Image source: Trans*Folx Fighting Eating Disorders (http://www.transfolxfightingeds.org/)
Dealing with an eating disorder is a daunting, disheartening and isolating experience for anyone. It is an especially difficult struggle for those who identify as transgender or claim a gender identity that falls under the larger trans umbrella of gender diversity. Not only do we struggle with the preoccupations, exhausting compulsions, self-loathing and health ramifications generally associated with eating disorders; many of us also face daily stressors, discrimination and violence related to our gender identities. According to the National Transgender Discrimination Survey (2013), 27% of respondents reported an annual income of 20k or less, 78% of youth cited harassment (or worse) in schools, and a staggering 41% of survey respondents had attempted suicide. Despite having more formal education than the general population, trans and gender-diverse communities face increased chances of job loss, higher rates of unemployment and higher risks of homelessness (especially trans youth forced or choosing to leave transphobic or violent homes). Trans people of color face increased targeting and surveillance by regulatory and punitive systems like foster care, juvenile detention, police profiling and detention, jails and prisons. On top of that, those of us struggling with eating disorders or body/exercise issues must also negotiate the complex ways in which body dysmorphia and dysphoria are interlinked and adjust to new cissexist1 norms that dictate how we should look, eat, and take up space. We must also navigate healthcare systems that uphold problematic gender binaries and often fail to provide accessible, compassionate, appropriate and gender-literate care.
Given all the ways in which trans and gender-diverse identities are marginalized, oppressed and erased, it is unsurprising that trans communities face higher risks of developing (and not seeking treatment for) eating disorders. However, while the little research that exists agrees that EDs are pervasive problems; these studies all emanate from ED spheres rather than trans health spheres, and thus fail to address the complexity and depth of the issues we face. This research often makes problematic generalizations based on small sample pools and focuses only on gender dysphoria and participants’ desires to suppress assigned sex or conform to cisgender/binary standards of beauty. Worse yet, these studies usually perpetuate the dangerous transition-as-cure narrative that is unrepresentative of and eclipses the experience of many non-binary people; presupposing that we all want, need, and can afford a traditional medical transition. More frequently, trans experiences are left out of research altogether, and trans people pursuing recovery (if they can even afford this cost-prohibitive care) are usually met with therapists and facilities ill-equipped to address our unique issues; never mind being able to provide gender-literate, safe spaces or proper trans healthcare, like prescribing hormones. Furthermore, recovery facilities providing higher levels of care (such as residential treatment centers) are generally sex-segregated or ‘women only.’ Lacking standard guidelines for including or serving trans populations, these institutions often resort to arbitrary, exclusionary and ignorant assessments regarding who qualifies as a woman or man.
T-FFED: Trans Folx Fighting Eating Disorders was established to provide accessible healing spaces for trans and gender-diverse communities, to amplify marginalized voices and experiences and raise awareness around eating disorders as social justice issues. We aim to develop a standard for trans cultural competency in the ED recovery field; bridging the gap in knowledge and understanding between trans and ED spheres and cultivating gender literacy and allyship among healthcare professionals.
If you are a therapist or recovery facility interested in receiving training to better serve (and market your practice to) trans and gender-diverse clients, please contact us at firstname.lastname@example.org. We verily look forward to working with you and together creating a more informed and compassionate recovery community!
1Cissexism is the imposition or default assumption of cisgender, hetero binaries as normative and desirable.
Dagan VanDemark is the Founder of T-FFED: Trans Folx Fighting Eating Disorders. They are deeply committed to activism and increasing education around intersectional feminist issues, transgender rights and visibilty, and dismantling the prison industrial complex. They live with their partner and three crazy dogs in downtown Los Angeles, and they are honored to be on the curation/review board for NEDA and Melissa Fabello's 'MarginalizED Voices' anthology.