My Experience as Non-binary and Anorexic
Editors note: In the following article, Chris has provided a very honest and deeply personal account of their experience of the intertwined nature of non-binary gender identity and anorexia. These are their personal experiences and they should not be used to draw broad conclusions about all transgender, non-binary, and/or anorexic people, particularly regarding the order in which gender affirming care and anorexia services are provided. There is some existing literature on coincidence of gender dysphoria and anorexia, including on trans masculine, feminine and non-binary folks. Overall, it tends to identify gender minority stress and inadequate management of gender dysphoria as inciting issues and indicates that gender affirming care serves as a protective factor against anorexia (see Loria et al., 2024; Harrop et al., 2023; Protos, 2021; and Cusack, Levenson, & Galupo 2022 for more information).
Content warning: Specific numbers related to BMI and calories are included in this article.
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Beginning to give an account of my non-binary identity and eating disorder feels like a rather overwhelming task, because these have been the 2 most prominent and strongest features of my adult life. I do have several other psychological/neurological issues, most notably autism, OCD, and Generalised Anxiety, which I will discuss later in this piece. However, these issues have been somewhat overlooked, due to my gender “issues” and eating “issues”. In fact, even my gender “issues” have been overlooked due to my eating “issues”. The anorexia and my non-binary gender identity are highly intertwined, so I will be discussing these together, as they are often difficult to separate.
I’ll begin with a summary of my identity as anorexic, or being someone with anorexia. I am categorised as having a Severe and Enduring Eating Disorder (SEED). I recognise this label as I feel that my eating disorder is both severe and enduring. It is severe, in the sense that my BMI is currently within the anorexic range (below 17.5); and it is enduring, in the sense that my BMI has been within that range consistently for 20+ years, since circa 2004/2005. Furthermore, it has led to 5 in-patient admissions each around 6 months on average; and even on discharge my BMI has been below 17.5. I have lived my life precariously close to being admitted/re-admitted to Hospital for my eating disorder, with my BMI usually hovering around the 13.5 – 14.3 mark.
I am aware that this piece is being written for a transgender forum, and I will focus on my genderfluidity, non-binary and trans identity; but I felt it was important to start with the facts and figures re my experience with anorexia. And, if you will now indulge me, I will give you a more complete account of being anorexic in terms of its day-to-day impact and history.
At no point have I really experienced recovery from anorexia; and even in-patient admissions to a specialised Eating Disorder Unit (Cheadle Royal) have only helped me to make temporary improvements to my general health, and gain some temporary weight. This said, I can just about remember a time in my life when I had no issues with food. During High School (from the age 11 -16) and 6th Form College (from the age of 16-18), food just didn’t play a particularly important in my life. I didn’t really think about what I ate. I would eat foods I don’t eat now. But, more importantly, food wasn’t something I thought about, or had routines around.
For me, anorexia developed between 2002 – 2005, during my Undergraduate studies. However, it wasn’t until 2005-2006, when I was doing my MA, that I acknowledged I had an eating disorder and sought treatment. By the time I acknowledged that I was anorexic and sought treatment I was seriously within the anorexic BMI range (my BMI was around 11 – 12 in late 2005/early 2006). Therefore, there was no issue about diagnosis. In fact, I am not sure a “Professional” did really diagnose me as an anorexic – I simply said I was anorexic and they didn’t probe any further due to my BMI.
The nature of my eating disorder is quite specific, with certain very marked characteristics, and the marked absence of certain eating disordered characteristics. Firstly, I have never been an “exerciser”. I do not like exercise, sport or physical activity, and have never used this to manage my weight. Secondly, I have never been a “binger”. I have never been bulimic, and have never been able to consider inducing vomiting, as I am rather squeamish and disgusted by vomit (I probably have emetophobia). Thirdly, I have never gone through periods of complete starvation, or near starvation and have never gone more than 12 hours without eating. I have always eaten regularly, eating at least 500-1,000 calories a day, even at my most extreme time; and mostly I’ll eat 3 meals, and far more than 1,000 calories a day.
