Much of what we think we know about eating disorders and gender is wrong and harmful.

When a relative of mine developed an eating disorder, it blew past the radar of everyone who cared about him.

“He’s just a picky eater,” they explained. “It’s a diet,” they brushed off. “He has a weird relationship with food, but it’s nothing to be worried about,” they declared. The implication always hidden that if he were a girl, there’d be reason for concern.

But why stress over him? Boys don’t get eating disorders, the thinking went. He’ll eventually grow out of this phase.

But when I came home from college one summer to see how he’d withered away, skeletal beyond recognition, I told his mother that this was unacceptable: “Aunty, he’s sick. You need to do something.”

When he finally saw a doctor, he was given an eating disorder diagnosis almost immediately. He had all of the obvious signs of anorexia nervosa: extreme caloric restriction, body image disturbance, fear of weight gain. But because he came in male packaging, they were missed by his family and friends.

The assumption that eating disorders are predicated on womanhood — and a very particular cisheteronormative standard of womanhood at that — is harmful to people who are suffering and fall outside of that stereotype.

And it means that men aren’t the only gender category where eating disorders are missed. Trans people, queer women, and masculine people, to name a few, are groups in which eating disorders consistently go unnoticed.

Breaking down the stereotype that eating disorders only affect certain kinds of women means allowing more room for people of various genders and sexual identities to be acknowledged in their struggles and survivorship.

So, here are four myths about gender and eating disorders that we need to smash right now.

The idea goes like this: The more feminine you are, the more at risk you are for developing an eating disorder, regardless of gender.

If you’re feminine, people assume you overemphasize the importance of beauty. This may, in turn, make you more susceptible to engaging in extreme behaviors to fit an ideal.

And the assumed relationship between eating disorders and weight loss is often overstated. A drive for thinness alone isn’t what causes eating disorders.

But people think that feminine people develop eating disorders in their pursuit of the thin ideal.

Here’s the truth: Our assumptions about eating disorders and femininity may be the result of long-standing researcher bias regarding gender roles.

While scales created to measure gender identity seem to prove objectively that femininity is a risk factor of eating disorder development, the scales themselves are subjective: The gender roles in the scales are rigid, associating femininity with women and masculinity with men.

Yes, eating disorders are more common in women. No, that doesn’t inherently make femininity a predictive factor.

Instead, it’s been found that when these scales allow for more fluidity in gender roles, nuances around femininity and masculinity in eating disorder development are no longer evident.

Eating disorders affect people regardless of the gender roles they subscribe to.

As mentioned earlier, we tend to make the association between femininity and eating disorders. A consequence of this is that folks tend to assume the only men who struggle with their body image and develop eating disorders must be gay, bisexual, or queer.

It is true that queer men are more likely than their straight counterparts to experience negative body image and develop eating disorders. But that doesn’t mean that straight men don’t.

In fact, according to the National Eating Disorders Association, the majority of males with eating disorders are heterosexual. And this could partly be linked to the fact that masculine beauty standards are becoming stricter and more extreme.

According to Dr. Harrison Pope, a Harvard psychiatrist who studies bodybuilding culture, “There has been a striking change in attitudes toward male body image in the last 30 years,” he told The New York Times.

Moreover, portrayal of men as lean and muscular “is dramatically more prevalent in society than it was a generation ago,” Pope said.

It’s no surprise, then, that one-quarter of men with a normal weight perceive themselves to be underweight.

As such, disordered eating behavior, especially compulsive exercise, is on the rise for straight men. Research has found 90 percent of teenage boys exercise at least occasionally with the goal of bulking up, while 6 percent of them have experimented with steroids.

Eating disorders aren’t reserved for women. Anyone of any gender can have an eating disorder. And knowing how eating disorders present differently in men can help us recognize the signs more quickly.

Point blank: Trans youth are at an increased risk for eating disorder development. In fact, they’re the group most likely to have received an eating disorder diagnosis in the past year — even when compared to straight, cis women.

And yet, when we think about eating disorders, we rarely, if ever, concentrate on the experience of trans folks. Trans experiences are often pushed to the side and overshadowed by the myth that eating disorders are most common in straight, cis women.

But according to a large-sample 2015 study, trans folks “may use disordered eating behaviors to suppress or accentuate particularly gendered features.” And the safety issues involved in not “passing,” or being read by others as their gender, might play a role here.

At least 26 trans people — most of them trans women of color — were murdered in 2018. Considering this danger, combined with the body dysphoria some trans people experience, it’s little surprise that trans folks may use weight loss or gain to “suppress features” of their gender assigned at birth or to “accentuate features” associated with their gender.

Trans folks are more likely to engage in compensatory behaviors often associated with bulimia nervosa, such as:
  • the use of diet pills
  • self-induced vomiting
  • laxative misuse

There are also several reasons why trans folks may be more likely to have an eating disorder diagnosis. For example, they’re more likely to already have contact with mental health professionals: 75 percent of transgender people receive counseling already, which could lead to an eventual diagnosis.

Regardless, the high rates of eating disorders in the trans population are alarming. It’s high time for us to recognize how seriously we need to take this community.

As a queer woman myself, this myth really bothers me.

The thinking goes that because queer women belong to a sub- or even counterculture, we’re protected from mainstream beauty standards. Because we don’t worry about preferences meant to entice men, we escape those standards entirely.

Not so fast.

It’s true that dating in lesbian culture, as compared to the dominant culture, lacks the same emphasis on physical appearance. And it’s true that queer women are, on the whole, more satisfied with their bodies and less concerned with the media’s portrayal of women’s attractiveness than straight women.

But the idea that queer women, especially those who are also attracted to men, somehow escape patriarchal oppression is absurd. Queer women are still women. And on top of that, we face extra pressures due to our sexual identity.

One study found that, similar to straight women, the following played a role in eating disorder development for queer women:

  • a search for identity
  • an exertion of self-control
  • a pursuit of feminine beauty

That said, queer women specifically pinpoint the “response to the stress and uncertainty of not fulfilling heteronormative expectations” as an explanation for the development of their eating disorders. Researchers also noted they used their eating disorder as a way of “avoiding their sexuality by focusing instead on food or by ‘looking straight.’”

In short: The overlapping of gender and orientation complicates body image. It doesn’t make it easier.

As such, there’s no significant difference in eating disorder occurrence between straight and queer women at all. Queer women may be less likely than their straight counterparts to develop anorexia, but they’ve also been shown to be more likely to develop bulimia and binge eating disorder.

Queer women aren’t immune to beauty standards or eating disorders. Believing that we are makes it much harder for us to receive help.

The truth is simple: Eating disorders know no gender or orientation. They’re mental health conditions that can affect anyone. And obliterating the myths that say otherwise is an important step in making sure all people have access to acknowledgment, diagnosis, and treatment.

Melissa A. Fabello, PhD, is a feminist educator whose work focuses on body politics, beauty culture, and eating disorders. Follow her on Twitter and Instagram.