Decolonizing Wellness: A QTBIPOC-Centered Guide to Escape the Diet Trap, Heal Your Self-Image, and Achieve Body Liberation By Dalia Kinsey
Decolonizing Wellness: A QTBIPOC-Centered Guide to Escape the Diet Trap, Heal Your Self-Image, and Achieve Body Liberation By Dalia Kinsey

Decolonizing Wellness: A QTBIPOC-Centered Guide to Escape the Diet Trap, Heal Your Self-Image, and Achieve Body Liberation By Dalia Kinsey

Become the healthiest and happiest version of yourself using wellness tools designed specifically for BIPOC and LGBTQ folks.

theshirarose

Shira Rose (she/her) is an eating disorder therapist, LCSW who operates from a fat positive + Health At Every Size framework

thefriendIneverwanted

Nia Patterson (they/them) is a queer, fat body Liberation Coach, consultant, writer, speaker, activist, and author

newmoonrd

Meghan McGann, RD (she/her) is an anti-diet dietitian who advocates for inclusive care.

nic.mcdermid

Nic McDermid (she/her) is a fierce activist, feminist, advocate and content creator whose work focuses on disrupting the dominant discourse around weight and bodies, and challenging the ways in which certain types of bodies are both idolised and idealised.

pinkmantaray

Schuyler Bailar (he/him) is the first trans D1 NCAA men’s athlete. He is also in recovery from an eating disorder and self-harm.

queer.art_therapist

Wednesdae Reim Ifrach (They/Them) REAT, ATR-BC, ATCS, LPC, NCC, CLAT, LCMHC, LPCC is Fat, Trans/Non-Binary, Queer, Disabled. They hold a master’s degree in art therapy and their specialities include Their current specialties include gender affirming care, fat and body activism, intersectional social justice, complex trauma and eating disorder treatment.

resilientfatgoddex

SJ (they/them) is a Coach, Consultant, And Soon To Be Social Worker Focused On Fat Liberation Based In Anti-Racism And Anti-Colonialism.

the_bodylib_advocate

Patrilie Hernandez is a self-described culture examiner, knowledge sharer, weaver of relationships and ideas. higher-weight, multiracial, neuroatypical, bisexual, genderfluid femme of the Puerto Rican diaspora. They have worked in the health and nutrition sector as an educator, advocate, and policy analyst for over 15 years, which has shaped their understanding of how the pursuit of “health” seamlessly intersects with the built environment, equity, and social justice. It wasn’t until they were diagnosed with an eating disorder in December 2017 that they realized how much of their own disordered behaviors and thoughts around food, health, and bodies infiltrated all aspects of their personal life and career.

thefatdoctor

Dr. Asher Larmie is a fat doctor campaigning for an end to medical weight stigma so that everyone can access fair and equal healthcare irrespective of the number on the scales.

decolonizingfitness

Ilya Parker founded Decolonizing Fitness in an effort to help dismantle toxic fitness culture. It is an online resource hub for coaches, gym owners, personal trainers and anyone who is invested in cultivating movement spaces that are more affirming and supportive to diverse bodies.

heydrsand

Dr. Sand Chang (they/them) is a Nonbinary Somatic Therapist & DEI Consultant. Their work focuses on body liberation, trans health, and eating disorders

fedupcollective

FEDUP is a collective of trans+, intersex, and gender diverse people who believe eating disorders in marginalized communities are social justice issues. Their mission is to make visible, interrupt, and undermine the disproportionately high incidence of eating disorders in trans and gender diverse individuals through radical community healing, recovery institution reform, research, empowerment, and education.

FEDUP Collective

FEDUP is a collective of trans+, intersex, and gender diverse people who believe eating disorders in marginalized communities are social justice issues. Their mission is to make visible, interrupt, and undermine the disproportionately high incidence of eating disorders in trans and gender diverse individuals through radical community healing, recovery institution reform, research, empowerment, and education.

Eating Disorders & LGBTQ Community: Treatment Best Practices

Eating Disorders & LGBTQ Community: Treatment Best Practices 

From Walden Behavioral Care 

What research tells us

The COVID-19 pandemic has increased the diagnoses of eating disorders in people under 30 by 15 percent in 2020 compared with previous years according to a recent study. While eating disorders affect people of all genders, ages and ethnicities, some groups are particularly susceptible.  According to the Trevor Project National Survey, LGBTQIA2s+ folxs are 50 percent more likely to develop an eating disorder or die by suicide.

