"Never reflected anywhere": body image among ethnoracialized gay and bisexual men

Why do queer men experience negative body image? A narrative review and testable stigma model

Queer men (i.e., men who are not heterosexual; sexual minority men) are disproportionately affected by negative body image - they experience greater body dissatisfaction are more likely to develop eating disorders than heterosexual men. While existing literature has examined individual-level predictors of negative body image for queer men, less is known about why queer men as a group are disproportionately affected by negative body image. By synthesising existing theoretical frameworks, research, policy, and media reporting, this narrative review moves towards an understanding of systemic-level negative body image for queer men. Through the lens of hegemonic masculinity, we explain how systemic experiences of stigma work to inform unattainable appearance standards for queer men, and how these standards then contribute to pervasive negative body image concerns among this community. Next, we describe how systemic stigma works to exacerbate negative health outcomes for queer men with body image concerns. Finally, we present a synthesized model of the processes outlined in this review, articulate testable predictions for future studies, and describe practical implications that could be widely employed to improve body image for queer men. Our review is the first to propose a comprehensive explanation of systemic negative body image for queer men.

A conditional embrace-Swedish LGBTQ+ spaces through the eyes of ethnic minority non-heterosexual individuals

Introduction

In research on sexuality, marginalized sub-groups within sexual minorities have often been overlooked. From the vantage point of Sweden, internationally ranked as an exemplary progressive nation in equality issues and LGBTQ+ rights, and with an increasingly diversified population, the lived experiences of ethnic minority non-heterosexual people are still very much lacking in voice and visibility. The present study aimed to examine experiences within Swedish non-heterosexual spaces, held by ethnic minority non-heterosexual individuals.

Method

A thematic analysis of in-depth interviews with 22 Swedish non-heterosexual individuals, 13 cis-men and nine cis-women, with diverse first- and second-generation immigration backgrounds, was conducted.

Results

Two main themes were identified. The first theme, "Constantly contested identities," is composed of the sub-themes "Ingrained, intersecting ideals" and "Prejudiced spaces," and the second theme, "Effects and counteractions," of the sub-themes "Never fully human" and "Representation and separatism." The results, presented starting from a more theoretical level, moving to situated knowledge, and finally to psychological and practical implications, demonstrate that ethnic minority non-heterosexual people experience problematic and intersecting ideals, with related discrimination, in various Swedish non-heterosexual settings. Experiences of alienation, exotification, and tokenism were common among the participants and had negative psychological effects, including multiple-minority stress and a constant outsider feeling. Representation and participation in separatist forums were utilized as primary strategies to counteract the negative effects.

Discussion

The findings shed light on previously under-researched ideals and actions within Swedish LGBTQ+ spaces, and raises questions about how positive belonging can be achieved for multiple-minorities. Further research and continued critical discussions about ethnic minority non-heterosexual people's plight within non-heterosexual settings in Sweden, and beyond, is advocated.

Sexual racism and colourism among Australian men who have sex with men: A qualitative investigation

Sexual racism, referring to discrimination in the context of sexual and romantic partner-seeking, is pernicious among men who have sex with men (MSM). Two gaps exist in the literature on sexual racism among MSM: the potential role of colourism, wherein non-White MSM experience additional discrimination due to their skin tone; and the lack of current qualitative data about how Australian MSM construe sexual racism and colourism. We qualitatively investigated the manifestations and construals of sexual racism and colourism within an Australian sample of MSM (N = 39, 64% non-White) recruited via Grindr. Reflexive thematic analysis identified three themes: Manifestations of sexual racism; Recognising the racial hierarchy of desirability; and Diverse understandings of sexual racism. Participants recognised a racial hierarchy of desirability that privileges Whiteness and gives rise to multiple manifestations of sexual racism that harm non-White MSM. Notably, this hierarchy is intertwined with a skin colour hierarchy that favours lighter complexions among non-White men. Construals of sexual racism and colourism were diverse and ranged from beliefs that race-based sexual preferences are sacrosanct and beyond the purview of moral critique, through to beliefs that race-based sexual preferences are inherently political and entail a moral obligation for individuals to introspect and modify.

Online Dating and Mental Health among Young Sexual Minority Black Men: Is Ethnic Identity Protective in the Face of Sexual Racism?

