In Depth with LGBTIQA+ specialist Kai Schweizer
Kai Schweizer, who identifies as gender diverse, first joined the Butterfly podcast in 2020 for the episode Gender, Sexuality and Eating Disorders. Our host Sam spent some time getting to know how Kai’s emerging gender identity at an all-girls secondary school led to disordered eating behaviours. He’s now a respected specialist in LGBTIQA+ issues, including this community’s experience of eating disorders.
“We know that treating your discomfort with your body, your dysphoria, or your incongruence through disordered eating doesn’t solve the problem you’re experiencing,” he says. “It doesn’t reduce the distress that you’re feeling.”
While Kai’s teenage years were a struggle, he found a path to recovery. “It was amazing how quickly, upon starting to feel more congruent in the body I was living in, that it became more comfortable to nourish and care about it,” he says. “It is really easy to not care for the body you live in when it doesn’t feel permanent. As my body became more of a home for me, it became more important to take better care of myself.”
Today, Kai’s a sexologist and researcher focused on trans and gender-diverse health. Two in three trans young people have engaged in disordered eating behaviours, and Australia needs safer treatment options for the LGBTIQA+ community. In particular, Kai calls for more understanding that transitioning can play a key role in recovery.
For LGBTIQA+ support:
Sam Ikin 00:08
This is another episode of Let’s Talk in Depth where we pull one of our amazing guests aside and really dive deep into their journey. This month, to mark Sydney’s Mardi Gras, I sat down with Kai Schweizer, who joined us in Gender, Sexuality and Eating Disorders in Season One of Butterfly: Let’s Talk.
Kai Schweizer 00:28
I am a masters student of sexology, sexuality educator, research assistant, I wear many, many hats, here in Perth, Western Australia. I’m also a person with lived experience with a bunch of mental health issues that sort of informs the work I do as well.
We’ve come a long way from assuming that body image issues and eating disorders only affect young, wealthy, white straight women. But there are still plenty of barriers to treatment, particularly in the LGBTIQ+ community. And for Kai, their struggle began as an early teen.
I really started to notice things going badly with my health when I was about 13 or 14 years old. So, I had just started going to high school, and I was sent off to a private all-girls school. And that certainly wasn’t a good fit for me as a person who is not a girl but who is trans, or gender diverse. I had the minority stress of being uncomfortable in the school that I was in, and a lot of it was to do with hitting the wrong puberty and trying to sort of control that in any way I could. I spent quite a number of years very unwell trying to self-medicate, I guess, through an eating disorder to try and treat the puberty that was happening that was wrong. I was sort of wanting to control anything I could in my life, because of just feeling really trapped in the situation that I was in. And it wasn’t until I was an adult that I sought some help. Part of that was coming out and transitioning. And part of that was, you know, psychology and support. But it was something that for me resolved quickly as soon as I started getting the treatment that I needed. I don’t think it will ever completely go away, and that it’s something that I will have to always manage and deal with. But I certainly am much, much better now than I was when I was younger.
Can you share a little bit about the interaction between your gender identity or your sexuality, and the experience of an eating disorder? Do you feel like there was any kind of dynamic interaction between those elements of your life?
Yeah, I mean, that’s not the case for everybody. But for me, they were absolutely, completely linked. I don’t think that I would have developed an eating disorder if I wasn’t trans. Because for me, so much of it was “this puberty is happening, and it’s wrong,” and whether I was self-aware of it or not, I was really just desperate to stop that from happening. And unfortunately, when you limit your food intake here, and you are assigned female at birth, your period stops, you stop developing breasts. All the things that were causing me distress, were things that I could stop through really unhealthy behaviours, which, ideally, I wouldn’t have needed to do. And I could have received medical care that could have done that in a much healthier and less damaging way. Yeah, that was sort of all that I had going at the time, and it wasn’t necessarily conscious. But looking back, that was very much a part of what was going on for me.
As a teenager, I guess you don’t think about long term impact of anything. You’re only worried about fixing the problems that you see right now. Was this a traumatic time in your life? Is it something that’s left a mark on you? Or is this just something that you’re starting to see the effects of now?
