Eating Disorders and Body Image: What do Gender and Sexuality Have To Do With It?

By Diane Israel, Filmmaker, Beauty Mark

When I think about the challenges around being an LGBTQ-identified (Gay, Lesbian, Bi, Transgender, Queer) person, the word that best describes my experience is confusion. Life is confusing anyway, and being Queer – the term that I personally use – in our culture can add to that confusion, as well as create a great deal of stress, anxiety, and overwhelming emotions. The myriad of unique struggles related to sexuality and gender expression, such as coming out and harassment in schools or the workplace, can impact experiences of anxiety, depression, low self-esteem, trauma and developing unhealthy coping mechanisms such as substance abuse – all of which are common co-occurring conditions or contributing factors in the development of an eating disorder.

Eating disorders are often associated with straight, young, white females, but in reality, they affect people from all demographics and they are not caused by any single factor.  They arise from a combination of long-standing behavioral, biological, emotional, psychological, interpersonal, and social factors. Research suggests that eating disorders disproportionately impact some segments of LGBTQ populations, though there is much research still to be done on the relationship between sexuality, gender expression, body image and eating disorders. There is a strong genetic predisposition to the development of an eating disorder, but it interacts with the many contributing factors that can trigger onset. LGBTQ people my experience unique contributing factors such as trauma in the form of gay-bashing or harassment, losing social support, family, and potentially their home as a result of coming out (up to 42 % of homeless youth are LGBTQ), and extreme anxiety or depression associated with their sexuality or gender expression. In one study, gay and bisexual boys reported being significantly more likely to have fasted, vomited or taken laxatives or diet pills to control their weight in the last 30 days. While research indicates that lesbian women experience less body dissatisfaction overall, recent research found that beginning as early as 12, gay, lesbian and bisexual teens may be at higher risk of binge-eating and purging than heterosexual peers, with those identified as lesbian, bisexual or mostly heterosexual being about twice as likely to report binge-eating at least once per month in the last year.

LGBTQ people, in addition to experiencing unique contributing factors, they may also face challenges for accessing treatment and support. In my own personal development, growing up I always felt confused because like so many of us, I did not fit into the stereotypes of what it is to be a girl. I was a tomboy and lived this out through my dress, play, actions and behaviors. Eventually I became a champion athlete, and I believed that if I was to be a great athlete, I had to be a boy. In my day as a professional runner, women only got trophies if men did not show up for their awards. I tried to be a boy by trying really hard not to grow up as a girl. In other words I tried not to develop a female body and was terrified to get my menstrual cycle. For years I struggled with anorexia and exercise bulimia, which kept me frail, underdeveloped, confused and very androgynous. I thought that these behaviors would somehow keep me from being a woman, but who I was born to be was always fighting to come through. In order for me to get the treatment I needed, addressing these complex issues of sexuality and gender would be crucial. LGBTQ people who struggle with body image issues and eating disorders need culturally competent care.

It took me a long time to learn to be myself in a culture that devalues those who challenge narrow beauty standards and transgress gender norms. Now at 50, I don’t think of myself around the confines of being a woman or a man, being male or female. I feel my authentic self beyond the limiting ideals our culture has created and imposes upon us. I have learned that the incredible variety that exists among people is what is truly beautiful. If you or someone you know is struggling with an eating disorder or body image issues, I encourage you to seek treatment and support. For treatment referrals and more information about eating disorders, visit the National Eating Disorders Association (NEDA) online at or call NEDA’s toll-free Helpline: 800 931-2237.

It’s Time to Talk About It. NEDAwareness Week 2011 is February 20-26! Visit the NEDAwareness Week homepage under Programs & Events at to register today and learn more about how you can do just one thing to help raise awareness about eating disorders and become part of the solution.


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Center for Disease Control and Massachusetts Department of Education. 1999.     Massachusetts State Youth Risk Behavior Survey.

Matthews, Travis. 2005. NEDA Handout: Gay Men and Eating Disorders.

Ray, Nicholas. 2007. Gay, Lesbian, Bisexual and Transgender Youth: An Epidemic of        Homelessness. National Gay and Lesbian Task Force and National Coalition for       the Homeless.

Norton, Amy. 2009. Gay, Bisexual Teens at Risk for Eating Disorders. Reuters Health,      Sept 17, 2009.

Waldron, Jennifer J., Semerjian, Tamar Z., Kauer, Kerrie. 2009. Doing ‘Drag’:       Applying Queer-Feminist Theory to the Body Image and Eating Disorders across         Sexual Orientation and Gender Identity. In The Hidden Faces of Eating Disorders, Edited by Justine J. Reel & Katherine A. Beals, (63-81).

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