The Gendered Struggles You Don’t See: Eating Disorders and the Need for Inclusive Support

You might know that feeling—the one where you look in the mirror and the reflection doesn’t match how you feel inside. Maybe your body doesn’t align with your identity. Or perhaps, you’re doing everything you can to make it fit into a box that was never meant for you. Whatever it may be, it’s hard to escape that discomfort.

Eating disorders aren’t just about food—they can stem from emotional struggles, trauma, and a deep disconnect between our bodies and our identities. We are tired of the stereotype that eating disorders only affect cisgender women or that there is a cut and dry reason for they develop. Here's the thing: eating disorders can affect anyone and there’s a multitude of reasons for why. They affect people of all gender identities, and yet, the conversations we have rarely reflect that reality.

The Intersection of Gender and Eating Disorders

Eating disorders are different for everyone, however, for many people who are transgender and gender-diverse they develop in response to deeper feelings of discomfort—ones that often stem from gender dysphoria. Gender dysphoria can occur when you feel that your gender identity does not match the reflection you see in the mirror. For many who are trans and gender-diverse, gender dysphoria is a key risk factor for developing an eating disorder. This can be especially heightened during major bodily transitions like puberty.

During puberty, our body suddenly changes from the one we have grown to know, and these changes can be confronting for people of all gender identities. However, if you are trans or gender-diverse, you may experience more body dissatisfaction as your body may be changing in a way that does not match the way you feel in yourself. Changes that occur during puberty may make you feel as though you no longer identify with how your body looks. This is dysphoria. It can be emotionally draining and isolating but you are not alone in your feelings. We understand the emotional distress you may feel when your body doesn’t match up with how you identify.

The societal pressure to fit into gender norms can also be especially challenging for trans and gender-diverse people. There is a lot of pressure to conform physically with how society believes a certain gender identity should look. When you are already facing your own internal battle, societal pressures can make you feel invalidated in your gender identity. This can increase feelings of gender dysphoria and make you even more vulnerable to developing disordered eating behaviours.

But your identity is valid.

Trans Lived Experience:

Qualified sexologist Kai Sweitzer explains in the NeurospicED podcast that as a trans male “hitting puberty was very distressing” and he went to “great lengths to try and stop puberty from happening through restrictive eating”.

A Note on Self-Compassion:

Given how emotionally exhausting it is to experience gender dysphoria, it’s important to look after yourself and practice self-compassion during this challenging time. You could do this by:

• Challenge internalised stereotypes about what bodies "should" look like
• Remember that gender identity is not defined by body shape or size – your experience is valid
• Honour your body's resilience and wisdom – it has carried you through so much, and it deserves care and kindness
• Give yourself permission to evolve—your relationship with your body and gender will grow and change, and that’s okay
• Surround yourself with affirming people and spaces – that uplift and support your journey

Why Traditional Methods Miss the Mark

Gender-diverse individuals are at an increased risk of eating disorders. More than 19% of gender-diverse individuals struggle with disordered eating behaviours (Rassmussen et al., 2025). This is compared to 2% of cisgender women (Duffy et al., 2019). However, in the past, traditional diagnosis methods have not reflected this distinction. The medical field’s focus on eating disorders as a “women’s issue” often leaves out transgender, gender-diverse, and cisgender male individuals. Even the diagnostic criteria for eating disorders have historically centred on conditions that only apply to cisgender women—like the absence of periods. This criteria doesn't apply if you don’t fit the female gender norm.

We get the frustration of inaccessible healthcare. You’re already facing your own struggles, why can’t you get support that is gender affirming? We understand your experiences and can support you in a way that makes you feel validated and safe. Additionally, societal expectations surrounding gender and body image can make it harder to speak up if you are gender diverse. You may not feel comfortable discussing how you feel or may fear that your struggles won’t be taken seriously.

Eating disorders are complex, and your struggles are valid.

The Need for Gender-Affirming Support

You deserve care that is inclusive, compassionate, and tailored to your experiences.

This means treatment spaces where you feel seen and understood. We recognise that eating disorders are not “one-size-fits-all,” and the experiences of trans, gender-diverse, and cisgender people struggling with disordered eating are shaped by different factors, such as gender identity and societal expectations.

At Exhale Psychology Centre, we provide gender affirming care in an environment that is safe and supportive. We believe that each person is different and requires individualised treatment. Our approach is trauma informed, weight neutral and harm-reduction focussed.

Your gender identity is valid.

Let’s work together to support your journey towards fulfilment and enjoyment of life.

‍

References

Breton, E., Juster, R.P. & Booij, L. (2023). Gender and sex in eating disorders: A narrative review of the current state of knowledge, research gaps, and recommendations. Brain and Behaviour, 13(4), https://doi.org/10.1002/brb3.2871

Duffy, M., Henkel, K.E. & Joiner, T.E. (2019). Prevalence of self-injurious thoughts and behaviors in transgender individuals with eating disorders: A national study. Journal of Adolescent Health, 64(4), 461-466. https://doi.org/10.1016/j.jadohealth.2018.07.016

Rassmussen, S., Clausen, L., Pop, M.L., Højgaard, A.D., Kjeldsen, M.K. & Telléus, G.K. (2025). Eating disorder symptomatology among transgender and gender-diverse individuals: A cross-sectional study. Journal of Eating Disorders, 13(30). https://doi.org/10.1186/s40337-025-01212-2

‍