 For many trans and gender-diverse folks, the relationship with food and body isn’t just about appearance, it’s about survival, safety, and finding a way to feel at home in ourselves. That’s why eating disorders show up more often in our community. Not because there’s something wrong with us, but because we live in a world that often makes it hard to exist as we are. Research backs this up: trans and gender-diverse people are 2 to 4 times more likely to experience ED symptoms than cisgender people (Diemer et al., 2015). A recent meta-analysis found that 17.7% of trans men and trans women meet criteria for an ED (Rasmussen et al., 2023), and in a student sample, 17.6% of gender-diverse people had a diagnosed ED, compared to 1.8% of cis women and 0.2% of cis men (Duffy et al., 2019). These aren’t small differences, they point to a deeper truth about how we cope, survive, and navigate systems that weren’t made for us. Body Dysmorphia vs Gender Dysphoria Let’s start with a distinction that’s often misunderstood. Body dysmorphia is a mental health condition where someone fixates on a perceived flaw in their appearance. Gender dysphoria, on the other hand, is the distress that comes from the mismatch between their gender identity and how their body looks or is perceived by others. When access to gender-affirming care (like hormones, top surgery, or facial surgery) is limited by cost, gatekeeping, or legal barriers, folks may turn to food, restriction, or exercise as tools to make their body feel more aligned to their gender. One study found that this is a common reason people in our community engage in disordered eating - not to pursue a societal beauty standard, but to feel more like themselves (Austin et al., 2023). Using Food as a Way to Cope Many folks from our community carry trauma from being bullied, rejected by family, misgendered, denied healthcare, or simply navigating the world while trans. And when that trauma gets bottled up, when dysphoria builds and there’s no outlet, sometimes it feels like the only way to regulate is through food. Research shows that disordered eating can feel like the only available tool for coping when you can’t safely or affordably access affirming care (Connolly et al., 2021). For those who feel their body misaligns with their gender, it’s not always about wanting to be thin. I It could be about flattening their chest, delaying or reducing their curves, or making themselves smaller or larger just to feel safer in public. “Passing” Provides Safety and Pressure Let’s be real: in a world that’s often hostile to trans people, “passing” can offer protection. Being read as your true gender can mean fewer stares, less misgendering, and lower risk of violence. But it can also come with intense pressure to conform to cisnormative beauty standards like being thin, having certain body shapes, or hiding features that don’t match our gender identity. Ultimately, it means not necessarily presenting in a way that feels authentic due to body ideals. This pressure to conform, to pass, to fit a mold, to be “believable,” explains why some individuals may develop eating disorders and other mental health conditions because of passing. On the one hand it provides safety, but on the other the overwhelm of unattainable beauty standards, trans or not, can be devastating. Understanding Intersectionality There’s no single trans experience or way that eating disorders show up. Your race, where you live, your class, disability, community access, all of these intersect to shape how you experience dysphoria, stigma, and eating. Eating disorders don’t exist in isolation, and they don’t discriminate. They’re part of a bigger picture. Therefore, while we understand that eating disorders may be more prevalent in trans individuals, understanding that the cause of their ED is not simply because they are trans is essential. When the ED Feels Like the Only Way to Be in Your Body If you’re using food or body changes to cope - you’re not alone. Sometimes, an eating disorder can feel like the only way to be in your body when surgery isn’t an option, hormones are inaccessible, or the world doesn’t let you exist as you are. Particularly at the moment, when our community is being actively and aggressively discriminated against. However, I want to remind you that you are worthy of love, nourishment and to exist just as you are. In that sense, that’s why harm reduction is so important. Healing doesn’t have to mean jumping straight to full recovery. It might start with learning how to respect your body as it is, creating environments that encourage you do to do, and engaging in community that empower you to thrive. Not because you’re supposed to love it right away, but because you are a living, breathing human who deserves care, no matter what. And if there’s resistance within? That’s okay too. You’re allowed to feel conflicted. However, exploring that and understanding your internal critics concerns is key to moving forward. The Beauty of Trans and Queer Embodiment Something I just wanted to note before I end this blog is how proud I am to be part of this community. Here’s the thing - our bodies, our genders, our lives don’t follow rules. We’re fluid, we’re expansive, we question, we transform. And that’s something to be celebrated. Trans and gender-diverse people embody a different kind of wisdom. One that asks: What does it mean to feel at home in yourself? How do we live differently in bodies that the world tries to shape for us? These are powerful, radical questions. They challenge a system that profits off rigid ideals and binary thinking. Yes, eating disorders are more common in our communities. But that’s not the end of the story. We’re also some of the most adaptive, creative, resilient people out there. We know how to live in the in-between, that place between survival and authenticity. We know how to hold change, step into the unknown, and rebuild ourselves again and again. Instead of focusing only on what’s wrong, let’s uplift what’s working: our capacity for change, our deep self-reflection, our refusal to be boxed in. These aren’t symptoms, they’re strengths. If You’re Reading This… Whether you’re trans, nonbinary, or somewhere else on the gender spectrum, or you’re here to better understand and support someone you love, know this: you are not alone. Your body deserves safety, care, and respect. And healing doesn’t mean conforming, it means finding your own path to being more whole. If you’re struggling, reach out to someone you trust. And if that’s not an option yet, know that there are folks out here rooting for you. We see you.  When you're navigating recovery from disordered eating, the idea of complete freedom from your eating disorder can feel overwhelming. Without the eating disorder, you might fear losing the clarity of rules that made things feel predictable. While recovery can mean freedom, diving straight into the deep end can often feel too much - and result in running back to past behaviors for safety.
