#196 Hadley Freeman On Life Beyond Anorexia

Raquel: 1:07

Hello, everyone. Welcome to the FiLiA podcast. My name is Raquel Rosario Sanchez, and I am the spokeswoman for FiLiA. Today, we are very grateful to hear from author Hadley Freeman, to discuss her book, Good Girls. Hadley Freeman is a staff writer at the Sunday Times. She worked for more than 20 years at The Guardian, and her writing has appeared in many publications.

She is also the author of Be Awesome: 1:39

Modern Life for Modern Ladies. It covers topics that are vital for any modern woman to consider, like 'How to read women's magazines without wanting to grow a penis', and 'Beyond the Armpit, a guide to being a modern day feminist'. Be Awesome tackles body image, sex, dating and feminism head on. But today we are here to discuss Good Girls, which is Hadley Freeman's memoir about her experience with anorexia and her long journey to full recovery. First of all, Hadley, how are you?

Hadley: 2:20

I'm good. Nice to speak to you, Raquel.

Raquel: 2:25

I always like to go back to the very beginning with authors. At one point, you have your personal experience of Anorexia.

Hadley: 2:35

Mm-hmm.

Raquel: 2:36

And it's a long journey. And you have your career as a columnist, first at The Guardian, and then at the Sunday Times. At what point did you decide, you know what, I want to write a book about what I have been through with anorexia, and then the broader context of what's happening culturally, socially. At one point did you decide, I'm ready to write a book about this?

Hadley: 3:01

So I really avoided writing about it for as long as possible. I didn't want people to see me just as an anorexic or recovered anorexic. I'd worked really hard to get away from that. And I really avoided writing about it in any book. And the book I wrote before this one is called House of Glass, And that required a huge amount of research. It took like 20 years of research. It's the story of my grandmother and her three brothers during the war, when they were living in Paris. And after that, I thought, okay, I'm never going to write about myself, or anything connected to me again. And fairly soon after that, I started hearing from friends who have teenage daughters and they were asking me for advice because their teenage daughters were struggling with eating or self harm. And I thought, actually maybe it would be sort of helpful if I wrote about my experience, because I was very ill and it's very... You know, it's relatively rare for someone who's been in hospital, who was in hospital as many times as me to recover and to have a platform to be able to write about it. And I thought, you know, this, maybe it actually is selfish to not write about it. I should be showing people it is possible to recover and and what helped me. So that was it really.

Raquel: 4:21

You mentioned that you've been in hospital many times. Did you envision when you were in those moments that there would be a way out? You know, you discuss in your book how anorexia shrinks your world to tiny details. Very destructive forms of self obsession, it's very much like your focus on yourself. But I don't mean it in a...

Hadley: 4:48

Yeah, for sure. For sure. I think... Well, the first time I went into hospital I was 14 and it was the autumn of 1992. And I Just took it as a given, of course, you know, just go to hospital and I'd be fixed right away. And then I would go back to school and do my GCSEs. And yeah, I thought that was how it was. And after, I guess the third stay, third admission, I began to realise I had no idea how to live in the outside world. There was no... I couldn't... If being in the outside world meant feeding myself and eating and maintaining weight as opposed to losing weight, it just was completely foreign to me. It'd be like someone said, you can only live in the outside world if you walk on your hands all day long. Like I just couldn't understand how people did it. And certainly by the sixth, seventh admission, I... It's not that I consciously gave up on ever recovering. I just couldn't ever see how I would ever do it. So it took nine admissions in total. And they all lasted about between three to six months, before I finally started to recover. But you know, when you're in hospital, you're just meeting other sick people and certainly in the last hospital I was in, I was meeting women who'd been ill for 40 years. You know, I was there with 50-year-olds, 60-year-olds. So I just sort of thought, oh, that's what it is. It almost normalises, you know, being ill forever. So I just thought, all right, this is my life now. I'll just live in hospital and get fed up and then leave and lose the weight and then go back into hospital and be re-fed. Like, and that's going to be my life now for the rest of time.

Raquel: 6:24

Can you speak to us about What was going through your mind at that time? You know, was it all just like the everyday of today I have to eat X food that my doctors are giving me? And then tomorrow is another day of doing the same thing. Because we see you as an author and with so many women going through similar with anorexia, that their world can be so extensive. You write about so many different topics, and when you're in those moments of self destruction, it's hard to believe that the world of someone so brilliant can be so reduced. to the tiny minutiae of everyday chores or tasks, you know?

