Body Image and Sociocultural Norms

Body Image Among Sexual and Gender Minorities: An Intersectional Analysis

Body image is consequential for overall well-being and has a complex relation to gender. Sexual and gender minority (SGM) individuals develop body image amid intersecting systems of oppression, such as sexism, cisnormativity, heteronormativity, and gender binary pressures. This study used an intersectionality framework to examine how various aspects of gender identification (cis/trans, binary/nonbinary, woman/man identification) related to body image differences among SGM individuals. We also assessed whether identification with conventionally masculine and feminine personality traits predicted body image. We used one-way and two-way ANOVAs and linear regressions to analyze two indicators of body image (body appreciation and drive for muscularity) in a sample of 643 SGM individuals (148 sexual minority (SM) cis women, 171 trans women, 121 SM cis men, 43 trans men, 160 nonbinary individuals). Results implicated cisnormativity as an influential and hierarchical force for body image, although woman/man and binary/nonbinary identification also played roles in group differences. With a few exceptions, masculine but not feminine trait identification significantly predicted body appreciation and drive for muscularity, indicating a complicated association with overall body image. These findings underscore the value of an intersectional lens for analyzing how broad social forces may manifest in individual-level body image for SGM individuals.

Sexual orientation differences in pathways from sociocultural and objectification constructs to body satisfaction: The U.S. Body Project I

Objectification theory and the tripartite influence model provide useful frameworks for understanding the body image experiences of men and women. However, there is little systematic investigation of how sexual orientation moderates the links between these constructs and body image satisfaction. It has been hypothesized, for example, that the associations of surveillance (i.e., monitoring of one's appearance due to objectification by others) would be strongest for groups targeted by the male gaze (e.g., gay men, lesbian women, and bisexual men and women). Here we proposed an integrated sociocultural model and examined these pathways in multigroup structural equation models in a national sample of heterosexual, bisexual, and lesbian women (ns = 5395; 598; 213, respectively), and heterosexual, bisexual, and gay men (4869; 194; and 194, respectively) aged 18-65 years. Sexual orientation moderated some of these pathways. The most consistent pattern was that appearance pressures were internalized to a greater extent among bisexual participants. The pathways to poorer body image were generally similar among heterosexual and gay/lesbian men and women. These findings highlight the importance of examining sexual orientation-specific influences on body image across diverse groups, as well as the commonalities in the experiences of men and women across sexual orientations.

The Relationship between Body Appreciation and Health Behaviors among Women and Adolescent Girls: A Scoping Review

Literature on body image and health behaviors has largely been pathology-based, investigating body dissatisfaction and disordered eating. Body appreciation is a useful construct of positive body image and has been used to understand its relationship with health behaviors beyond eating. This scoping review explores the literature on the relationship between body appreciation and physical health-promoting behaviors and health-compromising behaviors. A comprehensive search of databases was conducted to gather correlational studies written in English between January 2005 and November 2019. Behaviors related to eating and exercise were excluded. Nine quantitative studies met inclusion criteria. Evidence suggests an overall positive relationship between body appreciation and health-promoting behaviors, including preventive sexual health behaviors, preventive cancer behaviors, and seeking medical attention. Alternatively, body appreciation is negatively associated with health-compromising behaviors including risky sexual activity and alcohol and tobacco use. Promoting positive body image, above and beyond the reduction of body dissatisfaction, may play a crucial role in the health and well-being of women and girls. Research that examines positive body image in groups that are racially diverse and include sexual and gender minorities and people without healthcare access is urgently needed.

Sexual Orientation Differences in Lethal Methods Used in Suicide: Findings From the National Violent Death Reporting System

We examined sexual orientation and sex differences in seven methods of suicide among adult suicides reported in the United States National Violent Death Reporting System (2012-2015; N = 59,075). Overall, most sexual minorities (i.e., lesbians, gay men, bisexuals) identified in the dataset used hanging (38%) followed by firearm (30%) and drug or poison ingestion (20%). Sexual minorities were more likely than heterosexuals to be younger, female, and Black/African American. Multivariate sex-stratified analyses in the overall sample showed that strong sexual orientation differences in lethal methods existed among men but not among women. However, when we compared sex differences in lethal methods among sexual minorities only, we found that lesbian/bisexual women, as compared to gay/bisexual men, were more likely to use a firearm or drug or poison ingestion than hanging. Findings suggest that the higher rate of suicide mortality among sexual minorities is likely driven by hanging, a method of suicide that is not particularly amenable to lethal method restricted-access prevention approaches. Future research directions, clinical training recommendations, and intervention opportunities are discussed.

Demographic predictors of objectification theory and tripartite influence model constructs: The U.S. Body Project I

We examined how demographic factors (gender, sexual orientation, racial group, age, body mass) were linked to measures of sociocultural appearance concerns derived from objectification theory and the tripartite influence model (McKinley & Hyde, 1996; Schaefer et al., 2015) among 11,620 adults. Men were less likely than women to report high body surveillance, thin-ideal internalization, appearance-related media pressures, and family pressures; did not differ in peer pressures; and reported greater muscle/athletic internalization. Both men and women expressed greater desire for their bodies to look "very lean" than to look "very thin". Compared to gay men, heterosexual men reported lower body surveillance, thin-ideal internalization, peer pressures, and media pressures. Black women reported lower thin-ideal internalization than White, Hispanic, and Asian women, whereas Asian women reported greater family pressures. Being younger and having higher BMIs were associated with greater sociocultural appearance concerns across most measures. The variation in prevalence of sociocultural appearance concerns across these demographic groups highlights the need for interventions.

