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Guest Editorials

Eating disorders in the trans* community

by Mikki Enoch

Many in this community know me. I am the reigning Ms. Gay Pride of the Royal Court of the Golden Spike Empire. I sit on the board of directors of the RCGSE. I am a disabled veteran. I am a transgender woman. I have an eating disorder. Why does this matter and why am I telling you this? I am because eating disorders are a common issue in the transgender community.

The topic of addictions in the LGBTQ community commonly addresses the adverse effects of alcohol and illicit drugs, but the deadliest kind of mental illness is largely ignored: eating disorders. Modern research suggests eating disorders, drug addiction and alcoholism possess many similarities. Under normal conditions, the brain’s pleasure centers respond to behaviors such as being in love, exercise and general health, but they can also be falsely stimulated by artificial substances and behaviors with drugs, alcohol and food abuse.

Eating disorders come in many varieties. The most common are anorexia nervosa, bulimia and binge eating, but others exist. The stereotype of the rich, white coed who wants to be thin doesn’t accurately represent the spectrum of eating disorders. Unfortunately, this image of eating disorders ignores the reality shown by recent research that there is a significantly greater risk for eating disorders for transgender people than their cisgender peers.

For both transgender people and others with eating disorders, the way the body looks and works are commonly distorted in their minds. They may be affected by societal expectations of how their bodies should look. Transgender women may desire to lose weight to meet an ideal of feminine beauty through thinness. Transgender men may desire to prevent the development of female sex characteristics such as breasts or larger thighs, or to suppress a menstrual cycle.

My reasons for the development of my eating disorder are complex, but my attempt to receive culturally competent treatment isn’t that unusual.  I am currently in one of the few eating disorder centers that specifically addresses eating disorders for the LGBT community.

When I think my body doesn’t meet the ideals of a feminine body, I like my body thinner because I see more curves. In reality, the shape I see isn’t female; it is malnourished. I see the curves of my hips, but the reality is that my bones are showing. I didn’t want this when I started losing weight from Crohn’s disease and a gluten allergy. I had initially cut back how much I was eating to prevent pain and nausea. Weight loss is common in Crohn’s disease because it can affect the way the body absorbs nutrients. However, I became addicted to the new shape that I pictured in my mind and continued to restrict my food intake.

With the help of my physicians and mental health providers, I get the treatment I need. I am in a small group of transgender women who receive care in a place where my gender is respected in and out of treatment. In my first center, I was initially told I would be housed according to my “biological sex,” ignoring both my identified and legal gender. The second center is still learning how to house according to identified gender, but they are doing it by ensuring that all roommates of transgender clients are asked before room assignment.

Having my gender identity respected makes me better able to work toward recovery. I am able to think about my personal history, which includes many traumas, more than I even care to accept. I talk about why I don’t want to eat, not about how important it is to be seen for who I am instead of how they choose to see me. My treatment helps me work toward being able to return to my life and my goals. I want to serve my communities. I want to enjoy time with my family and friends. I can see this happening for me, but I know many suffer in silence.

When I hear transgender people talk about losing weight I now cringe.  When I hear people talk about hating their bodies I shiver. I am not saying I don’t still feel the same way, but I now know how much I am damaging my mind and body when I act upon the urges. I hope other transgender women with eating disorders get the same help I am getting and learn how to live and not hate their body.

About the author

Mikki Enoch

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