Body image and associated factors among sexual minority men: A systematic review

Prospective relationships of body appreciation and functionality appreciation with body dissatisfaction and psychological quality of life among sexual minority men

Cross-sectional studies indicate that body appreciation and functionality appreciation are independently predictive of positive outcomes, including lower body dissatisfaction and improved psychological wellbeing. Sexual minority (e.g., gay, bisexual) men are underrepresented in positive body image research, warranting an examination of whether positive body image might also engender positive impacts on body image and psychological wellbeing for this population. We examined the longitudinal relationships of body appreciation and functionality appreciation with psychological quality of life (a multidimensional construct that encompasses psychological wellbeing, mental health, and self-worth), body fat dissatisfaction, and muscularity dissatisfaction among 821 sexual minority men. We used cross-lagged panel models to examine the bidirectional relationships of these constructs across three timepoints spanning 18 months. Greater muscularity dissatisfaction, body fat dissatisfaction, and psychological quality of life impairment were associated with lower body appreciation over time. Body appreciation was positively associated with psychological quality of life impairment over time, but did not predict any other outcome over time. Functionality appreciation was an outcome in one model: greater psychological quality of life impairment was associated with lower functionality appreciation over time. Functionality appreciation was not associated with muscularity or body fat dissatisfaction in either direction over time. These findings can guide intervention development. For example, future research might explore the efficacy of interventions for improving body appreciation on men's muscularity dissatisfaction, and vice-versa. Further, interventions for improving men's psychological wellbeing may be beneficial for both their body and functionality appreciation.

Mapping the pathway to anabolic-androgenic steroids (AAS) use

This short communication introduces a model for the use of anabolic-androgenic steroids (AAS), with body dissatisfaction as the central factor, shaped by sociocultural, psychological, and behavioral influences. Media-driven body ideals, gender, and sexual orientation may significantly influence body image, while low self-esteem and certain personality traits also contribute to dissatisfaction. Disordered eating behaviors (DEB) and intense physical exercise act as indirect contributors, particularly in fitness communities, where "conventional" body modification methods (i.e., exercise and diet) may fail to meet internalized ideals. The model highlights a vicious cycle: body dissatisfaction drives AAS use, which, in turn, worsens dissatisfaction. Social media amplify this cycle by promoting unrealistic standards, while marginalized groups, including LGBTQI+ populations, face additional pressures to conform to heteronormative beauty norms. The overlap between body dissatisfaction, DEB, and intense physical exercise underscores the need for nuanced research to disentangle these inferences. The model predominantly reflects Western body ideals, limiting its applicability across cultures. Addressing body dissatisfaction through early interventions targeting both societal standards and individual vulnerabilities is critical. Also, approaches accounting for aspects of sex and gender diversity are essential to promote body acceptance and reduce the risk of AAS use and DEB.

Exploring the Relationships Between Body Image, Sexual Well-Being, and Community Connectedness among Gay, Bisexual and Queer+ Men

Sexual minority (SM) men are more likely than heterosexual men to experience body dissatisfaction due to prevailing body ideals (e.g. lean and muscular) within the SM community. Negative body image can have harmful effects on well-being, and, by extension, sexual well-being. The current study aimed to investigate whether SM men's minority identification and LGBTQ+ community connectedness moderates the relationship between drives for muscularity and sexual anxiety. To address this aim, 298 Australian-residing SM men completed an online survey that examined drive for muscularity, sexual anxiety, and connectedness or identification with the LGBTQ+ and SM-specific communities. As hypothesized, the results showed a positive relationship between drive for muscularity and sexual anxiety. Additionally, LGBTQ+ community connectedness, but importantly not SM identification, was found to moderate this relationship, showing a positive association only when connection was at low or average levels. These results highlight the beneficial effects that LGBTQ+ community connection can have for SM men, such as protecting them against the harmful impacts of poor body image on sexual well-being. These results also provide preliminary insights into the need to expand the understandings of bodily diversity, and diversity of sexual well-being experiences, among SM men less connected to the broader LGBTQ+ community.

