Including the excluded: Males and gender minorities in eating disorder prevention

Cohn, Leigh; Murray, Stuart B.; Walen, Andrew; Wooldridge, Tom

doi:10.1080/10640266.2015.1118958

Cited by 38 publications

(35 citation statements)

References 13 publications

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“…Further, research consistently validates that men avoid healthcare screenings (i.e., secondary prevention) due to fear, lack of awareness, or low perceived threat (i.e., "it cannot happen to me"), thus lessening the cost benefits associated with early detection. 19 Lastly, tertiary prevention often does occur for many men; however, the issue with this form of engagement is that it often is very costly, invasive, and more often than not, lacks restorative abilities. 17 Tertiary prevention (i.e., palliative care), often serves as a touchpoint where men have to engage the health care system due to declining health and ability.…”

Section: Originsmentioning

confidence: 99%

Practical Strategies for Improving Men’s Health: Maximizing the Patient-Provider Encounter

Leone

Rovito

Gray

et al. 2021

International Journal of Men's Social and Community Health

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Inconsistent access to a healthcare provider (HCP), which can lead to advanced morbidity, is an oft-cited barrier to advancing health. Extensive review of the literature consistently suggests men are far less likely to engage within the healthcare system. This is particularly problematic pertaining to preventive services. As many health conditions are preventable and/or treatable in earlier stages, delay in screening and treatment often leads to long-term negative health outcomes. Lack of early and frequent preventive healthcare (e.g. primordial, primary, and secondary prevention) may even be perceived as “normative” where poorer health outcomes in males are expected.1 In fact, some evidence demonstrates a clear connection that seeking help via healthcare runs contrary to masculinity and dominant masculine principles, such as being strong/sturdy, working through pain, avoiding weakness or anything perceived as feminine, among other psychosocial phenomena.2,3 Changing healthcare “culture” concerning the care of men (i.e. gender-sensitive care) may provide a salient avenue to encourage more consistent and preventive contact or “touch points” in the patient-provider dynamic. There is a need to understand how social norms and practices in healthcare and medical settings can be effectively leveraged to address life-long male health outcomes versus focusing on late(r)-stage palliative care. The purpose of this article is to advance dialogue concerning practical considerations, such as resources (e.g. time, money) and methods (e.g. practitioners considering whether men respond best to immediate efforts to establish rapport versus a traditional power-based dynamic during the medical interaction) so as to inform gender-sensitive touchpoints in the healthcare of men. Location and types of facilities where men are willing to seek care (preventative or palliative) also need to be considered in a holistic, gender-sensitive patient-provider model of healthcare. Implications, policies, and evidence-based practical strategies for leveraging medical education, prevention programming, proper and improper recognition and management, and long-term treatment are presented and discussed with the practitioner in mind.

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Section: Originsmentioning

confidence: 99%

Practical Strategies for Improving Men’s Health: Maximizing the Patient-Provider Encounter

Leone

Rovito

Gray

et al. 2021

International Journal of Men's Social and Community Health

View full text Add to dashboard Cite

show abstract

“…However, eating disorders are also thought to be stereotypically a "female" problem, and many men receive late diagnosis or do not receive a diagnosis at all. Although this in itself is problematic, for Frank, it is even more so because members of the LGBTQ community are at high risk of developing eating disorders (Cohn et al 2016). Thus, although Frank's identification as male may be seen as advantageous in the traditional intersectional context, in this case, it may disadvantage him unless his physician recognizes (1) the potential biases in how she considers Frank's diagnosis and (2) Frank's intersectional identity.…”

Section: Case Threementioning

confidence: 99%

Can Intersectionality Help Lead to More Accurate Diagnosis?

