Finding Affirming Eating Disorder Treatment for Transgender Individuals in Philadelphia

Finding the right help for an eating disorder is challenging enough. When you're also navigating your gender identity, it can feel nearly impossible to find someone who truly understands both experiences. You might have looked at treatment options that felt sterile, heteronormative, or just completely disconnected from your reality as a queer or trans person. That's not just frustrating—it's isolating when you're already dealing with so much.

This article explores what culturally competent eating disorder care looks like for transgender and gender-diverse individuals, and how to find support that honors all parts of who you are. Because healing shouldn't require you to leave pieces of yourself at the door.

Key Takeaways

• Affirming eating disorder treatment addresses both your relationship with food and the complex ways gender identity intersects with body image
• Therapeutic approaches like Internal Family Systems, Psychodynamic Therapy, and Art Therapy can help you explore identity and eating patterns in creative, embodied ways
• Understanding the difference between gender dysphoria symptoms and eating disorder behaviors is essential for meaningful recovery
• Your recovery journey is yours to define—it doesn't have to look like anyone else's path
• Finding a queer-identified therapist with specialized training in both eating disorders and gender-affirming care can make all the difference

Why Traditional Eating Disorder Treatment Falls Short for LGBTQ+ Folks

Traditional eating disorder treatment programs often miss the mark for queer and trans individuals. They're frequently designed with cisgender, heterosexual experiences in mind, using recovery narratives that can feel alienating or even invalidating. When you're a 35-year-old non-binary tech worker who's spent years navigating perfectionism and people-pleasing while also managing gender dysphoria, cookie-cutter treatment approaches just don't cut it.

The reality is that your relationship with food and your body isn't happening in a vacuum. It's deeply connected to how you experience your gender identity, how the world responds to that identity, and the unique stressors that come with being queer or trans in a society that doesn't always make space for you.

What Makes Care Truly Affirming

Affirming care means working with someone who understands that your eating disorder and your gender identity aren't separate issues to be addressed in isolation. As a queer-identified eating disorder therapist with advanced training in gender-affirming care, I approach treatment by recognizing how these experiences intertwine in your daily life.

This means I won't ask you to put your gender journey on hold while we address eating disorder symptoms. Instead, I help you understand how these parts of your experience influence each other, so recovery can feel authentic to who you actually are—not who some treatment manual says you should be.

Understanding the Intersection

For many transgender and gender-diverse people, disordered eating behaviors can develop as a way to manage gender dysphoria or attempt to control body characteristics that don't align with their gender identity. Maybe you've restricted food to prevent curves from developing, or to maintain a body size that feels less feminine or more androgynous. Perhaps you've used exercise compulsively to achieve a specific physique that feels more aligned with your internal sense of self.

These behaviors often make sense as coping strategies—until they don't. Until they start controlling your life, impacting your health, and ironically, making it harder to move toward the gender expression you want.

In my practice, I help you:

• Differentiate between symptoms driven by gender dysphoria versus those rooted in eating disorder patterns
• Develop strategies that support your gender affirmation while also honoring your body's nutritional needs
• Address fears about body changes during transition without defaulting to restrictive eating
• Create a recovery path that respects your authentic self and your transition goals

Therapeutic Approaches That Actually Fit

When you're working through an eating disorder while also navigating gender identity, the therapeutic approach matters deeply. I use a relational, experiential style rather than a traditional CBT approach, which means our work together goes beyond symptom management to explore the deeper roots of your relationship with food and your body.

Psychodynamic Therapy: Getting to the Root

Psychodynamic therapy explores how your past experiences—particularly from childhood and family dynamics—influence your current relationship with food, your body, and your sense of self. For many of my clients, this approach helps untangle what parts of their identity are authentically theirs versus what they've internalized from family expectations, societal pressures, or survival strategies developed early on.

This deeper exploration can be particularly powerful when you're trying to differentiate between people-pleasing patterns (maybe restricting to meet others' expectations of how you should look) and authentic choices that support your wellbeing and gender expression.