Femininity Concerns and Feelings About Menstruation Cessation Among Lesbian, Bisexual, and Heterosexual Women: Implications for Menopause

Background: Women differ in how they psychologically respond to the end of menstruation and onset of menopause; however, little empirical evidence exists for understanding how sexual orientation and gendered dynamics contribute to menstrual experiences in middle-to-late adulthood. We investigated if women's attitudes toward the cessation of menstruation vary by their sexual orientation. Methods: Using data from the Midlife in the United States Study (MIDUS, N = 3471), we examined the relationship between women's sexual orientation and attitudes toward menstruation cessation. We also assessed their femininity concerns, such as their worries about attractiveness and fertility in the context of aging. Results: Sexual minority (SM) women, compared with their heterosexual counterparts, expressed less regret of their menstrual periods ending. SM women also expressed lower concerns about femininity compared with heterosexual women, and concerns about femininity mediated the relationship between sexual orientation and regret. That is, SM women felt less regret about menstrual periods ending than heterosexual women, and this finding was partially explained through SM women's lower concerns about femininity (attractiveness and fertility). Conclusions: Our results contribute to a growing body of research on the psychological strengths of sexual minorities by highlighting SM women's potential strengths in an aging context. We propose implications for understanding aging stigma and women's health, and we discuss how menopause may be differently experienced by women based on sexual orientation.

Role of Sex on the Relationship Between Sexual Minority Status and Misperceptions of Body Weight Among High School Students

PURPOSE

Misperception of body weight during adolescence is a risk factor for negative self-image, harmful eating/dietary habits (e.g., binge eating and purging), and body dysmorphia. Sexual minority youth, particularly males, may be at increased risk for misperceptions of body weight, relative to youth who do not identify as a sexual minority. This study examines the risk for misperception of body weight among sexual minority youth and explores biological sex as an effect modifier in this relationship.

METHODS

We pooled data from the 2015 and 2017 Youth Risk Behavior Surveillance Surveys. Participants were 18,634 high school students who were not overweight/obese. Multivariable logistic regression examined the association between sexual minority status (i.e., gay, lesbian, bisexual, and unsure) and misperceptions of body weight (i.e., self-perceived as overweight/severely overweight). Weighted multivariable logistic regression analyses, stratified by biological sex, were used to compare this relationship across males and females. Covariates included race/ethnicity, grade, bullying victimization, television/electronic screen time, and tobacco use.

RESULTS

Overall, 16.6% of the sample self-reported misperceptions of body weight. Sexual minority youth had 1.49 (95% confidence interval [CI]: 1.28-1.73) greater odds of misperception of body weight, adjusting for covariates; this relationship was found across biological sex, but that the main effect was significantly greater among sexual minority males (adjusted odds ratio: 2.24, 95% CI: 1.65-3.03) relative to sexual minority females (adjusted odds ratio: 1.33, 95% CI: 1.11-1.59).

CONCLUSIONS

Sexual minority youth had greater odds of overestimating their weight status. Biological sex appears to modify this relationship with sexual minority males being at particularly high risk for overestimating their weight status.

Body image disturbance and sexual orientation: An updated systematic review and meta-analysis

Negative body image, or body image disturbance (BID) has been associated with depression, low self-esteem, and the development of eating disorders. Furthermore, BID may affect an individual regardless of gender or sexual orientation. To synthesise the current literature, we conducted a meta-analysis of 48 studies to determine if BID differed between lesbian versus heterosexual women, lesbian women versus gay men, and gay versus heterosexual men. Body image measures were grouped according to similarities in constructs measured, resulting in five different categories (global satisfaction, figural-rating scales, cognitive measures, affect measures, and male body image). The results indicated that lesbian women reported experiencing less BID compared to heterosexual women on measures of global satisfaction, but more compared to gay men, and gay men reported experiencing greater BID compared to heterosexual men on three out of five analyses. Moderation analyses indicated that the study quality was not a statistically significant moderator of the effect sizes. Results from this updated meta-analysis indicate that, to some degree, BIDs affect individuals regardless of gender and sexual orientation; however, there is some variability associated with sexual orientation.

Sexual and gender minority individuals report higher rates of abuse and more severe eating disorder symptoms than cisgender heterosexual individuals at admission to eating disorder treatment

Eating disorders (EDs) occur at higher rates among sexual/gender minorities (SGMs). We currently know little about the risk factor profile of SGMs entering ED specialty care.

OBJECTIVE

To (a) compare history of abuse-related risk in SGMs to cisgender heterosexuals (CHs) when entering treatment, (b) determine if SGMs enter and exit treatment with more severe ED symptoms than CHs, and (c) determine if SGMs have different rates of improvement in ED symptoms during treatment compared to CHs.

METHOD

We analyzed data from 2,818 individuals treated at a large, US-based, ED center, 471 (17%) of whom identified as SGM. Objective 1 was tested using logistic regression and Objectives 2 and 3 used mixed-effects models.

RESULTS

SGMs had higher prevalence of sexual abuse (OR = 2.10, 95% CI = 1.71, 2.58), other trauma (e.g., verbal/physical/emotional abuse; OR = 2.07, 95% CI = 1.68, 2.54), and bullying (OR = 2.13, 95% CI = 1.73, 2.62) histories. SGMs had higher global EDE-Q scores than CHs at admission (γ = 0.42, SE = 0.08, p < .001) but improved faster early in treatment (γ = 0.316, SE = 0.12, p = .008). By discharge, EDE-Q scores did not differ between SGMs and CHs.