High school was definitely the worst time of my life, for sure, so far. Hopefully, the worst time of my life, my whole life through. I was really unwell the whole time. Like many people in disorder, I was cold all the time. I was sick all the time. I didn’t enjoy life for years on end. And they’re kind of all a blur now because I just wasn’t very with it at the time. But I was so wrapped up in it that I stopped living life for many years. And I do have some permanent effects. I have permanently reduced my bone density, which is a problem now that I do a lot of running like ultra-marathon running and whatnot, which I love doing. But I do have an increased proneness to fracturing, stress fractures and things, as a result, which is really frustrating. But yeah, physically, there’s long term impacts that I wish weren’t the case, for sure. And mentally I’m still kind of working through all of the stuff that happened when I was younger and coming out and having to sort of figure out who I was, is a complicated journey that has taken a long time.
So we like to talk about how there’s still a lot of stigma around eating disorders. But as far as your development went, that stigma was probably the least of your concerns. I mean, you had so many other conflicting and competing issues all going on at once.
There is stigma around eating disorders for everybody. But it’s eating disorders amongst LGBTQIA+ people that are my pet peeve area of learning and research and study, as well as my lived experience. And unfortunately, while people who are transgender diverse are some of the most likely people to develop eating disorders, we’re also some of the least likely people to actually get treatment. I can completely understand why. There’s a lot of discrimination in the medical care system, and a lot of misunderstanding of how to treat someone who has complex and different needs at the same time. And the idea that eating disorders are only something experienced by women, and you’re someone who’s trying to avoid being perceived as a woman, you don’t want to add that additional stigma on top of it. So yeah, it’s a really challenging area and something that we’re only just starting to understand now.
Wow. So that stigma wasn’t just something that was quite uncomfortable for you to bear but it was also being amplified through your gender identity?
In my head, you know, eating disorders were a girl’s thing, and I am not a girl so they can’t be something that I have. I just am sick, and I’m dealing with it, and it’s fine. But I found it very difficult to accept the diagnosis label of that, just because of what in my head that meant. And obviously, it’s not true. Not all people who experienced eating disorders are women. In fact, a larger portion of people aren’t. But you know, that’s the sort of the representation that I’d seen as a young person. And it’s exciting to see that that’s slowly starting to change now. And I think that would have made a difference to how early I reached out for help, probably.
Well, we’re doing what we can to change that and I think you sharing your story, as openly as you are right now is certainly something that is going to be helping us along the way as well. Take us through the experience of looking for help for the eating disorder? I think you touched on this a bit earlier, but you said you know that a lot of the medical professionals aren’t well equipped to help people or at least they weren’t when you were looking for help. How did you get diagnosed? And then how did you look for treatment and support?
Yeah, it was a very long gap between the sort of initial symptoms and getting help probably, say seven years of just struggling in quiet. And part of that was I hadn’t told anyone that I was trans yet. And I was worried that a psychologist would figure it out the moment they looked at me and then, you know, someone would tell my family, or it would be a whole lot of disclosure would happen too quickly. So, I was wrapped up in a multitude of other concerns about seeing a mental health professional. Like I said, I was going to an all-girls school that had the legal right to kick me out if they found out. So, there was a lot of hiding and making sure that no one found out. And then once I’d finished school, then I was like, okay, I can actually seek real help now, instead of trying to hide it from everybody. It took me a while to find a psychologist that was respectful and helpful and understood all the different parts of me. You know, sometimes you find a psychologist who can help with one thing, but they don’t understand other parts of you and then you spend a lot of time teaching them instead of them helping you. You want someone who understands all the facets of who you are because sometimes those facets are contributors too. Some of the people that I tried, they understood how to treat eating disorders, but they didn’t know anything about LGBTQIA+ people and identities. And because that was such a core part of why I was sick, I didn’t get better until I found someone who could understand all the components.
So what helped you throughout the recovery journey, and I’m assuming I’m saying that as though you’re in recovery, but I mean, this is a dynamic for me, at least it’s a dynamic process where I swing one way or the other all the time. But what if you did find recovery? Can you tell us how you found that and how you’re going with that today?
Because so much of my eating disorder was wrapped up in being uncomfortable with my body, about things that I actually could change through healthy behaviours, taking those steps and going through a medical transition process was really helpful. And I did see a lot of mental health professionals who told me, “You know, you need to recover from your eating disorder before you can transition. We’re not going to help you with that until you deal with this.” But it just created this loop where I couldn’t deal with my eating disorder until I transitioned, and they wouldn’t let me. So, nothing was getting better, and I got very lucky that eventually, I found a team, you know, GP and psychologist and psychiatrist and everyone who really supportive. And it was amazing how quickly upon starting to feel more congruent in the body that I was living in that it became more comfortable to nourish it and care about it, because it is really easy to not care for, or look after the body you live in when it doesn’t really feel permanent, or like yours. And yeah, as it started to become more of like a home to live in for me where I was, like, cool, this is where I’m going to be for my life, it became more important to me to take better care of myself and to be more comfortable.
