Transgender men experience high rates of eating disorders due to dysphoria, intense social stigma, and a desire for control in a world that deprives them of it, according to an investigation by LGBTQ+ news outlet Uncloseted Media.
According to one study, over 70% of LGBTQ+ people under 24 either are diagnosed with or suspect they have an eating disorder. These rates are substantially higher in transgender men, according to a systematic review of the literature.
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“Eating disorders are rooted in control,” Lydia Rhino, a program director at The Eating Disorder Foundation, told Uncloseted Media. “It’s scary to be a trans person in the United States. When there’s no safety or acceptance in a lot of places, eating disorders are a way to express, ‘I can’t control what other people are doing outside of me, but I can control this.’”
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Rhino cited the tense political climate that pathologizes the very idea of being trans, with body dysmorphia and attempts to alleviate dysphoria playing substantial roles.
“If you have lived in a body that does not feel like yours, where people have identified you one way, and you know that it didn’t feel accurate, why would your body be something that you respect and treat well?”
Daniel-José Cyan, a transgender man with an eating disorder, told Uncloseted, “I have struggled with my relationship to food since childhood. When I was in the fifth grade, I was heavily teased and bullied by my peers, my teachers and my family for my weight. I counted calories, I avoided meals, and food became equal to fatness and that, to me, was one of the worst things you could be,” he says. “Food became a thing for survival. I ate because being hungry would make me physically sick. I always thought I had some sort of anorexia, but according to a nutritionist I’m seeing, it’s called binge-restrict eating disorder.”
He said the pressures of being raised as a girl contributed to this. “I didn’t have a boyhood. I had a girlhood. That’s how I was taught to understand my body and food, because there were these impossible beauty standards of what it meant to be a girl.”
Cyan mentioned the difficulty in talking about his eating disorder as well, which makes seeking treatment harder. “I feel like it’s taken less seriously because I look like a man, and it’s more embarrassing to have to deal with it as a man. When I was considering my gender, I always thought men don’t have to care about what they look like. But that was not the case.”
This bias can even impact providers, who may deprive transgender men of care.
Evidence suggests that one way to alleviate eating disorder symptoms in trans men is gender-affirming care.
Regardless, recovery is a difficult process. Emmy Johnson, a therapist specializing in LGBTQ+ people with eating disorders, told Uncloseted, “Recovery is not linear. If you are not ready to pursue recovery, you still deserve support, and we want to help you stay alive and reduce the harm that the eating disorder is causing you.”
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