DISCUSSION

Our main hypothesis of greater abuse histories among SGMs was supported and could be one explanation of their more severe ED symptoms at treatment admission compared to CHs. In addition, elevated symptom severity in SGMs at admission coincides with greater delay between ED onset and treatment initiation among SGMs-possibly a consequence of difficulties with ED recognition in SGMs by healthcare providers. We recommend increased training for providers on identifying EDs in SGMs to reduce barriers to early intervention.

Stereotypes of physical attractiveness and social influences: The heritage and vision of Dr. Thomas Cash

Dr. Thomas Cash conducted seminal work on the beliefs and stereotypes related to attractiveness as well as their impact, and their transmission through cultural and interpersonal processes. This initial work has inspired and given rise to an important body of research significantly increasing our understanding of these processes. Here we review the initial contributions and research directions set up by Dr. Cash, as well as the main findings of the research that has built on his foundations. Specifically, we review findings related to the existence of attractiveness stereotypes and appearance ideals, research examining the social and interpersonal impacts of such stereotypes, and finally the sociocultural transmission of these beliefs. Future directions related to the extension of our understanding to appearance characteristics beyond shape and weight, as well as increased focus on minority identities and their intersection, are proposed.

Body Appreciation in Lesbian, Bisexual, and Queer Women: Examining a Model of Social Support, Resilience, and Self-Esteem

Purpose: There is increasing research on positive body image, but no studies to date have examined these constructs in lesbian, bisexual, and queer (LBQ) women. However, LBQ women are at increased risk for mental health concerns and disordered eating, and there is evidence that body appreciation might be both adaptive and protective. This study examined factors that could uniquely relate to body appreciation in LBQ women.

Method: Women identifying as LBQ (N=150) completed demographics and measures of social support, resilience, self-esteem, and body appreciation. We tested a hypothesized mediational model of social support leading indirectly to body appreciation through resilience and self-esteem, controlling for body mass index.

Results: All direct effects, except social support to body appreciation (p=0.696), were significant (ps=0.017–0.001), reflecting a full multiple mediation. As hypothesized, the effect of social support on body appreciation was indirect (p=0.011), through resilience and self-esteem.

Conclusion: This is the first study to investigate factors that might facilitate positive body image in LBQ women. Although preliminary, results suggest social support, resilience, and self-esteem might be important targets of body image interventions with LBQ women.

Body Image as Well as Eating Disorder and Body Dysmorphic Disorder Symptoms in Heterosexual, Homosexual, and Bisexual Women

Body image disturbance is a core symptom of eating disorders (EDs) and body dysmorphic disorder (BDD). There is first evidence that females' body image differs depending on sexual orientation, with heterosexual women (HEW) appearing to show more body image disturbance symptoms than homosexual women (HOW). Such disparities might be moderated by everyday discrimination experiences and involvement with the lesbian community. However, to date, there has been no comprehensive assessment of a broad range of body image facets such as drive for thinness, leanness, and muscularity; body avoidance; body checking and body dissatisfaction; and ED and BDD pathology as well as moderating factors. Moreover, studies have often neglected bisexual women (BIW). A total of N = 617 women (n = 180 HOW, n = 322 HEW, n = 115 BIW) completed an online survey assessing the various facets of body image, ED and BDD pathology, discrimination experiences, and involvement with the lesbian community. Significant group differences were found regarding drive for leanness and thinness, body checking, investment behavior, and body ideal (all p<.05). BIW showed significantly more body checking than HOW. Compared to HEW, HOW reported a significantly lower drive for leanness and thinness as well as compared to HEW and BIW less investment behavior. HOW preferred a body ideal with significantly more body fat than did HEW (all p<.05). In contrast, no differences emerged in body dissatisfaction, drive for muscularity, body-related avoidance, ED and BDD pathology, and body image disturbance (all p>.05). In all groups, discrimination experiences were positively related to ED and BDD pathology and to body image disturbance (all p < .05); however, discrimination was significantly correlated with more body image facets in HEW than in HOW or BIW. Involvement with the lesbian community was positively correlated with a larger ideal body size in HOW (p < .05) and negatively correlated with drive for muscularity in BIW (p < .05). Despite the group differences in several body image facets, we found no consistent evidence of increased vulnerability to body image disturbance or associated pathology depending on sexual orientation. However, in HEW, discrimination experience might pose a risk factor for the development of body image-related pathology and single facets of body image disturbance.

Bodies in motion: spaces, emotions and representations that (de)construct realities

OBJECTIVE To analyze the social representations of the body among Brazilian and Costa Rican transsexual people through their life stories. METHOD Qualitative and descriptive multicenter research. The study population consisted of 70 participants. Two organizations cooperated to collect the information, one in Florianópolis, SC-Brazil and one in San José, the capital of Costa Rica. Content Analysis was used to analyze the data. RESULTS Based on the results, a single social representation of corporeality was unveiled: "Modeled bodies: about the elasticity of corporeality". This representation described two clear elementary context units (discourse matrices). The first associates the body with an inconclusive, transitory, volatile, pliable, moldable and fluid object, while the second relates the body with a separate institution, but regulated and controlled by others. CONCLUSION In conclusion, the transsexual body is a volatile, transient, transformable institution, crossed by the marks of a historicizing and historicizable time, which comes within the scope not only of what can be named by means of linguistic signs, but also of what belongs to the unnamable in terms of sociocultural perceptions and feelings.