However, I have always maintained a very low body weight. There are 2 main aspects of my eating disorder. The first is the maintenance of a very low body weight. Furthermore, I cannot really contemplate reaching something even approaching an underweight range BMI (as opposed to being within the severely anorexic BMI range). Second is the rigid control of my food intake. There are 2 aspects to the control of my food intake. The first is that I am very calorie-controlled (I don’t actually count calories per se, but that is only because I stick to a limited range of foods that I have already calorie-counted). This calorie-controlled way of eating also means I eat only a very narrow range of foods (i.e. I do not eat high-calorie ones). Secondly, I don’t have days when I indulge, break from the eating disorder, and consume a normal number of calories. Every day involves a limited and controlled intake of the food I consume. Thus (excluding during in-patient treatment), I have not consumed more than 1,500–2,000 in a day since becoming anorexic and my usual intake would be substantially below 2,000. The combination of a controlled diet that excludes high-calorie options (e.g. sugar, butter, cheese), and the consistency of this diet means that my body weight is maintained at a very low BMI.
That is probably sufficient in terms of the general experience of anorexia. The more interesting aspect is how it links with my sense of gender dysphoria. And I think that the connections between my gender dysphoria and anorexia are significant. First, I’ll give you some facts and figures surrounding my gender, before moving into the more personal account.
I was born male in 1983 in Salford, Greater Manchester within the North-West of England. I do not generally use the term “trans”, because I never felt male and am not sure I could ever be truly female. For me, it is not about transitioning from one place to another, as implied for me by the notion of trans. Thus, the idea of experiencing gender dysphoria feels a more authentic way of discussing my relationship to gender, which is about the expression and the continuation of my non-binary gender identity. I also like the idea of gender euphoria, as it suggests liberation from gender. Thus, my gender identity is non-binary, genderfluid, genderqueer, or even genderfuck.
However, in terms of giving an account my relationship with my gender “issues”, it is important to understand that much of the discourse around gender identities was very limited at the turn of the Millennium, and I was unable to articulate much of this then. This was a time when the discourse of “non-binary”, and “gender fluid” etc. were not available to me, as they were not a part of the common cultural milieu. Transgender discourse was a fringe idea, and I did not feel that transition quite fitted with my sense of self. Thus, I found myself unable to understand myself. This is where the eating disorder came in, partly as a way to express a non-binary identity, and partly to supress feelings of gender dysphoria. The loss of weight meant that my body felt less male; thus the limited food intake was driven by a desire to impact on sex characteristics. I’ll return to this link in a moment, but I think it would be useful to look at what else was going on for me between the ages of roughly 12-22, around 1995-2005.
The eating disorder began when I started University, because whilst I was at High School, I was able to wait for “life to begin”. I wanted to be in a mature place and with adults; but when I started Uni, I suddenly felt an intense internal pressure to start “living”, to “start my life”. I did not have close friendships in my teens, and had been very isolated, feeling I did not belong. Throughout my teens, I was very unsure of my sense of self and identity, especially in terms of my gender identity, but rather than trying to make friends or develop a sense of my self, and of my self in relation to others, I always felt I could wait until I was an adult. However, as I started Uni, this inability to connect with other people or myself and my gender became very acute, and pressing, and I felt I needed to address my feelings urgently. Thus, I experienced a period of quite significant psychological distress and anorexia emerged as a coping mechanism that kept me from suffering deeper psychological distress.
Anorexia is also about control, which is a bit of a cliché when talking about eating disorder; however, for me this is true, since I felt a sense of being unable to control my situation when I was doing my BA. I didn’t know where my life was heading, and felt I had little control over what would happen. I felt that I did not have control of my identity and gender as I could not find a way of articulating it (as I say, at the time, the language of “gender non-binary” was not used/understood). Thus, for me, anorexia became a means of coping with, and controlling and managing, psychological distress. One of the ways it does this is to simply occupy much of my thinking time and enforce structure and routine into my life. In doing so, anorexia mutes existential concerns about sexuality, gender, identity, being and living. My thoughts and energy become re-directed toward the doing of anorexia, and I do not have the energy and mental space to be as concerned about the directionlessness of my life, sense of lack of control over life, or confusions about identity. Furthermore, anorexia lets me navigate away from existential dilemmas about the purpose of life, since each day I need to do my anorexic thing, which gives me reason and purpose and structure to my existence.
