Beyond the Binary: Understanding Eating Disorders in the LGBTQ+ Community

Eating disorders do not discriminate — they affect people of every race, size, gender identity, and sexual orientation. Yet among LGBTQ+ individuals, the risk is significantly higher. From the unique psychological pressures of navigating identity, to systemic barriers in accessing affirming care, understanding eating disorders within the LGBTQ+ community requires a nuanced and compassionate lens.

Why the LGBTQ+ Community Faces Elevated Risk

LGBTQ+ individuals experience higher rates of eating disorders than their heterosexual and cisgender peers. These disparities don’t exist in a vacuum. They reflect the impact of social stigma, trauma, discrimination, and marginalization — all of which are recognized contributors to disordered eating and other psychiatric conditions.

Body image distress, minority stress, and gender dysphoria are common risk factors, and members of the LGBTQ+ community often experience these in combination. In addition, they are more likely to encounter obstacles to treatment, including bias in healthcare settings, lack of provider understanding, and financial or geographic barriers to competent care.

Prevalence and Risk Factors Across Subgroups

Gay and Bisexual Men

Gay and bisexual men face one of the highest rates of eating disorders among male populations. While men represent approximately 15% of eating disorder diagnoses overall, an estimated 42% of men with eating disorders identify as gay. These individuals are significantly more likely than heterosexual men to engage in behaviors like bingeing, purging, and the use of diet pills or laxatives.

Part of this heightened vulnerability stems from cultural ideals within certain segments of the gay community. The emphasis on lean, muscular bodies — amplified by media, dating apps, and social dynamics — can fuel disordered eating as a means of achieving perceived social acceptance or desirability.

Additionally, societal stigma around men and eating disorders can delay diagnosis and treatment. Parents, peers, and even clinicians may misattribute symptoms to athleticism or puberty, especially in adolescents.

Lesbian and Bisexual Women

The research around lesbian and bisexual women is more nuanced. Some studies suggest that lesbian women may experience slightly lower body dissatisfaction than their heterosexual peers, possibly due to more inclusive body ideals within certain queer subcultures. However, other data show comparable — or even higher — rates of disordered eating, especially among bisexual and questioning women.

This complexity points to the danger of generalizing across groups. While some lesbian women may feel more liberated from heteronormative body pressures, others face additional layers of stress related to visibility, acceptance, or internalized stigma that can impact their relationship with food and body.

Transgender Individuals

Transgender people are among the most at-risk groups for disordered eating. Approximately 16% of trans individuals report a history of an eating disorder — a number that is likely underreported due to stigma and lack of data collection.

For many, disordered eating may be tied directly to gender dysphoria. Some may attempt to suppress or accentuate certain features of their body to align with their gender identity or to “pass” more easily in public spaces. These behaviors are often reinforced by societal pressure and fear of discrimination or violence, which remain everyday risks for many trans individuals.

The stakes are tragically high: nearly 40% of transgender adults report having attempted suicide. Because eating disorders carry the highest mortality rate of any mental illness — largely due to medical complications and suicide — the intersection of disordered eating and transgender identity represents a serious and urgent public health concern.

Non-Binary and Gender-Expansive People

While less studied, emerging research shows that non-binary and gender-expansive individuals face elevated risks of disordered eating as well. One study found that nearly a quarter reported recent dietary restraint, and over 12% reported recent binge eating.

These individuals often face invalidation of their gender identity, leading to feelings of isolation, invisibility, or even harassment. The stress of navigating a world that frequently fails to acknowledge their existence — or that dismisses their identity as “not real” — contributes to psychological distress, which may manifest through eating disorder behaviors.

The Role of Minority Stress

Minority Stress Theory helps explain the elevated rates of eating disorders in LGBTQ+ populations. This framework suggests that the chronic stress of experiencing discrimination, rejection, and marginalization increases vulnerability to mental health issues. For LGBTQ+ individuals, this might look like being bullied at school, experiencing family rejection, feeling unsafe in public, or hiding one's identity to avoid harm.

These chronic stressors — especially when layered on top of trauma or unmet needs for acceptance — can lead to coping behaviors that include bingeing, restriction, purging, or compulsive exercise. In this context, disordered eating can be both a form of self-punishment and a misguided attempt at control or safety.

Barriers to Treatment

Even when LGBTQ+ individuals seek treatment, they often encounter providers who lack cultural competence or who rely on narrow diagnostic criteria that don’t reflect the lived experience of diverse bodies and identities. Men may not be screened at all. Trans and non-binary individuals may be misgendered or have their identity pathologized. Lesbian and bisexual women may feel invisible in heteronormative treatment settings.

These gaps underscore the importance of affirming, inclusive, evidence-based care — delivered by providers trained in both eating disorder treatment and LGBTQ+ mental health.

What Helps: Affirmation, Connection, and Competent Care

Despite these challenges, protective factors can play a powerful role. Research shows that social support, family acceptance, access to gender-affirming care, and peer connection can all reduce the risk of eating disorders and improve recovery outcomes.

Healing begins with being seen — truly seen — in your whole identity. That includes access to care that honors who you are, affirms your gender, and supports your full humanity.

In Summary

Eating disorders in the LGBTQ+ community are not just about food or body image. They are deeply intertwined with the experience of living in a society that often marginalizes queer and trans identities. By expanding awareness, removing stigma, and ensuring access to competent care, we can take meaningful steps toward healing and equity.