Examining Objectification Theory

Many theorists have suggested that living in a culture in which women's bodies are sexually objectified socializes girls and women to treat themselves as objects. This study developed a theory-based measure of cultural sexual objectification and explored the relationship between women's reports of cultural sexual objectification experiences and self-objectification. The possible moderating effects of sexual orientation were explored using hierarchical moderated regressions. The major findings, in a sample of 361 women, were (a) women's reports of sexualized gaze/harassment were significantly related to their own self-objectification, (b) lesbian and heterosexual women reported similar levels of sexualized gaze/harassment, and (c) the relationship between sexualized gaze/harassment and self-objectification was not significantly different for the lesbian and heterosexual subsamples. Potential implications for counseling and directions for future research are discussed.

Adolescents and Eating Disorders:

Little is known about the incidence and prevalence of eating disorders among adolescents of color who are poor or identify themselves as gay or lesbian. Among American women, eating disturbances are equally as common among Native, Asian, or Hispanic Americans as they are among Caucasians. African Americans were at higher risk of developing eating disorders than were Hispanic and Asian Americans. Media and gender-role body stereotype and body dissatisfaction are strongly linked and have been shown to be the strongest predictors of disordered eating. As these youth adopt Western values about beauty, they may be at increased risk for developing eating disorders.

Positive Perceptions of Genital Appearance and Feeling Sexually Attractive: Is It a Matter of Sexual Esteem?

The present study examined the relationship between perceptions of genital appearance and self-perceived sexual attractiveness. The study sample included men and women (aged 18-45 years, M = 23.7, SD = 4.98) who identified as heterosexual (n = 1017), gay or lesbian (n = 1225), or bisexual (n = 651). Participants responded to an online survey assessing their self-perceived sexual attractiveness, genital self-image, genital self-consciousness during sexual activity, and sexual esteem. Based on previous findings, we hypothesized a positive link between genital self-perceptions and self-perceived sexual attractiveness, with sexual esteem acting as a mediator. We tested this hypothesis using structural equation modeling. Analyses revealed a significant association between both genital self-image and genital self-consciousness and self-perceived sexual attractiveness. However, these relationships were at least partially mediated by sexual esteem, across both gender and sexual orientation. The findings suggest that, regardless of gender or sexual orientation, individuals who maintain a positive genital self-image or lack genital self-consciousness, are more likely to experience greater sexual esteem, and in turn, feel more sexually attractive. The findings have implications for the importance of genital appearance perceptions and improving individuals' sexual esteem and self-perceived sexual attractiveness.

Perceiving beauty in all women: Psychometric evaluation of the Broad Conceptualization of Beauty Scale

Women's ability to broadly conceptualize beauty (i.e., perceive many looks, appearances, body sizes/shapes, and inner characteristics as beautiful) has been identified as a facet of positive body image in qualitative research. A scale is needed to be able to assess this construct within quantitative research. Therefore, we developed the Broad Conceptualization of Beauty Scale (BCBS), which measures the extent women define female beauty widely within external and internal characteristics, and examined its psychometric properties among four community samples totaling 1086 women. Exploratory and confirmatory factor analyses revealed a unidimensional structure with nine items. The internal consistency, test-retest reliability, and construct (convergent, discriminant, and incremental) validity of its scores were upheld. Researchers and clinicians can use the BCBS alone to assess women's perceptions of female beauty, or they can use the BCBS alongside women's perceptions of self-beauty to more comprehensively explore women's ability to broadly conceptualize beauty for others and themselves.

Differences in Psychosocial Predictors of Obesity Among LGBT Subgroups

PURPOSE

The purpose of the current study was to examine the overall presence of and differences in rates of overweight/obesity among a large, nationally diverse sample of lesbian, gay, bisexual, transgender (LGBT)-identified individuals (i.e., cisgender lesbians, cisgender gay men, cisgender bisexual women, cisgender bisexual men, transgender women, and transgender men) and to identify specific psychosocial predictors of obesity within each of the six LGBT subgroups.

METHODS

A total of 2702 LGBT-identified participants participated in the online study. Participants completed a series of demographic questions (including weight and height) and the Depression Anxiety Stress Scale 21.

RESULTS

The percentage of participants who were overweight/obese did not differ significantly across LGBT subgroups, with 61.1% of the total sample being overweight/obese. However, the percentage of participants who self-reported body mass indexes in the obese range differed significantly across the six LGBT subgroups, with the highest prevalence in transgender men (46.0%). In addition, the predictors of obesity varied by subgroup, with age a significant predictor for cisgender lesbians, cisgender gay men, and cisgender bisexual women, relationship status for cisgender bisexual women, employment status for both cisgender gay men and cisgender bisexual women, education level for cisgender lesbians, and depression, anxiety, and stress for cisgender gay men. None of the examined psychosocial factors emerged as predictors of obesity for cisgender bisexual men, transgender women, or transgender men.

CONCLUSION

These findings suggest that there are substantial variations in the presence and predictors of obesity across LGBT subgroups that support the need for culturally tailored healthy weight promotion efforts within the LGBT community.

Self-perceived vs. actual physical attractiveness: Associations with depression as a function of sexual orientation

OBJECTIVE

A commonly held belief about physical attractiveness is that attractive individuals are psychologically healthier than less attractive individuals (i.e., the "beauty is good" stereotype). To date, the data on this stereotype and its relationship with depression is limited, with a paucity of literature comparing subjective and objective appearance evaluations and depressive symptoms. Additionally, there is no known research on this relationship among sexual minorities (i.e., gay and bisexual individuals), a highly vulnerable population. The primary aims of the study were to assess the prediction of depression symptoms by subjective and objective appearance evaluation, and secondary aims were to assess the interaction of subjective and objective appearance with sexual orientation.