Social and Mental Health Factors Associated with Sexual Satisfaction Among Older Gay Men

The internalization of ageist stereotypes or messages based on the framework of an aging gay man is known as internalized gay ageism. Internalized gay ageism may influence an older gay man's sexual satisfaction. The aim of this study was to examine the relationship between internalized gay ageism and sexual satisfaction and determine if body image was a potential mediator. A cross-sectional online survey collected data on sexual satisfaction and other variables related to sexual health and well-being among older gay men. Inclusion criteria included: aged 50 or older, identified as gay, identified as male, assigned male at birth, and resided in the Midwestern region of the United States. Descriptive, bivariate, and mediation analyses were conducted. A complete mediation effect was found between internalized gay ageism and sexual satisfaction when mediated by body image. Older gay men who were in open relationships were more sexually satisfied than single/widowed older gay men. Future research should continue to explore internalized gay ageism, relationship status, body image, and sexual satisfaction among older gay men.

Eating disorders among an online sample of Canadian and American boys and men

There is a continued need to identify the prevalence and sociodemographic correlates of eating disorders, particularly among the under-researched group of boys and men, to inform prevention and intervention efforts. Data from The Study of Boys and Men, a sample of 1553 boys and men aged between 15 and 35 years in Canada and the United States, were analyzed in 2024. Probable eating disorder diagnoses were identified using a previously established algorithm based on current diagnostic criteria. A multivariable logistic regression analysis was used to determine the sociodemographic correlates of meeting the criteria for any probable eating disorder diagnosis. The prevalence of meeting the criteria for any probable eating disorder diagnosis was 21.3 % (95 % confidence interval [CI] 18.7-24.1), while meeting criteria for a probable bulimia nervosa diagnosis had the highest prevalence (5.8 %, 95 % CI 4.6-7.1) and anorexia nervosa had the lowest prevalence (0.34 %, 95 % CI 0.1-0.8). Boys and men who identified as gay (adjusted odds ratio [AOR] 2.28, 95 % CI 1.35-3.85) or bisexual (AOR 2.22, 95 % CI 1.23-3.99) had higher odds of meeting criteria for any probable eating disorder diagnosis, compared to those who did not. Finally, boys and men who had a higher body mass index (BMI) (AOR 1.18, 95 % CI 1.14-1.23) had greater odds of meeting criteria for any probable eating disorder diagnosis. Findings add to the growing understanding of eating disorders among boys and men. Targeted and tailored prevention and intervention programming is needed for sexual minority boys and men, and those with higher BMIs.

The Intersectional Influence of Experienced Stigma on Clinically Significant Depressive Symptoms Among Gay, Bisexual, and Other Men Who Have Sex with Men

We sought to determine how intersectional stigma, operationalized by interactions of perceived stigma experiences in adulthood attributed to various social identities/characteristics (age, gender, race, ethnicity/nationality, religion, height/weight, other aspect of appearance [unrelated to the identities/characteristics listed-e.g. height/weight/race/gender], physical disability, sexual orientation, and HIV status), associates with clinically significant depressive symptoms (DS). We used data from the Multicenter AIDS Cohort Study (Baltimore/Washington, DC; Chicago; Pittsburgh/Columbus; and Los Angeles) on 1,385 sexual minority men (SMM), collected April 1, 2008-March 31, 2009. Classification trees predicted DS. An exploratory factor analysis (EFA) identified stigmas that tended to co-occur. We calculated and decomposed the joint disparity in DS risk between stigmas comprising each EFA factor. Thirty-four percent of men were classified with DS. Stigma was most commonly attributed to sexual orientation. Participants with stigma attributed to multiple social identities/characteristics had an increased risk of DS. In classification trees, covariates (especially income) were stronger predictors of DS than stigmas. Intersectional effects were observed between appearance and physical disability stigma (positive effect), and between race and ethnicity/nationality stigma, and sexual orientation and HIV status stigma (negative effects). Interventions to reduce stigmas among SMM, as well as improve the socioeconomic position of SMM in general, are needed.

