Adolescence is difficult for every young person, and eating disorders are distressingly common. Add uncertainty about gender or sexual orientation to the mix, and an even more challenging brew is concocted.
Marcia Lemm, a gay woman, struggled with anorexia and bulimia while growing up.
“As a queer person, there is an additional learning experience about your body,” she says.
“As a teenager, I was so determined to present in a way that was acceptable to my family and to society as I knew it.”
Lemm found there was a scarcity of specialised support for LGBTQI people with eating disorders.
“I think better education for GPs and health practitioners on the LGBTQI experience with eating disorders, and encouraging people to talk openly about, is essential,” she says.
According to the National Eating Disorders Collaboration, an Australian Government Department of Health initiative, about 9 per cent of Australians have an eating disorder.
Anorexia nervosa is the most dangerous, with a mortality rate of 20 per cent. However, it is under-diagnosed, as a result of people concealing the illness.
The issue of gender identity and eating disorders is relatively unexplored at the moment. However, a Washington University School of Medicine study found that transgender students were four times more likely to be diagnosed with anorexia nervosa.
Another study by Mental Health UK found that 53 per cent of people who identified as lesbian or bisexual felt depressed about their body image, compared to 33 percent who identified as heterosexual.
Olivia Hendry, a gay performer who trained as a professional dancer, has recently started to identify as gender-fluid or non-binary.
“It’s incredibly difficult to nourish a female-coded body, when a lot of the time it feels incorrect,” says Hendry, who lives in Perth. “I wish I could have a more ‘neutral’ frame.”
Growing up in an intense dance training environment contributed to Hendry’s poor body image and disordered eating habits.
“I was also a queer person who grew up in a heavily religious environment, which I now see turned my attraction to women into a comparison with women.”
Amelia Trinick, a clinician with the Butterfly Foundation, Australia’s leading eating disorder support organisation, says: “Stigma and [its] interaction with the physical changes occurring, and expectations to fit into a particular body type, may be exacerbated by the pressure on those transitioning to look a certain way for their experience to be valid.
“This may lead to actions to suppress or accentuate particular parts of the body, which can often come through changes in diet and exercise.”
The discrimination many LGBTQI people face can cause a condition called “minority stress”, which may lead to disordered eating patterns aimed at creating a sense of control.
Recently, changes been made to reflect that fact that people with eating disorders do not always conform to the straight, white female stereotype.
The Butterfly Foundation has updated the “traditionally feminine” face of its company, and plans to unveil a revamped website later this year.
It is also hiring ambassadors from often under-represented or marginalised groups, such as members of the LGBTQI community and Indigenous Australians.
Hendry says: “I believe there needs to be more support and education offered to those with gender dysphoria about the importance of fuelling the body/vessel that carries their identity, regardless of its presentation.”
Trinick agrees that the availability of practitioners who understand the LGBTQI experience is “very important, as it can work to reduce stigma, provide community and understanding, and ultimately, safe treatment”. She adds:
“Funding is a huge key to be able to support awareness and research in this area. Advocacy is obviously a huge part of this as well.
“Another part of the story is creating pathways for representation of diverse communities within the research field itself, as well as highlighting the importance of the lived experience within the research.”
Hendry says: “There is always hope. I had been suffering for 10 years before I’d been diagnosed. That is too long.
“No one deserves their childhood to be wrenched from them. But even after all this time, I see a full recovery in my sights. It is never too late to get help.”
For support, call the Butterfly Foundation National Helpline on 1800 33 4673.