METHOD

Participants were 4882 American emerging adults (M age=22 years; 2253 males, 2629 females) taken from a U.S. nationally representative dataset (Add Health)

RESULTS

Increased negative subjective appearance evaluation was associated with elevated rates of depressive symptoms (B=-.27, p<.001), while objective appearance evaluation was not significantly related to depressive symptoms. Sexual orientation significantly moderated the relationship between subjective appearance and depression (B=.19, p=.009), with a stronger positive association between negative appearance evaluation and depressive symptoms noted among sexual minority vs. heterosexual participants.

LIMITATIONS

Limitations include cross-sectional design and self-report nature of questionnaires.

CONCLUSIONS

Findings suggest that the 'beauty is good' stereotype may not be valid in regard to depressive symptoms, and that subjective appearance evaluation is a robust predictor of depression, particularly for sexual minority individuals.

The meaning of quality of care in home care settings: older lesbian and bisexual women's perspectives

Research suggests that the experience of being a lesbian or bisexual woman influences women's interactions with health care providers, and their perception of the quality of care. Limited research to date, however, has examined how ageing and sexuality mediates women's experiences of quality, when accessing health care in the community. To fill a gap in the literature, this study investigated older lesbian and bisexual women's perspectives on the meaning of quality of care in the context of receiving home care services. This was a qualitative single case study. Sixteen participants, aged 55-72 from Ontario, Canada, participated in semi-structured interviews between 2011 and 2012. The interviews were recorded and transcribed. The interview data were analysed using iterative thematic analysis and guided by a feminist ethic of care perspective. Participants described quality of care in ways that were in line with a feminist ethic of care; that is, they wanted care providers to be responsive and attentive to their needs, to involve them in the caring process and to demonstrate respect and caring. Participants also indicated that providers' comfort with, and knowledge of, sexual diversity was important for enabling quality of care. These findings deepen our understanding of how to support quality of care for this population through changes to provider education and training, and health policy.

An Examination of Past and Current Influences of Rurality on Lesbians' Overweight/Obesity Risks

PURPOSE

The purpose of our study was to separately examine past (i.e., rural or non-rural background) and present (i.e., current rural or urban location) influences of rurality on the weight status and diet/exercise behaviors of lesbians.

METHODS

A total of 895 lesbians participated in the online study. Participants were surveyed regarding their rurality status, weight/height, and diet/exercise patterns. A 2×2 (location×background) ANCOVA was conducted to explore influences of rurality on body mass index (BMI), while controlling for age, race, and education. Chi-square analyses were used to examine the relationship between dimensions of rurality and diet/exercise behaviors.

RESULTS

There was a significant main effect of current location on BMI. No significant interaction between location and background on BMI was found nor was there a significant main effect of background. Lesbians currently living in rural areas were on average obese (M=30.61), with significantly higher BMIs than urban-residing lesbians (M=28.53). The only significant differences that emerged for lesbians' diet/exercise patterns were for current location-more rural-residing lesbians reported they never engage in exercise in comparison to their urban-residing counterparts, with a greater percentage of urban-residing lesbians reporting frequent exercise. Rural lesbians were also more likely to report a diet high in protein.

CONCLUSION

Findings suggest that current rather than past influences of rurality may have a significant impact on lesbians' weight and diet/exercise behaviors and highlight significant obesity-related health disparities for rural-residing lesbians. These findings offer support for the development of culturally-appropriate healthy diet/exercise and weight promotion efforts that are accessible to rural lesbians.

Experiences of Sexual Objectification, Minority Stress, and Disordered Eating Among Sexual Minority Women

Our study extended a modified version of objectification theory to a sample of sexual minority women in order to understand their experiences with body image and disordered eating concerns. Specifically, reported experiences of heterosexist discrimination and internalized heterosexism were integrated into the objectification theory framework. A total of 243 U.S. sexual minority women (primarily White and lesbian) participated in our online study. Results of a path analysis and tests of direct and indirect relations elucidated the important role of heterosexist experiences in sexual minority women’s eating disordered behaviors. Moreover, internalized sociocultural standards of beauty and internalized heterosexism were important predictors of sexual minority women’s body image concerns. Overall, our results supported the applicability of tenets of objectification theory to sexual minority women, with some important modifications. Our study demonstrates the importance of attending to stressors that uniquely affect sexual minority women, which arise from a sexist and heterosexist sociocultural context.

An ecological framework for sexual minority women's health: factors associated with greater body mass

In recent years, many studies have focused on the body of sexual minority women, particularly emphasizing their larger size. These studies rarely offer theoretically based explanations for the increased weight, nor study the potential consequences (or lack thereof) of being heavier. This article provides a brief overview of the multitude of factors that might cause or contribute to larger size of sexual minority women, using an ecological framework that elucidates upstream social determinants of health as well as individual risk factors. This model is infused with a minority stress model, which hypothesizes excess strain resulting from the stigma associated with oppressed minority identities such as woman, lesbian, bisexual, woman of color, and others. We argue that lack of attention to the upstream social determinants of health may result in individual-level victim blaming and interventions that do not address the root causes of minority stress or increased weight.

