Psychology of Sexual Orientation and Gender Diversity, Vol 9(4), Dec 2022, 422-433; doi:10.1037/sgd0000515
Conceptualizations of eating disorders (ED) have primarily been based on the experiences of cisgender women. Yet trans and nonbinary individuals (TNB) may be at greater risk than cisgender individuals to suffer from eating disorders, disordered eating, and body image concerns. The current study takes a phenomenological approach to explore how TNB individuals conceptualize eating and/or body image issues. Qualitative data were obtained from 82 TNB participants who self-reported eating and/or body image concerns. Primary analyses focused on participants’ responses to an open-ended prompt regarding how participants understand the relationships among gender identity, gender expression, and weight and shape control behaviors. Thematic analysis identified five themes: (a) gender dysphoria, (b) puberty, (c) emotion (dys)regulation, (d) gender expression, and (e) recovery/transition. Results indicate various factors salient to gender identity and expression and eating concerns. Findings extend beyond the traditional focus on gender dysphoria by highlighting other important factors for TNB individuals, such as the function ED psychopathology serves (e.g., gender avoidance and self-punishment). This broadens the ED field’s understanding of how gender dysphoria relates to ED psychopathology, rather than focusing solely on the physical body. Distress and associated behaviors related to both gender dysphoria and eating disorder psychopathology may be reciprocal and reinforcing and, as such, should be considered in tandem in treating TNB clients experiencing EDs and body image concerns. This work may better identify ED risk and maintenance within this population and thus optimize prevention and intervention. (PsycInfo Database Record (c) 2022 APA, all rights reserved)