So, it might sound strange when I say this: a consistent meal and snack structure can be liberating - when it's offered as a container, rather than an inflexible rule book you cannot divert from. A container is not one-size-fits-all. It’s not a restriction. It's a supportive shape that helps hold what might otherwise feel too big, too chaotic, or too much. Why We Need a Container Without a container, we’re often guided by automatic, engrained behaviors. These can be habits we didn’t consciously choose, but repeat out of familiarity, fear, or survival. Without something new to bump up against, we’re left swimming in a sea of default reactions. A container gives us something to grapple with, something to reflect against. It helps us pause and ask:
A Flexible Framework The container is not meant to be rigid. It has room, capaciousness, for day-to-day fluctuations. For moments that feel hard, for emotions that don’t make sense and behaviors that arise in order to cope. The container doesn't eliminate these parts of you, but rather creates space for understanding them. It makes it possible to get curious, to slow down, to choose something new. It says: “Let’s hold all of this gently, explore it with compassion and understand what’s here”. Interrupting Habit Energy In recovery, you may notice yourself pulled toward familiar patterns, the behaviors which at first helped you feel a sense of autonomy and protection. Over time, these behaviors became ritualistic, unbreakable, and in a lot of cases automatic, often happening without you even realising. This is what I call habit energy — the inertia of long-held coping mechanisms. A container interrupts these behaviors by giving you space to recognize them and offering a steady, compassionate rhythm to return to. It helps the parts of you that want recovery, even if it’s scary and inconsistent, have something to lean on. A way to say, “I want to care for myself, even if that feels unfamiliar.” Building Safety, Not Perfection The beauty of the container is that it moves with you. It doesn’t demand perfection, label you as “good” or “bad” or offer a pass/fail metric. Instead, it offers consistency. Reassurance. A rhythm that your nervous system can begin to trust. Over time, this sense of structure can start to feel like deep safety instead of the brittle numbing offered by restriction. A gentle scaffold helps you show up, again and again, even when recovery feels hard. Facing Ourselves with Courage Recovery isn't just about food or body image. Often this is what it outwardly seems to impact, but it's about being able to cope in moments of profound discomfort: fear, panic, shame, judgement, isolation, confusion, and many more. When we have a container to return to, we can face those difficult moments and be able to hold ourselves without needing to escape entirely. It gives us the space and time we need so that we don’t to face everything at once or feel like we need to do it “right” and right now. We can pause, find comfort, get steady, and then work on what is showing up in a way that supports us moving forward. If you're in recovery or considering it, know this: You don’t need to be perfect to begin. You don’t need to “get it right” to be worthy of care. You just need a safe enough space to explore what’s really going on inside, and that’s exactly what a container can offer.  If you’ve been through eating disorder recovery, you already know what it means to live in a state of survival. You’ve existed in fight, flight, freeze, or fawn. You’ve ridden the waves of anxiety, helplessness, rage, and grief. You’ve felt disoriented by change and destabilized by the unknown. And now, here we are again. With Trump back in the administration (and with something new and destabilizing seeming to happen every day) the country feels shaky, volatile, and unsafe. For many of my clients in recovery, I’ve seen how this is triggering the same patterns we’ve worked so hard to untangle. The body remembers. The nervous system tightens. The old behaviors tempt us to fall back into old, unhelpful patterns of numbness, disconnection, and giving in. But there’s another F we’ve learned through recovery: Face. In recovery, we learned to face the truth: things had to change. We had to change. We had to stop pretending we were fine and look directly at what was going on inside us, no matter how painful or overwhelming it was. And now, once again, it’s time to face what’s happening in our country. It’s tempting to shut down. To despair. To dissociate. To hide. But you’ve been here before. You’ve