Racialized Sexual Discrimination (RSD), also known as 'sexual racism,' is pervasive within online dating venues. RSD is associated with poor mental health outcomes among young sexual minority Black men (YSMBM), and there is limited research on factors that may mitigate this association. Ethnic identity has been identified as a potential protective factor for racial/ethnic minorities who encounter racialized stressors, though some evidence suggests that ethnic identity may also intensify the negative effects of racial discrimination. Using data from a cross-sectional web-survey of YSMBM (n = 690), a series of linear regression models were estimated to examine the moderating effect of ethnic identity search and ethnic identity commitment on the relationship between RSD and depressive symptoms/feeling of self-worth. Results indicated that having moderate-to-high scores on commitment attenuated the association between being physically objectified by White men and higher depressive symptoms. However, having high scores on commitment intensified the association between being rejected by Black men and lower feelings of self-worth. Stronger identity commitment may be protective against objectification from White men, though it may also exacerbate negative outcomes related to in-group discrimination. These findings may have important implications for the development of individual and group-level interventions addressing ethnic identity among YSMBM.

A Good App Is Hard to Find: Examining Differences in Racialized Sexual Discrimination across Online Intimate Partner-Seeking Venues

Young sexual minority Black men (YSMBM) report widespread instances of Racialized Sexual Discrimination (RSD) when seeking intimate partners online. RSD is associated with negative psychological health outcomes; however, little is known about the differences between virtual environments, and whether users are exposed to differential types/frequencies of RSD across different virtual environments. Using data from a cross-sectional web survey of YSMBM (N = 548), a multivariate Kruskal–Wallis test was conducted comparing those who primarily used Jack’d and those who primarily used Grindr to meet intimate partners; the frequency with which these two groups encountered six RSD domains was compared. Men who primarily used Grindr reported more frequent instances of White superiority and rejection from White men compared with men who primarily used Jack’d. Men who primarily used Jack’d reported more frequent instances of physical objectification from Black men compared with men who primarily used Grindr. RSD may manifest differentially based on the specific venue that YSMBM use. Such differences may reflect the sociodemographic makeup of these spaces, as well as differences in acceptability/normalization of different forms of RSD. These findings have implications for the development of anti-RSD initiatives that target the specific sociocultural norms that are unique to different virtual environments.

Online Sexual Health Information Seeking Patterns Differentiated by Social Location and Physical Location among Gay and Bisexual Men in Ontario, Canada

Objective

This research aimed to understand the varying needs of diverse gay and bisexual men (GBM) in relation to online sexual health information-seeking dependent upon differing social sociodemographic variables and geographic location.

Methods

A total of 1802 GBM in Ontario participated in this study. Multivariable regressions were conducted to analyze differences in information-seeking based on ethnicity group, HIV status, recent sexual behavior and regionality (urban and rural location).

Results

There were significant differences in online sexual health information-seeking content based on these demographic variables.

Conclusions

Implications for sexual health outreach and service provision for diverse GBM are discussed as well.

"White, Tall, Top, Masculine, Muscular": Narratives of Intracommunity Stigma in Young Sexual Minority Men's Experience on Mobile Apps

What forms of intracommunity stigma do young sexual minority men narrate as they participate in communities through mobile apps? In a content analysis of 32 interviews with a racially diverse sample of young sexual minority men (ages 19-25; 84.4% non-White) from four regions of the USA, a majority of men (62.5%) spontaneously discussed mobile apps (e.g., Grindr, Scruff) when asked about their experience of community more broadly. Men's narratives revealed engagement with intracommunity stigma related to body size, race/ethnicity, gender expression, and sexual position (e.g., bottom). Stigma related to HIV status, substance use, and social class were not spontaneously narrated in response to questions about men's experience in communities. Expressions of stigma were frequently experienced intersectionally, particularly regarding racialized stereotype expectations (e.g., "Asian men are twinks, effeminate"). We discuss the ways in which sexual minority men reproduce dominant ideologies related to racism, misogyny, and masculine body ideals as they engage with one another on mobile apps. To the extent that many young men rely on mobile apps for community connection, their experiences of community might serve to exacerbate, rather than ameliorate, the deleterious impact of stigma.

Demographic and sociocultural predictors of face image satisfaction: The U.S. Body Project I

Despite substantial literature surrounding how people process and perceive faces, there is very little research investigating how people evaluate their own faces. We examined how gender, body mass, race, age, and sexual orientation were linked to people's satisfaction with the appearance of their eyes, nose, facial shape, and face overall among 11,620 adults recruited via Mechanical Turk. Most people mostly or definitely agreed they were happy with their facial appearance. There were notable racial differences, with Asian participants tending to report greater dissatisfaction. For example, only 66% of Asian women and 60% of Asian men mostly or definitely agreed that they were happy with the appearance of their eyes, which was lower than other racial groups. BMI and age were not strongly associated with face satisfaction. Sexual minority men were less satisfied than heterosexual men. About one in four gay and bisexual men, compared to only one in seven heterosexual men, reported dissatisfaction with their overall facial appearance. Men and women with poorer face image engaged in more appearance surveillance, more strongly internalized the thin-ideal, and perceived stronger sociocultural pressures from peers, parents, and media. The current study highlights important sociocultural and demographic factors tied to poorer face image.

