Title

Eating-related pathology at the intersection of gender identity and expression, sexual orientation, and weight status: An intersectional Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) of the Growing Up Today Study cohorts

UMMS Affiliation

Clinical and Population Health Research Program, Graduate School of Biomedical Sciences; Department of Population and Quantitative Health Sciences

Publication Date

2021-07-01

Document Type

Article

Disciplines

Gender and Sexuality | Psychiatry and Psychology

Abstract

The objective of this study was to investigate how gender identity, the overwhelmingly prioritized dimension of social identity/position in eating-related pathology research, intersects with gender expression, sexual orientation, and weight status to structure the social patterning of eating disorders and disordered eating behaviors among young people in the U.S. Data were drawn from the 2010/2011 Growing Up Today Study (GUTS; N = 11,090-13,307). We conducted an intersectional Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) by nesting participants within social strata defined by intersecting gender identity, gender expression, sexual orientation, and weight status categories in a series of multilevel logistic models for four outcomes (past-year purging, overeating, and binge eating; lifetime eating disorder diagnosis). To illustrate the advantages of intersectional MAIHDA, we compared the results to those from unitary and conventional intersectional analyses. The intersectional MAIHDA revealed a complex social patterning of eating-related pathology characterized by heterogeneity and outcome-specificity. Several multiply marginalized strata (e.g., those including gender nonconforming, sexual minority, and/or larger-bodied girls/women) had disproportionately elevated prevalence, although all estimates were driven by additive effects. Notably, these patterns were obscured within the unitary and conventional intersectional analyses. Future epidemiologic research on eating-related pathology should continue to adopt an intersectional approach through the use of appropriate methodologies.

Keywords

Eating disorders, Epidemiology, Gender, Intersectionality, MAIHDA, Sexual orientation, USA, Weight status

DOI of Published Version

10.1016/j.socscimed.2021.114092

Source

Beccia AL, Baek J, Austin SB, Jesdale WM, Lapane KL. Eating-related pathology at the intersection of gender identity and expression, sexual orientation, and weight status: An intersectional Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) of the Growing Up Today Study cohorts. Soc Sci Med. 2021 Jul;281:114092. doi: 10.1016/j.socscimed.2021.114092. Epub 2021 May 31. PMID: 34118689; PMCID: PMC8372301. Link to article on publisher's site

Journal/Book/Conference Title

Social science and medicine (1982)

PubMed ID

34118689

Related Resources

Link to Article in PubMed

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