Hadley: 7:09

Well, that's far too kind of you to say that about me, Raquel, but thank you. You know, a big part of anorexia is to not think about the big world, you know? The big world can seem really scary, and to have all this freedom, suddenly in front of you can feel very scary. And so anorexia reduces a person's world to just focusing losing weight, what they won't eat, what their exercise rituals are. And then being in hospital and being totally institutionalised and just obsessing over which nurse is going to be on duty that day and what the meal plan is that day and all that. So it's a way of reducing your world, in the same way drug addiction is as well. You know, you just become obsessed on where you're going to get drugs. And that is what anorexia is. And anorexia almost invariably starts... First of all, it's mainly suffered by girls and women and it almost invariably starts around puberty. And I think that there are many reasons for that, that we can discuss, but I think part of it is this fear of the freedom that adolescence brings. You're no longer a child. You suddenly have freedom to go out maybe a bit more. You have freedom to hang out with boys, go on dates, make out with them. You're loosening the ties from your parents. And, you know, there's this idea that all teenagers are desperate for that, and probably most are. But then there are others who are very scared of that, and anorexia is a way of bringing yourself... first of all, tying yourself very tightly to your parents, or your doctors, and becoming sort of childlike. There's no sexuality, there's no going out, there's no having fun, and there's no freedom. So that's a big part of it, I think.

Raquel: 8:57

As opposed to boys who are raised to sort of be in this expansive mentality that the world is there to conquer, that they go out and achieve things, whereas girls are not massively socialised the same way. That's a really interesting point. I was just about to ask you, in your opinion, Hadley, why does anorexia happen?

You write in your book: 9:18

'Out of all the mental illnesses, anorexia is the most commonly discussed as if it's sparked by an external source, whether it's anxiety about exams or anxiety about Jodie Kidd's thighs. In fact, the opposite is the case.'

You quote a doctor who says: 9:35

'It's fairly well established that personality disorders, depression and schizophrenia. can develop from trauma. But anorexia has the lowest relationship with trauma'. And you mentioned that out of the many anorexics that you have met in your life, one was abused by her brother, another accidentally killed her twin in a car, but in the vast, vast main, nothing massively terrible has happened to any of you. So it was sort of, anorexia came across as an accretion of small, normal awful life experiences that you metabolise different from most people.

Hadley: 10:14

Yeah. So when we're looking at anorexia, especially from a feminist perspective, what is the cause in your opinion? Well, it's fascinating to me how for so long girls and women have expressed unhappiness by not eating. You go back to women in the middle ages or in you know renaissance times These women who... these girls usually, like Catherine of Siena, would stop eating when their parents are trying to sell them off into marriage, usually. Almost invariably, this is the story. You have a 12 or 13 year old girl in the 800s or 1400s, parents trying to sell her off into marriage, and she stops eating, becomes worshipped as a saint, and gets put into a nunnery or just worshipped with followers. And here today, you have girls when they're 13, 14, starting to go through adolescence, suddenly stop eating. You know, it almost seems like this kind of natural female response to the fear of puberty. But why is it that girls do this so much more than boys? Well, for me, just speaking for myself. I found that, I felt ashamed. I didn't feel like I could speak up and say that I was unhappy or that I was anxious or that I felt filled with shame or self disgust just for normal... just because I was growing up and I felt anxious about how my body was changing. I felt anxious about how boys were looking at me. I felt anxious about how to be a woman in the world. I didn't even know what that really meant. And so not eating, I thought would be a non verbal way of letting people know that I was unhappy because I didn't feel it was right to say that I was unhappy. I thought it would make me look spoiled. Also, I felt that not eating almost was a form of sort of... Having almost physical needs seemed to me incredibly unfeminine and undignified, whether it was saying that I needed help or saying that I wanted food. And this was a way around that. And I think that's a very common message that a lot of girls get. You know - don't have needs. Don't say that your feet are hurting too much to wear high heels. Don't say that you don't like something'cause you'll be seen as a bitch. And boys don't have that so much. Boys are allowed to complain. You know, women now are told they're Karens if they just complain in a restaurant about their meal. So I think that's a very strong message that girls and women get sent right away, is don't speak up and don't complain. Well, not eating is a really great nonverbal way of expressing that. Another thing is that it is a massive fear of sexuality. I do think that's a massive thing with anorexia, which is why it comes on in puberty. Girls don't really know what's expected of them and girls' bodies can develop much faster perhaps than their emotional maturity. And suddenly you have these 14-year-old girls walking around with breasts, with more shapely hips or whatever. Men looking at them and whistling at them and acting as though they're, you know, 'jail bait' and all that. And inside they still feel like they're 10 years old. And that is very, very scary for a lot of girls. And not eating is a way to starve your body back down to being more childlike. And with boys, they express their unhappiness outwardly. So what you get with unhappy teenage boys is that they get into fights, they drink, they take drugs. It's a very outward manifestation, an aggressive manifestation of their unhappiness. Girls and women take their unhappiness out on themselves, which is why eating disorders and self harm. are so overwhelmingly suffered by girls and women. They're punishing themselves. They feel something's wrong with them for feeling this way. So there are very specific socialised reasons why anorexia is so overwhelmingly a female disease.

Raquel: 14:04

Thank you so much for that answer. That's really thoughtful. I wonder if you make... In your book, you used the term eating disorders, so sparingly, but you're more likely to use the term mental illness.