Establishing initial validity and factor structure for the muscularity-oriented eating test in gay men

Eating disorders (EDs) affect men at higher rates than previously estimated, with many traditional ED measures likely underestimating the prevalence of eating and exercise-related pathology among males. The development of the Muscularity-Oriented Eating Test (MOET) represents an important advancement in ED assessment, enabling valid and reliable assessment of muscularity-oriented ED pathology among men. The current study sought to provide initial validity of the MOET among gay men. N = 264 gay men, recruited via MTurk, participated in a brief online survey, completing the MOET and other well-validated measures of eating pathology and body image psychopathology. Factor structure, mean, standard deviation, and intercorrelation between measures were assessed. The MOET demonstrated adequate factor structure, similar to that reported in the initial validation sample, and was significantly correlated with other measures of eating and body image psychopathology. The current study suggests initial validity of the MOET for use among gay men. Future research is needed among younger and more diverse samples of SM men, along with evidence of adequate test-retest reliability and absence of differential item functioning among gay men.

Body Image Concerns, Correlates, and Community Connection Among Black and Latinx Sexual Minority Cisgender Men and Transgender/Gender Nonconforming Young Adults

AbstractPurpose: We extended the focus on body image research beyond cisgender, White sexual minority men (SMM) by describing body image concerns among Black and Latinx SMM and transgender/gender nonconforming (TGNC) adults and by examining protective effects of community connection. Methods: From 2016 to 2020, 447 Black and Latinx SMM (94%) and TGNC (6%) individuals in Los Angeles provided data semiannually. Participant endorsement of any body image concerns was determined by five body image codes (weight, fitness, appearance, body area dissatisfaction, and general body image) applied to participants' open-ended lists of health and body concerns. Fixed effects multivariable logistic regression was performed to examine the association between gay and racial/ethnic community connection and odds of any body image concerns, accounting for multiple records per person. An interaction term between gay and racial/ethnic community connection approximated the protective effect of connection to multiple, intersecting communities. Results: The majority of participants (51%) reported a body image concern, most commonly weight concerns, at least once across three years. Body image concerns were more common among Latinx participants (χ² = 17.79, p < 0.001) and participants experiencing food insecurity (χ² = 4.11, p = 0.04) and unmet basic financial needs (χ² = 10.56, p = 0.001). Gay community connection was protective against body image concerns, but only for participants who had high racial/ethnic community connection (adjusted odds ratio = 0.87, p = 0.05). Conclusion: Body image concerns were notable, especially among those with low community connection and higher socioeconomic burden. These findings suggest that building connections within SMM/TGNC and racial/ethnic communities may aid in building a support network that buffers against body image concerns.

Being in a queer time: Exploring the influence of the COVID-19 pandemic on LGBTQ+ body image

Aim

The isolating public health measures mandated during the COVID‐19 pandemic had complex influences on the lives and body image of lesbian, gay, bisexual, trans, and queer individuals (LGBTQ+) in Canada. The aim of this study was to explore the impact the COVID‐19 pandemic had on body image for LGBTQ+ Canadians.

Methods

The qualitative research process was guided by queer theory and poststructuralism and consisted of an online survey with open‐ended questions and semi‐structured virtual interviews. A total of 70 self‐identifying LGBTQ+ individuals completed the survey, and eight individuals partook in the interviews. Responses were analysed using Foucauldian discourse analysis.

Results

Four major discursive considerations were found to shape participants' experiences, including, (a) time for reflection, (b) time away from social surveillance, (c) time to work on oneself, and (d) time to (dis)connect. Woven through these considerations were social discourses of hetero‐cis‐normativity, healthism, and resistance.

Discussion

The COVID‐19 pandemic was a ‘queer time’ for LGBTQ+ people. Competing social discourses created complex and often contradictory meanings of bodies and body image. COVID‐19‐related self‐isolation was for some participants a reprieve from constant body monitoring while for others it was a time of continued pressure to embody body ideals. Participants suggested that nutritional messages during such times be ones of compassion and non‐judgement of bodies.

