July 20, 2015 Jenna Jarrold

Beyond "He" and "She": Teens and Gender Identity

teen gender identityGender identity has become a hot topic in the mental health field. It's of special concern for eating disorder professionals, since new research indicates a far higher incidence of eating disorders among transgender and gender fluid young adults.

The Gender Spectrum

Individuals are typically assigned one of two genders at birth, based on external genitalia. However, gender is multifaceted, not binary, and many individuals fall somewhere in between.

Gender Identity Terms:

  • Gender fluid: Gender identity that may change over time
  • Non-binary: Used to describe people whose gender in not strictly male or female
  • Transgender: For people whose gender identity differs from the sex or gender they were assigned at birth.

There are many possible explanations for the high correlation between gender fluidity, negative body image and eating disorders. For example:

  • Rejection or fear of rejection by friends and family members
  • Negative self-image based on non-conforming gender expressions or transgender identity
  • Violence or bullying can contribute to development of post-traumatic stress disorder, which sharply increases vulnerability to eating disorders
  • Lack of body acceptance or desire to have a body appear differently
  • Lack of support from family and friends

"Sensitivity to concerns about gender identity is important to us," says Jodi Tudisco, Clinical Director for Mirasol's teen eating disorder treatment program. "We're recognizing that we need to adjust some aspects of our program, for example, the gender identification section on our intake form and the use of gender pronouns."

Mirasol therapist Jenna Jarrold agrees. "We're very open to not labeling clients by gender. It takes time for staff to learn to use gender-neutral pronouns, but it's important to show clients that we are making an effort."

There's some helpful information on the use of gender-neutral pronouns at genderneutralpronoun.wordpress.com.

Exploring Gender Identity in Treatment

"Clients admitting to treatment have lost themselves to their eating disorders," says Tudisco. "Our job is to help clients find themselves. As part of the process of self-discovery, teen clients are likely to look at all aspects of themselves, including gender identity and sexuality."

Tudisco advises parents of children and teens exploring their gender identity to focus on providing support. "The most important thing parents can do is to be open to learning about their children while they discover who they are. This kind of validation from parents can become a powerful tool in helping clients accept and love themselves."

If a client chooses to inform family members about gender identity during the course of treatment at Mirasol, therapists work to support both the client and the parents through this process. As Tudisco explains, "We don't treat gender neutral or gender fluid clients any differently than other clients, because ultimately treatment is about acceptance and self-love." Tudisco goes on to say, "Rapidly changing attitudes toward gender identity create an opportunity for staff to improve the way we role model. The behavior I want to model focuses on the individual rather than a gender label."