Hadley: 14:21

Yeah. And I wonder if this was a conscious decision on your part and what led to that? Well, I guess I avoided the term eating disorders just because I cover such a wide range and you know, as much as people think of bulimia and anorexia as so closely related, they're actually incredibly different. I actually see anorexia as closer to overeating in the way the... you know, your behavior is being so obviously physically manifested. In the sense that bulimia, you tend to... people who suffer from bulimia tend to stay at the same weight. Anorexia and overeating, obviously what they're doing is very visible on their bodies, i.e. they're either extremely underweight or they're extremely overweight. So, you know, eating disorders. Yeah, that's a huge umbrella term and it can be a bit confusing. Mental illness, yeah, I do use that term very specifically because I think people sort of denigrate anorexia as just this kind of silly little rich girl's disease when in fact it's an incredibly serious mental illness. And I think they denigrate it that way because it is so predominantly suffered by girls, and therefore it's, you know, silly in a way that schizophrenia isn't silly, but the fact is it has a much higher mortality rate than schizophrenia, and therefore should be taken very seriously.

Raquel: 15:39

And you talk in your book about how, when this sort of phase of coming in and out of hospitals was over for you, then the mental illness mutated to other forms of self destructive behaviour. I was just thinking about how when someone has... when we have clearly identified mental illnesses, for example, schizophrenia, then we know that the person has schizophrenia and this is what they need treatment for. When we sort of... perhaps it's not the verb, but it's more of like when we belittle or categorise anorexia as an eating disorder, then we can just sort of say, oh, this is just a little eating thing that this person has, not taking into account that the second that you go through the - if the person survives, obviously - the second that they go through the hospital treatments or the support that they need from their parents and stuff, their close ones, then that, if it is unaddressed, then the psychological disorder, it's just going to shift to something else. As you mentioned, it's just going to mutate because it's not being framed as like, hey, there's a problem here that is beyond the food.

Hadley: 16:53

Yeah, I mean, it's not looking at the emotions that have caused the person to stop eating. You know, it's not just that someone's not hungry and that's why they become anorexic. It's because they're deeply unhappy; they're full of self loathing; they're deeply anxious. And they use the anorexia to try to distract from that almost in a kind of form of self soothing and then, okay, fine, you deal with the eating issue. You feed them up to a healthy weight. They're now able to start, you know, eating normally in some way, but those emotions are still there. And so they'll come out in a different way. So, you know, one common way is alcoholism. And I do know some girls I was in hospital with who did recover, you know, to a certain degree from their eating issues, but then immediately became very bad alcoholics. I had problems with drugs for a long time through my twenties and thirties. And, yeah, I see there's a huge overlap between anorexia and addiction. Both are... you are addicted to this feeling you get from your habit, whether it's starvation or whether it's crack cocaine or whatever it is that you're taking. And it's both... all of them are ways to not think about whatever it is that's making you so unhappy.

Raquel: 18:02

Absolutely, absolutely. I do wonder if this is a conscious decision by medical establishment and organisations that work with issues like anorexia to frame it as disordered eating, which I think is the term that is in use now, as opposed to just bluntly calling it a mental illness. And I wonder if we frame it as mental illness, if it would be taken more seriously?

Hadley: 18:29

It may be. I mean, I do also think just the fact that it's so predominantly suffered by women inherently makes, you know, some people not take it seriously. Like it's just the truth. In the same way postnatal depression wasn't taken seriously for so long, or even postpartum psychosis wasn't really understood or taken seriously. Anyone who's listening to this podcast will know that illnesses that are predominantly suffered by women tend to be dismissed by the medical establishment and that has certainly been a massive problem with anorexia. And it's so interesting in the years since I was treated - I last left hospital in the mid 90s - there's now increased focus on the biological contributory factors to why someone develops anorexia. For example, does it have something to do with their metabolism? Does it have something to do with their thyroid? Does it have something to do with their brain chemistry? You know, these are really being seriously studied now in medicine, whereas before it was just assumed these are just spoiled, silly little girls who are given too many things by their parents and are now trying to get their parents attention even more. Now people are looking at, oh, actually, are there... serious physiological underlying factors that we could be looking at in the same way we look at contributory factors to heart disease. I personally don't feel I do have those physiological factors. I feel like mine was entirely psychological and emotional, but isn't that interesting? It's taken until the 21st century for doctors to even consider there might be physical factors that play a part in anorexia as opposed to just thinking of it as silly little girls with daddy problems.

Raquel: 20:07

Absolutely. Thank you so much for that. I was just about to ask you if you thought that it would be taken more seriously if there wasn't the factor of the dismissal of girls and women, because we know that anorexia has the highest mortality rate of all psychiatric illnesses, as you write in your book, and that 90 percent of anorexics are women. So you just answered my question there. I also wanted to ask you, growing up as a teenager, did you connect at one point that this desire that you had, the impetus that you had to sort of abolish yourself by making yourself smaller and smaller, did you... at what point did you connect that this was perhaps linked to a broader social structural issue when it comes to patriarchy?

