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Beyond Binaries - Exploring How Gender Identity Impacts Eating Disorder Recovery

body movement eating disorder gender health help holistic yoga therapy inclusive therapy lgbtq2sia yoga therapy yoga toronto Mar 11, 2022

This blog is part of a special 12-month series titled, “Inclusive Eating Disorder Recovery: How Yoga Therapy Can Help” written for Yoga for Eating Disorders. Through my blogs and related social media posts, I will explore how we can use the ethics of Yoga, personal practice, movement, breath, focused attention, and meditation to create recovery spaces that are inclusive and reflective of diverse lived experience. Join in the conversation on Instagram by following along @yogaforeatingdisorders and @holisticyogatherapist.

Gender binary (phrase): The classification of gender into two distinct, opposite and disconnected forms of masculine and feminine whereby people are categorized exclusively as either male or female, based on biological sex.

In last month’s blog post, we explored how the philosophical principles of yoga, or the niyamas (nee-yuh-muhs), are guides for both addressing cultural and implicit biases, definitions of beauty, and healing body dissatisfaction. This month we investigate how gender identity impacts eating disorder recovery, and how yoga therapy can support a more inclusive eating disorder recovery for transgender, non-binary and agender individuals.

Socially and culturally men are expected to conform to stereotypical masculine behaviours and interests and women are expected to conform to stereotypical feminine behaviours and interests. This social and cultural binarism shapes the names we are given, the way we groom ourselves, the clothing we buy, the prices we pay for services, how we are treated, and how we are taught to see ourselves.

But gender has not always been viewed this way. Indigenous cultures from around the world have creation stories that include a spectrum of fluid and dynamic identities and ways of being. Often transgender, non-binary and agender individuals have special roles or community responsibilities and are valued leaders, teachers, and participants. 

A Third Gender

Ayurveda, the sister science to yoga, also includes mention of a third gender or constitutional way of being. It notes that gender identity should not be determined by biology but by psychology, and that our behaviours and choices related to names, sexuality and relationships are more definitive of what our gender identity is than our genitalia.

Colonization along with the general shift towards patriarchal social structures, and the spread of white supremacy changed the social and economic status for transgender, non-binary and agender individuals in these indigenous cultures. It continues to seriously and significantly impact their wellbeing.  

What the Research Says

Research indicates that people who identify outside of the gender binary are at more risk of developing disordered eating practices. Individuals diagnosed with gender dysphoria may have higher rates of dissatisfaction with their bodies. This dissatisfaction is associated disordered eating as part of an attempt to change bodily characteristics - either to shift away from those associated with the biological sex, or to better accentute those of the desired identity - especially if cultural bias indicates those attributes are highly desirable. 

However, there is little exploration of what the experience with treatment and recovery systems is like. The small amount of research that has been done indicates that discrimination within the healthcare system has impacts on access to, and experiences during treatment, and that community can play a positive role in recovery.

Why Yoga Therapy Can Help

How can yoga therapy support a more inclusive eating disorder recovery for transgender, non-binary and agender individuals? We have already explored how the yamas (yuh-muhs) and niyamas (nee-yuh-muhs) - or the first and second limbs of yoga provide recommendations for living in a healthy relationship with body, breath, mind and your environment. They can be particularly useful if you don’t feel fully at home in their bodies because of socially imposed ways of looking, being and expressing yourself.

Another limb of yoga that can be helpful is the fifth limb of pratyahara (pruh-tyah-hahr-uh). This aspect of the practice is often translated to mean withdrawal or the senses from the external world or sensory transcendence. You might wonder if this is possible, and if it is, how it can support recovery.


Our senses - what we see, hear, smell, taste and touch - determine how we engage with the world and how we respond to the often relentless, ongoing stimulus of being alive. Being continually responsive to every email alert, shiny object, and delightful smell leaves us distracted, exhausted, and disconnected from how we are really feeling and what we actually want. It can make it easy to completely ignore hunger, or to eat past the point of fullness as we let our past experiences, desires, attachments and aversions influence our actions without fully realising what is happening.

The practice of pratyahara or the deliberate, gentle refocusing of our attention internally instead of externally allows the time and space to allow our nervous system to relax and to access a deeper state of resting and healing. You might do this through a yoga nidra (n-ih-d-r-aa)  practice, or a mindfulness practice. 

You can also implement this practice as part of your daily routine by being mindful about routines that support your daily wellbeing like a consistent bedtime, or a mindful eating ritual. Over time, these positive habits help us restore our relationship with ourselves, be attentive to what we need in the moment and provide a space to rest and restore mind and body.

A pratyahara practice gives us the chance to look at ourselves without the bias, and distraction from the outside world. It can also help create the distance necessary for us to see social and cultural patterns or practices we embody that can be detrimental to our health and wellbeing. This has implications for researchers, clinicians and care seekers.

Call to Action

If you are a researcher in this space, you use a pratyahara practice to become more aware of how social and cultural patterns and practices shape who you work with, and how you work with them. You might also use this sharpened inner awareness to make room for non-binary experiences without further segregating populations. The practice of inward awareness might also help you decolonize your approach when working with systemically excluded colleagues, or change how you work with communities.

If you are a care provider, you might use a pratyahara practice to become more aware of how the external world shapes your internal perception of the people you support. You might also use that shift to a deeper internal awareness of how you practise to integrate more inclusive care practices, like exploring gender and sexuality questions with careseekers who present with an eating disorder, if they are open to it. You might also share these practices to support your colleagues with resources to model how it can be done and encourage them to do something similar.

If you are seeking care for yourself, or someone else, your practice of the pratyahara might help you find the distance and language you’d like to use to share your experiences, as well as to identify the sorts of care that would be most helpful to you. You might also  use the practice to better connect to a deeper space of rest and restoration so you feel better resourced to navigate existing systems and structures that can be overwhelming as you seek care and support?

If you are already using the practice of pratyahara to refocus your attention internally and to drive intentional healing within yourself or in your community, we would love to learn more about what you are up to. Please share how it is going so far, what has worked well, and what you might set aside. Tell us in the comments, or message us on instagram at @holisticyogatherapist  and @yogaforeatingdisorders

Resources to Support Your Exploration

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