Compassionate Bodies, Compassionate Practice: Navigating Body Image Tensions among Gay Men

Our purpose in writing this Perspective in Practice is to create awareness about the role of compassion within dietetic practice, particularly the role of compassion for body image tensions. Nine self-identifying gay men were recruited to a photovoice research study that explored their beliefs, values, and practices relating to food and their bodies. Compassion was found as one way to navigate body images tensions. It is not the intent of this article to review all aspects of this research study but to use it as an example to illustrate compassion in dietetics. We suggest that our findings reveal the strength of using compassionate practice within the dietetic profession. In doing so, we call upon dietitians to incorporate compassion into their clinical and client care practices to foster health and healing for all communities, especially among those who struggle with body image tensions.

Gay male pornography and the racialisation of desire

Very few studies have focused on the role pornography plays in influencing and modelling sexual desire on the basis of race and ethnicity. Using sexual script theory as an analytic tool, the purpose of this empirical study was to explore indicators of the racialisation of desire based on a sample of gay male pornography users in Québec (Canada) (n = 974). Because gay male pornography use is widespread, and because it is not simply used for the purposes of education and validation but also influences sexual norms and cultural scripts in a social context where sexual racism seems prevalent, this study offers a new perspective on a timely phenomenon. Based on our findings, the final nested linear regression model demonstrates that higher levels of racialised desire attributed to gay male pornography use were associated with the following: being at least 55 years old; having a yearly income of less than $45,000 CAD; using interracial gay male pornography; not primarily using gender-diverse gay male pornographic content (heterosexual, bisexual, transsexual); having higher levels of perceived pressure to conform; having a higher preference for bareback pornography; and having higher levels of acquired sexual knowledge.

Age, period, and cohort patterns in the epidemiology of suicide attempts among sexual minorities in the United States and Canada: detection of a second peak in middle adulthood

PURPOSE

Sexual minority adults experience fivefold greater risk of suicide attempt, as compared with heterosexuals. Establishing age-specific epidemiological patterns of suicide is a prerequisite to planning interventions to redress the sexual orientation suicide inequity, and such patterns must be carefully interpreted in light of correlated period and cohort effects. We, therefore, combined US and Canadian data (1985-2017) from primary (two pooled multi-year national surveys, N = 15,477 and N = 126,463) and secondary (published, meta-analytic, N = 122,966) sources to separately estimate age, period, and cohort trends in self-reported suicide attempts among sexual minorities.

METHODS

Age- and gender-stratified cross-sectional data were used to infer age and cohort effects. Age-collapsed meta-analyzed data were used to infer period effects among sexual minorities of all genders.

RESULTS

We identified a bimodal age distribution in recent suicide attempts for sexual minorities across genders, though more pronounced among sexual minority men: one peak in adolescence (18-20 years of age for both genders) and one peak nearing mid-life (30-35 years of age for men; 35-40 years of age for women). This pattern was also apparent using recall data within birth cohorts of sexual minority men, suggesting it is not an artifact of birth cohort effects. Finally, we observed decreasing trends in lifetime suicide attempt prevalence estimates for both sexual minorities and heterosexuals, though these decreases did not affect the magnitude of the sexual orientation disparity.

CONCLUSION

In the context of exclusively adolescent-focused suicide prevention interventions for sexual minorities, tailored suicide prevention for sexual minority adults should be pursued throughout the life course.

Racialized Sexual Discrimination (RSD) in the Age of Online Sexual Networking: Are Young Black Gay/Bisexual Men (YBGBM) at Elevated Risk for Adverse Psychological Health?

Young Black gay/bisexual men (YBGBM) are a highly marginalized population across multiple health outcomes. Most research on YBGBM health has focused on HIV/sexual health, but there is a demonstrable need for research examining racism and psychosocial functioning among this population. Racialized Sexual Discrimination (RSD), also known as sexual racism, is an important but under-investigated phenomenon that may have implications for the psychological health and well-being of YBGBM. This paper provides an overview of empirical research on RSD as experienced by gay/bisexual men of color in online partner-seeking venues. First, the researchers discuss how racialized experiences are a documented online phenomenon, with a variety of manifestations, and identify the potential effects that this phenomenon may have on the psychosocial health of YBGBM, and gay/bisexual men of color as a whole. Second, the researchers synthesize the RSD literature with a broader literature examining psychological well-being across race and sexual orientation. Third, the researchers present a theoretically grounded conceptual model detailing the pathways between RSD and psychological well-being using a stress and coping framework. The paper concludes with recommendations for future research on this topic, including scale development and hypothesis testing.

