"Coming Out:" Gay Men and Eating Disorders By Travis Mathews Coming out of the closet isn't usually someone's idea of a good time. There's always the perceived risk that the confidant is going to drop you into a box labeled discard. Even in today's cheeky milieu of Will and Grace, admitting you're gay continues to be a cautionary tale, more so for some than others. What's helped me during those more difficult disclosures was the idea, the hope, the promise of a community that would support me if any worst case scenarios materialized. The resources for men coming to terms with their sexuality are plenty and the visibility of these resources helps in softening feelings of isolation and shame. I knew this, and I knew that I wasn't alone, even if I sometimes felt that way. So it was difficult to grasp why my struggle to come forward, to come out, about an eating disorder fell on deaf ears. The promise of support that had been there a decade earlier, when I announced I was gay, seemed forgotten, cowered under the shame of a having a woman's illness. I knew eating disorders affected women disproportionately (a 1997 study suggests a 1:6 ratio), but I knew from the most cursory scan of the gay community that we were a body-obsessed bunch. In time, I began meeting men who candidly spoke of their struggle with body image and food and I heard some constants that helped in explaining the lack of support. These were largely, but not exclusively, men who had felt emasculated or bullied for some part of their lives and were therefore reluctant to align with something that would further feminize them. I might be gay, but I'm not that gay, was the message. In short, I uncovered internalized homophobia within a community rampantly silenced behind rainbow pride stickers. As a filmmaker, I began sleuthing about the community to at once understand the many facets of eating disorders among gay men, to create a resource that was previously absent, and frankly, to distance myself from my own process by getting behind, not in front of, the camera. Over the course of two years I focused on seven gay men who had or were struggling with body obsession and eating disordered behavior to get a personal understanding of the larger community's silence. I also traveled to Roger's Memorial Hospital, the only residential center in the country that has a separate treatment program for men, to get a clinical understanding of the issues. These accounts are the crux of what became the documentary, Do I Look Fat? As I've traveled with the film, people continue to ask me the prevalance of eating disorders among gay men. My answer remains the same: it's difficult to know with real certainty. Men, both gay and straight, are generally reluctant to seek medical attention for any health related issue, eating disorders being no exception. And our culture feeds this reluctance by its steady framing of eating disorders as a woman's issue, with male footnotes for good measure. It's also hard to gage how prevalent this is because the language used to discuss eating disorders among men is limited. It's easy to overlook crystal meth use as a method of weight control or contracting HIV as a free ride to weight loss—when you haven't heard the words describing such phenomenon. Arnold Anderson, at the University of Iowa School of Medicine, agrees that men are underrepresented for a number of reasons, not least of which is lack of professional knowledge. In an article published in the medical journal The Lancet he writes "in terms of severity, there's no question that medically, psychologically and socially, the impairment is equally as great [as with women]." Numbers may be hard to nail down, but studies consistently show gay men disproportionately represented among men with eating disorders. Considering that gay men are thought to represent about 5% of the male population, it's alarming that they represent a significantly higher percentage of the male eating disordered population. The reasons behind the higher incidents are complex, painful, and in part, unflattering to the gay community, but the alternative to facing them head on is continued isolation and shame, both of which feed our proverbial friend, the closet. It occurs to me that I'm asked to come out of the closet with each screening of Do I Look Fat? by disclosing my relationship to this material. It's a real turnaround because the audience response has been almost exclusively positive, less the cautionary tale I was fearful of meeting. It's been the start of something I was fretfully searching for just a few years ago: language, support, and awareness. For this beginning, with my own healing and with that of the community, I'm grateful. And it is just a beginning.