Identifying Eating Disorders in Gender Expansive Community

woman on path to mindfulness

The gender-expansive community refers to individuals who do not fit within the binary gender identity system of male and female [1]. This is a population that has been, at best, overlooked by society. At worst, they have been discriminated against and emotionally or physically harmed by society for quite some time. Due to our culture’s beliefs regarding gender as a binary, data on this population is scarce.

Additionally, “when research is presented, it generally conflates all gender-expansive identities and experiences with transgender identities and experiences, even though the terms are not synonymous [1].

Research on these individuals is also scarce when it comes to disordered eating beliefs and behaviors. What research does exist often combines sexual and gender minorities (SGM) into one group even though they are distinct [1].

With this limitation in mind, the literature does indicate that individuals identifying as SGM “have higher rates of ED self-diagnosis, engage in more compensatory behaviors (e.g., use of diet pills and laxatives), and have more severe ED symptomatology [1].”

Identifying eating disorders in this population means understanding the risk factors they experience.

Gender Expansive Identity & the Body

Gender expansive person struggling with eating disorder

Individuals who experience gender dysphasia report higher dissatisfaction with their bodies [1]

. This is likely due, in part, to cultural ideals of appearance and their relationships to those ideals.

Additionally, these individuals may experience distress related to incongruence between their biological sex and gender identity, as research indicates higher reports of body dissatisfaction in individuals that identify as transgender prior to gender confirmation treatments [2].

Discrimination & Body Appreciation

Studies show that discrimination is negatively correlated with body appreciation, meaning that as discrimination increases, body appreciation decreases [1. Not only that, “transgender individuals who are more visually gender-nonconforming experience more public discrimination [1].”

Gender Minority Stress Model

The Gender Minority Stress Model is often used to examine the unique stressors experienced by those in the gender expansive community and how these relate to negative health outcomes [1].

These individuals experience “high levels of gender-based victimization and discrimination and a greater amount of stressful life events as a result of their gender expression, which are each associated with negative mental health sequelae [1].”

This community is at high risk for eating disorders, as indicated by a recent study that found that “nearly one-quarter of gender-expansive individuals reported dietary restraint in the past 28 days [1].”

Identifying eating disorder behaviors in this community involves a compassionate understanding of the unique risk factors that make them susceptible.


[1] Nagata, J.M. Et al. (2020). Community norms for the Eating Disorder Examination Questionnaire (EDE-Q) among gender-expansive populations. Journal of Eating Disorders, 8:74.

[2] Unknown (2021). Body image, sexual orientation, and gender identity. Mental Health Foundation. Retrieved from

About the Author:

Image of Margot Rittenhouse.Margot Rittenhouse, MS, PLPC, NCC 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 Hope 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.

The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a 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 January 26, 2021, on
Reviewed & Approved on January 26, 2021, by Jacquelyn Ekern MS, LPC

About Baxter Ekern

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