Eating Disorder Organization Pushes Gender Ideology on Minors

Individuals with eating disorders, especially those who are not yet adults, often struggle with the psychological complexities of anxiety, depression, and body image. It is therefore particularly worrying that a group would impose a dangerous ideology onto a child who is psychologically and physically suffering. 

And yet, that appears to be what is happening at the Eating Recovery Center (ERC), a nationwide eating disorder treatment center with numerous facilities and a great deal of online resources.

Although ERC’s website appears to be geared towards eating disorders, it only takes one click to find the following page, titled “Supporting Trans People with Eating Disorders: A Guide for Providers.”

This header appears cleverly crafted. There is a noticeable difference between these words on the webpage and the actual URL, which ends with “family-based-treatment-for-trans-youth-with-eating disorders [emphasis ours].”

The headline hides what the rest of the page explicitly says – namely, that the content is primarily centered on youth. 

To begin, ERC centers its care around the so-called “gender-affirming” model. It endorses the “right to be affirmed” and the right to “receive gender-affirming medical care and gender-affirming mental health care. Full stop.”

It continues:

Eating disorders in transgender teens

First, let’s talk about trans youth. Adolescence is a time of blossoming gender identity and expression…For trans youth, when the body image doesn’t quite line up with who they want to portray in the world, like when a trans male begins to grow larger hips and breasts, gender dysphoria can arise. And it is extremely painful.

An organization that ostensibly seeks to treat eating disorders should not be rushing to “affirm” the self-professed gender of a distressed child; doing so pushes children onto the transgender medicalization pathway and encourages further harmful interventions. This is important, given the ERC’s explicit advice:

As eating disorder professionals, we must ask ourselves if the person we see in our office has a true eating disorder or sub-threshold eating disorder behaviors that are intended to increase acceptance and affirmation as their identified gender. Is the eating disorder about losing weight or is it about aligning with one’s identified gender?

This poses a serious concern: why does ERC advocate for “affirming” a youth’s gender identity, yet encourage scrutiny of an eating disorder to determine if it might be masking gender dysphoria?

Could ERC’s approach suggest to a patient that his or her eating disorder might stem from being transgender?

As concerning as this sounds (and also being at odds with solid, medically-based mental health care), there is solid reason to believe ERC is doing exactly that. Consider the following from the same page:

Benefits of gender-affirming treatment for trans individuals

Here’s one of our favorite data pieces to share.

When trans individuals take part in gender-affirming gender reassignment and gender dysphoria treatment, there is often a reduction in eating disorder behaviors. When one’s gender is affirmed and gender dysphoria is reduced, eating disorder symptoms decrease.

Isn’t that amazing? Treating underlying gender dysphoria is critical to supporting the health of transgender individuals, and this is supported by the data.[10, 11] By starting hormone treatment and gender-affirming surgery, body dissatisfaction decreases along with eating disorder symptoms.

First, the claims here are dubious.

Large-scale analyses such as the Cass Review and the Department of Health and Human Services’ “Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices” demonstrate that the evidence supporting so-called “gender-affirming care” to treat sex-confused children is greatly lacking.

Second, the way in which ERC makes these claims (“Isn’t that amazing?”) indicates an almost cheerleader-like endorsement of gender ideology. It’s as though ERC is so committed to the so-called “gender-affirming” approach that it resists even entertaining the possibility of an alternative being valid.

And is ERC so intent on this being true that the idea is suggested to patients when it may not even be a relevant clinical consideration? Imagine what that would do to a young mind.

But then ERC reveals its position by explicitly admitting that it’s doing exactly that:

Screen all patients with gender dysphoria for eating disorders and vice versa

Further, every patient you talk to who has gender dysphoria should be screened for eating disorders. Every patient you see for an eating disorder should be asked about gender dysphoria.

An example of a question that you might consider asking would be, “From head to toe, what do you like/not like about your gender?”

For the record, screening for co-morbid psychiatric disorders and conditions is perfectly acceptable. Pushing gender ideology onto children through that process is not.

As if that were not enough to be appalled at the actions of ERC, it gets worse. In the section on the same page titled “Family-based treatment for trans youth with eating disorders,” ERC informs readers:

Here at Eating Recovery Center, we believe, and research has indicated, that the core tenets of family-based treatment (FBT) are essential to helping people recover from eating disorders. When it comes to trans youth, however, we must be cautious. We cannot assume that trans teens are fully supported by their family. We cannot assume that families will affirm their child’s preferred gender, name, and pronouns. If the trans patient does not feel affirmed, respected, and seen, they may struggle to do hard work with their family of origin in a family therapy setting and eating disorder recovery may stall.

Creating a warm and accepting environment in treatment is an essential component to support recovery.

For FBT and Emotion-Focused Family Therapy (EFFT) to work, the family must be in a place where healing can occur. Keep the options open for trans patients to work with a “family of choice” if their “family of origin” is not affirming because, while we do put some individual life activities on hold during treatment, we don’t want to put a patient’s gender development on hold [emphasis ours].

This comes across as painting the family of the patient as a potential enemy – or just plain ignorant. ERC is sending a message here that starts with an assumption that many parents are not acting in their children’s best interests.

Is ERC suggesting that it is better equipped to serve as a parent than the actual parents themselves? Does ERC truly believe that a child’s family should effectively be “replaced” simply because the parents question immediate “affirmation?”

By this model, it is de facto decided before you even arrive that if you question ERC, you are harming your own child.

This isn’t treatment based in science. It’s more akin to the power of suggestion used at an illusionist’s show, except in this case, the audience is the minds of our youth. 

Rather than relying on fleeting social trends or unproven theories, ERC should stop promoting gender ideology on kids when the evidence simply isn’t there. Children struggling with legitimate problems deserve better.