A 2015 study published in the Journal of Adolescent Health revealed that an eating disorder diagnosis is highest among individuals who identify as transgender, and higher still among people who identify as a sexual minority (i.e. lesbian, gay, bisexual) when compared with heterosexual women who identify as women (i.e. cisgender females).

These heartbreaking statistics speak to the magnitude of treatment for mental health needs in the queer community. And sadly, when it comes to mental health, there continues to be an inaccurate dominant narrative that only certain bodies get eating disorders, when in fact LGBTQIA2s+, BIPOC and AAPI people are more likely to develop an eating disorder than this narrative would suggest.

 Where we fall short 

Despite this, there’s little evidence-based research on effective treatment practices for this population, sometimes making it difficult for healthcare providers to meet the distinct needs of the LGBTQ+ community.

Additionally, many providers lack adequate knowledge of the unique issues faced by LGBTQ+ people, such as life stressors due to marginalization, the ways in which bodies and identities intersect, and the importance of establishing outpatient providers that are welcoming and educated about their specific needs.

How to build inclusive treatment environments

Inclusive treatment environments – built on knowledge, respect, empathy and understanding for everyone – are imperative. Based on my work as an eating disorder specialist, and my own experience as a member of the LGBTQ+ community, I’d like to share a few tips:

1) Develop cultural humility. Cultural humility is an “ability to maintain an interpersonal stance that is other-oriented (or open to the other)” and should be viewed as an evolving concept. Seek to increase your personal understanding through self-education so as not to tokenize a person or group of people. We can act equitably by reading books, blogs and pausing in conversation to make room for other, perhaps-less often-heard, voices.

2) Include names and pronouns during introductions. This not only applies to clients, but to ourselves and our colleagues. By introducing ourselves using names and pronouns and asking the name and preferred pronouns of those we meet, regardless of whether they choose to answer, we sidestep treating people differently based on our own assumptions and biases.

3) Properly identify gender neutral spaces. Although gender-neutral bathrooms are becoming more common in workplaces, college campuses and other public areas across the U.S., more can be done. Explicit signage such as gender-neutral bathroom markers, rainbow decals, or transgender flags is highly encouraged. They communicate a welcoming and safe space for all types of individuals.

4) Host regular trainings. Knowledge is powerful in creating inclusive settings. There are many great organizations offering workplace trainings, some free of charge. This includes a local chapter of Gay, Lesbian, and Straight Education Network (GLSEN) of PFLAG, or a local college or university’s LGBTQ+ center.

Change is a process. Signage, training and self-education are all great places to start though not an ending point. A more complete list of best practices on working with LGBTQ+ populations as recommended by the APA (American Psychological Association) is another resource for continued improvement and inclusivity.
Walden’s Rainbow Road 

To help our industry begin to address the disparities for the LGBTQIA2s+ community, Walden Behavioral Care recently launched Rainbow Road, an IOP that addresses the specific needs and challenges of this population in terms of body image, relationships, and the social cultural trauma experienced being queer in an often-hateful world.

Rainbow Road is the first of its kind in the country in terms of eating disorder treatment for queer clients, by queer and allied providers who have a deep understanding of intersectional therapy and the nuances needed to work with this population in a way that is affirming and creates sustainable recovery.

We are proud to be modeling what the new societal expectation should be for mental health and eating disorder treatment providers and programs, and how to compassionately care for people of all genders and sexualities.

If you’re interested in learning more about our Rainbow Road IOP, Walden is here to help you. Contact us today and tell your evaluator that you are interested in Rainbow Road.

Author M Reim Ifrach  (They/Them) is the Director of Rainbow Road IOP for Walden Behavioral Care. Their credentials include: REAT, ATR-BC, LPC. M is on the Board of Directors for Project HEAL and a contributor to the Museum of Modern Art’s “Artful Practices” Program. When M is not seeing clients, they teach Masters Level students on Diversity Practice in Art Therapy, Eating Disorders and Gender Affirming Care. M’s passion lies deeply with the LGBTQIA2S+, BIPOC+ and AAPI communities and seeks to expand mental health care to be more inclusive of all those with marginalized identities and barriers to treatment.

