Transgender and Eating Disorders

Christie Caggiani, RDN, LDN, CEDRD

Christie Caggiani, RDN, LDN, CEDRD

It has long been said that eating disorders don’t discriminate: we know they affect people of all ages, education levels, ethnic backgrounds, lifestyles and genders.  We’ve become clear that it affects middle-age women at an alarming rate, is on the rise in underdeveloped countries and impacts males as well as females. Yet little has been researched on the prevalence of eating disorders among the transgender community.  However, the research is slowly emerging, giving us some insight on the impact felt in this community.

One study of 289,024 college students found that transgender students, compared to cisgender students, are almost five times as likely to report an eating disorder and two times as likely to use unhealthy compensatory methods (e.g., vomiting) for weight control.*  Another study of almost 2,500 teenagers shows that transgender individuals are almost three times as likely to restrict their eating, almost nine times as likely to take diet pills, and seven times as likely to take laxatives.*

Transgender individuals face an even higher eating disorder risk than gay and bi-sexual men. According to the research, a staggering 16 percent of transgender folks say they have been diagnosed with an eating disorder just in the last year, one Washington University study found.

Given the body focus prevalent in both eating disorders and transgender individuals, it’s not surprising that this combination proves to be higher risk.  As they struggle to claim their gender identify, the pressures to achieve unrealistic measures of the body ideal can be extremely dangerous.  The discomfort of being in the body they don’t relate to, heightens the desire to change it through disordered behaviors. Additionally, the stressors associated with gender identity, acceptance and transition all increase the risk of using eating disorder symptoms as an attempt to cope.  At the same time, those struggling with eating disorders are often grasping for their own identity, attempting to find it within the confines of the deadly disease. While a transgender individual claiming their own gender identity can ultimately be freeing, using an eating disorder as an identity can be catastrophic.

It is clear that much more research has yet to be explored, yet we know that promoting a positive and supportive relationship with food, body and movement helps all individuals indiscriminately.


J Adolesc Health. 2015. Aug; 57 (2): 144-9.

J Adolesc Health. 2016. doi: 10.1016/j.jadohealth.2016.08.027.