Wrestling gender dysphoria, fitness as a recovering anorexic

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The gym has always been my sanctuary. To this day, nothing alleviates stress, depression, or gender dysphoria (i.e., unease with one’s body or sex assigned at birth) than leaving the gym soaked in sweat with pumped muscles. Even pre-transition, gym clothes made me feel confident and affirmed in my gender, the way that my boy shorts hung off my non-existent ass and my sports bra and t-shirt gave the appearance of a flat chest. The way that I seemed to fit in more with the guys than the women, by virtue of my clothes and boyish haircut, and my interest in gaining muscle mass. 

For someone who has been on testosterone for five plus years, and who has tried for probably twice that long to gain muscle, I’ve not had much success. I’m in shape, and strong, but you might not know that second part just by looking at me. I recently came to terms with the fact that one of the main reasons for this is my eating habits. That is, I simply don’t eat enough to support muscle growth. Easy fix, right? Not for a recovering anorexic.

I was diagnosed with anorexia nervosa in my mid-teens, and remained actively anorexic through my early twenties. But it turns out I am not so much a “former anorexic” as a “recovering anorexic,” in the same way that I am still a recovering alcoholic at four years sober. I may have won this round, but my disorder has not surrendered. Or in recovery speak, “my disease is always doing pushups.”

My eating habits and weight are relatively “normal” now, but I still struggle with body dysmorphia and have a tendency to under-eat when I’m stressed or anxious or having trouble regulating my emotions. And for me this can be a slippery slope. After a few days of subconscious restricting, I notice that I have lost weight, which triggers my body dysmorphia and my old disordered beliefs, such as the belief that I don’t deserve to eat as much as other people, or the belief that I should never weigh more only ever less.

Body dysmorphia is an obsessive fixation with a perceived defect or flaw in one’s appearance- a flaw that is actually minor or imperceptible to others. When I was actively anorexic, this “flaw” was the presence of fat anywhere on my body. Even when I was deathly thin, all I saw was fat, and starved myself to get rid of it. I also strived to eat as close to nothing as possible, sometimes as little as 300 calories per day. I didn’t mind being hungry; in fact, I thrived on it. It meant that I was restricting successfully, that I was losing weight, and that I was in control. I now understand that this was the opposite of control, and I have no desire to revisit that living hell again. I would actually love to bulk up. Which brings me to my current conundrum, and the topic of this blog post: what to do with my leftover anorexic programming, namely as a trans man who is trying to get ripped.

Erik Savereide, a Project Lead for the Duke Eating Disorder Research Laboratory, writes: “If we start to think about it, eating disorders and gender dysphoria actually do have some significant similarities. At their core, both are marked by an unhappiness with one’s body, and usually a desire to change it. Eating disorders often entail a desire to lose weight, whereas gender dysphoria commonly leads to people wishing to change their body to align it more closely with their gender identity.” To this I will add that gender dysphoria, unlike anorexia or bulimia, is not a disorder. Nor is gender dysphoria experienced by every trans person. Nor is it the only valid reason to transition. It should also be noted that while restricting calories, purging, etc., in an attempt to treat body dysmorphia is ineffective (your body image never improves, only worsens), changing one’s body by means of hormones or gender confirmation surgery is proven effective in treating gender dysphoria, and reducing depression and suicide among trans folks.

I think of my gender dysphoria and my body dysmorphia as two ghosts quietly lurking in the attic of my mind, invisible and out of the way much of the time, until a picture frame flies off the wall and I know that one of them caused it. I think of dysphoria as a boy and my eating disorder (Dysmorphia) as a girl. The boy ghost (Dysphoria) likes to complain that I’m too weak and too small. He is on his best behavior when we’re at the gym, happily counting reps and adding weights to the barbell. Afterward he disappears into his room, and Dysmorphia comes looking for me. She’s a total bitch. “You’ve gained weight.” she chides. Suddenly my gains melt to blubber in the mirror, and I’m a shapeless blob that has let himself go completely. “But I’ve only gained five pounds,” I stammer. She rolls her eyes. “You can’t gain muscle without gaining fat,” she says. “Sure, but I can lift more now! Which means I’m stronger and I’ll be better in bed!” She’s stares blankly at me, unimpressed. “I’m still at the low end of a healthy weight range?” I offer. She has already started drafting a weight loss plan. Next thing I know Dysphoria emerges from his bedroom, calling me a sissy for counting calories like a girl when I should be trying to bulk. 

It’s wild to me that these contradictory impulses can inhabit the same mind at the same time. At times it has caused me question my sanity, and even my transness (am I really trans or do I just have a severely distorted body image?) But my therapist assures me that it’s common to have different “parts” of oneself that come into conflict. The goal, they say, is not to remove or repress the dissenting part, but rather to bring the parts together, and encourage them to listen to and empathize with each other. This is how self-growth and self-healing happens, they tell me. As for my eating disorder contradicting my transness, they say that eating disorders are (unfortunately) actually very common among trans folks, with rates of eating disorders at least three times higher in the trans population than the cis population. One reason for this is that eating disorders can be an effective means of suppressing unwanted sex characteristics. For example, transmasculine people may attempt to stunt breast growth, reduce their hips, or eliminate menstruation by restricting caloric intake and maintaining an unhealthily low weight. But it wouldn’t be accurate to say that dysphoria causes eating disorders in trans people, since eating disorders are know to stem from a complex interplay of biological, psychological, and environmental factors. Also, every trans person is different.

Therapy and recovery work has helped challenge my warped perceptions of my body and its needs, my unhealthy and unsustainable methods of self-regulating. But as I’m finding, much like my alcoholism, my eating disorder is cunning, baffling, and powerful. I am only just beginning to unpack and challenge the countless little habits and preferences that support or are supported by its outdated programming. What if I did eat more? What would it hurt? What would it allow me to do or be that I’m currently not allowing myself to do or be? I’m a 34 year old man, and I’m just now finding the courage to ask these questions. It’s uncomfortable and even a little scary at times, but I have faith that if anyone can do it, a trans person can.

Sources:

https://eatingdisorders.dukehealth.org/education/resources/gender-dysphoria-and-eating-disorders

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