Hadley: 21:00

Well, I definitely wasn't thinking about it in those terms. I mean, this was in the mid 90s, and I was, I guess, about 17 when I started recovering. I didn't, I mean, really thought about and you know, so it was different time, different age. I knew always on some level that I was trying to say I'm unhappy without articulating it, but I didn't think more deeply than, you know, than that. I didn't think, why do I feel I shouldn't articulate it? I mean, if I thought anything, I thought, well, I shouldn't articulate it because my parents give me anything. Therefore to say I'm unhappy will show that I'm really spoiled like Veruca Salt in Charlie and the Chocolate Factory or something. That's how I thought of it. I didn't think of it as in terms of women. And I didn't even really question why it was always all women in hospital with me except for one stay when there were two anorexic men in hospital with us. I did used to think how it was quite weird that while the patients were all women and the nurses were all women, the psychiatrists tended to be men and they were the ones with the ultimate power. And I didn't like that. I do remember that. And I didn't actually recover until I got a female psychiatrist, the wonderful Janet Treasure, and a female therapist who I call, or child psychologist, who I call in my book, JF. And I really didn't like having male doctors. I found that they were really dismissive, the ones that I had. That they saw me as just another stereotype. That they saw me as just a spoiled little, privately educated girl with American parents who live in London, and they really didn't look at me as a person. I have since met lots of male doctors who work in eating disorders, particularly while writing this book, who are absolutely wonderful. And so I'm not saying this about all men, but I did find that talking... that women in the psychiatric profession tended to have more of an insight into what was going on with me, as opposed to just thinking of me as a foolish girl who just needed to eat a Snickers bar.

Raquel: 23:04

Or more empathy.

Hadley: 23:06

Yeah, definitely more empathy and just more... kind of a sense of simpatico. Like they weren't just looking at me as another number on a sheet.

Raquel: 23:20

So then why are those men given that position of authority over young women who are going through immense distress?

Hadley: 23:28

Well, you know, we hear all the time, sadly, about arrogant doctors and the damage they cause. My friend, Merope Mills, has been writing very beautifully about the death of her daughter, Martha, in King's hospital two years ago, because the, the doctor there didn't take Martha's concerns seriously. Martha was 12 and, and dismissed Merope as a hysterical mother. And then Martha died from sepsis in hospital. So, I mean, it still goes on. The male doctor I had was actually stripped of his medical license a few years after I'd left him, for having an inappropriate relationship with a patient. So...

Raquel: 24:06

That's exactly what I was going to ask you. I was thinking, wait, so you have this cohort of young girls who are incredibly vulnerable and distressed. You have men in positions of authority. They're in an external environment away from their homes and close ones. You know, it feels a little bit like a recipe for a lot of misconduct from the men who want to behave in that way.

Hadley: 24:32

Yes. And, you know, it's obviously not, I mean, I do want to keep stressing this, it's obviously not true of all male doctors or male nurses who work in eating disorders. But I did encounter a lot of instances like that during my treatment and then talking to girls afterwards during their treatment. So my first psychiatrist who I had for a year, I really didn't like him. He was incredibly arrogant, dismissive and patriarchal and I left him and then he had this secretive relationship with the patient. After that, there was a male nurse who used to like us to sit on his lap and would call us up on his days off. I have a friend - a friend who I met in hospital - and she then went to another hospital and there was a nurse there who used to leave - a male nurse - used to leave notes on the girl's beds and he actually ended up impregnating some of the patients and is still on the run somewhere in France.

Raquel: 25:23

Oh my god.

Hadley: 25:24

I know. I interviewed a girl when I was writing this book who had just gotten out of a well known hospital near London, and she said that there was a male nurse there who said that in order to find out how close the girls were to menstruation, he had to give them what he called pelvic exams. Unsupervised. And also would make them all get weighed totally naked every morning. So I mean, it absolutely goes on. Of course it goes on wherever there are vulnerable patients. You know, you hear terrible stories about geriatric healthcare as well, but there is something particularly about anorexia where you have these, you know, slightly childlike, vulnerable girls and women, who are very thin and have a tendency maybe to look at people in authority around them as. quasi parental figures. You know, it'd be very easy for a predatory man to take advantage of that.

Raquel: 26:18

And there's the focus on the body, the constant focus on the body, checking this thing or another thing...'It is part of my professional duty to look at this young woman's body and examine it.'

Hadley: 26:30

Yeah. Absolutely. And, you know, they know we're all staring at our bodies all the time, too. And, therefore, if they're staring at us, we almost won't even notice it because it's normal to us to be constantly, you know, circling our arms and looking at our thighs. And yeah, and you get weighed every morning in hospital as well. So there's all that. So there's a lot of... you know, if you are a predatory man who works in healthcare, I can see why working on an anorexia ward would be tempting is how I would put it.

Raquel: 26:59

And perhaps when you're in such a vulnerable state and as women, you know, we all know what it's like to feel at different stages in our lives, distressed or vulnerable, like the validation that you would get from an adult authority figure. that could be a big factor to, to people who are not well.

Hadley: 27:21

Yeah.

Raquel: 27:22

So there's exploitation. There's an exploitation there. Okay. Wow. That's really interesting. Thank you, Hadley. I was wondering if... you describe in your book,

Good girls: 27:34

A story and study of anorexia, you describe anorexia as a full time job that consumes your mind and your thought, just constantly thinking about tiny issues that represent a larger problem. I wonder if you could tell us about how you have managed to break out of those patterns.