Experiences of racism, sexual objectification and alcohol use among gay and bisexual men of colour

Objective: Previous research has shown that experiences of racial discrimination and sexual objectification are associated with health risk behaviours among gay and bisexual men of colour. However, little is known about whether racial discrimination and sexual objectification are associated with alcohol use among this population. This community-based study examined the association between racial discrimination, sexual objectification and alcohol use in a sample of 369 gay and bisexual men of colour (Black/African/Caribbean, Latino/Latin American, South Asian, and East and Southeast Asian) in Toronto.Design: Data were drawn from an online survey designed to examine issues of racism, homophobia, health and well-being among gay and bisexual men of colour in Toronto. Regression analysis assessed the relationship between scores on the Racism and Life Experiences Scale, Sexual Objectification Scale, and the CAGE questionnaire (a screen for alcohol use disorder).Results: Multivariable logistic regression analyses revealed that experiences of racism and sexual objectification are significantly and positively associated with a screening for alcohol use disorder. The interactions between Latino/Latin American race/ethnicity and experience of sexual objectification were also positively associated with a screening for alcohol use disorder.Conclusions: Health professionals should consider the role of racial discrimination and sexual objectification within the context of risk and treatment for alcohol use disorders, harm reduction, and HIV prevention for gay and bisexual men of colour.

The Role of Psychological Flexibility as a Mediator Between Experienced Sexual Racism and Psychological Distress Among Men of Color Who Have Sex with Men

Previous research has shown that individuals belonging to multiple marginalized groups experience higher levels of psychological distress, which is linked to experiencing discrimination based on their multiple marginalized identities. One way that gay and bisexual men of color face discrimination is in the dating and sexual situations within the men who have sex with men community, which is sometimes termed sexual racism. Previous research has found that experienced discrimination on the basis of their race/ethnicity is positively related to depressive symptoms. The present study examined whether psychological flexibility mediates the effect of experiencing sexual racism on psychological distress. In this study, 439 men of color who have sex with men completed a series of questionnaires online on Amazon Mechanical Turk. Results showed that the indirect effects of experiencing sexual racism through psychological flexibility on depression (95% CI .22, .39), anxiety (95% CI .15, .29), and stress (95% CI .18, .33) were significant while controlling for demographic variables. Therefore, this model showed that psychological flexibility mediated and explained the effect of experiencing sexual racism on psychological distress. Clinical implications and future avenues of research are discussed.

Mind, Body and Boundaries: Self-Presentation on the Nordic LGBTQ Online Dating Scene

Online dating is continually on the rise and nowadays a widely used and accepted way to find different kinds of companionship. This relatively new interpersonal phenomenon has provided an especially important virtual space for non-heterosexuals. Previous research on behaviors and trends on dating communities online for sexual minorities has focused primarily on sites for gay men in Anglo-Saxon countries. The purpose of the present study is to examine self-presentations on the Nordic LGBTQ online dating scene and possible gender-dependent differences in self-presentation. The Nordic countries are commonly perceived as progressive in issues regarding gender equality and LGBTQ rights. The countries on average also have low population density with large rural areas and consequently limited scenes for non-heterosexuals. A testimony of this is the study's selected dating site, which is based in Sweden but encompasses the neighboring countries and markets itself as a Nordic meeting venue. The present study embarks on new territory within psychology-, gender-, and queer research by examining self-presentations on a mixed-gender LGBTQ dating site, situated in the supposedly liberal Nordic countries. Based on qualitative and quantitative data from a stratified sample of 716 cis-gendered, predominantly Swedish online dating profiles, on a well-established Nordic online dating site for non-heterosexual men and women, statistical calculations and a thematic analysis (TA) were executed. The findings show that central self-presentations concern mind versus body, lust and longings, and boundaries, where gender frequently functions as the dividing line. Women self-present more through personality and romantic longings compared to men, who to a higher degree emphasizes body, and lust. Self-presentation is also expressed through resistance against boundary-breaking contact on the site. The boundaries that are guarded regard age, anti-racism and most pronounced - boundaries against male harassment of non-heterosexual women. The implications of self-presentation, possible discrimination and misrepresentation on the Nordic LGBTQ online dating scene are discussed.

Heterosexism, Racism, and the Mental Health of Sexual Minority People of Color

In the present study, we examined the additive and multiplicative associations of heterosexist discrimination, racist discrimination, internalized heterosexism, and internalized racism with psychological distress and well-being in 318 sexual minority People of Color. We tested multiplicative associations via two sets of interactions: cross-oppression (Heterosexist Discrimination × Internalized Racism, Racist Discrimination × Internalized Heterosexism) and same-oppression (Heterosexist Discrimination × Internalized Heterosexism, Racist Discrimination × Internalized Racism). Consistent with the additive perspective, heterosexist discrimination and internalized racism were uniquely positively associated with distress, whereas internalized heterosexism and internalized racism were uniquely negatively associated with well-being. The Heterosexist Discrimination × Internalized Racism and Racist Discrimination × Internalized Racism interactions were significant in relation to both distress and well-being. Internalized racism was associated with significantly poorer mental health until heterosexist and racist discrimination reached high levels. We discuss the implications of our findings for research and practice with sexual minority People of Color.

