The eating disorders treatment community has a lot to learn about assessment, etiology, and treatment of those who identify LGBTQIA+. Most everyone wants to be an ally in the treatment community, but few know how to effectively do so. It takes a willingness to admit we do not know nearly enough beyond rates of diagnosis and that we must listen, learn and grow as providers so we can better meet their needs.
Eating disorder research has provided little evidence-based practices that describe unique programming for LGBTQIA+ clients. But the obvious practical solution is to start with respect for the inclusive language, fluidity of gender and sexuality, and experiences of neglect and trauma from family or community who may not support them the way they need.
Individual stories break down to issues of self-compassion, self-worth, depression, stigma, and belonging. Case after case in my own program, the client is not interested in recovering from the eating disorder as much as they need to feel loved and accepted for who they are, that their body is their true home, and expresses their genuine identity.
A recent research article looked at 84 transgender individuals in treatment for an eating disorder around the country. Not one of them said they had a positive experience in treatment. While that might be an anomaly to literally have zero positive responses, most LGBTQIA+ eating disorder support groups in social media are filled with individuals who report feeling this way.
Recovery is not a singular focus on nutrition rehab – though it is a major goal, of course! But without empathy for how and why recovery is so much harder and looks so different for cisgender straight individuals, we do not do justice or honor those who do not fit the common mold of the eating disorder client.
And we must recognize that race, religion, socio-economic background, abilities, nationality, and age all play additional roles that influence the unique experience of those who identify LGBTQIA+. We have much to learn. But learning starts with asking good questions and listening intently about what each person needs.
Ultimately, a treatment program provides a home for every “Body.”