An Examination of the Tripartite Influence Model of Body Image

According to the tripartite influence model of body image, appearance pressures from family, friends, partners, and the media lead to body dissatisfaction and restrained eating behaviours. There is strong support for this model among young, White heterosexual women. Evidence suggests that women who identified as lesbian as bisexual (LB) may be protected from sociocultural pressures around thinness, but no known research has tested the tripartite model among LB women. The current research tests this model with 264 heterosexual and 208 LB adult women. Heterosexual women reported more thin-ideal internalization than LB women. For both groups of women, pressures from the media, male romantic partners, and family were most strongly associated with weight satisfaction and thin-ideal internalization. However, the impact of these pressures differed for the two groups; the heterosexual women’s model included significant pathways from these pressures to weight satisfaction and restrained eating, which were not significant for the LB women. Differences also emerged between our findings and previous research with younger women; pressure from friends was not related to body image in the model for either group. These findings suggest that further research is needed to explore how diverse groups of women experience sociocultural pressures around thinness.

Sense of Belonging to Layers of Lesbian Community Weakens the Link Between Body Image Dissatisfaction and Depressive Symptoms

There is evidence to suggest that body image dissatisfaction and depressive symptoms are related among lesbians and that the strength of this relationship may be influenced by individuals’ sense of belonging to the lesbian community at each of the three layers: broad, organizational, and friendship. The broad layer provides an overarching ideology and, within this layer, individuals may not have direct contact with each other. The organizational layer is represented by groups, organizations, or activities, which exist to bring together lesbians who have a shared interest or proximity, such as lesbian support, social, or interest groups. The friendship layer refers to one’s personal network of friends, and it provides general support and acceptance of oneself as a whole person. A sample of 162 self-identified Australian lesbians completed measures of body image satisfaction, depressive symptoms, and sense of belonging. Results demonstrated that sense of belonging to each layer moderated the body image dissatisfaction→depressive symptoms relationship such that the relationship weakens with increasingly higher levels of sense of belonging. Results further showed that high levels of sense of belonging to the organizational and friendship layers were particularly protective. Examining each layer of community simultaneously has shown the importance of more intimate relationships, in addition to the relationships at the broad layer. The results have significant implications for treatment interventions. Practitioners should consider ways to connect lesbians to these more intimate layers of community.

Body appreciation, sexual relationship status, and protective sexual behaviors in women

The relationship between body appreciation and sexual risk reduction behavior in women is under-explored. This cross-sectional study examined the relationships between body appreciation, male condom use, and sexually transmitted infection (STI) testing among a community-based sample of women (n=285). Logistic regression results revealed that after controlling for age, BMI, and sexual orientation, having more than one sexual partner moderated body appreciation and current male condom use (OR=4.21, p<.01, CI=1.510-11.726). Body appreciation was not a significant predictor of STI testing in the previous 12 months. This suggests that women with higher body appreciation may be more likely to engage in some protective sexual health behaviors. Interventions that seek to improve body appreciation instead of body size change such as weight loss or gain may encourage certain protective sexual behaviors in women.

Do lesbian women have a better body image? Comparisons with heterosexual women and model of lesbian-specific factors

Body dissatisfaction is prevalent among women but may be less common among lesbian women. Although research trends toward this conclusion when samples are well-matched and body mass index (BMI) is controlled for, many studies do not exhibit these characteristics. Furthermore, few studies have examined sociocultural contributors to group differences. I addressed limitations of past research with a large community sample of lesbian (n=479) and heterosexual (n=400) women. I contrasted the two sexual identity groups on several body dissatisfaction measures, and tested theoretically derived relationships between lesbian-specific cultural factors and body dissatisfaction. As predicted, lesbian women reported lower body dissatisfaction than did heterosexual women on three of four measures, and expressed a larger ideal body size. A structural equation model of lesbian-specific risk and protective factors for body dissatisfaction did not reveal significant relationships. This study represents a first attempt to model culturally specific influences on lesbian body image.

Aging and the Body: A Review

In this article, we examine the existing sociocultural research and theory concerned with the aging body. In particular, we review the body image and embodiment literatures and discuss what is known about how older adults perceive and experience their aging bodies. We analyse how body image is shaped by age, culture, ethnicity, gender, health status, sexual preference, and social class. Additionally, we critically elucidate the embodiment literature as it pertains to illness experiences, sexuality, the everyday management of the aging body, appearance work, and embodied identity. By outlining the key findings, theoretical debates, and substantive discrepancies within the body image and embodiment research and theory, we identify gaps in the literature and forecast future, much-needed avenues of investigation.

Sex typicality and attractiveness in childhood and adulthood: assessing their relationships from videos

Prior research suggests that sex typicality (especially femininity of females, but also masculinity of males) relates to perceptions of attractiveness, for both heterosexual and homosexual individuals. Using videos from childhood and adulthood, we investigated how different components of sex typicality contributed to this effect, whether the sex of the evaluator or of the target moderated the effect, and how the relationship of attractiveness with sex typicality varied across the lifespan. In Study 1, videos of 45 female and 50 male heterosexual and homosexual adult targets (ages 18-30 years) were judged by 56 female and 65 male heterosexual and homosexual raters (ages 18-30 years). Results suggested that both heterosexual men and lesbians viewed more feminine women as more attractive. Femininity of appearance was a primary contributor to this relationship. Masculinity was not related to men's attractiveness. Study 2 used similar methodology (44 male and 46 female heterosexual and homosexual targets and 22 male and 20 female heterosexual raters). Study 2 replicated results of Study 1. In addition, Study 2 included ratings of childhood videos of targets (ages 0-15). Results suggested that childhood femininity related to attractiveness of both young girls and young boys and that the relationship became stronger for girls as they got older. The impact of femininity on attractiveness may, therefore, depend on both targets' sex and their maturity.

