Can discrimination in the medical field withhold a person’s eating disorder recovery? What should clinicians know about treating the LGBTQ+ community? How can medical facilities create more inclusive spaces? In this podcast episode, Dr. Cristina Castagnini speaks about the challenges faced by the LGBTQ+ community in ED treatment with Dr. Margherita Mascolo.


As Chief Medical Officer at Alsana, Margherita Mascolo leads the medical component of Alsana’s Adaptive Care Model®. Margherita has over 10 years of hands-on experience and extensive knowledge in the treatment of eating disorders. She works closely with Alsana’s medical leadership including Chief Nursing Officer, Lyn Goldring on the development and implementation of our medical care. Margherita is board-certified in Internal Medicine, has published multiple peer-reviewed articles on the medical complications of eating disorders, travels nationally and internationally to speak on these complications, and has earned her certified eating disorder specialist (CEDS) certification. Visit Alsana and connect on Facebook, Instagram, Twitter, and LinkedIn.


  • Discrimination
  • Poor representation
  • Dr. Mascolo’s advice to other clinicians


Because the LGBTQ+ community is still poorly understood and under-resourced, their needs are often not met in professional and medical settings.
There’s a lot of fear of and experiences of adverse consequences … a lot of violence and bullying towards [this] population, unfortunately. (Dr. Mascolo)
Often doctors and physicians have a difficult time assessing and prescribing the appropriate treatment for the LGBTQ+ community.

Poor representation

They may struggle with:
  • Medical forms and questionnaires that use binary terminology
  • Washrooms that are binary with no genderless option
  • Receiving appropriate physical exams that align with the gender with which they identify from medical staff
  • Having difficult conversations with medical staff
These are all things that unfortunately we don’t necessarily think about but they can be very oppressive and … difficult for this population. (Dr. Mascolo)

Dr. Mascolo’s advice to other clinicians

Be sensitive to the fact that the LGBTQ+ population is marginalized, and they are often discriminated against. A lot of the community struggles with eating disorders. Like any other patient, be respectful of where they are in their healing journey and what they identify with.
Just be inquisitive and ask the person with whom you’re having the conversation what their preferred gender is, how they like to be addressed, what their pronouns are … and address them in that way. (Dr. Mascolo)
Be aware of the fact that their day-to-day life is very different from yours.



I am a licensed Psychologist and Certified Eating Disorder Specialist. While I may have over 20 years of clinical experience, what I also have is the experience of having been a patient who had an eating disorder as well. One thing that I never had during all of my treatment was someone who could look me in the eye and honestly say to me "hey, I've been there. I understand". Going through treatment for an eating disorder is one of the hardest and scariest things to do. I remember being asked to do things that scared me. Things I now know ultimately helped me to get better. But, at the time, I had serious doubts and fears about it. If even one of my providers had been able to tell me "I know it's scary, but I had to go through that part too. Here's what will probably happen...." then perhaps I would not have gone in and out of treatment so many times. My own experience ultimately led me to specialize in treating eating disorders. I wanted to be the therapist I never had; the one who "got it". I will be giving you my perspective and information as an expert and clinician who has been treating patients for over 2 decades. But don't just take my word for it...keep listening to hear the truly informative insights and knowledge guest experts have to share. I am so happy you are here!


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