Internal Family Systems: Making Peace with All Parts of Yourself

Internal Family Systems (IFS) is a therapeutic approach that views the psyche as naturally multiple—made up of different "parts" that each have their own perspectives, feelings, and motivations. This framework can be incredibly helpful for understanding the internal conflicts many people experience around eating disorders and gender identity.

Maybe you have a part that desperately wants to restrict food to manage dysphoria, while another part knows you need nourishment. Perhaps there's a part that feels shame about your body, another that's angry about how people perceive you, and yet another that just wants to feel at peace in your skin.

Through IFS, I help you develop curiosity and compassion toward these different parts, understanding what they're trying to protect you from and what they need. This approach reduces the internal battle and helps you move forward with more integration and self-compassion.

Art Therapy: When Words Aren't Enough

Sometimes talking about your experiences with food, body image, and gender identity feels overwhelming or inadequate. Art therapy provides another language entirely. You don't need to be artistic or creative—the process itself is what matters.

Through drawing, painting, collage, or sculpture, you can express feelings about your body, your transition, or difficult past experiences that might be too complex or painful to verbalize. This can help you see patterns you hadn't noticed before and process emotions in a gentler, more embodied way.

For trans and gender-diverse clients, art therapy can be particularly powerful for exploring the relationship between internal gender identity and external body experience, processing dysphoria, or imagining future possibilities for yourself.

Exposure and Response Prevention for OCD

If you're dealing with OCD alongside your eating disorder and gender identity exploration, you know how intrusive thoughts can latch onto your deepest anxieties. Maybe you have obsessive thoughts about your body changing in unwanted ways during transition, or compulsions around checking your appearance, eating rituals, or body-checking behaviors.

I use Exposure and Response Prevention (ERP) to help you gradually face anxiety-triggering situations (the exposures) while practicing not engaging in compulsive behaviors (the response prevention). This includes weekly homework assignments where you'll monitor obsessive thoughts and compulsions while practicing your exposure exercises.

For example, if you have intrusive thoughts about weight gain during hormone therapy, we might work on tolerating that anxiety without resorting to restrictive eating or excessive exercise. It's about learning you can handle discomfort without needing to control it through disordered behaviors.

Navigating Gender Dysphoria and Eating Disorder Recovery Together

One of the most complex aspects of recovery for transgender individuals is untangling what's driven by gender dysphoria versus what's rooted in eating disorder pathology. These experiences can overlap in ways that make it hard to know which is which.

Understanding What's Driving What

Living in a body that doesn't feel aligned with your gender identity is profoundly challenging. When you add an eating disorder to the mix, things become even more complicated. Sometimes, disordered eating behaviors start as an attempt to manage dysphoria—changing your body shape to feel more masculine, feminine, or androgynous. It can feel like your body and your sense of self are in constant conflict.

In our work together, I help you sort through these feelings and behaviors with curiosity rather than judgment. We'll explore questions like: Is this food restriction about trying to control a specific body characteristic related to gender? Or has it become its own pattern that's actually making you feel worse? Is this exercise routine supporting your transition goals and mental health, or has it become disordered?

Getting clear on these distinctions helps us address both your gender identity affirmation and your relationship with food in ways that actually support your wellbeing.

Affirming Your Gender While Supporting Your Health

You shouldn't have to choose between affirming your gender identity and taking care of your physical health. In my practice, I help you find the balance—exploring ways to express your gender, connect with supportive communities, and work with affirming healthcare providers while also maintaining nutritional health.

This might involve looking at gender-affirming options beyond body manipulation through food restriction. It could mean exploring clothing, binders, tucking, packing, voice training, or other forms of gender expression that feel authentic without compromising your physical wellbeing. It's about building a life where you feel comfortable in your body, whatever that means for you.

Managing Body Changes During Transition

If you're undergoing hormone therapy or considering gender-affirming surgeries, body changes are inevitable—and sometimes, they can trigger eating disorder thoughts or behaviors. Hormonal shifts, changes in fat distribution, muscle development, or even just how clothes fit differently can bring up intense feelings, especially when you're also working through disordered eating patterns.

