People with eating disorders can sometimes feel as though they’re floating, uncomfortably trapped inside a form that’s incoherent. One of my patients describes navigating her eating disorder as almost like “sleepwalking through life.” When a person begins waking up, that’s where I step in, helping patients figure out how their lives became so overwhelming, out of control and disconnected. I am a queer psychotherapist who has been treating eating disorders in trans, nonbinary and gender nonconforming communities for a decade. In April, I began hosting Living in this Queer Body, a podcast that addresses myriad challenges to embodiment, an elusive state for many queer people.
Eating disordered (ED) behaviors are often an effective way to make sense of the lingering impact of trauma on one’s body and psyche. We know that trans, gender-nonconforming, and nonbinary people are disproportionately impacted by violence, social objectification, and dysphoria and experience all-consuming anxiety about shaping their experience with their bodies. Colonialism, racism, and heteropatriarchy also have a significant bearing on what is defined as “healthy” or “body-positive:” Navigating mainstream body and health expectations—for instance, the trend of “clean” eating that often leads to extreme restriction and orthorexia—is rigorous enough. Achieving a state of “body positivity” in a body that experiences dysphoria is not the most helpful goal to aim for.
Each interview begins with the same question: “How did you come to know, at an early age, about what it meant to be in a body?” Tea Leigh, a nonbinary tattoo artist who appeared on the podcast, describes their long-term challenge with queer embodiment as “living in a body I didn’t want to be in and caring for other people was a way of avoiding that.” Leigh went on to explain: “After many years of addressing [in therapy, with medication] my crippling anxiety and fear of chronic pain, and finally slowing down [with work], for the first time since coming out as nonbinary, I wasn’t scared of myself, of my body, the scary things going on with it.”
When I attempt to answer my own question, I recall the pain and discomfort that were my greatest teachers. Born into a Catholic community in Missouri, my body felt like a burden—misshapen and wrongly gendered, excessive and disruptive, filled with shame. Complex memories puncture this childhood fog: the shame of being sick, the love of being in the sun, the feeling of chasing fireflies in the summer. As a young queer person, I needed someone to notice the visible discomfort I felt in my gendered Catholic-school uniforms, and to recognize that I related to my body as a vehicle for the aspirations of people around me. I needed someone to be curious about what made me feel good and what I considered to be a boundary violation.
My work now—as a parent, a psychotherapist, a podcaster, and a group facilitator—is informed by these unmet needs. Speaking to other queer people about conflictual body experiences has long reassured and empowered me, so after a particularly difficult bout with a chronic health condition in 2018, I decided to have more of these conversations in a podcast format. My psychotherapy work and podcast aim to support the multifaceted aspects of the queerly bodied experience, providing a forum to understand the underlying connectivity or feelings that are often perceived as disconnected. I didn’t initially set out to chart the prevalence of disordered eating in the queer community, but, as a clinician, I knew how commonplace the issue is.
Still, it has been surprising to listen to guests speak openly about their struggles, both past and current, with disordered eating, including orthorexia (described by podcast guest Meg Bradbury as an “unnatural obsession with computing and health”), anorexia, bulimia, and binge eating. Living in this Queer Body explores common themes, such as disidentifying with the cis (often white) eating disorder rhetoric, minimizing “struggles with food,” and needing support to be able to connect their disordered eating to dysphoria. Interviewees frequently say they don’t know how to gauge what’s “healthy” for them in terms of food intake and exercise, thanks to social pressures. I find that it is common for patients, podcast guests, and listeners to feel unsure about how to connect their deeply painful experiences of dysphoria and body dissatisfaction with their disordered eating behaviors.
Podcast guest Lindsay Mack voiced this when she spoke of trying to resolve her relationship to food and nourishment, calling it “the final frontier of my life.” She elaborated: “[Growing up], I often was hungry. I grew up very poor and when I got [food], I had to kind of hoard it and have a lot of it. Food was often the only comfort, a source of love. Most of my life I spent my time really using food or alcohol or sugar as an abusive tool essentially to keep me at a level of joy and nourishment that felt comfortable. It kept me moving a little slower so that I didn’t feel the full intensity of myself.” Controlling nourishment via excessive or under-consumption of food or other substances often requires a lot of emotional processing, particularly in a queerly identified body that has experienced cumulative childhood trauma.
Other factors that can lead to disordered eating in the queer community include social pressure to conform to binaristic norms; overexposure to trauma and social stressors that sometimes lead to chronic pain; inadequate healthcare; and self-harming impulses connected to what Avgi Saketopoulou, a psychoanalyst whose work addresses issues around trauma, gender, and sexuality, calls “massive gender trauma.” When she was building her career and taking care of a sick parent, Jenna Wortham, a journalist at the New York Times, was also restricting her food intake and overexercising as a way to mediate anxiety. “I was constantly using my body in really physical ways without thinking about the wear and tear, and I went through this period where I was battling a lot of body dysmorphia and disordered eating and working out a lot and punishing myself with extreme workouts, which was about trying to contain my body,” she said.
Controlling nourishment via excessive or under-consumption of food or other substances often requires a lot of emotional processing, particularly in a queerly identified body that has experienced cumulative childhood trauma.
Jack Ferver, a podcast guest and choreographer, notes remembering the physical sensations that accompany traumatic body memories can be overwhelming. “The body can be so terrifying when it’s in pain. Maybe it sounds really ridiculous to some people but if you’ve been in a lot of physical pain and frightened of inflammation, then you know, food becomes terrifying and then ‘what a great way to trigger my anorexia!’” Ferver’s perspective reflects a familiar refrain from many of my interviewees: There are emotional landmines that are more easily traversed by those who have more control over what happens to their bodies. Perhaps one way to address commonality of disordered eating in the trans, gender nonconforming, and nonbinary community is to find ways to sift through our dissociative fogs about bodily sensations.
I have found that queer people are really desperate to talk about the experiences their bodies hold. “I remember the first time I ever wrote ‘Navigating food is difficult for me,’” adrienne maree brown, author of Pleasure Activism: The Politics of Feeling Good, said in our podcast conversation. “Just saying out loud, ‘This happens to me.’ So many people in my queer community were like, ‘Oh my God! Thank you for talking about this.’ This conversation impacts the quality of our lives, what happens when we come together in space.” As Wortham, Mack, and Ferver point out in their stories, restrictive mindsets often reflect dangerous and painful restriction in their everyday lives.
When we hear someone talk about wanting to “get rid” of or change a part of their body by either exercising or overmanaging food intake, we should pay more attention to the distress in their language. “A lot of people who come to me who have disordered eating or orthorexia are really just trying, in their own way, to modify their bodies so that they can feel good and better and feel more in alignment [in their gendered bodies],” says Decolonizing Fitness founder and podcast guest Ilya Parker. “[B]eing sensitive to the nuance of that and working through that with people seems really important.”
By addressing with curiosity, as Parker does in their work, the queer body’s multiplicity of experiences, we can hopefully access a pathway to the depth of dysphoric distress and support the people we love as they work to heal. It is my hope that, in promoting conversations about both the importance and the challenges of nourishing queer bodies, we can begin to feel affirmed, access attuned support, have relationships, make career decisions, fuck, create, and begin to live a more embodied existence.