For the first time ever the American Health Association-National College Health Assessment survey allowed students to identify as transgender. Out of this effort emerged
Gender Identity, Sexual Orientation, and Eating-Related Pathology in a National Sample of College Students, Diemer, Grant, Munn-Chernoff, Patterson and Duncan in the Journal of Adolescent Health.
Abstract:
This study examined associations of gender identity and sexual orientation with self-reported eating disorder (SR-ED) diagnosis and compensatory behaviors in transgender and cisgender college students.
The survey of 289024 college students from 223 American universities uncovered 479 who self-identified as transgender (0.16%...about 1 in 600).
In order to obtain information about eating disorders, participants were asked if they had ever been treated or diagnosed with an eating disorder...and also asked if they had vomited, taken laxatives or used diet pills in the past 30 days.
In separate questions the students were asked about substance abuse, mental health, sexual behavior and nutrition.
The researchers discovered that transgender students reported the highest rates for treatment and diagnosis of an eating disorder as well as the use of laxatives, vomiting, and diet pills. The next highest group were the many-time defending champion cisgender heterosexual women. cisgender heterosexual men were once again the least likely to suffer from eating disorders.
The researchers posited several reasons for the result.
1. To suppress or accentuate gendered features
The researchers hypothesize that one reason transgender individuals may be more prone to eating disorders is because of their desire to alter their body.
It has been suggested that striving for weight loss may be a way for transgender women to conform to feminine ideals of slimness and attractiveness. Transgender men and women may also use weight loss to suppress secondary sexual characteristics.
2. Stress
Another reason for the rise? Transgender individuals may experience greater “minority stress” than other groups, which the researchers define as “the excess stress experienced by individuals in stigmatized social categories.
Transgender people experience particularly high levels of stress due to things like discrimination, bullying, and violent victimization”—and past research has shown a strong link between stress and poorer mental health outcomes, which can include eating disorders.
--Alexis Duncan, co-author
3. Previous contact with mental health professionals
More transgender individuals reported being professionally treated for an eating disorder than other groups, and the researchers believe this could be because transgender individuals already have more contact with mental health professionals to begin with.
Transgender individuals are often required to attend counseling to receive gender affirming treatments, increasing their overall rate of interaction with mental health professionals
75% of the transgender students reported having received counseling on gender identity.
One reason the researchers did not report was the fact that transgender students might have engaged in behavior that might ameliorate the lack of a safe place to use a toilet.
Conclusion?
More nuanced examinations of these topics are necessary for the development of targeted eating disorder intervention and prevention efforts for the gender and social minority community. Clinicians should also be aware that transgender clients may be at increased risk for eating-related pathology and should adjust screening practices accordingly.
--the researchers