Body image research among sexual minority men in the Mekong region: A scoping review

Body image among sexual minority men (SMM) has received increasing attention. However, the current literature has primarily focused on white SMM and body image and physical appearance concerns among SMM. In response to a call for more nuance in understanding how SMM perceive and make sense of their body image in a broader sociocultural context, we conducted a scoping review to examine the extent and nature of body image research among SMM in the Mekong region. We searched CINAHL, MEDLINE, Scopus, PsycInfo-1806 (Ovid), ProQuest Central, Social Science Premium Collection, and Web of Science and identified 25 studies that met the inclusion criteria. Overall, the findings suggest that body image research in the Mekong region is limited in the range of topics, study populations, and methods, with quantitative studies on preferences for masculine physical traits among young and well-educated Chinese SMM dominating. Furthermore, the current literature is primarily influenced by Western scholarship, which predominantly uses Western measurement and theories. We encourage scholars from other countries in the region, including Vietnam, Laos, Cambodia, Myanmar, and Thailand, to engage sociocultural approaches in research on the body image of SMM.

The influence of erotic camsites on improving men's body comfort: A qualitative analysis of mechanisms

A significant portion of U.S. men experience body dissatisfaction, which can be harmful and limiting to their overall quality of life and well-being. Positive interactions, especially those occurring in the context of sexual behavior, have the potential to enhance men's body self-perceptions. In this study, we explored the impact of engagement with erotic camsites on men's comfort with their own bodies via web-based survey. A sample of 5,828 predominantly heterosexual, cisgender men recruited from LiveJasmin.com reported their demographics, camsite behaviors, and whether camsite use increased their body comfort. Our findings revealed that 19% of participants (n =  1,088) reported increased body comfort. We thematically coded qualitative responses to identify mechanisms for increased comfort. Key mechanisms included receiving positive feedback from models (i.e., performers), engaging in self-exposure on video, discussing body and sexual preferences with models, and experiencing perspective shifts. These results provide preliminary evidence that camsites are interactive environments in which feedback and self-expression might positively influence body comfort. While these findings suggest potential benefits, they also raise questions about the broader implications of such digital interactions for body image, highlighting the need for further research to understand the complexities of these technologically-mediated spaces.

Body image distress and disordered eating among gay and straight men from Greece and Cyprus

Sociocultural factors play a significant role in the development of body image distress and disordered eating behavior in diverse populations, including men. One group which seems to be at increased risk, is sexual minority men. However, these factors have rarely been studied outside of Western populations. The present study sought to explore these factors in Greek and Greek-Cypriot men. Greek and Greek-Cypriot men (N = 367; n = 162 gay; n = 205 straight) completed measures of sociocultural pressures, appearance comparisons, body dissatisfaction, body appreciation and disordered eating. Results indicated that gay men were more likely to have disordered eating habits than straight men. Additionally, gay men had significantly lower scores on measures of body-image related wellbeing (i.e. satisfaction and appreciation), and higher on measures of societal pressures and appearance-related comparisons, appearance-related anxiety and disordered eating. Greek and Greek-Cypriot gay men had lower levels of muscularity internalization than straight men. Our findings extend research on body image distress and disordered eating in gay and straight men to Greek and Greek-Cypriot populations.

Tackling bisexual erasure: An explorative comparison of bisexual, gay and straight cisgender men's body image

Previous body image research often grouped both gay and bisexual men into a single category: sexual minoritised men, limiting our understanding of how sexual identity influences body image. However, there is strong reason to believe that bisexual and gay men experience distinct body image concerns. Here, we explored motivations to alter one's leanness and muscularity, as well as (dis)satisfaction with body fat, muscularity, height and penis size, and functionality appreciation across gay, bisexual, and straight cisgender men. We sampled 378 white participants aged 18 to 85 (nbisexual = 125, ngay = 128, nstraight = 125). We found that bisexual men were significantly less motivated to be lean and showed lower muscularity dissatisfaction relative to gay men but showed comparable levels to straight men. Our findings demonstrate that despite research perceiving the body image of bisexual and gay men as homogenous, they experience differences in their body image concerning leanness and muscularity dissatisfaction. Future body image research should incorporate this understanding by not artificially grouping bisexual and gay cisgender men and instead acknowledging the potential uniqueness in their experiences.