Hadley: 27:53

Well, at a certain point, I had to make a decision, you know, I subconsciously realised this. I could either stay in this... tiny, shrunken world forever and just let my life drift past, or I could sort of really grit my teeth, try to shut those thoughts out and, you know, get on with my life. And I was very lucky in that I was still a teenager and my therapist at the time had made me keep up with my schoolwork, even while I was in hospital. So I hadn't dropped out of the school system, even though I dropped out of various schools, I was working with tutors and stuff who helped me keep up with my year and I took my GCSEs in hospital. And so that helped. And then I had this offer to go to university, and I knew I wanted to do that. At a certain point, the desire to get on with my life outweighed my desire to be anorexic. And that's really a miracle, to be honest, you know, not very long before that I wouldn't have felt that at all. And there are various factors that contributed to that. I think the most important one is, as I said, I kept up with my schoolwork. If I had totally dropped out of the school system, I think I'd have been completely lost because there's nothing then to recover for. And I was the only girl my age in hospital who did keep up their schoolwork. All the others dropped out to focus on their recovery, which is what doctors advised at the time. And all of them either really struggled much longer than I did to recover or didn't recover at all. And, you know, I'm not saying it's a simple causation, but I just really think you can't underestimate how important it is for anorexics to keep some toe in the outside world, so that there's a reason for them to recover.

Raquel: 29:39

And there's the factor in education of self reliance and sort of responsibility. You know, you have to complete your exams and no one else is going to do it for you. If you want to go to university, you have to take the steps, you know, so it's a factor that was future focused, you know, where perhaps if you don't have that, then where are you... what are you looking forward to?

Hadley: 30:04

Exactly. And for a lot of the girls who were in hospital with me who were like in their mid to late twenties. What happened to them is they dropped out of school, usually around the time of their GCSEs, and they're in and out, in and out, in and out of hospital. And when they would leave hospital, they would live at home with their mom, do a bit of maybe light volunteering work nearby, maybe at their local Oxfam or working at the local state nursery or something like that. And then just keep losing weight and then go back in. But they had no friends, no network, and no sense of progression through life. And I think also it just got to a point where I was growing up a little bit and I didn't want to stay home with my parents all the time. I actually wanted to leave and I realised the only way I could do that was if I, you know, in some way managed to feed myself.

Raquel: 30:52

Speaking about the network, and if you don't mind me asking, Hadley, how did your family cope with what was happening? You mentioned that at one point, you know, one day you were 13 and you were looking forward to what all - most - typical 13-year-olds are looking forward to, which is like exams or something. And then the next year your parents are faced with a daughter who is going through something extremely serious.

Hadley: 31:19

Yeah.

Raquel: 31:20

Over, not just at the beginning, but over the next 20 years, did you have proper support from your family and friends, and how did they manage to cope with something that is so distressing?

Hadley: 31:32

Yeah, so, I mean, it's incredibly hard on the family. As anyone who's listening to this, if they have an anorexic in their family, they'll know. You know, my mother is sort of permanently traumatised. I'd say both my parents are, they're constantly waiting, I think, or expecting me to self destruct again at some point. And my sister was - I have a little sister who's 15 months younger than me - and she was really angry with me for a long time because my illness really overshadowed her childhood and her younger years and we went from being very close to being completely separate. You know, we were living in totally different universes. And I basically made her live as an only child throughout her teenage years, which she was definitely less than pleased about 'cause she was so used to having me around. So it was, it was really... it was really hard and I did have a lot of guilt about that for a long time.

Raquel: 32:25

But were they supportive of your process?

Hadley: 32:29

Oh, yes. I mean, they were slightly bewildered, you know, by what on earth I was doing. And you know, suddenly I went from being this pretty normal 14-year-old to psychiatric hospital inpatient. But yes. And when my therapist said that it was safe for me to leave home, once I left hospital for the last time, and I went off to this sort of special boarding crammer school to do my A levels in a year to catch up. And they were... my parents paid for that and let me go, which is amazing, you know. They didn't just lock me up in a tower and my mother didn't... sort of turn... you know, make it her job to be my nurse, which must have been a huge temptation, but was actually really good in a lot of ways because it encouraged me to be independent. So yeah, I'm very grateful to them.

Raquel: 33:17

That's wonderful to hear. Thank you for sharing. You know, you mentioned on your book that there are some links and similarities - sorry, not links, similarities - between anorexia and gender dysphoria.

Hadley: 33:30

You're right.

Raquel: 33:31

'Eating disorders and gender dysphoria are disorders of the body, body obsession, body hatred, body alienation. They are both rooted in the belief that if you change your body, you will no longer hate yourself. Girls are represented so disproportionately in both because they learn from an early age that how their bodies look determines how onlookers define them. It speaks louder than their own voice when it comes to how others see them. Is it really such a surprise that so many of them learn to see their bodies as prisons to be rejected? And that they believe that if they change their bodies, they will change their life, their destiny, their inner self.' Can you tell us a little bit more?