Another important factor in understanding the role anorexia plays for me is to understand how it is a distinct identity that gives me a label I can use. I do not like the way the label “eating disorder” often forecloses helping the person holistically, as it turns the focus to “tackling” the eating disorder, and fails to address the debilitating existential problems and angst that triggered it. However, I do embrace the identity/label of anorexia. I have always struggled to articulate a clear sense of my identity and have felt unable to align myself to any particular one. Most notably, I do not have a sense of being male (or female). Other labels/identities that might allow someone to understand themselves and/or place them within society and a group have never felt particularly significant or meaningful to me. For instance, I do not feel a strong sense of race, class, regional identity, national identity, religious identity, or sexual identity (my gender dysphoria makes heterosexual and homosexual binaries unstable and confusing, or non-existent). This, of course, is not to say that I don’t have a national, an ethnic identity and other identities, but I don’t feel a strong connection toward them or sense of connection to those who share that identity. I similarly don’t have an identity derived from belonging to a particular organisation or a particular passion (e.g. through membership in a political party, or as a follower of a football club). I have, therefore, turned to the label/identity of “I am anorexic”, as it provides a definite identity. However, anorexia still provides a sense of uniqueness (particularly if you are male, or non-binary), since it is an identity that is unusual, and marked by standing outside of the norm. Thus, anorexia provides both a sense of identity and a sense of difference. To me, the sense of difference and uniqueness, and “being special” derived from having anorexia may be even more pronounced for people assigned male at birth, as anorexia predominantly impacts women and girls. Thus, experiencing something associated with girls/women allows me to further lean into my genderfluidity. This makes recovery from anorexia particularly difficult for me because it is so intwined with my gender identity.
Being anorexic provided me with that sense of a label and an identity, when I didn’t have any other. However, as I say, I also find the label problematic because it forecloses the sense that I am an individual as it can reduce me to being merely an anorexic patient. However, I am not just someone with an eating disorder; I am also someone with gender dysphoria and a non-binary gender identity.
For me, anorexia has provided a way of both expressing a non-binary identity and supressing it. An extremely low body weight has helped me to remove a male identity/persona and adopt an androgynous, gender-blurred, gender-neutral identity. I do not see myself as a woman, but I am frequently mistaken for a woman. However, I do not see myself as a man, either, so a physical body that disrupts the male/female binary feels like the most reasonable representation and articulation of my identity. Anorexia also supresses some of the feelings surrounding gender dysphoria. It also acts a suppressor of all difficult emotions and needs because it diverts attention to itself and away from the “real” world. Anorexia partially numbs some aspects of generalised existential angst and general emotional turmoil of being alive. It also numbs sexual urges, needs and desires that I find difficult to acknowledge. Thus, anorexia reduces the impact of the uncomfortable aspects of gender dysphoria, whilst also allowing me to express a gender non-binary presentation.
I am trying to improve my relationship with gender dysphoria by re-embracing it as gender euphoria. In re-exploring my relationship with gender, I am beginning to connect more with a more lived trans/queer life. This re-exploring gender, rather than supressing it as gender “issues,” is something that has, in part, emerged as I have started working with a new therapist, whose approach to psychotherapy/psychology is different to any of the previous therapists/psychologists I have seen. Until very recently, my interactions with healthcare had been focused on my eating disorder, further suppressing my exploration of my gender dysphoria/euphoria, as the priority was managing my eating disorder. I’ll now take you through a brief resume of my interactions with healthcare in order to demonstrate how the eating disorder has siloed me into a particular type of healthcare intervention and limited my ability to address other underlying neurological and psychological issues, including: gender, autism, OCD and anxiety.
Whilst at University, I was going through a turbulent emotional time and first addressing my gender dysphoria and, as a result, I sought counselling. However, the prolonged waiting list, interrupted by assessments to determine which waiting list and psychological service I was to be seen by, led me to develop my own coping mechanisms. This involved some experimentation with alcohol, but largely developed into acute anorexia. By the time, I had emerged at the top of the waiting list for talking therapy, I knew I was anorexic. Thus, I was never able to access any psychological support therapy to address my gender “issues”, since I was then referred on to the eating disorder service. There was no wait this time, since my eating “issues” were so severe that I needed immediate outpatient therapy and, ultimately, inpatient care.
