Trans kids are vulnerable to eating disorders. This therapist knows what they’re going through.

This story was originally published by The 19th.Penny Gautreaux has spent her career helping people in crisis. But facing her own took a village.A licensed social worker and therapist, Gautreaux struggled with an eating disorder for 24 years. As a transgender woman, dysphoria tied to her gender made it worse. She was hospitalized twice for being undernourished. She was, as she puts it, gearing up for a third round of hospitalization when the people in her life stepped in. Her own therapist gave her an ultimatum: no more appointments unless she got help. Gautreaux’s long-time partner, spurred by this professional warning, “all but carried” her to a treatment program, Gautreaux said. Seeking help was a long time coming: her disordered eating had begun when she was 11. Transgender youth are particularly vulnerable to eating disorders, or EDs. Dysphoria plays a role, but the risk is compounded by other factors like depression and discrimination. The risk is highest for adolescents and young adults: Trans college students are up to four times as likely to have an ED diagnosis as their cisgender peers. For Gautreaux, her disordered eating had to do with her family. “There were people in my family who felt that my size was going to be a deterrent to my future, and so I was put on severe diets,” she said. “Most families think they’re helping, because we live in a culture that’s fatphobic.” The situation worsened when she came out as trans and was kicked out of the house. From 17 to 24, she was what she described as “on-and-off” homeless — often sleeping in her car or staying with friends. That made things worse. When she had to choose between buying food or putting gas in the car to have air conditioning in the summer heat, she chose gas every time. That wasn’t just survival, she said; that was her eating disorder at work. For many LGBTQ+ people, Gautreaux’s story is familiar. LGBTQ+ people are more likely to have an eating disorder than cisgende