Body fat and muscularity dissatisfaction are not prospectively associated with psychological wellbeing among sexual minority men: A case for separating within- and between-person variation in examinations of body image phenomena and their outcomes

Extensive cross-sectional research reports that body fat and muscularity dissatisfaction contribute to negative psychological outcomes among sexual minority men; however, longitudinal models are necessary for accurately quantifying the strength and direction of these relationships. We investigated the bidirectional longitudinal relationships of body fat and muscularity dissatisfaction with psychological quality of life among 2953 sexual minority men using random intercept cross-lagged panel models. Consistent with existing literature, we found that higher average muscularity and body fat dissatisfaction were associated with higher average psychological quality of life impairment between-persons. Unexpectedly, these constructs were not significantly associated within-persons/longitudinally. These findings conflict existing literature's conclusions that muscularity and body fat dissatisfaction consistently contribute to poorer psychological wellbeing in this population. A significant between-person relationship in the absence of within-person relationships suggests that intermediary constructs (e.g., body ideal internalization) may account for the between-person effects of muscularity and body fat dissatisfaction on psychological wellbeing. Future research can accurately estimate these effects and identify reliable intervention targets by ensuring that within- and between-person relationships are examined separately, rather than being conflated.

Effects of Substance Use on Condomless Anal Sex in a Large Sample of Adolescent Men Who Have Sex with Men: A Within and Between Relationship Design

Substance use is a significant risk factor for HIV infection among adolescent men who have sex with men (AMSM). Substance use may reduce the use of HIV prevention measures or increase the likelihood of engaging in activities with a higher risk of HIV transmission, but there is a lack of studies dedicated to analyzing these mechanisms in adolescents and young MSM. This study aimed to explore the impact of substance use on condomless anal sex (CAS) in a large, racially diverse sample of AMSM. Additionally, we investigated how an individual's general level of substance use moderated the association between substance use before sex and CAS at the partnership level. Baseline data for an HIV prevention intervention were collected through online surveys from April 2018 to June 2020. The sample consisted of 1624 AMSM (M age, 16.69 years) who reported at least one sexual partner in the previous 3 months. Participants provided information about their three most recent sexual partners, including their relationship to the partner, PrEP use, frequency of alcohol, marijuana, and non-prescription drug use before sex, and the number of CAS acts. Participants also completed measures of their substance use frequency. Multilevel modeling in Mplus was used for data analysis, accounting for sexual partnerships nested within participants. All models controlled for PrEP use and relationship status. Results revealed a significant positive association between the frequency of non-prescription drug use before sex and CAS at the partnership level. This indicates that higher non-prescription drug use frequency before sex was associated with a greater number of CAS acts with partners. Moreover, the cross-level interaction between alcohol frequency and non-prescription drug use before sex was statistically significant. Specifically, for participants with high alcohol frequency scores, there was a significant positive association between non-prescription drug use before sex and CAS at the partnership level. AMSM with higher average alcohol consumption were more likely to engage in CAS when using non-prescription drugs prior to sex with a partner, compared to those with lower alcohol consumption. This study's use of multilevel data analysis contributes innovatively to the field by shedding light on how substance use operates within sexual relationships and different partnership dynamics. Tailored interventions targeting substance use should be developed to reduce HIV risk among AMSM.

Social cure model: testing the link between identity centrality and body appreciation in diverse sexual orientation and gender identity groups

BACKGROUND

The level of experienced sociocultural pressure to have an idealized body can vary depending on a person's gender identity and sexual orientation. The current study explored whether differences in levels of body appreciation among people with different sexual orientations and gender identities vary because of differing levels of experienced pressure by in-group members and varying levels of experienced hostile behaviors because of their looks or body. Thereby, the study tests the social cure model, according to which high levels of identity centrality are associated with better mental health.

