Gender in Eating Disorder Diagnosis and Treatment: An Introduction

Gender has been central to the diagnosis of eating disorders since the field first began in the 1970’s. Seen initially as a woman’s response to the pressure to be thin, eating disorders remain focused largely on women’s mental health. For decades, treatment philosophies and residential programs have been steeped in feminism and women’s rights, and for good reason.

Accordingly, the changing understanding of gender also heralds a shift in the foundation of eating disorder treatment. Most clinicians and programs remain fixed on the gender binary world. Most treatment focuses on women. The resources and understanding of eating disorders in men are scant, but the concept of eating disorders not reliant on gender barely exists.

Many in the newest generation of people struggling with eating disorders live in a world with a broader understanding of gender. One central message is that gender is not a defining element of being a person, and the goal is to treat a person, not a man or woman.

Adaptations in the eating disorder treatment world are slow and minimal. Paying attention to pronouns is a start and one of the few things clinicians have begun to consider.

The larger impact on this field remains to be seen but will likely lead to several significant changes.

Diagnoses are still dependent on gender and need to be seen from a gender neutral, clinical standpoint.

Many treatment approaches see gender as a focus of the philosophy. Feminism and the way women are seen in society are a large part of the history of eating disorder history and recovery. Treatment needs to be revamped to focus on recovery and not gender.

The gender binary understanding of eating disorders will become increasingly moot in a world of seeing people as people. Accordingly, clinicians need to learn how to treat people as individuals. Although this statement may seem clear, the profound effects of separating gender from treatment are yet to be seen.

Last the societal pressures that engender eating disorders such as the drive for thinness, an ideal body type, fatphobia and social media influence are equally powerful drivers for these illnesses for all people. This assumption needs to be central to all clinicians on the field.

The underlying reason for the continued increased incidence of eating disorders has changed enormously in the last forty years. I’ll look more into this decades long shift and how treatment needs to change with the changing idea of gender in subsequent posts.