Research on influences of eating disorders have informed diagnosis and treatment of eating disorders, particularly for White cisgender women. A Perfect Biopsychosocial Storm is a theory of influences of disordered eating development: sociocultural influences of rigid body shape and size ideals, high rates of trauma and violence, experiences of objectification and sexualization, and biological changes (Maine & Bunnell, 2010). For transgender individuals, recent findings suggest disparities and negative mental health outcomes such as elevated prevalence of disordered eating, body image concerns, and self-reported disordered eating. For transgender men and women, researchers found that disordered eating may be related to attempts to masculinize/feminize the body, through effects like suppression of weight and secondary sex characteristics. For nonbinary individuals, motivations are unclear regarding masculinization/feminization. Further, while previous research has implicated experiences of marginalization in reduced body appreciation, impact on disordered eating behaviors in nonbinary individuals have yet to be explored. This study addressed gaps in research regarding experiences of nonbinary individuals with disordered eating. Through Grounded Theory qualitative analysis, I developed a framework to understand disordered eating among nonbinary individuals. Disordered eating was the surface-level manifestations of experiences such as trauma, distress surrounding bodily changes in puberty, and marginalization. Repeated marginalization, like misgendering and identity erasure, created conditions of shame to be associated with identity and self. Shame is a universal emotion that occurs when one does something they perceive as social transgressive and, thus, prevents connection. Shame motivates individuals to reduce socially transgressive behavior to increase connection with others. When one experiences marginalization and repeated shame surrounding identity, identity and self then can be experienced as a social transgression that prevents belonging. For example, participants described feelings of shame in comparison to the stereotypical image of a nonbinary person (White, masculine-leaning/androgynous, thin, tall). Disordered eating facilitated emotional coping, and, for some participants, helped achievement of gender presentation. Disordered eating also was associated with consequences of further shame around eating behaviors, and feelings of lack of control. Recovery and healing was supported through combating shame and disempowerment: being seen and empowerment through choice.

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This study investigated the connection between Body Dissatisfaction and Drive for Thinness to several psychological correlates: Ineffectiveness, Interpersonal Distrust, Perfectionism, Interoceptive Awareness, and Maturity Fears. Regression analyses indicated that these five correlates together accounted for 23% of the variance in a measure of Body Dissatisfaction. Body Dissatisfaction and the five correlates together accounted for 52% of the variance in a measure of Drive for Thinness. Results of the path analysis confirmed that Ineffectiveness, Interoceptive Awareness and Maturity Fears were the strongest predictors of Body Dissatisfaction. In turn, Body Dissatisfaction, Ineffectiveness and Interoceptive Awareness were the strongest predictors of Drive for Thinness. Gender differences and prevalence rates of eating disordered behavior were reviewed. Consistent with other research, this study confirmed high levels of bingeing and purging behavior (44%) among college men and women. / Ph. D.