METHODS

An online cross-sectional questionnaire study was conducted with 1,587 people (51.3% cisgender women, 39.3% cisgender men, 9.5% non-binary; 52.9% identified as heterosexual, 27.7% identified as bisexual/pansexual, 11.2% identified as gay/lesbian, 8.2% identified as asexual/demi/queer; Mage = 32.9, SD = 12.6) from German-speaking countries. Variables were assessed with German-language versions of the Multidimensional and Multicomponent Measure of Social Identification, Body Appreciation Scale-2, the Perceived Stigmatization Questionnaire, and the Sociocultural Attitudes Towards Appearance Questionnaire-4, revised. A manifest-path model was calculated.

RESULTS

Non-binary persons reported lower levels of body appreciation than did cisgender men and sexual minority persons reported lower levels of body appreciation than did heterosexual persons. Furthermore, sexual minority persons experienced more hostile behaviors directed towards them because of their looks or body than did heterosexual persons. Similarly, non-binary persons experienced more hostile behaviors than did men. Non-binary persons were subjected to lower levels of in-group pressure than were men. Gay/lesbian persons and asexual persons were subjected to lower levels of in-group pressure than were heterosexual persons. More hostile behaviors and stronger in-group pressure were related to lower body appreciation. In cisgender women and men indirect links revealed associations between strong identity centrality and low levels of body appreciation through the mediator of high in-group pressure.

CONCLUSIONS

Data in sexual minority individuals or non-binary persons supported the social cure model, according to which persons can find support and validation for their looks and body from in-group members. In cisgender women and men, strong identification as a woman or man can be related to stronger in-group pressure and in turn to lower body appreciation.

The role of minority stress in disordered eating: a systematic review of the literature

PURPOSE

Sexual and gender minorities (SGMs) show a heightened risk of disordered eating compared to heterosexual and cisgender people, a disparity which may be caused by exposure to minority-specific stressors, such as discrimination and violence. This systematic review aims to summarize available evidence on the role of minority stress in disordered eating and SGM-specific aspects.

METHODS

Following PRISMA guidelines, scientific search engines (EBSCO, PUBMED, Web of Science) were screened up to 31st of January 2024, including English-language original research papers containing analyses of the relationship between minority stress and disordered eating. 2416 records were gathered for screening. After application of inclusion and exclusion criteria, thematic analysis was conducted regarding 4 research questions: effects of minority stress on disordered eating, mediating factors, specificities of SGMs and differences between identity categories.

RESULTS

30 studies were included. Several aspects of minority stress are reliably associated with different forms of disordered eating. The relationship between minority stressors and disordered eating is mediated by aspects such as shame, body shame, or negative affect. SGMs show several specificities, such as the presence of a role of LGBTQIA + communities and additional gender-related pressures. Bisexual people and gender minorities appear to feature comparatively higher risks, and gender-related factors shape paths leading to disordered eating risk.

CONCLUSION

Minority stress is an important predictor of disordered eating, making SGM people's health particularly at risk. Institutional and organizational anti-discrimination policies are needed, as well as further research. Clinical interventions may benefit from exploring and incorporating how minority stressors impact SGM people. Evidence level I-Systematic review.

Self-compassion and relationship status moderate the relationship between sexual minority status and body image concerns

A growing body of research suggests that sexual minority men (SMM) experience greater body image concerns including body shame, body surveillance, drive for muscularity and drive for thinness than heterosexual men. However, little is known regarding the potential factors that can buffer these relationships. The aim of the present study was to examine the role that both self-compassion and relationship status may play in decreasing the strength of the relationship between sexual minority status and body image concerns. A sample of n = 106 SMM and n = 145 heterosexual men completed an online survey assessing body image concerns, self-compassion, and relationship status. Findings revealed that SMM reported higher levels of body image concerns (on all measures, except drive for muscularity) as compared to heterosexual men. Self-compassion moderated the link between sexual orientation and drive for muscularity: in men with higher levels of self-compassion, sexual orientation was no longer associated with drive for muscularity. But, among men with less self-compassion, SMM reported higher drive for muscularity than heterosexual men. Moreover, relationship status moderated the relationship between sexual orientation and body shame and drive for thinness, such that, among SMM only, being in a relationship was associated with lower levels of these concerns.

