This blog has been written by Anthony*, post-graduate student and member of Sydney’s LGBTQIA+ community.
In the month of Mardi Gras, Sydney’s annual celebration of queer life and culture, it is important to reflect on the ways that queer identity shapes all parts of our lives.
The 2014 General Social Survey was the first recording of Australian queer demographics, and found that 3% of the adult Australian population identified as “gay, lesbian, or ‘other’”.
The 2016 Census was the first time it was possible to record a response other than “male” or “female” to the question of the respondent’s sex. More than 1,250 responses indicating a gender identity other than “male” or “female” were recorded, some of which specified in further detail.
Needless to say, this does not give a complete picture of the many and varied forms of queer identity and life, but it does begin to capture a portion of the population.
The exact percentage of LGBTQIA+ individuals affected by eating disorders is difficult to quantify, but studies suggest that while men make up only 5% of people diagnosed with eating disorders, 42% of those people identify as homosexual or bisexual.
Very little research exists on eating disorders in transgender individuals, but the studies that do suggest a greater incidence than in the general population.
Whilst we have come a significant way from the assumption that eating disorders exclusively affect young, straight, white, rich, cisgender women, there are still significant barriers to accessing treatment for people who do not fit this narrative.
This is especially the case for transgender people, like myself, who have complex and contradictory relationships with our bodies.
We don’t fit easily into a pre-written narrative of eating disorder treatment or recovery and this can lead to a lack of treatment altogether.
It is important in working with LGBTQIA+ clients broadly to think about the social determinants of their health, such as discrimination and harassment, as well as violence.
These factors lead to queer people being more likely to attempt suicide, more likely to be homeless, at a higher risk for HIV and STDs, and with the highest rates of tobacco, alcohol, and other drug use.
Queer people are also more likely than the general population to meet the criteria for a mental disorder, and to report self-harming and substance abuse. Because of this, these populations have complex needs.
How do the needs of queer people differ from the general population in eating disorder treatment?
Primarily, the most important thing healthcare providers can do is to understand our identities and relationships - and acknowledge that our lives might look different to the norm.
Avoid assuming that all clients are cisgender and heterosexual, as doing so perpetuates an “othering” view of queer people, which in turn perpetuates homophobia and discrimination.
It is also important for providers to keep in mind that by virtue of being “out”, queer people open ourselves up to risks of violence, harassment, bullying, homophobia, rejection and even homelessness.
The anxiety that comes with existing as a queer person in the world deeply affects us all, and it plays a significant compounding factor in our emotional lives.
It is also crucial not to perpetuate stereotypes about the LGBTQIA+ community, especially in assuming that people of a particular identity all look a particular way, or have the same goals and motivations.
For transgender people particularly, accessing treatment, or even basic healthcare is an incredibly complicated process, as our legal documentation often does not match our name or appearance.
This increased vulnerability and fear of discrimination or pathologising of our gender identities makes seeking help incredibly difficult, and a less-than-ideal first point of contact can result in delayed or prevented access to treatment.
One of the biggest complaints within queer communities about healthcare more broadly is the lack of knowledgeable and culturally competent care available.
Every queer friendship group has a host of horror stories of healthcare providers who, through ignorance or ill-will, have failed to treat them with dignity and respect, let alone help with whatever brought them to this clinician in the first place.
When thinking about something that makes you as vulnerable as seeking eating disorder treatment, it is easy to see how a negative interaction could lead someone to fail to return.
While you are celebrating Mardi Gras this year, take a moment to think about the less glitter-filled aspects of queer identity and how they affect LGBTQIA+ people every day of the year.
For further information and resources: www.acon.org.au