Cho

2019

The American Journal of Bioethics

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With their intersectional conceptual framework, Wilson and colleagues create a constructive platform through which physicians and other healthcare providers can discuss the multidisciplinary nature of patient care (Wilson et al. 2018). Their framework emphasizes how physicians should recognize the ways in which their patients' identities may impact their medical care, focusing on the patients' attitudes towards their providers and the efficacy of their treatment plans. Although this is an important aspect of using an intersectional framework in clinical medicine, I believe intersectionality also calls for physicians to recognize the ways in which they themselves are affected by their patients' identities. More specifically, I argue that physicians must pay special attention to the ways in which they or their field may be unconsciously biased towards or lack information about certain identity groups. This slight shift in directionality is especially important in tackling systematic errors and delays in diagnosis. Wilson and colleagues do briefly mention that intersectionality may aid diagnosis during their case presentation of Mr. Fuentes, but they do not provide concrete details on how this may be done (Wilson et al. 2018, 20). I propose that an intersectional framework that considers how patients' multiple identities affect both their own attitudes towards their physicians and their physicians' attitudes towards them may help improve diagnostic accuracy Missed diagnoses and misdiagnoses Despite improvements in diagnostic technologies, errors and delays in diagnosis continue to pose serious physical and psychological harm to patients, as well as financial harm to the healthcare system (Khullar et al. 2015). Systematic biases that disproportionately affect historically marginalized groups underlie some of these misdiagnoses (

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“…If asked, researchers have excluded transgender individuals from substantive data analyses due to statistical considerations stemming from the (typically) very small number of said individuals recruited into research samples. To some extent, this progression parallels the historical neglect of cisgender males in the eating disorders field, who were also regularly excluded from eating disorders research [12,13]. Beyond inclusion, the issue of gender extends to the development of eating disorder measurement instruments and diagnostic criteria, which were largely developed and evaluated with samples of (cisgender) females.…”

mentioning

confidence: 99%

Gender, Embodiment, and Eating Disorders

Griffiths

Yager

2019

Journal of Adolescent Health

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Duffy et al. [1] have published an important study in the Journal of Adolescent Health about the health of transgender individuals. In a survey of 365,749 college students living in the United States, 678 (.2%) self-identified as transgender. Among those identifying as transgender, Duffy et al. observed a past-year eating disorders prevalence rate of 18% (nearly one in five) compared with rates of 1.8% and .2% for cisgender women and men, respectively. Of those transgender individuals with eating disorders, the authors observed a past-year suicide attempt prevalence rate of 75%da figure both shocking and compelling. The authors accurately state that the high rate of suicidality among transgender individuals with eating disorders is likely the result of multiple compounding issues, including the widespread discrimination and violence perpetrated toward transgender individuals [2] and the intrinsic pathos of eating disorders, which are known to potentiate suicidality [3]. But why are eating disorders so common among transgender individuals in the first place? In this editorial, we articulate one potential answer by drawing on two interrelated psychological concepts: gender and embodiment. In the eyes of many, eating disorders are synonymous with females, anorexia, and an intense desire to be thin [4]. Meanwhile, the field of eating disorders is contending with new manifestations of eating disorders that arise from different yet equally intense desires. Muscle dysmorphia, a psychological disorder nicknamed "reverse anorexia," is the manifestation of an intense, psychopathological desire to be muscular [5]. Gender differences in the prevalence of anorexia nervosa and muscle dysmorphia accord with gender differences in the types of bodies that women and men covet [6]. Generally speaking, women desire to be thin, whereas men desire to be muscular. By extension, women are overrepresented in anorexia, and men are overrepresented in muscle dysmorphia [6]. Eating disorders can be understood as moving targets [7]. Different desires for different bodies motivate different attitudes and behaviors. If we are willing to accept that different people desire different bodies, then we must also accept different manifestations of the psychopathology that arises 1054-139X/

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Including the excluded: Males and gender minorities in eating disorder prevention

Cited by 38 publications

References 13 publications

Practical Strategies for Improving Men’s Health: Maximizing the Patient-Provider Encounter

Practical Strategies for Improving Men’s Health: Maximizing the Patient-Provider Encounter

Can Intersectionality Help Lead to More Accurate Diagnosis?

Gender, Embodiment, and Eating Disorders

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