Sexual Self-Esteem and Orgasm Consistency: Exploring the Unique Roles of Body Image and Genital Image

We explored the unique roles that body and genital image play in behavior-specific orgasm consistency, beyond overall sexual self-esteem. US adults (N = 599; 64% women) completed questionnaires online. Hierarchical regression analyses predicted orgasm consistency during receptive oral sex and penile-vaginal intercourse (PVI) with additional clitoral stimulation (WAS) and with no additional clitoral stimulation (NAS) for the woman. Body image, genital image, and gender were entered in later steps to assess model improvement above sexual self-esteem. Models accounted for age, sexual and racial minority identities, and current relationship status. Results indicated that genital image improved all models and predicted higher orgasm consistency across all behaviors for men and women. For orgasm during receptive oral sex and PVI-NAS, sexual self-esteem was no longer significant once genital image was included. Genital image was a stronger predictor of women's versus men's orgasm during PVI-NAS; no significant gender differences were found for oral sex and PVI-WAS. Body image was not significant in any models, contrary to expectations, suggesting role overlap with sexual self-esteem. Genital image appears to play a unique role in sexual pleasure beyond overall sexual self-esteem and body image.

Pleasurable and problematic receptive anal intercourse and diseases of the colon, rectum and anus

The ability to experience pleasurable sexual activity is important for human health. Receptive anal intercourse (RAI) is a common, though frequently stigmatized, pleasurable sexual activity. Little is known about how diseases of the colon, rectum, and anus and their treatments affect RAI. Engaging in RAI with gastrointestinal disease can be difficult due to the unpredictability of symptoms and treatment-related toxic effects. Patients might experience sphincter hypertonicity, gastrointestinal symptom-specific anxiety, altered pelvic blood flow from structural disorders, decreased sensation from cancer-directed therapies or body image issues from stoma creation. These can result in problematic RAI - encompassing anodyspareunia (painful RAI), arousal dysfunction, orgasm dysfunction and decreased sexual desire. Therapeutic strategies for problematic RAI in patients living with gastrointestinal diseases and/or treatment-related dysfunction include pelvic floor muscle strengthening and stretching, psychological interventions, and restorative devices. Providing health-care professionals with a framework to discuss pleasurable RAI and diagnose problematic RAI can help improve patient outcomes. Normalizing RAI, affirming pleasure from RAI and acknowledging that the gastrointestinal system is involved in sexual pleasure, sexual function and sexual health will help transform the scientific paradigm of sexual health to one that is more just and equitable.

On liking how you look and feeling sexy: Quantifying the overlap between sexual desirability and body satisfaction in a sample of Australian Grindr users

The body image field aims to cultivate positive body image. To do so, it must appreciate factors contributing to positive body image. Sexual desirability is one such factor. Using experience sampling data from Australian Grindr users, we aimed to quantify the overlap between sexual desirability and body satisfaction. We found sexual desirability and body satisfaction correlated strongly between- (r = .90) and within-persons (rMedian =.60). Using dynamic structural equation modeling, we analyzed 238 participants' data (T = 9058), finding that sexual desirability and body satisfaction were bidirectionally related - previous sexual desirability predicted current body satisfaction (β = 0.22) and vice versa (β = 0.17). Participants' average body satisfaction tended to be higher when sexual desirability contributed more to body satisfaction (r = .31) and was more stable across time (r = .19). We found sexual desirability and body satisfaction overlap considerably and that sexual desirability may contribute more to body satisfaction than vice versa. Our results suggest that (1) sexual desirability and its dynamics across time influence body satisfaction, and (2) research on sexual desirability and its relationship with body image should be a focus for the field. We discuss avenues for future research on sexual desirability.