Hadley: 34:19

Yeah. So I really wasn't planning to write about gender in this book because I write about it so much, I feel, in columns that I really wanted to take a break from it. But the more I just went back and talked to doctors and thought about the impetus for my anorexia and talk to the girls about the impetus for their anorexia, it just seemed to me increasingly obvious that there was an overlap between anorexia and gender dysphoria in teenage girls. And what really kind of made me write about it was as I was working on the book, I saw a news story come out and it just sort of had this casual mention that at GIDS, which is the only NHS gender clinic for young people in England and Wales, which is also now imminently about to be shut because of safety concerns, said that 70 percent of the inpatients there were adolescent girls. And that really struck me because 90 percent of the inpatients at an anorexia clinic are girls. So I went off and interviewed three doctors who formerly worked at GIDS and also talked to various psychologists, child psychologists, who have experience with gender dysphoria and also body dysmorphia. And what they said, one of them, Anna Hutchinson, said really brilliantly, she said, you know, in every generation, there's a symptom pool, and an unhappy adolescent girl will go to the symptom pool and pick out ways to express their unhappiness, and which, you know, what ways are current at that time. So, you know, once it was anorexia, then it was cutting, now it's saying that you hate... you know, you're not a girl, you're actually a boy. You know, gender dysphoria, for teenage girls, I don't really understand why people talk about it in the same way that they talk about, for example, trans women, i.e. adult males who identify as women. I mean, those are obviously two very different groups of people expressing very different things. A 14-year-old girl who says she hates her body and it's because she's a boy is very different from an adult male who says that he's always wanted to live as a woman. So, you know, for gender... when I see the girls who live around me in North London, who are, you know, say that they're non binary or that they're now identifying as boys. They look so much like the anorexics I knew on my ward. You know, they're binding their breasts, you know, they have flat chests. They wear these big oversized clothes that they're hiding themselves in. They look anxious, they look unhappy, and they look like they're trying to find... you know, almost like a do-over, like, can I be somebody else? And I have enormous sympathy with that feeling too, because when I left hospital for the last time, and I went off to boarding school, and I knew I had to eat, I couldn't bear to eat as Hadley, because that just seemed like a real self betrayal. So I changed my name for the year to Claire. And I thought, well, I can just pretend to be somebody else, you know, I can be somebody who eats. And that was how I did it. And so I understand that very common teenage desire to be somebody else. And that's what all the doctors I spoke to about this all said, and both gender dysphoria and anorexia, they are illnesses of the body, they are about self loathing, they're this belief that changing your body will give you a new personality and you get almost a do-over. And also that you can control how people see you. And it's such a rejection, as well, of your parents, both those illnesses. There's nothing more aggressive a teenager can do to their parent than refuse to be fed by them, because that's the first thing a mother does is feed her baby, and now that baby's refusing to eat. And with gender... when a teenage girl says, I'm not, you know, Elizabeth, I'm actually a boy called Asher, or whatever. You're rejecting the name your parents gave you, and you're rejecting who you are as a kid. So there's a lot going on there, and I think the emotions that underpin anorexia in a lot of teenage girls are now being expressed through gender dysphoria in a lot of teenage girls.

Raquel: 38:15

That is such a thoughtful and compassionate response, Hadley. The links that you're making between anorexia and gender dysphoria, you're explaining it in such an empathetic way. I wonder, were you free to write about this in your work as a columnist? You know, you've gotten into a lot of trouble for writing about gender. But what we just heard by now is an extremely compassionate and thoughtful analysis. Why is it that so much of the media at the moment is shutting down those analyses?

Hadley: 38:58

Yeah, well, I mean, it's this ridiculous double standard, as you know, even better than me, you know, you have someone, for example, like Roisin Murphy, just saying that she's concerned about Big Pharma exploiting vulnerable kids by giving them puberty blockers, and she is... she loses work and, her record company condemns her and, you know, donates her profits to some charity, et cetera, et cetera. And on the other hand, you have various trans activists being incredibly aggressive, shouting vulgarities at women saying, you know, 'Kill TERFs, punch TERFs in the face' et cetera. And they have basically no repercussions. It's seen as, well, all's fair for them. You know, they're a very vulnerable oppressed minority. So women can be as moderate and compassionate as anybody, but if they don't buy into gender ideology, they're seen as basically fascistic. Whereas a trans activist can say really horrible, threatening things, and they're seen as fighting the good fight. It's a very... it's a very strange disparity. And I'm amazed at how many people go along with it. But I think what, what the past seven or whatever years it's been now, have shown women like you and me is that there are a lot of people out there who've been really waiting for an excuse to be incredibly misogynistic, in a socially permissible way. And gender ideology has come along and, and been the answer to their prayers. And in terms of the teenage girl thing and the adult trans people, you know, that conflation, I just find... I find really abhorrent because I find it really exploitative. And I do think there are some adults out there who are using unhappy teenagers to justify their life choices, if that makes sense. An adult who comes out as trans in their 30s, 40s, 50s, they have nothing in common with a teenager who is deeply unhappy and saying that they need a new body and they need puberty blockers and all that. It's a completely different experience and one should not be used to justify the other, is my very strong feeling on that, speaking as someone who was a very unhappy teenager and tried to hurt their body in as many ways as possible.

