Investigation of associations between self-reported sensory processing, eating disorder symptoms, neurodivergence, and gender congruence from a lived experience lens

Laurence Cobbaert; Kai Schweizer; Kai Thomas; Rosiel Elwyn; Caide Bier; Sam L Sharpe; Phillipa Hay; Philip B Mitchell; Jane Miskovic-Wheatley

doi:10.1186/s40337-026-01551-8

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Investigation of associations between self-reported sensory processing, eating disorder symptoms, neurodivergence, and gender congruence from a lived experience lens

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Investigation of associations between self-reported sensory processing, eating disorder symptoms, neurodivergence, and gender congruence from a lived experience lens

Laurence Cobbaert, Kai Schweizer, Kai Thomas, Rosiel Elwyn, Caide Bier, Sam L Sharpe, Phillipa Hay, Philip B Mitchell and Jane Miskovic-Wheatley

Journal of Eating Disorders, Vol.Advanced access

26-Feb-2026

DOI: https://doi.org/10.1186/s40337-026-01551-8

PMID: 41742218

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Abstract

Clinical psychology

Eating disorders

autism

ADHD

neurodivergence

gender congruence

sensory processing

lived experience

gender diverse

transgender

gender non-binary

neurodiversity

exteroception

interoception

Background Eating disorders (EDs) are increasingly recognised among neurodivergent and transgender and gender diverse (TGD) individuals, yet most assessment and treatment models remain grounded in cisnormative and neuronormative assumptions and frameworks. Sensory processing, spanning interoception and exteroception, has been proposed as a potential factor that may help explain observed associations between neurodivergent traits, gender incongruence, and EDs. Empirical evidence, however, remains limited. This study examined whether sensory processing characteristics accounted for variance in observed associations between neurodivergent traits (with a focus on Autism and attention deficit/hyperactivity disorder, ADHD), gender incongruence, and ED symptoms in an adult community sample. Methods Participants (N = 195) completed an online Qualtrics survey involving validated self-report measures of exteroception, interoceptive sensibility, gender congruence, and ED symptoms (for example, Eating Disorder Examination Questionnaire Short, EDE-QS and Nine Item Avoidant or Restrictive Food Intake Disorder Screener, NIAS). Correlation, regression, and effects analyses were used to explore associations among self-reported neurodivergent traits, gender incongruence, sensory processing, and ED symptoms. Results Gender incongruence and Autistic traits showed positive associations with restrictive and avoidant ED symptoms. ADHD traits showed positive associations with a broader range of ED symptoms, including restrictive, avoidant, and binge eating presentations. Gender incongruence also showed positive associations with sensory processing differences across both exteroceptive and interoceptive domains: namely, elevated visual and auditory sensitivity and reduced body trust. Furthermore, interoceptive sensibility, particularly lower body trust, showed significant statistical relations with ADHD motor traits and EDE-QS scores. Interoceptive sensibility also showed significant statistical relations in models including gender incongruence and EDE-QS scores. Exteroceptive hypersensitivity showed a partial statistical relation in models examining gender incongruence and NIAS scores. Conclusions To the authors’ knowledge, this study provides the first lived experience-led empirical intersectional investigation linking interoception and exteroception with neurodivergent traits, gender incongruence, and ED symptoms. Results highlight the relevance of intersectional, sensory-informed, and identity-affirming perspectives for future research and the ongoing development of ED assessment and care.

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Title: Investigation of associations between self-reported sensory processing, eating disorder symptoms, neurodivergence, and gender congruence from a lived experience lens
Authors: Laurence Cobbaert (Corresponding Author) - UNSW Sydney
Kai Schweizer (Author) - The University of Western Australia
Kai Thomas (Author) - Cardiff University
Rosiel Elwyn (Author) - Cardiff University
Caide Bier (Author)
Sam L Sharpe (Author) - Kansas State University
Phillipa Hay (Author) - Western Sydney University
Philip B Mitchell (Author) - UNSW Sydney
Jane Miskovic-Wheatley (Author) - The University of Sydney
Publication details: Journal of Eating Disorders, Vol.Advanced access
Publisher: BioMed Central Ltd.
DOI: 10.1186/s40337-026-01551-8
PMID: 41742218
Copyright note: This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
Data Availability: The data that support the findings of this study are available from the corresponding author upon reasonable request.
Organisation Unit: Thompson Institute
Language: English
Record Identifier: 991209381302621
Output Type: Journal article

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