It's completely normal to have anxiety about these changes. In therapy, I help you process these feelings without turning to restriction, purging, or compulsive exercise. We work on building healthy coping mechanisms and developing a more accepting relationship with your body as it evolves—honoring both your transition journey and your recovery.

Addressing Trauma, Identity, and Eating Disorders

For many of my clients, eating disorders don't exist in isolation. They're often connected to experiences of trauma, particularly trauma related to identity, discrimination, or marginalization.

Identity-Based Trauma

If you've experienced family rejection after coming out, religious trauma, or discrimination because of your gender identity or sexual orientation, you know how deeply these experiences can impact your sense of safety and self-worth. Sometimes, controlling food or your body becomes a way to manage the pain of not being accepted for who you are.

In my practice, I create space to explore these connections. I understand how identity-based trauma can show up in your relationship with food and your body, and I work with you to process these experiences in a way that feels safe and affirming.

The Impact of Minority Stress

Living as a queer or trans person means navigating a world that doesn't always recognize or respect your identity. This constant stress—called minority stress—can accumulate over time, affecting your mental health in profound ways. For some people, eating disorders develop as a way to cope with this ongoing pressure.

I help you understand how societal marginalization might be influencing your eating disorder, while also building resilience against harmful messages from diet culture, transphobia, and other forms of oppression. This work is about reclaiming your space in the world and trusting your own experience.

What to Expect in Therapy With Me

Starting With a Free Consultation

If you're considering working with me, the first step is booking a 20-minute free phone consultation through my website. This gives us both a chance to see if we're a good fit. You can ask questions about my approach, share a bit about what you're dealing with, and get a sense of whether you feel comfortable with me.

If you decide to move forward, I'll send you an email to set up your client portal and complete intake paperwork before our first session.

The First Session

In our first session together, I'll ask about what's bringing you to therapy right now. What's motivating you to seek help? What are your hopes for recovery? I'll ask about your history with food, your body, and your gender identity, and I'll screen for eating disorder symptoms.

I'll also explain more about my therapeutic approach and what you can expect in the coming weeks. The first few sessions are really about both of us getting a feel for whether this is the right fit. You're not locked into anything—this is your chance to see if my style works for you.

Ongoing Therapy

Once we establish care, I typically meet with clients weekly for one-hour sessions. You'll have a consistent day and time that's your slot each week, which helps create stability and continuity in the work. If you need more intensive support, you have the option of meeting more than once per week or scheduling 90-minute sessions.

Between sessions, I might send journal prompts to help you continue exploring themes that came up in our work. If you're doing ERP for OCD, you'll have weekly homework involving monitoring obsessive thoughts and compulsions and practicing exposure exercises.

Defining Your Own Path to Recovery

Recovery isn't a one-size-fits-all process, and it definitely doesn't look the same for everyone. Your recovery is yours to define—not mine, not some treatment manual's, and not society's.

What Recovery Actually Means

For you, recovery might mean being able to eat intuitively without constant anxiety. It might look like going to brunch with friends without planning what you'll order days in advance. It could mean wearing clothes that affirm your gender without worrying about what your body looks like in them. Or it might mean simply having space in your mind for things other than food, exercise, and body monitoring.

True recovery involves understanding how your eating disorder developed—recognizing the ways it might have helped you cope with difficult experiences, dysphoria, or overwhelming feelings—without judgment. It's about recognizing that your worth isn't tied to your body size, your eating habits, or how well you conform to anyone else's standards.

The goal is moving toward self-compassion, trusting your own voice, and building resilience against harmful messages from diet culture and transphobia. It's about reclaiming your life and living more authentically.

Rebuilding Trust With Your Body

A significant part of recovery involves learning to listen to your body's signals for hunger and fullness, and quieting the critical voice that constantly judges your appearance or food choices. This can feel especially complicated when you're also experiencing gender dysphoria—when your body doesn't feel like yours to begin with.

I help you develop strategies to care for your body that feel genuine and aligned with who you are. This might involve embodied practices like mindful movement, body scans, or simply paying attention to physical sensations without judgment. It's not about changing your body to accept it; it's about finding ways to be more present in your body as it is right now, while also pursuing whatever gender-affirming steps feel right for you.