The subsequent focus on the eating disorder has meant that my gender “issues” were left unresolved, and supressed. I existed in a liminal, non-binary space, but without feeling able to explore my gender identity in a safe way. Similarly, the siloing of healthcare into an eating disorder service meant that my other psychological and neurological concerns were not addressed. For instance, I was finally diagnosed with Autism in 2025, at age 42! It was at the same time (2025) that I also received a formal diagnosis of OCD and was able to access some treatment for this. Though OCD had long been present and was mentioned in a medical letter as early as 2013, there was no attempt to treat it until 2025. There had been a slightly greater appreciation that people with an eating disorder do often have co-morbidity with depression and/or anxiety. I received a diagnosis for Generalised Anxiety Disorder around 2013 and have taken an SSRI (Sertraline) for this since then.
It is important to note here that I have always lived in the UK and my discussion relates solely to the UK’s model of healthcare, namely the NHS. Although, it is also worth noting that the NHS does make use of private healthcare facilities; and, whilst my outpatient care has been provided directly by the NHS, my stays at a specialist inpatient eating disorder unit were with The Priory, which is a private provider, and runs the specialised Eating Disorder Unit at Cheadle Royal.
I want to talk very briefly about treatment options. I have had 5 very lengthy in-patient admissions to a specialised Eating Disorder Unit (Cheadle Royal), and various forms of out-patient treatment. These have included minimal monitoring with a GP, 1 hour/week outpatient therapy, and intensive “Daycare” at the same unit that I was an in-patient. Therefore, I have a lot of experiences to draw on to suggest what may/may not have worked for me. The first thing I would say, regarding an eating disorder, is that there is no magic bullet. This is particularly true, I suspect, if the eating disorder is part of a complex nexus of psychological distress. I do not consider myself as solely eating disordered, in the sense that, while the eating disorder is a coping mechanism and a part of who I am, it is not entirely who I am, but a symptom of other unresolved human, existential issues and co-morbid with other “psychological diagnoses” (e.g. anxiety, OCD).
There may be some people who, after a course of CBT therapy or an in-patient admission, reach near-full recovery, and are only left with a few residual eating disorder thoughts/behaviours. However, often an eating disorder is a symptom of deeper psychological distress, and an in-patient admission(s) and talking therapy(ies) can only achieve some limited, and often temporary, “improvement”. For example, in-patient admission can (and almost inevitably does) produce weight gain and/or a general improvement in health (e.g. bringing blood results back to normal, or near-normal, ranges). Thus, in-patient treatment may sometimes be a necessity and can stabilise things. However, even an intensive 6+ month admission to a specialist Eating Disorder Unit is not necessarily a magic bullet. There is a need for awareness of the limitations of Hospital treatment, since it often fails to provide lasting results; it can become a “revolving door”, and is very time-consuming, and resource-draining.
Even more dangerously, in-patient treatment can make someone more eating disordered, which happened to me on my 2nd admission. I went in as a functioning adult who had, in the year prior to this admission, completed my PhD, lectured undergraduates and even postgraduates (albeit on part-time, temporary contracts), and lived on my own for over 4 years. However, after I left Hospital I felt like a failure, a non-functional adult, and that there was very little in my life. The one thing I did have was the eating disorder. Thus, the desire to hold onto it grew stronger and more powerful during the admission. I remember a distinct conversation with my psychologist a few days before I left that involved visualising a pie chart. We discussed what % of my life was about the eating disorder. I remember distinctly saying that it had only been 1 segment when I was admitted, but, as I was leaving, I had nothing but the eating disorder. During that time, my relationship with my parents crumbled, and everything about being an in-patient was focused on having an eating disorder. I felt I had been plucked out of my life, and thrown into a Hospital where my only role was as someone suffering from an eating disorder.
