Eating disorders disproportionately affect certain communities—including the lesbian, gay, bisexual, transgender, questioning or queer, intersex, and asexual and/or ally (LGBTQIA) community. Research indicates that individuals identifying in this population may be at high risk for the development of an eating disorder. The factors contributing to the heightened rate of eating disorders in the LGBTQIA+ community are numerous and varied, and include:
- Bullying (including homophobia and transphobia)
- Societal gender norms
- Disconnect from body due to gender dysphoria and/or discomfort with sexual orientation
- Loneliness (isolation, lack of acceptance in family, fear of rejection following coming out)
Healthcare disparities and barriers (ie. discrimination, lack of culturally competent and responsive care) ACUTE’s providers are committed to delivering empathic, evidence-based care to all patients experiencing a life-threatening medical crisis related to a severe eating disorder or advanced malnutrition caused by another diagnosis. Our experts understand and have vast experience treating the medical issues relevant to LGBTQIA patients. Alongside world-class medical treatment, ACUTE’s patients benefit from comprehensive psychiatric and behavioral support, including substance abuse detox when necessary. Via consultation with Denver Health’s renowned LGBTQ+ Primary Care & Health Services, ACUTE has unmatched capabilities to effectively treat LGBTQIA patients touched by extreme eating disorders or severe malnutrition from another diagnosis.
ACUTE’s Commitment to Patients
Every person is powerful, beautiful and important. Every patient is seen, heard and validated.
We will not make assumptions about your gender based on your appearance. We will ask you about your gender and preferred pronouns during initial assessment and upon admission to observe and respect your unique personhood. We will engage your support system, whether partners and family members identified as supportive by you; they will be informed and honored, regardless of their gender or legal status.
Our providers have a profound capacity to understand what another person is experiencing from within their frame of reference. Throughout your time at ACUTE, you will benefit from support and perspective from teammates who identify as LGBTQIA, as well as those who are thoughtfully trained in culturally responsive care. This means that our experts understand, relate to, and respectfully respond to the different backgrounds and identities of the patients they serve, with the goal of helping you a live healthy and affirmed life.
ACUTE’s providers deliver clinically competent care. They are knowledgeable about LGBTQIA issues, and the specific health needs of this patient population—particularly those issues related to complications of malnutrition and purging—and are respectful and affirming throughout the treatment process.
ACUTE’s expertise in treating the medical complications of severe eating disorders and malnutrition is an “inch wide and a mile deep.” ACUTE teammates have published specific research related to treatment best practices in LGBTQIA patients touched by extreme eating disorders, including this article detailing a heightened risk for recurrent refeeding hypophosphatemia in male-to-female transgender patient with anorexia nervosa. Our providers leverage the latest in research to deliver evidence-based, culturally responsive care linked to positive treatment outcomes.
“ACUTE takes a comprehensive approach to openness, understanding that it impacts an LGBTQ individual’s ability to receive appropriate medical and psychiatric care and also live a supported and authentic life in recovery. Openness helps providers better understand patient’s specific health needs and prevent, screen for, and detect conditions that disproportionately affect LGBTQ people.”
“ACUTE is LGBTQ competent, not just LGBTQ friendly. Our providers have specific and extensive training in LGBTQ-specific medical and behavioral health issues, and we collaborate closely with specialty departments at Denver Health, including their renowned LGBTQ+ Health Services and experts from Endocrinology and Infectious Disease. Additionally, ACUTE conducts research into the unique challenges facing LGBTQIA patients with extreme forms of eating disorders and severe malnutrition to further refine treatment best practices and improve patient outcomes.”
“In my role as a psychologist on ACUTE’s unit, I see our patients 3-5 days per week for about 30 minutes. All care is delivered at their bedside in a model we call “room-based treatment,” which tends to afford our patients the privacy and peace needed to foster the important work of healing. I deliver supportive psychotherapy, which means we’re not getting into “nitty gritty” of the eating disorder now, but rather we’re laying the groundwork for future successful behavioral care following discharge from ACUTE. I meet patients where they are as a supportive advocate, utilizing various interventions as appropriate including Acceptance and Commitment Therapy (ACT), Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT) and Cognitive Remediation Therapy (CRT). Every patient is different and our approach is individualized when it comes to identifying issues and help them to move forward and accept care and help. I know many LGBTQIA patients I’ve worked with have appreciated my transparency with respect to my personal experiences and understanding as a member of the LGBTQIA community. I’m so proud to work in such an inclusive treatment environment.”
Frequently Asked Questions
Q: Does ACUTE have experience treating LGBTQIA patients with severe eating disorders?
A: Yes. For more than 17 years, ACUTE has been delivering compassionate, informed and culturally responsive care to all patients experiencing life-threatening medical complications related to extreme anorexia nervosa, bulimia nervosa, ARFID or severe malnutrition. In addition to experience with patient care, our experts have published several research articles related to LGBTQIA patients, including this article about the elevated risk for recurrent refeeding hypophosphatemia in some transgender patients, and this article examining eating disorder pathology both across binary and minority-gender groups, and relative to racial/ethnic identification, which is necessary to inform screening and culturally-sensitive intervention efforts.
Q: Will I be called by my legal name or my preferred name at ACUTE?
A: Preferred name. At the time of assessment (and upon admission), ACUTE’s teams will inquire about your preferred name and pronouns to call you by the name/pronouns you prefer.
Q: What does culturally responsive care for LGBTQIA patients at ACUTE actually look like?
- Is comfortable with my sexual orientation or gender identity
- Asks me about my sexual orientation, gender identity and/or relationship status
- Has LGBTQIA-inclusive forms that list sexual orientation, gender identity and/or relationship status
- Uses gender-neutral language when talking about reproductive health, sexual health or relationship status
- Has signs, posters and other visible signals that the unit is LGBTQIA-inclusive
- Includes sexual orientation and gender identity in its posted non-discrimination statement
- Has gender-neutral restrooms on the unit
- Has LGBTQIA individuals on staff
- Asks me about and addresses me by my correct pronouns
- Asks me about and addresses me by my chosen name (rather than my legal name)
- Has trained frontline and medical support staff on LGBTQIA competency
- Has specific knowledge or training to deliver health care services to LGBTQIA people
- Has knowledge on transgender-specific and related health care needs
- Is comfortable with patients who identify as transgender
- Addresses my transgender-specific health care needs, not only other medical needs
- Has policies and forms that are transgender-inclusive
LGBTQIA Eating Disorder Facts
Q: Are eating disorders more common in gay men?
A. Yes. While gay males are believed to account for just 5% of the total male population, they make up 42% of men who have eating disorders; and compared to heterosexual men, gay men were seven times more likely to report binging and 12 times more likely to report purging. Among women, females who identified lesbian, bisexual, or "mostly heterosexual" were twice as likely to report binge-eating at least once per month in the last year, compared to heterosexual women.
Q: Does bullying cause eating disorders in LGBTQIA individuals?
Likely. While there is no single “cause” for an eating disorder, bullying can contribute to the development of the illness. The majority of eating disorders develop between the ages of 12 and 24; this is also the prime age when LGBTQIA youth are likely to begin experiencing bullying, harassment and violence. A 2018 CDC report found that high school students who identified as lesbian, gay, or bisexual (LGB), experienced both cyberbullying (27.1%) and bullying on school property (33%) far more often than their heterosexual peers (13.3% and 17.1%, respectively). Bullying leads to a feeling of disconnection and lower self-esteem; eating disorder behaviors may be a means to change the way they look to fit in, or eating disorder behaviors to numb the pain of the bullying.