Trans(cending) Recovery: Discussions with Trans and Non-binary Folks Around Recovery in the Context of Eating Disorders

Abstract

Eating disorders affect an estimated 1 million Canadians per year and have the highest mortality rate of all mental illnesses (Statistics Canada, 2016; Arcelus, Mitchell, & Wales, 2011). Research suggests that those who fall under the transgender umbrella are at a higher risk for developing mental health concerns, and more specifically disordered eating practices (Dhejne, Vlerken, Heylens, & Arcelus, 2016). Despite this the existing literature on this population is lacking, with little research going outside of the gender binary. Majority of the existing literature is limited in looking at individual case studies seeking to prove that transgender folks can struggle with disordered eating, rather than bring attention to the experiences of transgender individuals within eating disorder treatment and recovery. The purpose of this study was to expand on the current literature by bringing in the voices of lived experience. Semi-structured interviews were conducted with individuals, over the age of 18, who identify their gender as falling under the transgender umbrella who have participated in a form of eating disorder recovery for a minimum of one year. Through a thematic analysis, commonalities were uncovered between the participants stories leading to the identification of five themes: the connection between gender identity and eating disorder development, the impact of LGBTQ+ beauty standards, discrimination within the healthcare system, the use of the internet, and the role of community in recovery. The findings suggest there is a strong connection between transgender identity and the development of eating disorder behaviours that create an experience vastly different than the cisgendered reality in which the treatment programs are based. To address these differences the participants provided guidance towards recommendation for practitioners and treatment including: mandated training on both transgender identities and eating disorders, the development of supportive and inclusive environments, the creation of a transgender specific eating disorder treatment program. Further, topics for future research to deepen the understanding of the experiences shared within the study included: impact of online eating disorder support for trans and non-binary individuals, the variance in experience between binary transgender and non-binary identities within treatment, and the impacts of race and ethnicity on the experiences of transgender individuals.