How to be an LGBTQ+ Ally

How to be an LGBTQ+ Ally

written by undergradaute intern Emily deBettencourt

You may have noticed the word “ally” is being used more and more these days, but you might not know exactly what being an ally means. Webster’s dictionary defines ally as a verb: “to unite or form a connection or relation between: to associate.” The Human Rights Campaign defines an ally as “a person who is a member of the dominant or majority group who works to end oppression in their personal and professional life through support of, and as an advocate for, the oppressed population.” In GLSEN’s safe space kit they describe an ally as “an individual who speaks out and stands up for a person or group that is targeted and discriminated against.”

Being an ally doesn’t necessarily have to follow any one definition, it’s all about being accepting, supportive, and understanding to those in the LGBTQ+ community. Here’s a few simple reminders of how you can do that:

1. Don’t assume everyone is straight

I get it, it’s just habit to ask if a girl has a boyfriend but it’s always such an awkward situation for me when I have to correct that person and say “well, no… but I have a girlfriend.” One way to easily avoid this is to take gender out of the equation when you ask these questions: “do you have a partner?” Or, just don’t ask at all.

2. Respect people’s pronouns

This can be hard when we are so used to male or female pronouns but if someone doesn’t fall within that binary it’s important to validate their existence by using their preferred pronouns. If you’re not sure what someone’s pronouns are, find a polite and respectful way to ask. Ex: “What pronouns do you use?” Or you can introduce yourself and give your own pronouns to make things a little less awkward.

3. Avoid homophobic slurs at all costs

This is pretty straight forward, but you’d be surprised by the amount of people that still use these hateful words. There are countless other ways to say something is annoying, weird, bad, etc. besides saying it is “so gay.” Even if you don’t “mean it like that” it still perpetuates the rhetoric of homophobia and can be very hurtful.

4. Let your pride flag fly

I’ll never forget the relief I felt going to a new doctor and seeing that they were wearing a rainbow lanyard in support of LGBTQ+ patients. It’s not exactly easy going to any sort of appointment as a teen knowing you might have to come out to that person. Having pride flags or other welcoming LGBTQ+ posters, pins, signs etc. is one of the easiest ways to tell someone in the community that you accept them for who they are. (As a student or someone who doesn’t have a work place to display their pride, this can take shape as a sticker on your water bottle or computer, a pin on your backpack, a mini pride flag in your pencil mug or anywhere else.)

5. Speak up

One of the most important parts about being an ally is speaking up if you hear other people say negative things about the LGBTQ+ community. It is crucial to let people know that their language is not okay. There are so many LGBTQ+ people who don’t feel comfortable or confident enough to stand up for themselves, but if straight allies can stand beside them in advocacy, we will continue to move closer to a world of acceptance. It’s also important to help others learn about what it means to be an ally and help them find ways to support the community.

Why this is important at MEDA:

As MEDA works to promote eating disorder recovery and body positivity, it is imperative that we acknowledge how eating disorders affect the LGBTQ+ community at alarmingly disproportionate rates. For example, the National Eating Disorders Association reports that research shows gay, lesbian, and bisexual teens, beginning as early age twelve “may be at higher risk of binge-eating and purging than heterosexual peers.” Additionally, a 2015 study found that “transgender youth are four times more likely to suffer from an eating disorder and twice as likely to engage in purging” (Diemer et al.)

These statistics reiterate the importance of LGBTQ+ people having allies to turn to when they need help. As an undergraduate intern at MEDA, I’ve seen firsthand the compassion and dedication that MEDA has towards minimizing these disparities. Additionally, over the last few months here I have been on the receiving end of MEDA’s active ally-ship which has made me feel not only welcome, but important and heard as a member of the LGBTQ+ community.

References:

Diemer, E. W., Grant, J. D., Munn-Chernoff, M. A., Patterson, D. A., & Duncan, A. E. (2015). Gender Identity, Sexual Orientation, and Eating-Related Pathology in a National Sample of College Students. Journal of Adolescent Health, (2), 144.