Narrating rural lesbian lives: body image and lesbian community in central Pennsylvania

Research on women's body image has focused on the sexual objectification that women experience in society. The present study explored how rural lesbian women experience their bodies and how lesbian communities, as safe havens from the dominant heterosexual culture, contribute to their body image. Ten lesbians living in central Pennsylvania were interviewed for this study. Interviews were analyzed using interpretative phenomenological analysis, which aims to explore individuals' experiences and examine how they make sense of their world. The resulting themes focus on participants' descriptions of their feelings about their bodies, the role that lesbian, gay, bisexual, and transgender (LGBT) communities played in their sense of body image, and the difficulties of finding these communities in the central Pennsylvania area.

Women and body dissatisfaction: Does sexual orientation make a difference?

In this study, heterosexual (n=95) and nonheterosexual (n=84) women were asked to rate figure drawings and computer-generated images of women that varied in body fat, waist-to-hip ratio, and breast size in terms of self, ideal, and cultural ideal; discrepancy indices, indicating body dissatisfaction, were created for each body aspect. Nonheterosexual women had significantly higher body mass indices (BMIs) than heterosexual women, but when the effects of BMI were controlled, participants evidenced similar perceptions of their bodies, their ideal bodies, and the female cultural ideal, as well as similar levels of body dissatisfaction for body fat, waist-to-hip ratio, and breast size. The results of this study suggest that being a member of a society that highly values a thin, curvaceous, relatively large-breasted body puts women, regardless of sexual orientation, at risk for body dissatisfaction.

Overweight and obesity in lesbian and bisexual college women

OBJECTIVE

To estimate and compare the prevalence of overweight and obesity among self-identified lesbian, bisexual, and heterosexual college age women.

METHODS

A secondary analysis of the Spring 2006 National College Health Assessment was conducted with 31,500 female college students (aged 18 to 25 years) to compare body mass index (calculated from self-reported height and weight) among lesbian, bisexual and heterosexual college women.

RESULTS

Compared to heterosexuals female college students, lesbians and bisexual women were both significantly more likely to be overweight or obese. Lesbians were also less likely to be underweight compared to heterosexual college women.

CONCLUSIONS

Self-identified lesbian and bisexual college women were more likely to be overweight or obese than their heterosexual counterparts. Health care professionals and educators should target these high-risk populations for obesity prevention programs. This study highlights the need for additional research examining the potential risk factors for overweight and obesity among young sexual minority women.

Big and beautiful: attractiveness and health ratings of the female body by male "fat admirers"

This study examined the body weight and waist-to-hip ratio (WHR) preferences of "fat admirers" (FAs), that is, individuals who are sexually attracted to heavier partners. Fifty-six heterosexual men involved in the FA community rated a series of line drawings that varied in three levels of body weight and six of WHR for physical attractiveness and health. The results showed significant main effects of body weight and WHR, as well as a significant body weight x WHR interaction for both health ratings. In general, there was a preference for heavyweight figures and high WHRs for ratings of attractiveness and normal-weight figures and mid-ranging WHRs for ratings of health. Limitations of the study and explanations for fat admiration are discussed.

Visible and invisible ageing: beauty work as a response to ageism

This paper examines how older women experience and respond to ageism in relation to their changing physical appearances and within the context of their personal relationships and places of employment. We elucidate the two definitions of ageism that emerged in in-depth interviews with 44 women aged 50 to 70 years: the social obsession with youthfulness and discrimination against older adults. We examine the women's arguments that their ageing appearances were pivotal to their experience of ageism and underscored their engagement in beauty work such as hair dye, make-up, cosmetic surgery, and non-surgical cosmetic procedures. The women suggested that they engaged in beauty work for the following underlying motivations: the fight against invisibility, a life-long investment in appearance, the desire to attract or retain a romantic partner, and employment related-ageism. We contend that the women's experiences highlight a tension between being physically and socially visible by virtue of looking youthful, and the realities of growing older. In other words, social invisibility arises from the acquisition of visible signs of ageing and compels women to make their chronological ages imperceptible through the use of beauty work. The study extends the research and theorising on gendered ageism and provides an example of how women's experiences of ageing and ageism are deeply rooted in their appearances and in the ageist, sexist perceptions of older women's bodies.

Understand the queer world of the L-esbian body: using Queer as Folk and The L Word to address the construction of the lesbian body

Television is a tremendous force in constructing social understandings of the body. Using the first season of The L Word and Queer as Folk, this article addresses the manners in which the lesbian body is created and conveyed within a queer media world. Although diverse and complex, the images of the lesbian body have been created to be consumed by heterosexuals as well as lesbians and gay men. Central to this transformation of body is the creation of a consumable butch body--a body that is read firstly as a woman, but offers opportunities for the queer consumer to read lesbianism, even a version of butch. Additional aspects of body discussed include the evolution of body in conjunction with identity and the idea of "gaydar"--the reading of body to determine if one is lesbian.

