Risk and protective factors for disordered eating in LGBTQ+ youth: a systematic review; and, “He doesn’t understand but I know he'll always support me”: an interpretative phenomenological analysis of young people coming out to their parents
BACKGROUND: LGBTQ+ young people are at increased risk of negative health outcomes compared to heterosexual and cisgender peers. It is theorised that this relates to greater exposure to minority stress, as well as systemic barriers and negative experiences within healthcare. Further insight is needed into the experiences of sexual and gender minority individuals to inform resources and to develop clinical practice. AIMS: This thesis is split into two studies. The first aimed to conduct a systematic review of the literature to identify risk factors for and protective factors against disordered eating in LGBTQ+ youth. The second study aimed to gain a deeper understanding of LGBTQ+ young peoples’ experiences of coming out to their parents or carers. METHOD: A systematic search of eight databases was conducted using key words and inclusion and exclusion criteria to identify relevant research for review. The quality of the final papers was assessed. The empirical project utilised Interpretative Phenomenological Analysis and semi-structured interviews to examine the experiences of eight LGBTQ+ young people. RESULTS: The systematic review produced nineteen relevant articles which were judged to be of acceptable quality. A narrative synthesis identified body dissatisfaction, appearance pressure, bisexuality, emotional distress, bullying and gender incongruence as risk factors for disordered eating. Positive parent-child relationships and access to gender-affirming care were identified as protective factors. Findings from the empirical study revealed the significance of the nature of the parent-child relationship, navigating identity and expression and selective disclosure within LGBTQ+ young peoples’ experiences of coming out to parents. CONCLUSION: Though more research is urgently required, the systematic review highlighted possible risk and protective factors to be addressed at screening and within prevention and intervention strategies for disordered eating in LGBTQ+ young people. Clinicians and parents may also benefit from engaging with the coming out narratives of LGBTQ+ young people. Despite evidence of increasing acceptance of one’s own sexuality and gender, the study suggests that coming out remains a multi-faceted and challenging process for young people to navigate, particularly for those with complex family relationships and cultural considerations.