Raquel: 41:19

Absolutely. And you know, when we talk about anorexia, whether we frame it as eating disorders or mental illness, there's a seriousness in the conversation, or at least an understanding that we need to do more research, we need to have sober analysis, we need to understand what's happening, it's a serious issue that needs to be tackled. You know, there's at least some sort of level of seriousness in the broad majority of the sort of societal understanding. Do you think that we are in the very beginnings of having that same conversation about gender dysphoria in teenage girls in the future?

Hadley: 41:58

Well, I don't know. I mean, I thought we were after the Cass report came out. I really did think, oh, finally, you know, no one can argue with medical consensus. But people do argue with medical consensus. You know, there were some very negative reviews of my book just because of the doctor's quotes in them, and people saying, oh, it's Hadley Freeman who's saying, you know, trans is like anorexia... trans men are unhappy and are confused anorexics. I didn't say that at all, and neither did any doctor. But there are doctors I quoted in my book who say that gender dysphoria and anorexia definitely have overlaps for teenagers. And we've seen with the reaction to Roisin Murphy. She is saying... she's basically echoing the NHS policy at the moment, which is to not unnecessarily medicalise children. And she has been basically shouted out of the public sphere. And one music review last week said that because she said that, there's an 'ugly stain', quote unquote, on her otherwise superlative album. To me, it's just absolute madness. And I do think that there are some people who are so deeply entrenched in their kind of delusions about this at this point, that they can't... they either can't or they won't reverse. And that's a real problem and... although, you know, for example, the government in this country is fairly skeptical of gender ideology, there are a lot of public institutions are really deeply embedded in, in the various ideas of gender ideology and won't have, for example, authors who are seen as gender critical on their books. They won't publish books by them. They won't allow them to work at their academic institutions, as you know, and they won't hire them as civil servants. And I find that really extraordinary. It's become like communist witch hunting, essentially, but with terrible repercussions for a lot of young people.

Raquel: 44:05

Or maybe they won't let them write columns in their newspaper.

Hadley: 44:10

Or even that. You know, I mean, I don't wanna complain about what happened to me 'cause you know, I went straight to another newspaper, I'm completely fine. But it was, it was actually, yeah...

Raquel: 44:21

Hadley, I was just going to say, you know, you are an excellent journalist. Which is how you dodged my question, but I'm a very good interviewer, so I'm going to ask you again. Can you tell us a little bit about what's happening in newsrooms and in newspapers and the broader media when it comes to this issue of addressing gender dysphoria and girls? You know, because you've written a very sober book about your experiences as a young girl. And then you're saying, hey, there's similarities there. We have so much research into anorexia. We noticing similarities with what's happening with young girls and gender dysphoria. Yet somehow the media is... what's happening with them? What do you think is happening to the media?

Hadley: 45:07

Well, I think there's a couple of things. The first is that Stonewall did a really good job of convincing people that this is basically the new gay rights issue. And there's a lot of liberal journalists who fear being on the quote unquote 'wrong side of history'. You know, they don't want to be... the equivalent of, you know, journalists who promoted Section 28 in the 1980s. And so they quickly fell into line of like, oh right, trans rights are the new gay rights. And therefore any questioning of trans... of trans rights demands, any questioning of these demands, is basically like saying gay people should be put in prison. So there was that. And I think another factor, which Helen Joyce has talked about, and she's very correct on this, is that they're in the same way that anorexia, at least initially, was mainly found among a certain i.e. Caucasian, middle-class, educated families. That's not necessarily so true now. It's now found in all, across all social groups, but certainly for a while it was mainly reported in Caucasian middle-class educated, gender dysphoria girls. I mean, it's not just in Caucasian middle-class educated, as Julie Bindel has written, the highest rates are in Blackpool. But it is not uncommon among those kinds of families. And the people who work at newspapers tend to be Caucasian, middle-class and educated, and I know multiple journalists who have a teenage girl who's now identifying as a boy, and these parents tend to be quite defensive and protective of their children in a way that has good intentions. But it does mean, often, that it affects how a newspaper covers a subject because other people at the newspaper know about this situation that a journalist is having at home, and they don't want to say anything critical about how the journalist is proceeding with dealing with it with their child. Which I find slightly odd, to be honest, because I also know a lot of journalists who send their kids to private schools, for example, and yet liberal newspapers will roundly criticise the existence of public schools and, you know, the inherent injustice of them. And yet, when it comes to this issue, there's a real kind of walking on eggshells attitude around it. which... I don't know if that will change anytime soon, but I do think it's a real problem.

Raquel: 47:34

So Hadley, I wanted to closing... we only have a couple of minutes left. You know, your book, Good Girls, is about, not only this sort of headline grabbing times when you were in a psychiatric unit for anorexia, but also about the decades after, where you notice that destructive, self destructive behaviour mutates into something else. In your opinion, is there ever truly a way out?

