Canadian LGBTQ2S+ youth more likely to have eating disorders, says study

Trans and gender nonconforming youth in Canada are more likely to have eating disorders, and experience more serious symptoms, than cis people, according to a new study from researchers across Canadian and American universities. 

The study found that trans and non-binary people were also around 1-2.5 times more likely than straight cis men to report eating disorders. Researchers also found eating disorders in gay cis men were around 1.5 to 2.5 more common than compared to straight cis men. 

“Previous research into eating disorders among sexual and gender minorities often group everyone together, overlooking differences that may occur between identities,” lead author Laura Hallward, a post-doc fellow at Western University’s school of kinesiology, said in a press release. 

The paper, published in the International Journal of Eating Disorders last week, surveyed 2,714 respondents in Canada aged 16 to 30 in late 2021, and grouped respondents by gender and sexual orientation to see if there were clear differences.

The study used a self-reported questionnaire, which asked respondents about attitudes and behaviours across different categories, on a seven-point scale of severity. A score of over 2.48 across all categories was used as a marker of “clinical significance,” allowing researchers to identify respondents who may meet the criteria for a clinical diagnosis, but who had not received one. 

Of the participants, nearly three-fifths were straight men (27.4 percent) or straight women (31.2 percent), 11.7 percent were queer, bisexual, gay or asexual men, 23.3 percent were queer, bisexual, gay or asexual women. Just over 6.5 percent were trans or gender nonconforming, with almost all of that contingent identifying as non-heterosexual. 

The choice to combine all trans and gender-expansive identities into one category makes it difficult to directly compare binary trans people to their cis peers. The researchers also divided up sexualities into “gay,” “bisexual” and “queer,” with “queer” as an umbrella term for anything that wasn’t straight, bi or gay—so queer, pansexual, questioning and asexual people were grouped together in a way that may muddy results. 

Straight cis men were chosen to be the comparison group, as, per the study, “neither [their] gender nor sexual identity are considered minority statuses.” Researchers found that almost every group with at least one marginalized gender or sexuality identity were more likely to report disordered eating than straight cis men across the majority of different axis.

While 41 percent of straight cis men reported compulsively exercising at least once in the last 28 days, for instance, that number went up to 51 percent for gay men and straight women, 50 percent for bisexual trans people and 49 percent for bisexual women. Similarly, only 25 percent of straight men reported dietary restraint in the last month, but it rose to double that for queer women (49 percent), bisexual women, gay or lesbian trans people, and bisexual trans people (52 percent) and queer trans people (58 percent). 

“The findings serve as a reminder to healthcare professionals that eating disorders impact not only cisgender women, but also people with diverse gender and sexual identities,” Hallward said.

Previous health research has noted that people who experience attraction to multiple genders, be they queer or bisexual, often have specific health disparities, such as higher rates of substance abuse or mental health problems. 

Sexual minority trans people generally had the highest instances of all rates of eating disorder symptoms, though notably there were very few straight trans people in the study’s respondent group. The report notes that these findings align with scientific models, which suggest that holding “multiple marginalized identities” is associated with higher rates of eating disorders.

The study’s time frame also reflects the ongoing effect of the COVID-19 pandemic on eating disorder prevalence. While Statistics Canada in 2015 found that between one and three percent of the population reported ever having been diagnosed with an eating disorder, the report found that 11 percent of respondents reported a diagnosis.

“Compared to prior research pre-pandemic, participants in our sample also had greater eating disorder attitudes and behaviours,” co-author Kyle T. Ganson, an assistant professor at the University of Toronto’s social work faculty, said in a statement. “These findings continue to emphasize the likely impact of the COVID-19 pandemic on young people.”