Gender Identity and Eating Disorders: The Role of Gender in Treatment

Woman with morning coffee

The conversation surrounding gender identity is continuously evolving, but one aspect remains unchanged: our gender identity impacts the way we interact with the world and vice versa.

This is important to consider when addressing eating disorder prevention, treatment, and recovery. Varying gender identities experience eating disorder risks, causes, and symptoms differently.

What is Gender?

To begin, it is important to clarify what gender is. Gender and sex are not interchangeable.

The World Health Organization (WHO) defines sex as the “biological characteristics that define humans as female or male,” while gender is defined as “socially constructed characteristics of women and men – such as norms, roles and relationships of and between groups of women and men [2].” Discussing gender means understanding that one’s sex and gender are not necessarily linked.

Many maintain that gender is not binary and exists on a spectrum that depends heavily on personality, cultural norms, and preference. As a result, it isn’t statistically agreed upon how many genders exist. If Facebook’s 58 options are any indication of how many varying gender identities exist, there are more than most people know about.

Research on Gender and Eating Disorders

Most scientific research only looks into those categorized as “cisgender,” or those whose gender identity corresponds to their biological sex. While limited in this capacity, this research has found indications that cisgender females between the ages of 12 to 21 are at highest risk for developing an eating disorder compared to cisgender males with a ratio of 1:10 [3]. Studies have also found that, at all ages, body dissatisfaction is higher in cisgender women [3].

Woman with scarf

The WHO emphasizes that “when individuals do not conform to established gender norms, relations or roles, they often face stigma, discriminatory practices or social exclusion – all of which negatively impact health [4].”

Considering this, it is no surprise that research indicates those who do not fall into the binary categories of gender have been shown to have higher levels of disturbed eating behaviors than those who are cisgender male or female [5]. Research further indicates that women who feel conflicted about their gender identity show more disordered eating than their cisgender female counterparts [5].

There are numerous reasons why disordered eating is more common among those who don’t identify as cisgender. These individuals may be said to have gender dysphoria, or “a strong and persistent cross-gender identification and discomfort with one’s biological sex, or sense of inappropriateness in the gender role of that sex [5].”

Gender dysphoria often results in individuals feeling “enhanced body dissatisfaction due to the estrangement from their bodies and [they] may also be vulnerable to…eating disorders due to social stigma and negative self-image [5].”

Further, female-to-male persons “may strive for thinness in order to suppress female sexual characteristics such as breasts and hips, as well as menstruation. Male-to-female individuals may, in turn, strive for thinness to suppress masculinity and to correspond to a slim, female ideal [5].”

We all experience the world differently based on how we appear and behave outwardly. It is important to be aware of and sensitive to the varied experiences, and increased risk, for those who do not conform to socially constructed gender norms.

Image of Margot Rittenhouse.About the Author: Margot Rittenhouse is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims and offenders, and severely mentally ill youth. As a freelance writer for Eating Disorder and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.


[1] Sexual and Reproductive Health (2017). World Health Organization. Retrieved from
[2] Gender Equity and Human Rights (2017). World Health Organization. Retrieved from
[3] Garaigordobil, M., Maganto, C. (2013). Sexism and eating disorders: gender differences, changes with age, and relations between both constructs. Revista de Psicopatologia y PsicologiaClinica, 18:3, 183-192.
[4]Gender (2017). World Health Organization. Retrieved from

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published May 25, 2017.
Reviewed By: Jacquelyn Ekern, MS, LPC on
May 25, 2017.
Published on