Living Authentically

Ultimately, recovery is about living a life that feels more authentic and fulfilling. It means having healthier relationships—with yourself, with food, and with others. It means being able to handle life's challenges without defaulting to eating disorder behaviors.

This might look like spontaneously grabbing ice cream with a friend, fully participating in family meals without anxiety, or simply having the mental and emotional energy to pursue the things you actually care about—your art, your band practice, your video game campaign, your knitting projects. It's about feeling more in control of your life and more connected to yourself on a deeper level.

Finding a Therapist Who Actually Gets It

When you're looking for eating disorder treatment as a transgender or gender-diverse person, finding the right therapist can feel overwhelming. You need someone who understands both eating disorders and the complexity of gender identity—and ideally, someone who won't make you explain basic concepts about being trans or queer during every session.

Why My Perspective Matters

As a queer-identified eating disorder therapist with advanced training in gender-affirming care, I bring both professional expertise and personal understanding to this work. I'm married to a trans woman, which is a personal motivator for me in serving the LGBTQ+ community. I'm open about this because I want you to know that supporting trans and gender-diverse folks isn't just professional for me—it's personal.

I understand how traditional eating disorder recovery narratives can feel heteronormative and alienating to queer people. That's why I offer a more relational, experiential approach through Art Therapy, Internal Family Systems, and Psychodynamic work rather than standard CBT protocols. This difference matters—it's about honoring your whole experience, not just managing symptoms.

Creating a Safe Space

In my practice, you won't have to censor yourself or over-explain your experiences. I create space where you can be completely honest about your struggles with food, your body, your gender identity, and how these intersect in your life. You don't have to worry about being judged or misunderstood.

This safety extends to understanding the impact of discrimination and marginalization on your mental health. I'm knowledgeable about the specific challenges faced by the LGBTQ+ community, including internalized transphobia or homophobia, and I help you explore how your identity influences your relationship with food and your body without making assumptions.

Support for Partners and Families

If your partner is transitioning or your teen has come out as transgender, you might be feeling a mix of emotions—love, worry, confusion, maybe even grief. These feelings are normal, and they deserve attention too. Supporting someone through their gender journey while they're also dealing with an eating disorder requires understanding, patience, and often, professional guidance.

For Parents of Trans Youth

Creating a safe, affirming environment for your transgender or non-binary child is essential, especially if they're struggling with an eating disorder. This means allowing them to express themselves authentically and helping them find their inner strength as they navigate challenges at school and in social situations.

I offer therapy for queer and trans teens that helps them build confidence while addressing eating disorder symptoms. When appropriate, I work with families to create home environments where everyone feels connected, understood, and truly supported.

For Partners Navigating Transition

Being a partner to someone who is transitioning can bring both profound joy and complex challenges. You might be figuring out how to communicate your own needs, what intimacy looks like now, or how to maintain closeness as things shift. Your journey as a partner is valid and deserves attention.

I provide specialized support for partners of transitioning individuals, creating space where you can be honest about your own feelings without fear of judgment. This work can help strengthen your relationship and build deeper understanding between you and your partner.

Moving Forward

Finding affirming eating disorder treatment as a transgender or gender-diverse person doesn't have to mean settling for providers who don't fully understand your experience. You deserve care that honors all parts of who you are—your gender identity, your relationship with food, your past experiences, and your hopes for the future.

In my Philadelphia-based practice, I work with LGBTQ+ individuals who are navigating the complex intersection of eating disorders and gender identity. I offer both in-person and online therapy sessions, providing flexibility to meet your needs.

If you're struggling with an eating disorder and want to work with someone who truly understands the unique challenges faced by trans and gender-diverse folks, I invite you to reach out. You can book a free 20-minute consultation through my website to learn more about my approach and see if we might be a good fit.

Recovery is possible, and it doesn't require you to fit into someone else's definition of what healing should look like. Your path forward is uniquely yours—let's explore it together.