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Monday, July 16, 2012

Trans* Gender and Eating Disorders

First off, I should say that I don't have and have never been diagnosed with an eating disorder. Doctors and therapists have hinted at it, warned me about it, and evaluated me for signs of eating disorders, seemingly viewing me as "at risk" for such a disorder. The reason is that for many years, I attempted to diet myself into a more male body shape. And for many years I succeeded.

A photo of me at 18, sent to a gay man online, left him wow'd by my svelte form and smooth skin but unaware that I was born female. I had never taken hormones. I was naked.

For many years, I manifested my latent body hate and dysphoria by controlling strictly what I ate, and working out. I was also a model, doing figure modeling for classes and photography modeling for artists. Staying in a slim, muscular looking shape was not very hard for me at that age. I restricted calories-- and weight came right off. I was gender dysphoric, but I worked hard to have a masculine six pack I could be proud of and most importantly, no hips.

Now I'm 25. I have problems with fatigue and hypoglycemia (low blood sugar) which are helped tremendously-- eliminated, really-- by frequent, sizable meals with plenty of protein, fat and carbs. The more I eat, the better I feel; the more I eat the more I can exercise, have fun and enjoy life.

I actually enjoy being less thin, as a physical sensation as well. I'm not fat by any means-- I have a BMI in the upper-middle of the normal range-- but in American culture it's always considered "better" to be thinner. Every magazine tells you you will "feel better" if you are thinner. I think that's magazine speak for "you will get more sexual attention" and "people won't gossip about you negatively." Some people feel better thinner and some do not. Being overweight or obese can be uncomfortable, physically, at least to some people. But there's no particular reason that being average or heavy rather than being thin should feel better.

When I was younger, being thinner validated my gender identity. Now that I'm older, being average in weight validates my body's needs! And being bigger feels better. I hate the "disappearing" feeling I get from being thin. I have been unhealthily thin before (5' 5", 103 lb) and this makes it easier, much easier, to accept carrying more weight. I feel more comfortable in my skin when I am bigger. Of course, on the flip side, I look "curvier" too. But I love taking up space.

For most people, how they feel about their weight relates to their gender. For trans people, pre- or mid transition (or those who do not transition) weight relates to dysphoria. Clinicians who treat trans people should consider evaluating for eating disorders while keeping in mind that mild problems that suggest a disorder may be primarily linked to dysphoria. Gaining weight can hide physical features, as can losing extreme amounts of weight.

A Washington State University study shows that trans youth are at increased risk for eating disorders. Trans youth reported being diagnosed with these disorders at a high rate: 17%. Feeling better about their own bodies was attributed to hormones and sex reassignment. When eating disorders and "gender identity disorder" are co-occurring, hormones should not be held off until the eating disorder is resolved, because it is likely to be linked to gender dysphoria.

Author Ryan K. Sallins, who transitioned from female to male, writes: "My curves made me feel fat. My curves scared me. At the age of eighteen I decided that all of my discomfort in life would go away if I just lost weight... At the age of 24 I came out as a lesbian. When I did this, my eating disordered behaviors started to decrease....Eight months later I discovered how to fix what was wrong when I found a book about transgender men. Looking at their bodies and reading their stories I immediately knew why I was struggling with my own. I am transgender....There is hope for recovery. I am now 32-years-old and have been free of abusing food for nine years. I now know what hunger signals are, and I am able to nourish my body. Recovery begins when you allow yourself to love and recognize that being lovable is about respecting oneself and allowing your inner spirit to guide your actions."

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