02 May 2024

Banning Puberty Blockers Will Worsen the Eating Disorder Crisis Amongst Trans Youth

“As eating disorder professionals, trans people, and people with lived experience of eating disorders, we want to share our grave concerns about how this decision and any parallel actions in other nations will escalate the prevalence and severity of eating disorders among trans youth.”

By Kai Schweizer (they/he) and Lumen Gorrie (they/them)

Recently, The National Health Service (NHS) in the United Kingdom (UK) made the controversial decision to stop providing puberty blockers to trans youth. This decision has sparked discussions globally, with conservative groups in Australia also pushing for similar restrictions.

As eating disorder professionals, trans people, and people with lived experience of eating disorders, we want to share our grave concerns about how this decision and any parallel actions in other nations will escalate the prevalence and severity of eating disorders among trans youth.

Trans Youth and Eating Disorders

Trans youth experience alarmingly high rates of eating disorders. In an Australian study, 22.7% of trans youth had been diagnosed with an eating disorder and 2 in 3 had restricted their eating because of their gender.

Many trans people experience a distress and/or disconnect called ‘gender dysphoria’ because of our gender identity and sex presumed at birth not matching. It can be triggered by physical traits (e.g., “voice dysphoria”, “chest dysphoria”) or by the gendered way others interact with us socially (e.g., being misgendered or called the wrong name).

In many cases, trans young people develop eating disorders to manage their gender dysphoria by suppressing their own puberty.

For example, one study reported trans young people with eating disorders believing that achieving a low body weight through restrictive eating would stop their periods and halt breast development.

Trans Youth and Puberty Blockers

Puberty blockers are medications that can be used to temporarily pause puberty. These medications have been used since the 1980s in cisgender (non-trans) children who begin puberty too early. They are widely considered safe, effective, and reversible.

For trans youth, puberty blockers offer a vital means to prevent the development of secondary sex characteristics that can exacerbate gender dysphoria, while also affording them time to explore their gender identity and discuss potential future medical interventions with their families.

In the context of eating disorders, several studies have reported recovery in trans youth who accessed puberty blockers.

For example, in one study, a trans person said, “As an adolescent…I was afraid of the way my body was changing, so I used restriction to not allow it to change, so that I didn’t have to experience a body that didn’t feel like mine… Getting gender-affirming care really opened up my ability to nourish my body.”

Conclusion

The NHS’s decision will not stop puberty suppression for trans youth; it will stop safe puberty suppression.

It is well-documented that trans youth lacking access to puberty blockers resort to harmful disordered eating behaviours to suppress their puberty and manage their gender dysphoria. Removing access to puberty blockers will exacerbate the already epidemic levels of eating disorders within our community and cause significant harm and distress to trans youth and their families.

We urge individuals with lived and living experience of eating disorders, caregivers, families, clinicians, researchers, and anyone dedicated to eating disorder prevention to advocate for safe and medically supervised puberty suppression for trans youth.

About the authors:

Kai Schweizer (BA, MSexol) is an AuDHDer, trans health researcher, sexologist, youth worker, and PhD student with the University of Western Australia and the Telethon Kids Institute.

They are also a Research Affiliate at the Inside Out Institute for Eating Disorders, investigating the body image, eating, and exercise of LGBTIQA+ people. Kai’s PhD project aims to create clear guidelines for best practice in treating eating disorders trans and gender diverse people.

 

Lumen Gorrie (MPsych[Clin], BPsych[Hons]) is a clinical psychologist in Naarm, supporting neurodivergent, queer, trans, chronically ill, and disabled community members navigating eating disorders or differences.

Outside of this, Lumen is also involved in advocacy and education, focused on increasing accessibility and inclusivity for marginalised individuals across healthcare, systemic, and broader community contexts.

 

Get support

Support for eating disorders and body image concerns

  • Butterfly’s National Helpline counsellors receive LGBTIQA+ training and are committed to providing free, confidential and non-judgemental counselling, referrals and information to anyone experiencing an eating disorder or body image issue, as well as their friends and family. We understand that gender and sexuality are complex issues and unique to each individual. We make no assumptions about your story and we do not discriminate.
  • To find qualified eating disorder practitioners, search Butterfly’s Referral Database. You can customise your search to see healthcare professionals that specialise in treating the LGBTQIA+ community.
  • To read more lived experience insights from the LGBTQIA+ community, visit Butterfly’s Body Pride Resource Hub.

LGBTQIA+ specific support

  • Qlife provides anonymous and free LGBTQIA+ peer support and referral for people in Australia wanting to talk about sexuality, identity, gender, bodies, feelings or relationships. Call 1800 184 537, 3pm-midnight, 7 days a week.
  • Minus18 provide support for LGBTQIA+ youth focusing on life-affirming social inclusion, education, advocacy, and youth empowerment.

Related tags: body image and gender identity gender dysphoria gender identity lgbt LGBTQIA+ transgender Lived Experience trans trans body image trans eating disorders