7 Things Providers Need to Know about Gender Identity and its Effect on Body Image

Written by Christine Lang, MSW, M.Div. from Walden Behavioral Care 

Christine Lang is an adolescent clinician in the partial hospitalization and intensive outpatient programs for Walden Behavioral Care, providing individual, family and group counseling for adolescents and families with eating disorders. This includes a specialized treatment track for LGBTQ individuals

Did you know that transgender youth are four times more likely than their female, cisgender, heterosexual counterparts to have eating disorders? There are many factors that contribute to this population’s higher incidence of increased rates of body dissatisfaction, elevated rates of co-occurring mental health conditions such as depression and anxiety and increased risk for bullying, psycho-social stressors and emotional distress.

Even if you don’t consider yourself a specialist in working with these populations, it is important to have a general understanding of why they might co-exist and how you can best support individuals who present with either or both of these conditions.

1. Both transgender people and people with eating disorders may experience body dissatisfaction – the source of it may be both different and similar. In our culture, we seem obsessed with a particular ideal of “beauty” — one that has prompted an unhealthy diet culture, as well as general body unhappiness. Similarly, a trans person’s body may not match up to our society’s binary gender ideals of either “masculine” or “feminine” bodies, which may cause trans people to embody another layer of body dissatisfaction; neither are their bodies the right gender nor do they fit society’s ideal body type of that gender.

2. According to the current research, it seems that the idea of “an ideal thinness” and the idea of “an ideal femininity/masculinity” are risk factors for developing eating disorders.

3. Not everyone whose gender identities differ from their sex assigned at birth has a negative body image.

4. As clinicians, it’s important to help individuals to understand the function of their eating disorder. Many transgender people report using food and behaviors as a way to manipulate their bodies in an attempt to “better” align with mainstream culture’s idea of beauty and femininity / masculinity. I’ve also seen cases where a client’s eating disorder has nothing to do with either of those things—rather eating disorder behaviors are utilized as a way to cope with difficult situations / emotions. Having this information will help to guide treatment and determine the most appropriate interventions.

5. Our job is also to create a safe space where clients can notice and process their negative thoughts. This means, doing your best to ask for and use preferred pronouns and being aware of the unique stressors that can often be experienced by this population. Eating disorder treatment is hard—we want to make sure we are fostering an environment where individuals can feel comfortable making their recovery their number one priority.

6. Just as we don’t blame parents for the development of their child’s eating disorder, it is important that we help individuals understand that they are not to blame for being gender dysphoric. Those who have gender dysphoria experience a fair amount of body dissatisfaction because of external pressures created by society, which often become internalized forms of oppression. As such, it is important to work with individuals on identifying the difference between external oppression that has been internalized vs their own values and beliefs. Similarly, we work with individuals with eating disorders to be better able to distinguish between the voice of the ED and their own unique thoughts and feelings.

7. In providing an ongoing clinical space for individuals to explore the intersection of their gender identity and eating disorder behaviors, as well as the appropriateness of hormone therapy for themselves, we as clinicians will be better able to help provide long term eating disorder recovery.

If you or someone you work with is transgender and living with an eating disorder, there is hope for recovery.

Resources:

a) Author: Monica Algars, Katarina Alanko, Pekka Santtilla, N. Kenneth Sandnabba
Title: Disordered Eating and Gender Identity Disorder: A Qualitative Study
b) Jennifer Couturier; Bharadwaj Pindiprolu, Sheri Findlay, Natasha Johnson
Title: Anorexia Nervosa and Gender Dysphoria in Two Adolescents.
c) Stuart B. Murray, Evelyn Boon, Stephen W. Touyz
Title: Diverging Eating Psychopathology in Transgendered Eating Disorder Patients: A report of two cases.
d) Monica Algars, Pekka Santtila, N. Kenneth Sandnabba
Title: Conflicted Gender Identity, Body Dissatisfaction and Disordered Eating in Adult Men and Women
e) Lindsay A. Ewan, Amy B. Middleman, Jennifer Feldmann
Title: Treatment of Anorexia in the Context of Transsexuality: A Case Report
f) Sarah E. Strandjord, Henry Ng, Ellen S. Rome
Title: Effects of Treating Gender Dysphoria and Anorexia Nervosa in a Transgender Adolescent: Lessons Learned
g) Bethany Alice Jones, Emma Haycraft, Sarah Murjan, Jon Arcelus
Title: Body Dissatisfaction and Disordered Eating in Trans People: A Systematic review of the Literature

 

This blog was originally published on https://www.waldeneatingdisorders.com/7-things-providers-need-to-know-about-gender-identify-and-its-effect-on-body-image/ and is republished here with permission.