Is your ED treatment LGBTQIA+ affirming? Here’s how to make it truly inclusive

When treating eating disorders, it’s important to consider the person as a whole. There are things you need to address and be aware of when creating a treatment plan, such as whether they have co-occurring mental disorders, if they have a particular life situation that has prevented them from receiving treatment previously, if they’re in the BIPOC community, and certainly if they identify as LGBTQIA+. 

There is no one-size-fits-all model when it comes to eating disorder treatment, especially when it comes to the LGBTQIA+ community. These individuals are at a significantly higher risk for eating disorders than their cisgender, heterosexual peers, and what’s even more concerning is that many traditional eating disorder treatment models fail to address LGBTQIA+-specific issues.

What is LGBTQIA+-affirming care?

Affirming care isn’t just about being inclusive in the language we use toward our patients, in our marketing materials, and in medical records. It’s about being truly nonjudgmental, nondiscriminatory, and culturally competent. 

For eating disorder clinics, this means:

• Using inclusive language in all communication
• Training all staff in gender-affirming care and a trauma-informed approach
• Tailoring body image work to align with their specific gender identity
• Involving those from the LGBTQIA+ community in program design
• Regularly updating training materials, ensuring to consult with LGBTQIA+ clinicians and clients
• Updating forms and materials to reflect gender diversity and avoid binary language
• Displaying signs of LGBTQIA+ support, such as pronoun pins, safe space signs, and inclusive brochures

Tips for clinicians

• During the intake process, use inclusive language and include your pronouns when you first meet the patient. Also, ask for their pronouns if they do not disclose them upfront. Use these pronouns in all paperwork and notes, even ones your patient will not see. 
• Practice using gender-neutral terms like “siblings” instead of “brothers and sisters” or “everyone” instead of “ladies and gentlemen.”
• Use open-ended questions when talking to patients about their gender and body experience. Don’t make any assumptions based on looks. 
• Mirror your patient’s language when discussing body image, eating experiences, and their relationship with food or their body.
• Attend LGBTQIA+ affirming care training and follow trans-affirming providers and organizations.
• Understand the real cause of the eating disorder before creating meal plans—some patients may avoid certain foods not because of restriction, but to avoid triggering body changes.
• Use gender-neutral terms for anatomy (e.g., “chest” instead of “breasts,” “genitals” instead of gendered terms).
• Don’t assume eating disorders all look a certain way—body distress in trans clients may relate more to gender dysphoria than thinness or beauty ideals.
• Recognize when your interventions may reinforce cisnormative ideals and adjust them as necessary.
• Encourage patient feedback regarding inclusivity and be open to new ideas.

What NOT to do

When meeting with patients, it’s important not to make any assumptions regarding their gender or how they identify. This doesn’t just apply to verbal communication; it also applies to intake forms, any printed or online communication, and even therapeutic approaches. 

In addition, it’s important not to treat someone’s gender identity, body, or gender expression as if it's inherently a problem, disorder, or something that needs to be "fixed" or corrected. Make it clear that you understand that their gender identity is part of them. 

Absolutely do not ignore pronouns. We all know that slip-ups may happen occasionally, but try to be extra careful about remembering your patient’s pronouns. Those in the LGBTQIA+ community already face discrimination and hardships—you don’t want to offend or deter anyone from continuing treatment when they’ve already jumped hurdles to get to where they are. 

Continue to evolve and improve

Remember, providing gender-affirming care isn’t just about ticking off a checklist—it’s an ongoing process. Remaining culturally competent and sensitive to others will evolve how you provide care and require you to be aware of current issues to stay on top of. 

Also note that mistakes may happen along the way—what’s important is how you respond and correct these mistakes. 

Be prepared to continually learn and be open to new ideas, treatment methods, and ways of thinking. As a clinician, you have the responsibility to create a safe, inclusive environment for all of your patients, regardless of race, ethnicity, gender, diagnoses, or identity.

Accessible, compassionate care is Within Reach.

Learn more about our intentionally-virtual eating disorder treatment program.