Body Dissatisfaction, Cognitive Distraction, and Sexual Satisfaction in a Sample of LGB+ People: A Mediation Study Framed by Cognitive Psychology Models of Sexual Response

Introduction: Body dissatisfaction is a well-established risk factor for emotional problems and low levels of well-being indicators, such as sexual health. Cognitive models propose that dissatisfaction with one's body can cause cognitive distraction related to physical appearance during sexual activity. This may compromise sexual response, namely, sexual satisfaction in heterosexual cis women. However, this relationship has only been studied within heterosexual samples. The present study aims to test a mediation model using cognitive distraction related to body appearance during sexual activity as a mediator between body dissatisfaction and sexual satisfaction in LGB+ cis people (lesbian, gay, bisexual, and other minority sexual orientations). Methods: This cross-sectional online study comprised 165 cisgender LGB+ participants (n = 67 cis women, 40.6%; n = 98 cis men, 59.4%). Self-report questionnaires were used: the Global Body Dissatisfaction Scale, the Body Appearance Distraction Scale, and a Single-Item Measure of Sexual Satisfaction. Results: Cis women and cis men experience similar levels of body dissatisfaction, cognitive distraction with body appearance during sexual activity, and sexual satisfaction. Body appearance cognitive distraction during sexual activity mediated the relationship between body dissatisfaction and sexual satisfaction only in the men's sample. Discussion: Overall, in terms of gender and body dissatisfaction, our results reveal a reversed pattern than those found in heterosexual samples. This may be because LGB+ cis women may conform less to societal pressure, leading to less meaning given to body dissatisfaction in relation to sexuality, which may lead to more positive sexual outcomes. Likewise, LGB+ cis men present higher body dissatisfaction and experience lower sexual satisfaction, possibly due to the emphasis on physical appearance in the gay subculture. The results confirm the validity of cognitive models of sexual response.

A qualitative analysis of relationship advice from the perspective of people living with and recovering from eating disorders while in diverse romantic relationships

Eating disorders (EDs) have adverse consequences across life domains, ranging from physical health to interpersonal relationships. While research suggests that romantic partners have the potential to support ED recovery, partners to those with EDs often report feeling confused and helpless in the face of the condition. The extant literature on EDs in relationships centers on the experiences of cisgender, heterosexual women. The present study aimed to garner a more comprehensive understanding of the types of support people with EDs believe are most helpful from romantic partners by analyzing relationship advice from a diverse group of individuals with EDs who were in romantic relationships. As part of a larger study on romantic relationships in ED recovery, we analyzed responses to the question, "If you had to give one piece of advice to someone who learns that their partner has an ED, what would it be?" Through Consensual Qualitative Research-Modified, we identified 29 themes, which we grouped into 7 domains: Foster Open Communication, Create an Environment of Emotional Intimacy, Let Your Partner Guide You, Educate Yourself, Be Compassionate with Yourself, Use Caution when Discussing Food and Bodies, and a Miscellaneous domain. These findings highlight the importance of patience, flexibility, psychoeducation, and self-compassion for individuals working to support their partner's ED recovery, and can inform future couples-based treatments and interventions for EDs.

Can I Love My Body Even if It Doesn't Look Like the Porn Stars'? Longitudinal Associations Between Pornography Use Frequency and Body Appreciation in a Diverse Sample of Adolescents

Online technologies could play an important role in the sexual development of adolescents as they watch more pornography than before. Pornography may relate to adolescents' perceptions of their bodies, especially among those identifying as a sexual and/or gender minority (SGM) as they have an increased risk of body image concerns compared to their heterosexual, cisgender (HC) peers. The present study examined the cross-sectional and longitudinal associations over 3 years between adolescents' pornography use frequency and body appreciation, considering potential gender and sexual orientation-based differences. Results from linear univariate and parallel processes latent growth curve models with a multi-group approach among 2904 adolescents (MageT1 = 14.5 years, SD = 0.61; 51.4% girls, 16.3% sexual minority) demonstrated that HC and SGM girls' body appreciation slightly decreased over time. Moreover, HC boys, HC girls and SGM girls' pornography use frequency slightly increased over time. Cross-sectionally, greater pornography use frequency was associated with lower levels of body appreciation in HC girls and SGM boys, with a small effect size. However, longitudinally, pornography use frequency and body appreciation were not related to each other in either group. Our findings support that pornography use, in the short term, is negatively associated with adolescents' body appreciation, although these associations might not hold in the long term. Adolescents may be more critical of body ideals represented in pornography as they learn to think with more discernment about the pornographic depictions of bodies and sexuality.

