When gender dysphoria compounds body dysmorphia: body image, anorexia, and gender identity.

I’m tired.

I’m tired of hearing the eating disorder voice berate me: “you can’t, you can’t, you must, you shouldn’t, you did, now you will” rattle in my brain on repeat.

I’m tired of hearing it say, “You take up too much space, your legs shouldn’t touch when you sit in a chair, your stomach rolls. It’s disgusting – your hair, your skin, your face, your voice, YOU.”

I’m sick of negative thoughts continuing to creep in the shadows.

The regular, everyday sensations of fullness and hunger feel exaggerated in every part of my body.

I want to flee. I want to be a fugitive. But that’s kind of what got me here in the first place.

It feels intolerable. I feel like a blob of an hourglass shape with not even a hint of a rib to count.

I feel soft, and it feels wrong for ME to be soft.

As my weight restores and redistributes, my chest is feeling cumbersome.

This is the first time in over two years that I have been in this body shape. This is the first time ever that I’ve been in this body with the self-awareness I have today.

Body image issues are notoriously difficult to overcome in eating disorder recovery. As I’m working towards understanding my gender identity, I’m dealing with the effects of experiencing both body dysmorphia and gender dysphoria simultaneously.

Body dysmorphia is about shame. Shame about being in my body. Shame of what my body looks like or what I think it looks like, and shame about my body existing in this world. My distorted perceptions of and preoccupations with my stomach, my thighs, even at times my neck cause intense anxiety.  

Body dysmorphia is about having ruminating thoughts about the size of my thighs against chairs in the middle of a group and not being able to pay attention to the content. It’s about sitting across from my partner and focusing on my thighs touching each other, and not being able to focus on the story she is telling me.

Body dysmorphia is walking down the sidewalk in public with the crippling anxiety of seeing your reflection in the store window. Body dysmorphia limits my ability to function. It limits my ability to be present; to be here. Now.

My eating disorder lusts for a narrow, flat body. My eating disorder tells me that parts of my body are wrong, bad, and flawed. It tells me this over and over and over again. So these thoughts must be true, right????

I ask myself where the line is between body dysmorphia and my gender dysphoria.

Perhaps, and this most likely is the case, it’s a little bit of both and there is not one distinct line. It’s not that simple. 

Gender dysphoria, unlike body dysmorphia, is not a disorder in and of itself. The pathology, however, that is often associated with it is likely a consequence of having difficulty coping with dysphoric thoughts and feelings. Gender dysphoria dictates how my body should be a certain way so that it doesn’t conflict with my internal experience of my gender identity.

I feel restless, anxious, and acutely aware of typically gendered body parts such as my chest and hips. The dissonance between what feels internally true versus what is visible and real makes my body the source of suffering and distress. Because the way my body exists conflicts with my internal experience of my gender identity, the result is the strange sense of being something I’m not supposed to be. This intensifies my body dissatisfaction.

In treatment right now, I’m learning to accept my body as non-binary. I’m working on exploring ways to nourish my body and simultaneously learn to feel more comfortable in my body. The following dialectic can be true: I can nourish myself AND I can explore my gender identity.

That’s all easy to say right now, and in all honesty, it’s been a struggle. I’ve been exploring ways to feel more comfortable with my gender expression including using a chest binder, exploring pronouns, and the use of birth control to stop my period. The pain and discomfort that I’ve experienced with chest binding has made me think about what it means to change or alter my body from its “natural” state.

Is the pain worth it if I like the results?

Am I deserving of the pain because of my desire to change myself in the first place?

Why do I need to look a certain way to feel more like myself? The disappointment I feel with weight gain often overshadows everything.

I’m struggling with the idea that it feels imperative to change my body in order to feel a stronger sense of self. There’s also confusion because in a way, my eating disorder is just another way for me to change my body to align with my gender identity.

Why is it easier to justify the use of my eating disorder over chest binding, experimenting with pronouns, birth control, and wearing different clothing. There’s a lot of guilt associated with wanting to change my body from its natural form.

I recognize the privilege I have in regards to the treatment I’m receiving. I’m having difficult validating the privilege that exists in having access to things like birth control as well.

I struggle with legitimizing the privilege that exists in having the resources to purchase multiple binders to find a better fit and to find one that does not activate my body dysmorphia to the point where I want to crawl out of my skin all day.The guilt that comes with these recognitions is pervasive and humbling.

Even with this guilt and confusion around more philosophical nuances of altering one’s body, I’m learning how to accept my body and the countless intangibles within it.

I’m learning that my body is a non-binary body no matter what it looks like or feels like. I know that body parts don’t define femininity, masculinity, trans-masculinity, or androgyny. What makes a body non-binary is the person who resides inside of it and identifies that way.

In strength and healing,

OJ

When gender dysphoria compounds body dysmorphia: body image, anorexia, and gender identity.

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