Faculty Publication Spotlight: “That’s not at all what I needed” trans adults’ perspectives on trans-affirming primary care and eating disorders

Authors: Emil K. Smith and Erin N. Harrop

Transgender and gender diverse people (including both binary transgender persons and those outside the binary) experience higher rates of EDs than the general population. However, little is known about the lived experiences of trans individuals with EDs; and even less is known about their experiences in trans-affirming primary care. This study sought to close this gap in the research. The authors found that participants in the study encountered numerous barriers to accessing helpful ED support in the context of trans-affirming primary care, including ED-uninformed providers and weight stigma. Participants at times avoided disclosing their EDs to their primary care provider, fearing that this could result in additional harm (e.g. stigma or delayed gender-affirming medical interventions). Participants also expressed that they wanted their providers to recognize them as whole people (beyond their ED and transness) who experience joy.

Key Insights:

· The authors highlight how the standard medical model compartmentalizes patient experiences and care (e.g., mental vs. physical health), which impacts patient outcomes and experiences. This is especially true for marginalized communities like the trans community.

· Additional trainings for primary care providers (e.g., to explore how cultural norms around weight and gender inform their practice and negatively impact patients with EDs) could be beneficial.

· Further research and scholarship that centers the voices and lived experiences of trans individuals who experience EDs is merited.

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