share experiences, seek advice and assistance, and find hope.