Gender-informed care is close to my heart. When working with clients with an eating disorder, a gender-informed lens is necessary, and allowing space for clients to be seen and feel heard is vital to the recovery process. Doing so allows a provider to open their eyes past the binary and see individuals for who they are. In my work with Monte Nido, I educate staff on gender-informed care while continually looking for ways to further educate myself.
Knowing what has led someone to seek out treatment is essential to developing a care plan that will give an individual the tools to heal. When listening to their stories it is important to remain neutral and not discount any one person’s lived experience. As a professional develops a gender-informed dialogue within themselves, they are better able to meet the client’s needs. The first step is always respecting an individual’s pronouns, paying attention to how individuals introduce themselves, and the order of their pronouns listed (typically, they can be listed in order of preference). This is a great stepping stone to showing individuals that you care and are paying attention to how they identify.
My role within Monte Nido & Affiliates allows me to integrate and perpetuate gender-informed care, which is supported by leadership. Within Monte Nido, programming is gender-informed, and training is available for new and tenured staff. Monte Nido also offers in-service training to staff in collaboration with Schuyler Bailar, the first trans athlete to compete in any sport on an NCAA D1 men’s team, and the only to have competed for all four years (Bailar 2022).
He is an internationally-celebrated inspirational speaker and a respected advocate for inclusion, body acceptance, and mental health awareness (Bailar 2022). In addition, he is an alumnus of one of our programs and currently is a Monte Nido Fellow, where he works closely with the team at Monte Nido & Affiliates to continue teaching and guiding others on gender-inclusive care, particularly in the context of eating disorder treatment. It’s been very valuable for staff to learn from individuals with lived experiences who also have a passion for educating others.
In my experience, identifying as queer and non-binary does not mean one has learned all there is to know about being queer and non-binary. It’s important for providers to be open and learn from clients and other professionals. Actively looking for feedback and implementing it are crucial to developing as a professional. Another great resource for gender-informed care is the World Professional Association for Transgender Health (WPATH), an organization that promotes standards of health care through the articulation of its Standards of Care guide. Their guide is free and accessible thru their website. Other individuals to learn from are Alok Vaid-Menon and social medial influencer Matt Bernstein.
Nutrition support in individuals struggling with disordered eating is my passion. It is beautiful to see someone start to heal their relationship with food and their body. Body image distress is often intertwined into an eating disorder and gender non-conforming individuals may have additional layers to explore. I help clients build a dialogue to untangle the differences between gender dysphoria and body dysmorphia. These two concepts are often intertwined in an individual’s thoughts and can affect an individual’s relationship with food.
Recently, I had a client who identified as a trans woman, who was struggling with this exact topic. In fact, she was tearful throughout the sessions. In our last session together, she started to tell me that she felt fine with gaining weight and that it was not an issue for her. I proceeded to ask why she thought she gained weight, knowing that her weight goal was weight stabilization/ maintenance. We ended up discussing the fact that her weight had not changed since admission. She started tearing up and said, “body dysmorphia is a bit*h.” Also, during this session, I noted that she was relying on some negative behaviors used in treatment.
She noted that a milieu increasing in cisgendered women made her feel that she was less of a woman and this thought led her to connect with her eating disorder for comfort. We then discussed affirming practices and a few skills they can use when they step down a level of care. This session was one of the most powerful sessions I have had, and one that has stayed with me.
Naming an experience or thought is powerful. What is also powerful is when a client you’re working with can notice and understand these concepts and use tools learned in treatment to break their disordered eating pattern. Untangling the web of body dysphoria and gender dysphoria begins with understanding individualized experiences. Knowing someone’s path to treatment is key to helping them heal. Admitting that you don’t know some things, being vulnerable to making mistakes, and learning from them is part of being gender-informed. It is also having compassion for others who are learning as well. For me is it comforting as a provider that Monte Nido & Affiliates supports gender-informed care and all that comes with it.
Brett Hanna MS, RD/N (they/he) completed their undergraduate education at Kent State University in Nutrition and Dietetics, and Exercise Physiology and their graduate education at Florida State University majoring in Exercise Physiology, which a concentration in Sports Nutrition. During their graduate career, they worked and completed research at the FSU Institute of Sports Science and Medicine while completing a Dietetic Internship focusing on eating disorder care, sports nutrition, clinical nutrition, and food service. Shortly after graduation, they joined the Monte Nido East Bay team, and have recently become the Director of Nutrition Services for all of the Monte Nido programs on the West Coast.