done the impossible. You’ve sat with emotions that felt unmanageable. You’ve tolerated discomfort. You’ve made space for uncertainty. You’ve faced what scared you most, and came out stronger on the other side. This is not just about politics. It’s about survival, identity, safety, and truth. And if you’ve navigated recovery, you already have the tools to respond to this moment with clarity, integrity, and care. When the world feels like a trigger Let’s name it: This moment feels destabilizing. There’s a lack of security. A fog of uncertainty. It’s hard to trust the future. That is deeply familiar territory for those in recovery. It can mimic the internal chaos felt when you first tried to let go of disordered behaviors. And just like in recovery, there may be no immediate resolution. No single action that “fixes” the fear. But you don’t need to have all the answers right now, your job is to stay with yourself through it and do what you need to stay connected, well and safe. This isn’t about bypassing your feelings or pretending everything’s fine. It’s about learning to feel without letting things take over. Remember it’s okay to feel all the emotions, whether that’s all at once or in stages. You are allowed to be angry, you are allowed to cry, you are allowed to feel a spectrum of emotions all at once. Maybe you’ll feel numb, maybe you’ll be paralysed with overwhelm. It’s all okay, and it’s all manageable. What matters here is meeting those emotions with compassion – no judgement or expectations, simply making space for yourself and honoring how you feel. So, what now? If we’re being honest, honoring your emotions is one piece of the puzzle, but it can feel difficult to stay level-headed when things are changing rapidly, and what feels like out of your control, around you. So, if the world feels overwhelming right now, here’s what I’d like you to do:
Living through this political era is not easy, especially for those of us who have already fought so hard just to stay alive and present in our own lives. But you are not powerless here. The strength you built in recovery didn’t disappear, it’s right there, inside you, waiting to be used again. The work of facing doesn’t rely on knowing an outcome or that things will turn out “okay” - it is instead a very radical act – one grounded in choosing to show up regardless of the outcome. An act that is inherently hopeful and courageous. Face what is happening. Feel what is real. And then ask yourself: What do I want to do with this? Because you’ve done hard things before. You can do this too. Read This: Well + Good "The XL Way Diet Culture Capitalizes on Gender Roles and Expectations"12/28/2023
 “There is tremendous empowerment to be found in understanding
how rigid ideas about gender and bodies limit us all.” So pleased to be featured in this Well + Good piece alongside other providers and advocates. Click the image to read more!  So honored to be featured on my friend (and amazing therapist) Allyson's, podcast! Click the image to listen on Spotify!
 “I found that using substances...clouded my ability to be present to what I felt—both the good and the bad,” Coakley shares. “It also hindered me from being present with those I love.” They also list all the reflecting you can do while sober. For example, consider how drinking hurts your life, if it’s actually helping in the ways you want it to, and what aspects of your life change.
Super honored to be featured in this piece on the sober-curious movment & its intersection with diet culture alongside fellow RDs Mia Donley & Stephanie Kile. Click the image to read the full piece!  Learn more about how I work with my Nutrition Jobs career spotlight! Click the image to learn more.
 I was named one of the best nutritionists of 2022 by NY Mag!
'One of their clients, Sara, who would prefer to remain anonymous, spent the past few decades meeting with countless nutritionists and dietitians, and none felt like the right fit... until she found Coakley...they go beyond food, discussing Sara’s relationships and family as well as diet culture and systemic oppression more generally. “Hannah is the Eating Disorder Whisperer,” says Sara.' Click the link below for the full profile... “It’s just affirming the experiences and trying to create a space where someone feels like they can show themselves love.” — Hannah Coakley, MS, RD (they/them) See my interview with Healthline below: www.healthline.com/health/eating-disorder-treatment-needs-to-be-more-accessible-to-trans-people-heres-what-should-change  Illustrated by Jason Hoffman |