Status, sexual capital, and intraminority body stigma in a size-diverse sample of gay men

Gay men are more likely than heterosexual men to experience social pressure based on body weight, shape, and muscularity, which may drive disparities in body image concerns and eating disorders. Utilizing a sample of 1723 gay men living in the United States, the present study examined whether sociodemographic factors (used as proxies for status and sexual capital) and frequency of attending gay-specific establishments or gatherings (community involvement) were associated with gay men's experiences of negative or discriminatory pressures based on body size and shape specifically from other gay men (intraminority body stigma). Experiences of intraminority body stigma were significantly more common among gay men who identified as higher-weight (r = 0.28), less masculine (r = -0.21), less wealthy (r = -0.21), younger (r = -0.21), or people of color (ds = 0.25-0.28). Furthermore, indicators of low status and sexual capital were indirectly associated with less frequent community involvement via more frequent experiences of intraminority body stigma. In addition to frequency, the valence of interactions between gay men should be considered when assessing body image and eating disorder risk in this population. Future research is encouraged to examine intraminority body stigma as an intersectional source of intraminority stress to inform prevention and treatment efforts for gay 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.

Practical Considerations for Using the Eating Disorder Examination Interview with Adolescents

Approximately 35 years after its initial publication, the Eating Disorder Examination (EDE) remains one of the most widely used semi-structured interviews for assessing eating disorder diagnoses and symptomatology. Although the interview provides certain advantages over other common measurement approaches (ie, questionnaires), there are particular considerations regarding the EDE that warrant attention, including in its use with adolescents. The aims of this paper are therefore to: 1) provide a brief overview of the interview itself, as well as a description of its origin and underlying conceptual framework; 2) describe relevant factors for administering the interview with adolescents; 3) review potential limitations regarding use of the EDE with adolescents; 4) address considerations for using the EDE with pertinent subpopulations of adolescents who may experience distinct eating disorder symptoms and/or risk factors; and 5) discuss the integration of self-report questionnaires with the EDE. Advantages of using the EDE include the ability for interviewers to clarify complex concepts and mitigate inattentive responding, enhanced orientation to the interview timeframe to improve recall, increased diagnostic accuracy compared to questionnaires, and accounting for potentially salient external factors (eg, food/eating rules imposed by a parent/guardian). Limitations include more extensive training requirements, greater assessment burden, variable psychometric performance across subgroups, lack of items evaluating muscularity-oriented symptoms and avoidant/restrictive food intake disorder diagnostic criteria, and lack of explicit consideration for salient risk factors other than weight and shape concerns (eg, food insecurity).

The differential effects of state and trait masculinity and femininity on body satisfaction among sexual minority men

Masculine men are more likely to idealise being tall, muscular, and lean. Feminine men, on the other hand, are more likely to idealise leanness. At the trait level, masculinity and femininity have been linked with an unhealthy striving for these idealised traits and body dissatisfaction. However, it is unclear how feeling masculine or feminine in the moment might be associated with body satisfaction. Is feeling masculine and/or feminine associated with a boost in body satisfaction? In the first large-scale experience sampling study of masculinity and femininity (n_observations=25,133; N_participants=530), we find that state masculinity and femininity, but not trait, are associated with increased body satisfaction among sexual minority men. We also find a gender congruence effect whereby the positive associations between state masculinity/femininity on body satisfaction are more pronounced when these feelings align with trait levels of masculinity/femininity. Exploratory analyses revealed a moderating effect of eating disorder history. The associations between masculinity and femininity on body satisfaction were amplified for people who had been diagnosed with an eating disorder. This study presents the first evidence that the links between masculinity and femininity and body satisfaction can be delineated based on whether they are measured as traits or states.