Holiday Hurdles: The double struggle of transgender and non-binary people at Christmas
Besides the difficulties that spending an evening with your family may entail, another challenge may be found in the main focus point of the season: food. Even though when we think about eating disorders (ED), a very specific demographic comes to mind (young, white cis women), the truth is that they are even more prevalent in transgender and non-binary individuals. Gender-non-conforming folks are more than three times more likely to be diagnosed with an ED than cisgender people[1]. If demographic-specific research is still lacking, each gender minority is different, and ED patterns also depend on other factors such as race, class, family history for instance. Those factors can be brought up to understand this statistic better, and thus our close ones and ourselves.
The first answer can be found through the concept of minority stress. First developed by American researcher Winn Kelly Brooks in 1981, minority stress is a conceptual framework analyzing the mental health consequences of discrimination against minority groups. The prejudice and stress faced by queer individuals throughout their lives can induce mental health issues, such as EDs. For gender non-conforming people in particular, the consistent rejection faced can lead to unhealthy coping mechanisms such as food restriction, binge eating, or compulsive exercise.
Beyond minority stress, gender dysphoria, specific to transgender and nonbinary individuals, has been found to play a major role in the potential for eating disorders. Disordered eating practices can be used as a form of self-punishment when one’s unsatisfied with their physical appearance, or as a means to get closer to a certain ideal - of femininity, of masculinity, or of androgyny. An unhealthy relationship with food can easily be formed when its consumption -or restriction- seems to be helping us to “pass”. This is ultimately a result of both cisnormative and fatphobic media representations.
Indeed, the often vital incentive to “pass” as the desired gender leads transgender individuals to conform to the societal norm of what it is to be a man or a woman, body type included. Thus, for trans guys, there is pressure to present as more muscular while staying lean to avoid curves, considered feminine. For trans women, there is the ever-lasting expectation of thinness and “delicacy” as the epitome of femininity. For non-binary folks aspiring to androgyny, there is this persistent belief that to be androgynous, you have to be skinny. These representations are not just present within mainstream media, but also within our communities: we still perpetuate Western cisnormative and fatphobic concepts of gender expression.
So what can be done against ED prevalence within our communities?
Although we won’t solve the issue, which is only a symptom of deep-rooted systemic issues, with just care practices, we may as well start with that.
The first thing we can do is to be critical of media representations and mindful of our own online behaviors when it comes to physical appearance and gender expression. Secondly, we have to demand appropriate care and treatment for gender non-conforming folks dealing with ED. This requires appropriate training of the medical staff on transidentity and non-binarity and easier access to gender-affirming care. Despite the inertia of the medical system, we can at least try to put this in place at a community level. This starts with a “no comments” policy: At the table these holidays and daily, don’t comment on people’s appearance, don’t comment on people’s passing, and don’t comment on their food intake - and yes, even if you guys are friends. With that being said, we wish you a happy queersmas.
Ressources
Switzerland:
Association Boulimie Anorexie / 021 329 04 39 (FR) - Permanent help line, therapists and psychologist
La Main Tendue / 143 (FR, DE) - Permanent line of volonteers willing to listen to you and guide you
147 - General Help line for young people
144 - For acute and vital emergencies (ambulances)
France:
Fil Santé Jeune / 0800 235 236 (FR) - Permanent help line of therapists, psychologist and doctors
Fédération Française Anorexie Boulimie / 09 69 325 900 (FR) - Permanent help line of doctors, therapists and volonteers from EDs specialized associations
15 or 18 - For acute and vital emergencies (ambulances)
3114 - Suicide prevention help line
114 - SMS only Help Line
[1] Elizabeth W. Diemer, Jaclyn M. White Hughto, Allegra R. Gordon, Carly Guss, S. Bryn Austin, and Sari L. Reisner. Beyond the Binary: Differences in Eating Disorder Prevalence by Gender Identity in a Transgender Sample. Transgender Health. Dec 2018.17-23.
- Cusack, C. E., Iampieri, A. O., & Galupo, M. P. (2022). “I’m still not sure if the eating disorder is a result of gender dysphoria”: Trans and nonbinary individuals’ descriptions of their eating and body concerns in relation to their gender”. Psychology of Sexual Orientation and Gender Diversity, 9(4), 422–433.
- Goetz TG, Wolk CB. “Moving toward targeted eating disorder care for transgender, non-binary, and gender expansive patients in the United States”. Int J Eat Disord. Dec 2023.
- Kirby SR, Linde JA. “Understanding the Nutritional Needs of Transgender and Gender-Nonconforming Students at a Large Public Midwestern University”. Transgender Health. Mar 2020.
- Brian A. Rood, Sari L. Reisner, Francisco I. Surace, Jae A. Puckett, Meredith R. Maroney, and David W. Pantalone. Expecting Rejection: Understanding the Minority Stress Experiences of Transgender and Gender-Nonconforming Individuals. Transgender Health. 2016.
