Sexual and gender minority (SGM) adolescents' disordered eating: Exploring general and SGM‐specific factors

Abstract

Objective: Sexual and gender minority (SGM) adolescents disproportionately report disordered eating, yet have primarily been considered under a larger SGM umbrella. The current study 1) compared disordered eating between sexual minority (SM) and gender minority (GM) adolescents; 2) examined how general psychological factors (self-esteem, depression, and stress) and SGM-specific factors (e.g., feelings about SGM identity, access to SGM resources) were associated with disordered eating; and 3) examined whether associations between these factors differed for SM versus GM adolescents.Method: SGM adolescents in the U.S. (N = 8814; 35.0% GM; 43.7% cisgender girls; 66.9% White; M age = 15.6) reported their disordered eating, depressive symptoms, stress, self-esteem, and SGM-related experiences on an anonymous, cross-sectional online survey.Results: GM adolescents exhibited a higher prevalence of clinical threshold disordered eating than SM adolescents. Self-esteem was associated with lower odds of caloric restriction, purging, and binge eating. Depression was associated with higher odds of caloric restriction, diet pill use, purging, laxatives, and binge eating. Stress was associated with higher odds of purging. Associations were stronger for GM adolescents' caloric restriction. Positive feelings about SGM identity were associated with lower odds of caloric restriction, purging, and binge eating, whereas greater stress of "coming out" was associated with higher odds of caloric restriction, purging, and binge eating.Discussion: These results suggest that SGM adolescents' disordered eating is associated with both general psychological factors and unique SGM experiences. Results highlight the importance of considering how the unique experiences of SGM youth may leave them vulnerable to disordered eating behaviors.Public Significance Statement: Sexual and gender minority (SGM) youth are disproportionately affected by disordered eating. The current study found that higher depression and stress, and lower self-esteem, were associated with SGM adolescents' disordered eating. Furthermore, unique SGM experiences, such as stress about coming out, were also associated with eating pathology. Results highlight the importance of considering SGM adolescents' perceptions of their identity and social support.

The effects of sexual and gender minority stress on relationship functioning: A meta‐analysis

“…It is possible that positive identity-related experiences may improve relationship functioning among LGBTQ+ couples, or that adaptive relationship functioning may increase positive identity-related experiences. Positive experiences may also buffer the impact of SGM stress on relationship functioning, as has been observed in other areas of well-being (Craney et al, 2018;Fredriksen-Goldsen et al, 2014;Meyer, 2015;Roberts et al, 2022). Future research should explore this possibility to gain a full picture of the impact of identity-related experiences on LGBTQ+ relationships.…”

“…However, recent SGM stress theory literature has not solely focused on a negative valence approach but expanded to include coping and protective factors for LGBTQ+ individuals. Specifically, previous research has noted LGBTQ+ individuals report positive experiences unique to their identities, such as LGBTQ+ pride and community belongingness, which may foster resilience to SGM stress and promote well‐being (Craney et al, 2018; Fredriksen‐Goldsen et al, 2014; Meyer, 2015; Roberts et al, 2022). Additionally, researchers have begun to explore the experiences of LGBTQ+ individuals with intersecting marginalized identities, including LGBTQ+ people of color, immigrants, individuals with minoritized religious identities, and individuals with disabilities (e.g., Abreu et al, 2023; Farquhar‐Leicester et al, 2022; Fox et al, 2020; Lomash et al, 2019).…”

Practical Considerations for Using the Eating Disorder Examination Interview with Adolescents

“… 188 Certain sociocultural and peer factors, including appearance incongruence and dissatisfaction, stress related to communicating one’s identity to others, and social pressure to look a certain way may also be exacerbated for certain individuals with these identities. 187 , 189 , 190 Importantly, SGM refers to a heterogeneous group of identities, and distinguishing between gender and sexual orientations is important when considering and assessing body image and disordered eating. 189 , 191 Transgender and gender diverse adolescents also may exhibit body image concerns and restrictive eating/weight-control behaviors that are related to the experience of gender dysphoria (eg, a transgender boy engaging in restrictive eating to prevent/reduce development of feminine body characteristics).…”

Bias‐based bullying, self‐esteem, queer identity pride, and disordered eating behaviors among sexually and gender diverse adolescents

“…However, adolescents with certain marginalized social positions are disproportionately affected by disordered eating due to stigma, discrimination, and other minority stressors (Brooks, 1981;Hendricks & Testa, 2012;Meyer, 1995Meyer, , 2003. For instance, compared to their heterosexual and cisgender peers, adolescents who identify as lesbian, gay, bisexual, queer, or questioning their sexual identity and/or transgender, gender diverse, or questioning their gender identity (LGBTQ) engage in significantly higher rates of disordered eating than their cisgender and heterosexual peers (Austin et al, 2013;Guss et al, 2017;Parker & Harriger, 2020;Roberts et al, 2021Roberts et al, , 2022Watson et al, 2016).…”