Today is the International Day Against Homophobia, Biphobia and Transphobia (IDAHOBIT), a day which encourages us to not only be aware of but actively fight against discrimination. 

There is no one cause for eating disorders; we know they are often caused by a range of risk factors that come together.  

Many of these risks can be social factors. For groups like LGBTIQA+ who experience higher rates of discrimination, this too can cause higher risks of eating disorders. 

In 2021, the Writing Themselves In 4 report which surveyed 6,418 LGBTIQA+ young people, found 12.4% of participants had been diagnosed with an eating disorder – the second-most common mental health issue in the report behind anxiety and depression. 

While evidence about why this is currently limited, we can see how discrimination may create unique risk factors for LGBTIQA+ people. 

This year for IDAHOBIT, lets consider this, and how working against medical discrimination can protect LGBTIQA+ from eating disorders. 👇 

We need to make inclusive and affirming healthcare the norm, not the exception. 

Negative experiences during initial interactions with the healthcare system can delay recovery from an eating disorder. 

Medical discrimination discourages LGBTIQA+ people from seeking healthcare. Medical discrimination can range from microaggressions like making assumptions about a person’s gender or sexual orientation to outright denial of care and treatment. 

This may account for the reasons why, as one US study found, LGBTQIA+ people report more severe symptoms when entering eating disorder treatment. They also face additional barriers to accessing timely and appropriate care.  

For example in Australia, trans people report that when accessing healthcare they face: 

• deadnaming (for example, using their birth name instead of chosen name) 

• misgendering (for example, using incorrect pronouns) 

• intrusive and inappropriate questions about being trans 

• refusal of care due to being trans. 

Updating your gender on formal documents can help improve experiences interacting with the healthcare system. Unfortunately, this can be very expensive and time-consuming for trans and gender diverse people.  

In the state of Victoria, you can update documents like your driver’s license, Medicare card, birth certificate, and passport. However, each process requires different paperwork and can lead to different outcomes. This is just one example of the many barriers that can prevent people from receiving the right care at the right time. 

A 2021 study reported that more than 90% of trans and gender diverse people were misgendered in the span of a year. Of that same group, over half were misgendered more than once a day. 

These experiences are cumulatively invalidating and take a real toll. A lack of healthcare provider knowledge on these challenges is an additional barrier to care. 

The good news is that gender and sexuality-affirming clinicians can make a real difference.  

Actively reducing barriers to appropriate and timely care is essential for cultural competence. 

Clinicians can start with actions as simple as: 

• using a person’s correct name and pronouns,  

• asking about their identity and experience, and  

• getting training in gender and sexuality affirming mental healthcare. 

Staying curious, informed and respectful can go a long way in beginning to heal the legacy of mistrust between the LGBTIQA+ community and mental healthcare system, including eating disorder care.