Examining sexual racism and body dissatisfaction among men of color who have sex with men: The moderating role of body image inflexibility

Body image research with men who have sex with men (MSM) has largely focused on White MSM. The current study aimed to investigate whether men of color who have sex with men (MCSM) report similar levels of body dissatisfaction as White MSM. We also studied whether (a) the experience of sexual racism, a unique stressor for MCSM, is related to body dissatisfaction and (b) body image inflexibility moderates the relationship between sexual racism and muscularity-oriented behaviors. White MSM and MCSM (total N = 887) recruited through Amazon Mechanical Turk completed questionnaires assessing body dissatisfaction, body image flexibility, and experienced sexual racism on Qualtrics. We found that MCSM report more engagement in behaviors aimed at changing their bodies than White MSM. Additionally, experiencing sexual racism was related to higher body dissatisfaction and body image inflexibility in MCSM. In addition, body image inflexibility moderated by strengthening the association between experiencing sexual racism and muscularity-oriented behaviors. The present study highlights the need for further research with this understudied population, including intervention studies on mitigating the impact of experiencing sexual racism by increasing psychological and body image flexibility and studies aimed at reducing the incidence of sexual racism.

Exploring the use of fact-based and story-based learning materials for HIV/STI prevention and sexual health promotion with South Asian women in Toronto, Canada

Story-based learning is well recognized as an effective strategy for adult health education. However, there is a scarcity of research on story-based health education among women in South Asian diasporic communities. To address this gap, we undertook a pilot study in Toronto to explore how South Asian women respond to the use of fact-based and story-based materials for HIV/STI prevention. A total of 78 women were recruited from across the city. We engaged nearly half of the women (n=40) using fact sheets on HIV/STIs, and the remainder (n=38) using stories written by South Asian women on HIV/STIs. Surveys and focus groups were used to explore participants' responses in terms of knowledge, attitudes and perspectives. Results indicated that both approaches were effective in increasing participants' knowledge of HIV/STIs. Participants in the fact-based sessions tended to distance themselves from the idea of personal HIV/STI risks. Participants in the story-based groups were emotionally engaged, expressing personal commitments to take a stand against HIV stigma. In summary, within-culture stories are potentially effective tools that enable women to make sense of their own life situations and contextual vulnerabilities. Story-based materials are useful for breaking the silence of taboo topics, addressing stigma and discrimination and raising awareness about collective empowerment.

Prevalence of Obesity, Prediabetes, and Diabetes in Sexual Minority Men: Results From the 2014 Behavioral Risk Factor Surveillance System

Purpose The purpose of this study is to assess the prevalence and related odds ratios for obesity, prediabetes, and diabetes in sexual minority men (SMM) in relation to straight men. Methods A secondary analysis of 2014 Behavioral Risk Factor Surveillance System data from 19 states (n = 53 542) was conducted. Weighted means and standard errors were computed to estimate prevalence rates of obesity, prediabetes, and diabetes across male sexual orientation groups, respectively. Unadjusted and adjusted (demographics, depression, and health care access factors) weighted logistic regression models were developed. Results Obesity prevalence was lower in gay men relative to straight men with logistic regression modeling indicating gay men were significantly less likely to be obese, relative to their straight counterparts, in the unadjusted and adjusted models. In terms of prediabetes, rates were low across all sexual orientation groups with no significant differences observed. Yet bisexual men, relative to straight men, had higher rates of diabetes with significantly increased odds for the disease in both the unadjusted and adjusted models. Conclusion Findings indicate gay men have reduced risk for obesity while bisexual men may have increased diabetes burden. Across all male sexual orientation groups, prediabetes prevalence was low, suggesting the need for more aggressive prediabetes screening. Additional research is necessary to confirm the findings.

