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Sexual and gender minority youth (SGMY) experience higher levels of stress and incidents of disordered eating. Given these trends, it is unsurprising that SGMY diagnosed with an eating disorder report nearly four times greater odds than non-SGMY of attempting suicide, especially given the recurring harmful sociopolitical climate. However, there is limited research exploring the factors that may indicate risk for developing disordered eating, such as overeating, among SGMY. Disordered eating has also been found to be moderated by stress and exercise levels, yet the moderating effect of stress and exercise on overeating in SGMY has been grossly uncharted. This study aims to bridge the gap of knowledge of SGMY and overeating behaviors, and explores the relationship between stress and exercise and overeating behavior with respect to diverse sexual, gender and ethno-racial identities in a sample of SGMY.
Methods:
A cross-sectional U.S. national dataset of SGMY (n= 11,028) was analyzed. Bivariate relationships between the main study variables and overeating behavior were explored using a series of chi-squared and t-tests, and two logistic regression models were used to identify factors associated with overeating behavior. The first logistic regression model included sexual orientation, gender identity, ethno-racial identity, age, stress level, and exercise as main effects. The second set of models included interaction terms between sexual orientation, gender identity, race/ethnicity, stress, and exercise to assess potential moderating effects on SGM identities and overeating behavior.
Results:
Cisgender youth reported less overeating than transgender and gender diverse (TGD) youth (47.4% vs 52.6%) and regression models indicate TGD youth had a greater risk for overeating than their cisgender counterparts. Bivariate analyses indicate significant differences in overeating behavior among sexual orientation groups. Specifically, gay or lesbian (45.5% vs. 54.4%), straight (52.1% vs. 47.9%), and asexual (47.5% vs. 52.5%) youth reported engaging in less overeating behaviors than other sexual orientation groups. Bisexual, queer, pansexual, questioning, and “other” sexual orientation groups also had higher odds of overeating than SGMY identifying as straight. Among ethno-racial identities, Asian SGMY had the lowest rates of overeating, while the highest rates were reported by Native American and Middle Eastern/Arab youth. Finally, no interaction effects were found for SGMY and stress, or sexual orientation and exercise. However, an interaction effect was observed between gender identity and exercising. Specifically, the odds of overeating for TGD youth were higher than those for cisgender youth, regardless of their exercise level.
Conclusions/Implications:
The current study highlights the importance of addressing subgroup disparities among SGMY in relation to cis/heterosexism and anti-LGBTQ discrimination. It also points to the importance of adopting a critical intersectional feminist lens and LGBTQ-affirming approach to enhance mental health supports and health outcomes for diverse intersecting SGMY identities, especially SGMY experiencing stress and overeating. This presentation will explore related implications for social work practice, policy and research related to SGMY health. Given the significant disparities in health and mental health experienced by SGMY, it behooves social work researchers and practitioners to place greater focus on this emerging area of intersectional social work practice.