Eating Disorders in LGBTQIA+ Adolescents

Sexual and gender minority young people face elevated rates of eating disorders and body dissatisfaction compared to their cisgendered heterosexual peers, a disparity that has been documented in cross-sectional studies but is less well understood longitudinally. When do these differences emerge? Do they follow the same trajectories in all sexual and gender minority groups? And does the picture look the same now as it did in the 1990s, when most of the existing longitudinal data was collected? This project uses a contemporary Australian birth cohort to examine developmental trajectories of body dissatisfaction and disordered eating across adolescence in LGBTQ+ and heterosexual cisgender young people.

The existing longitudinal evidence has a specific limitation: most of it is male-only, US-based, and drawn from cohorts who were adolescents in the 1990s.

The Research

The project draws on a longitudinal general population study of Australian adolescents born in 2000–2001, examining two developmental windows: body dissatisfaction from mid-childhood to early adolescence, and disordered eating behaviours from early to late adolescence. The choice of starting point is motivated by evidence that body dissatisfaction, a key risk factor for eating disorders, can begin to develop in mid-to-late-childhood, before sexual attraction typically emerges and around the time that awareness of gender identity has formed. Beginning here allows the study to investigate the full developmental trajectory and identify windows where preventative intervention might be most effective.

The study compares trajectories across intersecting sexual and gender identities, addressing several limitations in prior work: the reliance on male-only samples, the focus on a narrow range of disordered eating behaviours, and the near-total absence of longitudinal data on gender minority youth. Using a contemporary cohort also allows the findings to speak to the experiences of young people growing up in a digital environment with different social norms around body image and identity than those of their predecessors.

My Involvement

I was involved in this project as a young person with lived experience, consulted as part of the research team's effort to ensure the study was shaped by the perspectives of LGBTQ+ young people. Consultation materials included background reading on body image and disordered eating, drawing on resources from YoungMinds, the National Eating Disorders Collaboration, and Verywell Mind, and feedback was sought on the measurement approach, what other factors the research might be missing, and how findings should be communicated.