A Strength-Based Approach to Understanding the Impact of Experiences of Discrimination Related to Identity-Based Stressors on Disordered Eating among a Sample of Sexual and Gender Diverse Individuals

A Strength-Based Approach to Understanding the Impact of Experiences of Discrimination Related to Identity-Based Stressors on Disordered Eating among a Sample of Sexual and Gender Diverse Individuals

Sexual minorities--Mental health

Susana Cruz Garcia

2025

University at Albany

Dissertation

English

Open Access

Empirical research investigating eating disorder (ED) behaviors among sexual and gender minorities has grown substantially in recent decades, though notable gaps call for further work to clarify mixed findings regarding the experiences of this heterogeneous population. This study sought to add to our understanding of disordered eating behaviors in LGBTQIA+ participants, with a specific focus on differences between lesbian and gay (LG) versus bisexual, transgender, queer, intersex, asexual, and other identities (BTQIA+), with the latter group remaining especially underrepresented in the literature. Study aims were firstly, to quantify ED incidence and the frequency of experiences of identity-based discrimination in sexual and gender minority respondents, and secondly, to examine the moderating roles of resilience and social support in the relationship between identity-based discrimination and eating pathology. Consistent with prominent theories of minority stress and eating pathology, it was hypothesized that BTQIA+ participants would exhibit similar or greater levels of discrimination and eating pathology than their LG peers. It was further hypothesized that intersecting minority identities, and specifically the intersection of race and gender and sexual minority status, would be associated with greater ED symptoms, and that resilience and social support would moderate the relationship between experiences of discrimination and eating pathology. As an exploratory aim, we also evaluated the factor structure of our primary measure of ED symptoms, the Eating Pathology Symptoms Inventory, in this diverse sample of sexual and gender minority individuals. Study participants were recruited via the online platform Prolific and grouped into two groups of LG (n = 164) and BTQIA+ (n = 233). They provided demographic information and completed measures of experiences of discrimination in daily life, disordered eating symptoms, resilience, perceived social support, and coping. Findings revealed that LG individuals reported greater symptoms of eating pathology compared to their BTQIA+ counterparts, but there were no significant differences in experiences of daily discrimination between the two groups. Holding more than one minority identity significantly impacted levels of ED symptoms in a subset of participants. Neither resilience nor social support moderated the relation between everyday discrimination and eating pathology. Furthermore, the EPSI eight-factor structure was found to be appropriate for use in LGBTQIA+ participants. This investigation provides a more nuanced understanding of the experiences of sexual and gender diverse groups regarding identity-based discrimination and eating pathology, encourages screening for EDs in this population, and may inform culturally-responsive healthcare practices that attend to the unique needs of LGBTQIA+ individuals.

Julia Arizono