Hadley: 48:03

Oh, definitely. I mean, I got out, you know, I'm not... I'm not a drug addict anymore, and I'm not anorexic anymore. But it does take conscious choice, and you can't really expect the world to sort of accommodate your needs and to bend around you. I often hear, or I often read, I don't even hear, I read in newspapers, for example, fears, concerns that some people have that putting calorie counts on menus will, you know, be harmful to anorexics, and I understand that fear, and it's very sweet and generous. But the fact is anorexia... we all live in a world in which, for example, obesity is a far greater problem than anorexia. So, you know, you can't avoid Diet Coke adverts when you're trying to recover. You can't avoid calorie counts on foods. These things exist and you just have to make a choice that you want to live in this world and live a functioning life. And that requires building up a bit of resilience or also just building up some determination to not let anything throw you off your path. And that is not saying recovery is easy or a choice, like I say, I had a lot of privileges and I was really lucky and I was incredibly lucky to find the doctors I did. But I also did have to keep making choices not to get upset, you know, when someone said to me, 'Oh, wow, you look... I would never guess you were anorexic' or, you know, little comments that people make - 'Oh, you've got a bit of a tummy' or 'Oh, are you pregnant?' You know, things that people say, to not use that as an excuse to then not eat. Like, you really have to make that decision yourself and only you can make it. And it's hard, but it, you know, it does come.

Raquel: 49:42

And one of our final questions, Hadley, what would you say to girls and women who are still stuck in that full time job or anorexia?

Hadley: 49:52

It's awful and you know, I am wary about giving advice, because I know I hated it when people gave me advice when I was sick. But what I would say to any of those girls or women is it really is better on the other side. I know you think that you couldn't possibly imagine, how you would cope with the feelings of anxiety and self loathing if you ate something and if you ate something every day. I know that fear and you will feel anxious. But it gets easier the more you do it. And life is so much better when your brain isn't constantly occupied with how hungry you are. Like, you can just do things. It's amazing. And it's fine. You know, okay, maybe your jeans might sometimes be uncomfortable or whatever, but the benefits far outweigh the disadvantages, I promise.

Raquel: 50:43

That's a very moving thought, and I just wanted to mention, you know, that reading your book, I thought that it was... it was very moving, but in a kind of sad way to read about this stage in your life, in which your life was narrowed to these tiny minutiae, of like issues that were tiny when you are out and recovered, but that in the mind of someone who's going through mental illness, it becomes a massive issue. And I say that because I read your book, Be Awesome, when I was doing my master's degree in women, gender and sexuality studies, and I just thought that was just like the greatest book of all time.

Hadley: 51:23

Oh, thank you. That's so sweet of you.

Raquel: 51:26

I thought that it was like the best book. It was, like, great advice. And it was like feminist analysis. And it was funny. It was just so funny. And it made me think, like when I was reading the book and stuff, you made me think that, you know, there's a way to be a feminist, an analyst, you know, a feminist writer that you can combine all of these aspects of your personality, you know, the funny side, the analytical side, the researching side, all of that. And you can exist in the world in that way. And when I was reading it, you know, I never thought... it was almost like right after your book came out in the early... I think it was 2012 or something.

Hadley: 52:10

Yes.

Raquel: 52:11

But it was right at that time and it inspired me to like pursue my writing career. And I never thought that I could be like interviewing you for a podcast. So I just think writing generates more writers, you know, and writers generate sort of... it inspires in a way that it's hard to describe. And I'm so grateful that your book is tough and difficult, but it's optimistic too, you know, and the message that you're conveying in your articles now at the Sunday Times and your work broadly, you know, it's optimistic in nature, you know. So I'm really grateful that you put down on paper something relating to a stage in your life that was not happy and joyous.

Hadley: 53:04

Oh, well, that is incredibly overwhelming to hear. I can also thank you, but you were always going to be a brilliant writer. You had no help from me, but thank you. That's really sweet of you.

Raquel: 53:15

I wonder if you have a final message to our FiLiA podcast audience, you know, women from all over and all backgrounds and I'm sure many of them have encountered your work. Could you talk to them about maybe final thoughts about your work as a writer or particularly about your recovery about from anorexia?

Hadley: 53:41

Well, I would just say to women out there listening to FiLiA podcasts, you know, I know that there are aspects of today that feel incredibly misogynistic and depressing. And you think how on earth are we ever going to get out of this weird madness that seems to have gripped the Western world, particularly, maybe mainly America and Britain when it comes to attitudes towards women. But I just find it so heartening to see these feminist groups like FiLiA rising up and women being so supportive of each other. And I've met so many amazing women through this movement, this sort of rise of radical feminism again. And so I just think, you know, there's real good sides to what's happening today. Like, there's a real awakening of feminist consciousness, I think. And so I feel good about it. I'm really looking forward to the FiLiA conference and, yeah, I hope to meet you all there.

Raquel: 54:34

Thank you so much. And thank you, Hadley Freeman, author of

Good Girls: 54:38

A story and study of anorexia, for being with us in the FiLiA podcast.

Hadley: 54:45

Thanks, Raquel.