Recent Suicide Attempts Across Multiple Social Identities Among Gay and Bisexual Men: An Intersectionality Analysis

This study draws from intersectionality to describe variations in recent suicide attempts (RSA) among gay and bisexual men (GBM) across sociodemographics. Using survey data, logistic regression modeling explored RSA in two analytical stages: (1) the individual effects of each sociodemographic were measured; (2) two-way interaction terms between sociodemographics were tested and added to the models created in stage A. In stage A, only education and income achieved significance. In stage B, the study found that (a) education and income interacted significantly such that the odds of RSA increased for those with a lower income and a lower education; (b) sexual orientation and partnership status interacted, resulting in decreased odds among bisexual men in heterosexual partnerships; and (c) income and education interacted with geography; the effects of these variables were significant only among urban men. These findings suggest that GBM are at unequal risk of RSA according to intersecting sociodemographics.

A systematic review and narrative synthesis of interventions for uncomplicated obesity: weight loss, well-being and impact on eating disorders

OBJECTIVE

Most weight loss research focuses on weight as the primary outcome, often to the exclusion of other physiological or psychological measures. This study aims to provide a holistic evaluation of the effects from weight loss interventions for individuals with obesity by examining the physiological, psychological and eating disorders outcomes from these interventions.

METHODS

Databases Medline, PsycInfo and Cochrane Library (2011-2016) were searched for randomised controlled trials and systematic reviews of obesity treatments (dietary, exercise, behavioural, psychological, pharmacological or surgical). Data extracted included study features, risk of bias, study outcomes, and an assessment of treatment impacts on physical, psychological or eating disorder outcomes.

RESULTS

From 3628 novel records, 134 studies met all inclusion criteria and were evaluated in this review. Lifestyle interventions had the strongest evidence base as a first-line approach, with escalation to pharmacotherapy and bariatric surgery in more severe or complicated cases. Quality of life was the most common psychological outcome measure, and improved in all cases where it was assessed, across all intervention types. Behavioural, psychological and lifestyle interventions for weight loss led to improvements in cognitive restraint, control over eating and binge eating, while bariatric surgery led to improvements in eating behaviour and body image that were not sustained over the long-term.

DISCUSSION

Numerous treatment strategies have been trialled to assist people to lose weight and many of these are effective over the short-term. Quality of life, and to a lesser degree depression, anxiety and psychosocial function, often improve alongside weight loss. Weight loss is also associated with improvements in eating disorder psychopathology and related measures, although overall, eating disorder outcomes are rarely assessed. Further research and between-sector collaboration is required to address the significant overlap in risk factors, diagnoses and treatment outcomes between obesity and eating disorders.

Male Body Practices

The pressure on boys and men to engage in extensive body practices (e.g., closely monitored eating and exercise habits) and achieve ideal male bodies has grown significantly over the past 20 years. Central to the depiction of ideal male bodies and body practices are both the pursuit and achievement of lean and well-defined muscles. The labels “pitches,” “purchases,” and “performativities” were inductively derived from the literature, and used to describe the multifaceted connections between masculinities, muscularity, and idealized male body practices. “Pitches” distil how popular culture posture norms of masculinity, and manly bodies and behaviors attainable and necessary. “Purchases” refer to men’s diverse buy-in to dominant discourses about acceptable male bodies and practices. “Performativities” chronicle how men embody and navigate gender norms as they evaluate their own bodies, behaviors, and eating habits and those of their peers. Based on findings from the current scoping review, future research could benefit from fully linking masculinities with the drive for muscularity to address health and social risks associated with the pursuit of the idealized male body. In highlighting the plurality of masculinities and the complexity of men’s diverse identities, health care providers can better reach and support men. Focusing on, and celebrating, a wider range of male bodies could help recenter dominant discourses about how and whose bodies and experiences are idealized. The current scoping review article offers an overview of how masculinities and muscularity have been linked to male body practices, and recommendations to advance this emergent field.

Body Talk: Body Image Commentary on Queerty.com

In this study, we conducted a content analysis of 243 photographic images of men published on the gay male-oriented blog Queerty.com. We also analyzed 435 user-generated comments from a randomly selected 1-year sample. Focusing on images' body types, we found that the range of body types featured on the blog was quite narrow-the vast majority of images had very low levels of body fat and very high levels of muscularity. Users' body image-related comments typically endorsed and celebrated images; critiques of images were comparatively rare. Perspectives from objectification theory and social comparison theory suggest that the images and commentary found on the blog likely reinforce unhealthy body image in gay male communities.

