Breaking the silence, replacing the stigma: eating disorders in the queer community

My teens and early twenties were defined by obsessive calorie restriction, multiple hospitalizations, and dangerously low weights. Given its duration and severity, my battle with anorexia is an important part of my story, but one I started to open up about only recently.

For me, anorexia has always been about control. When my body, my feelings, my school or home-life felt unmanageable, I could at least control what I ate. Even today, when my disease is over ten years in remission, I still habitually respond to stress by not eating. I catch and correct the behavior, but it still messes with me a bit. But until recently I never talked about it.

Like most mental and behavioral health disorders, eating disorders carry a stigma. There is the stigma that people who suffer from eating disorders are vain, self-absorbed, and superficially obsessed with their appearance. There is also the stereotype that eating disorders only occur in women. As a trans man, it’s the latter stereotype—that eating disorders are a women’s disease—that has bothered me the most, and propelled my secrecy. 

Trans people are held to rigid standards of masculinity/femininity compared to cis people, even compared to other members of the LGBTQ community. If a cis gay man plays with dolls as a kid, his friends may call him a sissy or bully him, and his parents may wonder if he’ll turn out to be gay, but they don’t seriously doubt whether he is male. If a trans boy played with dolls is a kid, he is assumed to be female, and the behavior may even be used as proof against him down the road if he comes out as trans and transitions. Because of this double standard, and the experience of having their gender questioned and challenged at every turn, trans people are often compelled to censor their personality, personal style, and/or personal narrative. I am no stranger to this compulsion, despite the value I place on authenticity. As much as I strive to be a whole, integrated person unwavering in “my truth” regardless of my audience, sometimes it’s easier to present a cookie cutter version that will satisfy said audience, and not raise questions about the validity of my identity or my experience. But my recovery journey is not just a recovery from, it is also a recovery of the truth.

According to the American Psychological Association, eating disorders disproportionately affect trans people, with trans youth four times more likely to suffer from an eating disorder than cis youth, and twice as likely to engage in purging. I didn’t know that I was trans when I was a child. I did know, beginning at first puberty, that I was uncomfortable in my body. I responded to this discomfort by restricting what and how much I ate—habits which quickly spiraled into a full-blown eating disorder that would completely consume my life for the next seven years. As a minor, I had been forced into treatment, a situation which, however understandable, made me feel even less in control. Like an addiction, you don’t recover from an eating disorder unless you want to. And I didn’t want to. But I was hospitalized twice, each time requiring me to miss over a month of school. 

By the time I reached legal adulthood, I was ready to move out and prove to my parents and doctors that I was in control of my eating disorder (which was now both severe and chronic). Of course, I wasn’t in control, my disease was. What actually happened was I started eating less, and then less, and then less, until I was eating 300 calories per day at most, and my weight reached an all-time low. I could not sleep, despite constant physical exhaustion. My emaciated body hurt everywhere. When I tried to convince myself to eat a bit more, my malnourished brain fritzed out. I was experiencing heart palpitations, and was afraid that if I did fall asleep, I would have a heart attack and wouldn’t wake up. Finally, I hit rock bottom. Knowing that the alternative was death, I admitted myself to inpatient treatment for the third and last time.

I’ve had therapists ask me if my eating disorder was the result of an environment in which I wasn’t able to be myself, where being trans and queer wasn’t an option. I’ve had family members suggest that my gender identity and sexual orientation are just the new face of my disease, which they caused in some way. Both theories strike me as reductive, overly simplistic and laughably linear. As if something as complex as gender or indeed, as an eating disorder, could be meaningfully explained in terms of “cause” and “effect.” Such theories also beg the question that trans people’s gender identities are somehow uniquely linked to trauma or environment or circumstance in a way that cis people’s gender identities aren’t. Admittedly, I personally think that all gender is linked to environment and circumstance (and thus trauma), but for some reason no one is asking cis people what trauma caused them to be cis.      

In the hospital, once I was medically stable and my brain was sufficiently nourished for therapy to start working, I started working toward recovery: a process that would take not weeks, but years. As I recovered, I unearthed parts of myself—my sexuality and my gender—that I had been repressing my whole life. This process was as terrifying as it was exhilarating. I didn’t do it perfectly. For one thing, I ended up switching out one self-destructive coping mechanism for another: anorexia for alcoholism. But that is another recovery story for another time. 

Though eating disorders often begin with preoccupations about food and weight, they are about much more than these things. Eating disorders occur in the queer community for the same reasons that substance abuse does: as a coping mechanism to deal with marginalization, invisibility, repression, rejection, religious trauma, and resultant anxiety, depressions, and low self esteem. Additionally, gay men feel pressure, both from outside and within the gay community, to achieve and maintain the ideal male physique. And trans people feel pressure, from both outside and within the trans community, to conform to impossible cis-normative standards of “passability.” All of these are risk factors.

Despite our proneness to eating disorders, queer folk are less likely than cis-het women to seek treatment, thanks to the myth that eating disorders only affect cis-het women. It’s time that we spoke out and busted this myth, and encouraged one another to get the help we need.