I’m not suggesting it’s ended, but it does sound like there is a happy ending to that story.
Yeah, it takes a long time. And having said that, for a lot of people, their eating disorder is not related to their gender identity in their body. It’s to do with the minority stress, so being picked on or discriminated against because of your gender or sexuality. And that certainly is still a factor that I notice from time to time. When I’m experiencing a lot of discrimination, say there’s a lot of negative representation happening in the media about my community, I do see, like, a small spike that I have to kind of work to pull back on. Because it’s not, a magical cure-all. Transitioning wasn’t a magical cure-all for everything that was going on for me. But it did make it a lot easier to manage and I am definitely doing a lot better than I was.
That’s wonderful to hear. It’s really nice. We talked to lots of people who haven’t found that kind of resolution yet. But it’s very nice to hear, Kai. The thing that we’re trying to do here is to encourage people to talk because what we do know is that talking about these issues, can firstly help the person who’s talking and it can help anyone else who’s listening as well to deal with any problems. In looking for help, you would have had to have spoken to someone about it. How did you do that? And then what kind of benefits do you get from opening up about things like this now.
I am acutely aware that my community faces really high rates of eating disorders, but really low rates of seeking treatment and I think part of that is really struggling to find the right health professional to help. But it’s also a lot of it is stigma and the people in my community are already facing lots of stigma from their existence and their identity. They don’t want to add any more layers to that. And people tend to think that all trans people are inherently mentally ill because of who we are when really, there are high rates of mental health issues because of discrimination and other factors. So, for me, I share my own personal experience to try and encourage more people to get the support they need. And my own experience informs the research and interests that I have in the academic side of all of this. Hopefully, once we understand more about eating disorders and LGBTIQ+ people we will be able to streamline the kind of treatment that people receive. And that’s been my fight for a couple of years now – doing presentations on eating disorders amongst LGBTIQ+ people, and particularly trans people, to all the health professionals that will listen to me and all of the academics that will listen. I’m just trying to get the understanding out there that this is a common issue that people need to be prepared for in their clinical practice.
And so, any advice for young people who might be going through a similar process to you what’s the best first step to take?
What we know is that treating your discomfort with your body or your dysphoria or your incongruence through disordered eating behaviours doesn’t really solve the problem that you’re experiencing. It doesn’t tend to reduce the distress you’re feeling. And particularly if it’s related to puberty suppression, there are completely healthy, reversible ways to do that. Here in Perth, we’ve got the Perth Children’s Hospital which has a gender clinic that does puberty suppressant drugs that have been studied for many, many years to confirm they’re safe. And that is a much, much better option than self-medication through life-changing, dangerous behaviours. And getting the support and help that you need through mental health care and physical health care is a much better plan for sure. But it’s okay to ask for help, really.
It is okay to ask for help and we certainly encourage people to do that. It sounds to me like that’s something you’re encouraging people to do, as well, quite a lot.
Yeah, absolutely. Get young people and anyone who’s an LGBTQ+ person who has the symptoms of an eating disorder to get help. Also encouraging the people who are the clinicians who treat people with eating disorders to really expand their understanding of who they are treating and how to treat people, because the treatment models that exist are really built around that young women group. Those treatments aren’t always effective for people outside of that. Teaching people that they can learn to love and accept their body works for some people, but if you’re a trans person whose body literally needs medical transition then that learning-to-love-your-body method really just doesn’t work. It has not been shown to be effective in any study ever. So yeah, it’s a process for sure. Get people to get help when they need it and also make that help more effective.
Good on you, Kai. Thank you so much for being so candid with us today. I appreciate it.
No worries, thank you.
And if you’re looking for support with eating disorders, or negative body image, the Butterfly Helpline is there seven days a week from 8 am until midnight (AEST/AEDT). The number to call is 1800 33 46 73 or you can go online to butterfly.org.au. You can totally chat online if you prefer to do that. If you like what we’re doing here but the Butterfly: Let’s Talk podcast and Butterfly In-Depth bonus episodes, please leave us a rating or leave us a comment on Apple Podcasts. We’d really appreciate that. That helps us out greatly. And as always, if you think somebody can benefit from hearing these kinds of conversations, please tell them about it. I’m Sam. For more on me go to ikinmedia.com.au. That’s I K I N. And until next time, thank you for your company.