Body Dissatisfaction in a Diverse Sample of Young Men Who Have Sex With Men: The P18 Cohort Study

Young men who have sex with men (YMSM) may be at greater risk for body dissatisfaction, compared to their heterosexual peers. However, differences within YMSM populations are understudied, precluding the identification of YMSM who are at greatest risk. This study examined body dissatisfaction in a racially/ethnically diverse sample of YMSM ages 18-19 in New York City. Using cross-sectional data from the baseline visit of a longitudinal cohort study of YMSM (N = 591), body dissatisfaction was assessed using the Male Body Attitudes Scale. Three outcomes were modeled using linear regression: (1) overall body dissatisfaction, (2) muscularity dissatisfaction, and (3) body fat dissatisfaction. Covariates in the models included race/ethnicity, sexual orientation, BMI, gay community affiliation, and internalized homonegativity. White YMSM experienced greater body dissatisfaction across the three models. Internalized homonegativity was a statistically significant predictor of dissatisfaction across the three models, though its association with body dissatisfaction was relatively small. The findings point to future avenues of research, particularly qualitative research to explore demographic and cultural nuances in body attitudes among YMSM.

Masculinities and ethnicities: Ethnic differences in drive for muscularity in British men and the negotiation of masculinity hierarchies

Although relatively little is known about ethnic differences in men's drive for muscularity, recent theoretical developments suggest that ethnic minority men may desire greater muscularity to contest their positions of relative subordinate masculinity. This study tested this hypothesis in a sample of 185 White, 180 Black British, and 182 South Asian British men. Participants completed self-report measures of drive for muscularity, need for power, adherence to traditional cultural values, and ethnic group affiliation. Taking into account between-group differences in body mass index, results indicated that White men had significantly lower drive for muscularity than Black and South Asian men, who were not significantly different from each other. In addition, greater need for power was significantly associated with higher drive for muscularity in ethnic minority, but not White, men. Greater adherence to traditional cultural values, but not ethnic group affiliation, was associated with lower drive for muscularity in all ethnic groups. These results suggest that ethnic minority men may desire greater muscularity as a means of negotiating masculinity and attendant ideals of appearance.

Relations of Sexual Objectification and Racist Discrimination with Latina Women’s Body Image and Mental Health

In the current study, we tested direct and mediated associations of objectification theory constructs and racist discrimination with eating disorder and depressive symptomatology in a sample of 180 Latina women (age range = 18-66). Results of a path analysis indicated that internalization of sociocultural standards of attractiveness was related to greater eating disorder and depressive symptomatology in part through the mediating roles of body shame and body surveillance, and body surveillance was related to greater eating disorder and depressive symptomatology through the mediating role of body shame. Sexual objectification did not yield hypothesized direct and indirect unique relations with criterion variables. However, racist discrimination was directly associated with greater depressive symptomatology and indirectly associated, through the mediating role of body shame, with greater eating disorder and depressive symptomatology. These results extend tenets of objectification theory to Latina women and point to the role of racist discrimination within this framework.

Sexually explicit racialised media targeting men who have sex with men online: a content analysis of high-risk behaviour depicted in online advertisements

Sexually explicit media may perpetuate racial and sexual norms among men who have sex with men. While men may be exposed to sexually explicit media in the online settings where they seek sex with other men, no studies to our knowledge have explored the relationship between the racial and sexual content of advertisements appearing in these spaces. In 2011, using a detailed codebook, 217 sexually explicit advertisements on a male sex-seeking website were coded for themes, actor characteristics and sexual acts depicted. Multivariable logistic regression models examined the association between skin colour, theme, sexual acts and condomless sex acts. Nearly half (45%) featured a 'thug' theme (a style emphasising Black masculinity/hip-hop culture), 21% featured a college theme and 44% featured condomless sex. Advertisements featuring only Black men, advertisements featuring Black men with men of other skin tones and advertisements depicting a thug theme were positively associated with depictions of condomless sex. Online sexually explicit advertisements featuring Black themes and actors more frequently depicted condomless sex than advertisements with White men alone. Future research should examine whether depictions of Black men engaging in condomless sex in online advertisements influence the sexual norms and cognitions of Black men who have sex with men and their partners.

Body image among eating disorder patients with disabilities: a review of published case studies

While individual cases of eating disorder (ED) patients with disabilities have been reported, there has been little synthesis of their experiences of body image and thin idealization. This study reviews 19 published clinical reports of ED patients with sensory, mobility-related, or intellectual disabilities and evaluates the extent to which their experiences align with or challenge current conceptions of body image in ED. ED patients with visual impairment reported a profound disturbance of body image, perceived intersubjectively and through tactile sensations. Reducing dependence in mobility was an important motivation to control body size for ED patients with mobility-related disabilities. ED as a way of coping with and compensating for the psychosocial consequences of disability was a recurrent theme for patients across a range of disabilities. These experiential accounts of ED patients with disabilities broaden current understandings of body image to include touch and kinaesthetic awareness, intersubjective dynamics, and perceptions of normalcy.