Sexuality sells: a content analysis of lesbian and heterosexual women's bodies in magazine advertisements

Controversies in the literature suggest varied views as to whether lesbian and heterosexual women accept different cultural norms about body shape and size. This article explores whether messages about the body from lesbian media deviate from mainstream, heterosexually focused media. In particular, I differentiate the messages within both media by the physical appearance of the model in the photo, and how the body is positioned in the type and context of the ad itself. Three hundred randomly selected photo advertisements from lesbian and mainstream women's magazines were examined. Lesbian models varied more in age and weight than mainstream models, and were more likely to be androgynous in gender appearance. In turn, mainstream models were more likely to be wearing revealing clothing that hindered their mobility, such as a tight skirt or stiletto heels. Advertisements in lesbian magazines placed their models in more defined contexts, such as in travel ads, and with more of a purpose than mainstream advertisements, where models were more likely to be placed in front of a non-descript backdrop. Lesbian advertisements were more likely to sell products that engendered community (e.g., travel, book club), whereas mainstream advertisements more often sold products that emphasized the self (e.g., clothing, beauty products). I consider how lesbian and heterosexual bodies are reproduced and impart messages about "doing" gender.

Lesbian body image perceptions: the context of body silence

As are all women, lesbians are influenced by Western society's expectations of what a woman should look like. However, they are also influenced by the lesbian subculture. One of the author's aims was to explore how the sociocultural contexts in which lesbians belong influence their perceptions of body image. She purposively selected 20 lesbians and used constant comparative analysis to guide data collection and analyze the resulting transcribed interviews. The internalization of the dominant culture's beauty expectations coupled with the adoption of a lesbian identity caused the participants to contend with a multitude of oppressive mandates from both sociocultural contexts. The author interpreted the outcomes of these oppressions through the lens of stigma theory. The results of the stigma assisted in the development of the context of Body Silence. The study results might serve to provide a better understanding of lesbian body image as an important component of lesbians' mental health.

Overweight and obesity in sexual-minority women: evidence from population-based data

OBJECTIVE

We sought to determine whether lesbians have higher rates of overweight and obesity than women of other sexual orientations.

METHODS

We compared population estimates of overweight and obesity across sexual orientation groups, using data from the 2002 National Survey of Family Growth.

RESULTS

Adjusted multinomial logistic regression analyses showed lesbians have more than twice the odds of overweight (odds ratio [OR]=2.69; 95% confidence interval [CI]=1.40, 5.18) and obesity (OR=2.47; 95% CI=1.19, 5.09) as heterosexual women. Bisexuals and women who reported their sexual orientation as "something else" (besides heterosexual, lesbian, or bisexual) showed no such increase in the odds of overweight and obesity.

CONCLUSIONS

Lesbian women have a higher prevalence of overweight and obesity than all other female sexual orientation groups. This finding suggests that lesbians are at greater risk for morbidity and mortality linked to overweight and obesity. This finding also highlights the need for interventions within this population.

Gender, sexuality, body image and eating behaviours

One hundred and twenty one participants reported sexual orientation, body mass index, body shape concerns, eating motives and eating styles. Measures of body dissatisfaction were greater in heterosexual women and homosexual men (ps <.05), while heterosexual women had smaller (ps <.001) ideal body shapes. Eating weight control motive was lower in heterosexual men compared to women (ps <.05). Restrained eating was lower in heterosexual men compared to heterosexual women or homosexual men (ps <.001). The findings support the role of socially prescribed body shapes on body shape concerns, eating motivations, and eating styles in men and women and suggest impacts are greater for heterosexual women and homosexual men.

Sociocultural context of women's body image

In our society, women's bodies are the locus of both increasing rates of obesity and body dissatisfaction. While these trends may seem contradictory or to result from each other, an alternative explanation is that they are both the products of an unfavourable sociocultural environment in the area of food and weight. Both body dissatisfaction and excess weight can seriously impact women's physical and emotional health. The strong cultural value placed on thinness, especially for women, unfortunately may take precedence over health. To effectively address the impact of women's body image dissatisfaction requires an understanding of the multiple contexts of women's lives. This study used a naturalistic paradigm to explore how women's personal and sociocultural context influences their body image. Forty-four non-eating disordered women ranging from 21 to 61 years old were interviewed twice using a semi-structured interview guide. Women's narratives revealed that body image is not a static construct, but is dynamic and fluctuates as women encounter new experiences and re-interpret old ones. The powerful and unconscious impact of the media on body image was mediated by women's internal contexts (self-confident and self-critical) and their relationships with others, such as partners and other women. Body image was not so much influenced by the nature of others' comments but interpretation of their meaning. However, health professionals' comments were typically not reinterpreted due to the health context in which they were given. While some women's narratives expressed their internalized sociocultural norms, others' described acceptance of their bodies following a process of reflection and empowerment. In light of these findings, efforts to improve women's body image, and by extension their health, can no longer only focus on diminishing the tangible power of industry and media, but must include transforming the social ties, practices and conventions in everyday relationships, including with health professionals.

Does body satisfaction differ between gay men and lesbian women and heterosexual men and women? A meta-analytic review

Studies investigating body image satisfaction among groups of different sexual orientations (i.e., gay men, lesbian women, and heterosexual men and women) have produced equivocal findings. To synthesise the available research, 27 studies (20 published and 7 unpublished) were meta-analysed (N=5220). Comparisons between heterosexual (n=1397) and gay men (n=984) produced a small effect size, with the former being slightly more satisfied with their bodies. An even smaller difference was observed for studies comparing heterosexual (n=1391) and lesbian women (n=1448), with greater levels of body satisfaction being evidenced by the latter group. Tests of homogeneity for each effect size were found to be highly significant. In an attempt to identify variables that may be responsible for the observed heterogeneity, the following categorical factors were assessed: the measures used to evaluate body satisfaction, date of study (1980s versus 1990s+), publication status (published or unpublished), and body weight. The results of this exploratory search for potential moderator variables as well as limitations of the current meta-analysis are discussed.