Following this 6+ month admission, I went downhill very quickly. Within 8 months I had reached the lowest weight I had ever been and ended-up having to be treated on a Medical Ward, as I was too physically ill to return immediately to the Eating Disorder Unit. Several weeks later, I was transferred from the Medical Ward at my local Hospital to the Eating Disorder Unit at Cheadle Royal, once again as an in-patient. This admission was more successful and I know that in-patient admissions are, in some cases and times a must. However, from my experience, I worry that in-patient treatment can be very negative and detrimental to someone’s life. If someone goes in for in-patient treatment as a functioning/semi-functioning, independent/semi-independent adult, they will find that the Hospital regime plucks them from this and shatters their sense of being a “proper” adult.
In terms of talking therapies, there also needs to be a greater acknowledgement of their limitations. CBT is a useful form of treatment if, and only if, the eating-disordered person goes into CBT therapy wanting and able to change. CBT is focussed on change. But, if change is not seen as desirable or felt to be possible, it is likely to be an annoying and frustrating experience. I find that CBT is often very distinctly not person-centred but rather that, as a treatment model, it tries to fit the patient within this model. Unfortunately, it is the dominant model, and I think this is because it prescriptively sets out goals and aims. Thus, it fits within a scientific methodological approach, as it aims to be measurable and quantifiable. Psycho-dynamic therapy seems less structured, as it seems to revolve around a qualitative exploration of the patient’s life and experiences. It also appears more person-centred as it focuses on each person’s unique and individual modes of understanding and relating to the world. However, I am just not sure whether any of the talking therapies can actually achieve as much as they claim or are assumed to be able to achieve. I am not sure talking therapies can substantially improve problem behaviours (e.g. eating disorder behaviours) or problem moods (e.g. depression or anxiety).
Talking therapies are the “in vogue” thing it seems. I sense that the current trend in culture and society is a backlash against medication. However, for me, hours of talking therapy and lengthy in-patient stays have achieved very little, either in terms of helping me to manage my weight and eating disordered behaviours, or in helping me to manage my moods of depression and anxiety. I started taking an SSRI (Sertraline) around 2013. And, whilst this is no magic bullet, and I still live with a very precarious BMI and unresolved issues around gender and mental well-being, it has done more than most other interventions. My weight has also been more stable since starting Sertraline. Furthermore, my mood has stabilised. I am still an introverted and anxious person that struggles with existential despair and gender “issues”. However, I have come to view this with a greater level of irony, detachment and acceptance. Thus, for me, Sertraline has been by far the most useful, long-term treatment option I have found. Unlike in-patient admissions, or time-limited courses of psychotherapy, medication is not something that changes, is in flux, or transient. That said, I obviously don’t like the thought that I may be on anti-depressant for the rest of my life (or, at the least, for the foreseeable future), though this is preferable to struggling with low moods and heightened levels of anxiety.
For around 10 years, from 2014-2025, I managed my eating disorder better and through very limited interventions (e.g. a 10 minute monthly check-up of bloods and weight with my GP, and a shortish 4 month in-patient admission). However, I did not address my gender dysphoria during this time. My mood and anxiety stabilised somewhat, but my OCD became even more entrenched and life limiting. This was a period of surviving, where managing the eating disorder sufficiently to prevent re-admission became my only real concern. Thus, life became very narrow due to the combined and very limiting routines of the OCD and anorexia. There was not the space to try to explore my gender identity and gender expression. I settled into a non-binary space, but one that also involved suppressing thinking about gender. I was closed off to my emotional and psychological needs and preoccupied by the needs of the OCD and anorexia.
