Eating Disorders and the Search for Safety in Trans Individuals

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… 
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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.