Eating disorder behaviors more severe among transgender and gender non-conforming youth in Canada
Eating disorders affect many adolescents and young adults with diverse identities in Canada. Yet, the portrayal of these disorders in both the media and in research often focus on white, cisgender women.
A new study, analyzing data from over 2,700 adolescents and young adults across all 13 provinces and territories in Canada, found that those who identified as transgender and gender non-conforming reported the most severe eating disorder attitudes and behaviors, while sexual minority (i.e., gay, lesbian, bisexual) cisgender women and cisgender men reported elevated eating disorder attitudes and behaviors compared to their heterosexual counterparts.
"The findings serve as a reminder to health care professionals that eating disorders impact not only cisgender women, but also people with diverse gender and sexual identities. Diverse presentations of disordered eating behaviors must also be considered," says lead author Laura Hallward, a postdoctoral fellow at Western University in the School of Kinesiology.
When compared with heterosexual cisgender men, gay cisgender men had more severe eating attitudes and behaviors and were between 1.5 to 2.5 times more likely to engage in eating disorder behaviors. In addition, cisgender women were between 2 to 3 times more likely to engage in eating disorder behaviors when compared to heterosexual cisgender men.
"Previous research into eating disorders among sexual and gender minorities often group everyone together, overlooking differences that may occur between identities," says Hallward. "Our study highlights that eating disorder attitudes and behaviors differ considerably based on people's gender identity and sexual orientation."
To date, there has been limited large-scale epidemiological research investigating eating disorders and related behaviors among Canadian adolescents and young adults with diverse gender and sexual identities. "More research needs to continue to separately examine how the intersection of gender and sexual identities influence eating disorder psychopathology," says Hallward.
Impact of COVID-19
Published in the International Journal of Eating Disorders, the study drew data from the 2021 Canadian Study of Adolescent Health Behaviors. The researchers found that eating disorders spiked among Canadian adolescents and young adults during the COVID-19 pandemic. In total, 11% of all participants reported a lifetime eating disorder diagnosis from a health care professional compared to between 1-3% reported by Statistics Canada in 2015.
"Among all participants, the prevalence of a lifetime eating disorder diagnosis was over 3 times that of prior Statistics Canada findings from 2015," says senior author Kyle T. Ganson, an assistant professor at the University of Toronto's Factor-Inwentash Faculty of Social Work.
"Compared to prior research pre-pandemic, participants in our sample also had greater eating disorder attitudes and behaviors. These findings continue to emphasize the likely impact of the COVID-19 pandemic on young people."
The study's authors argue that their research highlights the need to develop prevention, assessment, and treatment methods that consider the various presentations of disordered eating for adolescents and young adults among diverse sexual and gender identities in Canada, especially in the context of the pandemic.
More information: Laura Hallward et al, Examination of eating disorder psychopathology across sexual and gender identities among a Canadian sample, International Journal of Eating Disorders (2022). DOI: 10.1002/eat.23872