Ultimately, this led to a further in-patient admission for around 8 months in 2025. In January 2026, and following discharge from in-patient treatment in December 2025, I began ongoing weekly 1-hour outpatient psychological therapy through an NHS eating disorder service. These experiences have provided me with an opportunity to address a number of issues related to the eating disorder that were previously unaddressed (e.g. autism, OCD and gender dysphoria). It was during the 2025 inpatient admission that I actually received a diagnosis of autism and recognition of the debilitating aspects of the OCD. Since receiving the autism diagnosis I have not explored it in any great detail. I have not specifically had these issues addressed through pharmacological means, since many the problems that manifest in autism (e.g. difficulty maintaining social connections) are not directly addressed in this way. However, the SSRI, which manages anxiety, and the Aripiprazole that manages repetitive behaviours may help. The autism has been a part of the talking therapy I received as an in-patient (and subsequently as an outpatient), but it has not become the focus of my treatment. I am cautious about autism replacing anorexic as a label. I have not found it helpful to have everything perceived and interpreted through the lens of an eating disorder, and I do not think I would find it any better to have everything perceived and understood though the lens of autism. I am someone, an individual, who has anorexia and autism. I am also someone with gender dysphoria and attention has been shifted from this aspect of my identity due to the eating disorder. I do not want therapy for autism that negates the recognition that I am also an individual, or that I have gender dysphoria.
Rather like the Generalised Anxiety, the OCD is now treated pharmacologically. In addition to the SSRI, which has helped to minimise some of my troubling anxiety, I now take an atypical anti-psychotic (Aripiprazole) at a low dose. As with the SSRI, the atypical anti-psychotic is no magic bullet, but there has been a reduction to the debilitating aspect of OCD and I have become less rigid and routine-focused in general. These are also traits associated with autism, and it has been suggested that atypical anti-psychotics, such as Risperidone and Aripiprazole, can reduce some of the more troubling parts of autism (such as self-injurious headbanging in children; Bunting & Feldman, 2023; Advanced Autism, 2025).
One aspect of this less rigid, more flexible, less routine and structured way of living has been that it has allowed me to reconnect with my gender dysphoria. However, I am beginning to experience this reconnecting with my gender identity as gender euphoria rather than gender dysphoria. I am still non-binary, but rather than seeing non-binary as a fixed thing that I present in the same way day in, day out, I am seeing it as something to euphorically play with. It is a non-rigid, flexible, fluid, messy identity. I am trying to embrace a gender identity that is not a rigidly stable, non-binary existence, but a more fully alive genderqueer, genderfuck way of living that embraces the idea that gender can be messy.
I have spent my life trying to suppress gender, perceiving it to be a disordered dysphoria that had to be regulated through a fixed, unchanging kind of non-binary identity. I am now embracing the messy disorder of gender euphoria, where even the non-binary position need not become a rigid, inflexible identity. This is a very new place that I have only approached in the last few months.
References
Advancedautism. (2025, February 25). How risperidone helps in autism treatment. https://www.advancedautism.com/post/risperidone-for-autism
Bunting, A., & Feldman, H. (2023, April 26). Aripiprazole in autism spectrum disorder: Current evidence for use. BJPsych Advances, 29(5): 290-294. https://doi.org/10.1192/bja.2022.77
Cusack, C.E., Levenson, N.H., & Galupo, M.P. (2022). “Anorexia wants to kill me, dysphoria wants me to live”: Centering transgender and nonbinary experiences in eating disorder treatment. Journal of LGBTQ Issues in Counseling, 16(3). https://doi.org/10.1080/26924951.2022.2054492
Harrop, E.N., Hecht, H.K., Harner, V., Call, J., & Holloway, B.T. (2022). “How do I exist in this body… that’s outside of the norm?” Trans and nonbinary experiences of conformity, coping, and connection in atypical anorexia. International Journal of Environmental Research and Public Health. https://doi.org/10.3390/ijerph20021156
Para valorar camiseta de fútbol de la selección española con criterios claros, es recomendable revisar la versión local, visitante o alternativa. El pedido puede cerrarse después de confirmar la temporada indicada y cualquier opción de personalización.
Loria, M., Tabernacki, T., Fraiman, E., Perez, J., Zeki, J.A., Palozzi, J., Goldblatt, C., Gupta, S., Mishra, K., McNamara, M., & Banik, S. (2024). The impact of gender-affirming interventions on eating disorder diagnosis risk among transgender and gender-diverse individuals. Communications Medicine, 4(283). https://doi.org/10.1038/s43856-024-00704-7
Protos, K. (2021). Restricting the gendered body: Understanding the trans-masculine adolescent with anorexia. Clinical Social Work Journal, 49: 380-390. https://doi.org/10.1007/s10615-020-00758-9