How to Deliver Identity-Affirming Eating Disorder Care to LGBTQ+ Patients

Ensuring Your Program is Safe for LGBTQ+ Patients 

Ensuring that your practice or program is a safe, identity-affirming and LGBTQ-competent place for patients is the first step in delivering high-quality care for LGBTQ+ patients. Members of the LGBTQ community have an increased risk of developing an eating disorder compared to their heterosexual and cisgender peers. They are also more likely to experience barriers to care. Ensuring patients feel comfortable seeking out care leads to better outcomes. Without treatment, eating disorders can lead to severe medical complications like bradycardia and refeeding syndrome. Here are five ways to deliver identity-affirming care to LGBTQ+ patients. 

Leave Assumptions Behind  

The stereotypical eating disorder patient is heterosexual, cisgender and female. Providing competent care for your LGBTQ+ patients requires that you leave your assumptions about who can suffer from an eating disorder behind. Many patients will differ in terms of sexual orientation, gender identity and gender presentation. Patients may come with their own unique experiences that should be validated and respected throughout their care journey. 

Make Sure That Documents are Identity-Affirming  

Forms should be inclusive and allow patients to adequately describe their gender identity and sexual orientation. Include space for your patients to share their pronouns and make sure to reference these forms before interacting with the patient to avoid any assumptions based on appearance. 

Recognize and Validate the Impact of Stigma and Discrimination on Health  

LGBTQ+ patients experience unique barriers to care and social determinants of health that impact both their mental and physical health. Bullying, lack of community or family support, trauma, legal discrimination, increased levels of poverty and homelessness, stigma and higher risk for suicidality – they all impact LGBTQ+ patients’ health and access to care. It’s crucial to understand the entire patient and their circumstances. If possible, consult LGBTQ+ health services or connect your patients with organizations or resources that can help mitigate these factors, as they greatly impact on your patient’s outcome and long-term health.  

Minority Stress Model 

The minority stress theory (MST) is the theory that minority groups experience stress stemming from experiences of stigma and discrimination that in turn increases their risk for a number of negative physical and mental health outcomes. LGBTQ+ people experience forms of minority stress shared with other marginalized groups, such as discrimination, expectation of rejection, and prejudice-related life events, as well as unique stressors such as identity concealment and internalized homophobia. 

Be Open to Ongoing Learning  

Acknowledge that building a relationship with your patients and delivering the highest quality of care is an ongoing journey. Educating yourself on LGBTQ+ identities, LGBTQ+ culture and history, and the Minority Stress Model can give you a more well-rounded view of your patients and their barriers to care and needs. Seeking guidance, training and consultation on LGBTQ+ health allows you to keep learning and cultivating a safe space for your LGBTQ+ patients.  

Be Proud of Being an LGBTQ-Affirming Provider  

Being an open and public supporter of the LGBTQ+ community can help make patients feel safe and equal. Wear or include symbols in your practice that show it is a safe space for LGBTQ+ patients. If you have posters, brochures or other medical pamphlets, make sure these items include representation of LGBTQ+ individuals. Make your support of the LGBTQ+ community clear on your website and list your program on platforms that connect patients with affirming providers to make finding your services easier for LGBTQ+ patients. 

LGBTQ+ patients face unique challenges and barriers to care providers should be aware of. Commit yourself to closing gaps in care by ensuring your practice or program is a welcoming environment for people regardless of sexual orientation, gender identity or gender presentation.

References 

1. Frost DM, Lehavot K, Meyer IH. Minority stress and physical health among sexual minority individuals. Journal of Behavioral Medicine. 2015;38:1–8. doi: 10.1007/s10865-013-9523-8.  
2. Lewis RJ, Derlega VJ, Griffin JL, Krowinski AC. Stressors for gay men and lesbians: Life stress, gay-related stress, stigma consciousness, and depressive symptoms. Journal of Social and Clinical Psychology. 2003;22:716–729. doi: 10.1521/jscp.22.6.716.22932. 

Last Reviewed: March 2024 by Casey Shamy, LSW