Transgender and non-transgender lesbian, gay, and bisexual students are at greater risk for eating disorders, finds a new study.
The study used data from the American College Health Association–National College Health Assessment (ACHA-NCHA), a survey of 289,024 students from 223 US universities. Researchers found that the rates of self-reported eating disorders were highest in transgender people. Heterosexual men had the lowest rates.
“Transgender people were more likely to report a diagnosis of an eating disorder—bulimia nervosa or anorexia nervosa—in the past year,” says senior author Alexis Duncan, assistant professor at the Brown School at Washington University in St. Louis.
“They also reported using vomiting, laxatives, or diet pills more for weight control in the past 30 days than cisgender men and women, regardless of their sexual orientation.”
The ACHA-NCHA survey, the authors write in the study, “includes the largest number of transgender participants ever to be surveyed about eating disorders and compensatory behaviors, thus enabling us to conduct statistically powerful analyses of the relationship between gender identity, sexual orientation, and eating-related pathology.”
The students self-reported their mental health, substance use, sexual behavior, and nutrition history on questionnaires distributed between 2008-2011.
Of the ACHA-NCHA survey data, 268,066 students self identified as heterosexual, 5,057 as unsure, 15,422 as bisexual, lesbian, or gay, and 479 as transgender.
Transgender students were found to have significantly greater odds of past-year eating disorder diagnosis, past-month diet pill use, and past-month vomiting or laxative use compared to cisgender heterosexual women.
Transgender participants also were significantly more likely than members of any other group, including cisgender sexual minorities, to report past-year eating disorder diagnosis and past-month compensatory behaviors.
“I don’t think that this is particularly surprising to the LGBTQ community and/or to clinicians that work with members of this community,” Duncan says.
“There is a lot of anecdotal evidence of eating disorders among transgender people; however, there have been few previous studies that have compared transgender people to cisgender people, and to our knowledge, no single previous study has compared transgender people to both cisgender heterosexual and sexual minority individuals.”
The results appear in the Journal of Adolescent Health. Additional coauthors contributed from the University of North Carolina at Chapel Hill and Washington University.