Risk and Protective Factors of Disordered Eating in Gay Men, Lesbian Women, and Transgender and Nonconforming Adults

Objective: This study aimed to compare the prevalence of eating disorder (ED) attitudes and behaviours between gay men, lesbian women, and transgender and nonconforming (TGNC) adults. The study further sought to identify and compare the risk and protective factors, and examined a mediational model based on the interpersonal theory of eating disorders, whereby the association between interpersonal factors and disordered eating would be mediated by psychological constructs pertaining to the self and negative affect. Method: Data was obtained from a larger national study of health risk and protective factors among sexual minority and gender diverse populations. The present study included 97 gay men, 82 lesbian women, and 138 TGNC adults. Participants completed the Eating Disorders Screen for Primary Care, Patient Health Questionnaire Depression scale, Generalized Anxiety Disorder 7 scale, Self-Compassion Scale-Short Form, Negative Social Exchange subscale of the Multidimensional Health Profile, Interpersonal Needs Questionnaire, and Perceived Stigma Scale. Results: There was a significant difference between groups in possible ED caseness, with the lowest prevalence in gay men (47.6%) and the highest prevalence in lesbian women (66.7%). There was a low prevalence of inappropriate compensatory behaviours (self-induced vomiting, laxative misuse or diet pill use), with no significant difference in prevalence between groups. There was a significant difference between groups in weight-based self-worth, with the lowest prevalence in gay men (63%) and the highest prevalence in lesbian women (82%), and satisfaction with eating patterns, with the lowest prevalence in TGNC adults (30.2%) and highest prevalence in gay men (52.3%). Logistic regression analyses showed that possible ED caseness in gay men was predicted by depression, perceived stigma, and self-compassion; in lesbian women by depression; and in the TGNC group by self-compassion. Mediation analyses showed that thwarted belongingness and perceived stigma had an indirect relationship with possible ED caseness that was mediated by self-compassion and depression (for perceived stigma alone) in gay men, depression in lesbian women and self-compassion in TGNC adults. Discussion: The interpersonal theory of eating disorders partially extends to sexual minority and gender diverse populations, however, the results suggest that theoretical models and treatment programs need to be extended to include the role of stigma and self-compassion