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Why Did Our Neurodivergent, Trans Son Develop an Eating Disorder?

By Beth Ann

While painful to admit, we never saw the eating disorder coming. Will had come out as transgender 2 ½ years prior. Then followed his hairstyle changes, his new name, and his clothing style changes, which ultimately resulted in a very casual, loose-fitting, and layered style. So, when he developed anorexia at 17 ½ years old, we found ourselves asking why? What caused him to engage in this amplified form of self-harm?

Research into understanding the symptoms and causes of eating disorders is going strong. Experts have uncovered genetic components as well as psychological factors in those suffering from anorexia, bulimia, and binge eating. In years past, there was a correlation between eating disorders and sexual trauma. It was supported that ED sufferers often wanted to change their bodies to be less attractive or more childlike to stave off further abuse. Binge eating would result in weight gain and potential obesity while anorexia results in extreme thinness which often removes the sexual features of a young woman’s body.

When Will went through a full evaluation at the suggestion of his therapist, he received an autism diagnosis along with depression, anxiety, and PTSD because of a sexual assault that occurred at school during his freshman year. He had never told us about the incident. Sadly, he hadn’t even perceived it as an assault at the time. Years later, he realized it was and acknowledged the lasting damage.

It could be argued that this sexual trauma is at the root of Will’s eating disorder however, he sites being transgender as a more critical factor. His desire to pass as male caused him to want to lose his curves. I realized that both potential causes have one critical commonality: Will’s strong desire to change his body through weight loss. He is stuck in the wrong body. He will never feel comfortable in his female body. He is afraid of some medical interventions to change his body, so he sought control by restricting calories, losing weight, and minimizing his feminine features. Victims of sexual abuse often seek control to change their bodies as well as to suppress the anxiety and difficult emotions that result from the abuse. Extreme calorie restriction and weight loss helps them regain a sense of control over their bodies. Add Will’s autism to the mix and we shouldn’t be surprised in the least. Autism comes with perfectionism and rigidity in Will’s case. Both qualities are highly effective in supporting anorexia.

Fortunately, Will is recovering from his ED. He sought treatment following an almost 30-pound weight loss in 4 months. It is a constant psychological battle in his brain, but he desperately wants to be free of this disorder. We can only hope that conquering anorexia and the aftermath of the sexual assault will give Will the sense of control he so desires.

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