Body image and condomless anal sex among Young Latino sexual minority men

Body Image Perceptions and Visualization of Vietnamese Men Who Have Sex with Men (MSM)

Research on body image among men who have sex with men (MSM) has predominantly been approached with the assumption that all MSM conform to a culturally preferred body, and have a high risk of body image concerns leading to risky behaviors and negative health outcomes. Scholars have called for a more nuanced understanding of how MSM engage with their body images. In response, we conducted 30 semi-structured interviews with Vietnamese MSM to explore their perceptions and feelings of their bodies, including their current body, idealized body, and sexually desired body. Inductive thematic analysis was utilized. The findings highlight the diversity and complexity in Vietnamese MSM's perceptions and feelings about their bodies, which Western measurements of body image and body dissatisfaction might not fully capture. The participants also acknowledge the pressure of physical appearance; however, they do not always conform to the dominant body ideals and have a high risk of body dissatisfaction. We conclude with a call for reframing the approach to gay and bisexual men's body image to understand better how they navigate complex pressures and make sense of their body image instead of assuming they are at risk of body dissatisfaction.

Psychometric Evaluation of the Drive for Muscularity Scale and the Muscle Dysmorphic Disorder Inventory among Brazilian Cisgender Gay and Bisexual Adult Men

Despite high levels of muscularity concerns among sexual-minority men, most of the existing literature on the drive for muscularity and muscle dysmorphia focuses on heterosexual men and has mainly been conducted in Western and English-speaking regions. The present study aimed to evaluate the psychometric properties of the Drive for Muscularity Scale (DMS) and the Muscle Dysmorphic Disorder Inventory (MDDI) in Brazilian cisgender gay and bisexual adult men who were 18-50 years old. We evaluated the factor structure of both measures using a two-step, split-sample exploratory (EFA; n = 704) and confirmatory (CFA; n = 705) factor-analytic approach, which supported the original three-factor structure of the MDDI and resulted in a reduced two-factor solution with 13 items for the DMS. Convergent validity was supported through associations of the DMS and the MDDI with eating disorder symptoms, body-ideal internalization, self-objectification beliefs and behaviors, and body appreciation measures. Additionally, we found good internal consistency, and test-retest reliability of both measures. Results support the validity and reliability of the DMS and the MDDI in Brazilian cisgender gay and bisexual adult men and will support future studies exploring these constructs in Brazilian sexual-minority men.

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

Research suggests that the risk of body image concerns among sexual minority men is high. Recent work has increasingly examined body image in relation to psychological, interpersonal, and behavioral constructs, but these findings have yet to be consolidated and critically examined to identify potential risk and protective factors. The present study sought to systematically review and synthesize published findings on body image among sexual minority men. A total of 136 articles published between January 2011 and March 2022 were included. Sexual minority men were generally reported to have more negative body image compared to heterosexual men, yet findings varied across body image constructs. In correlational work, body image was often examined in relation to disordered eating, mental health, internalization of appearance ideals, objectification, sexual behavior and relationships, gay community identification and discrimination, and health concerns (e.g., HIV, AIDS). Robust relationships emerged among body image and stigma variables, including internalized homophobia and harassment related to LGBTQ+ presentation and intersecting minority identities. Sociocultural, objectification, and minority stress theories were employed to interpret findings and to delineate future directions grounded in intersectional approaches. Additional work focused on the role of stigma and discrimination in the development of these concerns across the lifespan is needed.

Gay Community Involvement and Condomless Anal Sex Among Sexual Minority Men in the USA

Sexual minority men (SMM) remain disproportionately burdened by sexually transmitted infections. Although gay community involvement has been theorized to be protective against many negative health outcomes, research examining the association between community involvement and condomless anal sex (CAS) has yielded conflicting results. The current study, conducted between 2018-2020, examined whether the importance one places on various aspects of community involvement was associated with CAS among a sample of young adult SMM aged 18-34 years with body image concerns (N = 180). Gay community involvement was measured using the Importance of Gay Community Scale, and the results of an exploratory factor analysis indicated the presence of two factors: "social activism" and "going out/nightlife." A zero-inflated Poisson regression was conducted to examine the association between gay "social activism," "going out/nightlife," and their interaction with the number of CAS partners. Upon examining a significant interaction, "social activism" had a protective effect against CAS at low levels of "going out/nightlife," but this effect was non-significant at higher levels. These results suggest that encouraging gay community involvement through activism could be effective at reducing CAS and addressing the health disparity that exists within this population.

Associations among romantic and sexual partner history and muscle dysmorphia symptoms, disordered eating, and appearance- and performance-enhancing drugs and supplement use among cisgender gay men

This study examined relationship status (e.g., single versus not single) and number of sexual partners in relation to muscularity- and disordered eating-related attitudes and behaviors among 1090 cisgender gay men enrolled in The PRIDE Study in 2018. Participants completed measures assessing muscle dysmorphia (MD) symptoms, disordered eating attitudes and behaviors, and appearance- and performance-enhancing drug or supplement (APEDS) use. In linear regression models adjusting for theoretically relevant covariates, neither relationship status nor number of past-month sexual partners was associated with disordered eating attitudes. In terms of MD symptoms, single (versus not single) relationship status was associated with greater appearance intolerance, and a greater number of sexual partners was associated with greater drive for size and functional impairment. In adjusted logistic regression models, a greater number of past-month sexual partners was associated with use of anabolic-androgenic steroids, synthetic performance-enhancing substances, protein supplements, and creatine supplements, as well as greater likelihood of engaging in compelled/driven exercise. Across all associations, effect sizes were generally small. Overall, results support that inquiring about sexual partners may have utility in evaluating risk for muscularity-oriented attitudes and behaviors among cisgender gay men. Future work will need to replicate these findings, particularly in more diverse samples.

Demographic and sociocultural predictors of sexuality-related body image and sexual frequency: The U.S. Body Project I

Body image is a critical component of an individual's sexual experiences. This makes it critical to identify demographic and sociocultural correlates of sexuality-related body image: the subjective feelings, cognitions, and evaluations related to one's body in the context of sexual experience. We examined how sexuality-related body image differed by gender, sexual orientation, race, age, and BMI. Four items assessing sexuality-related body image were completed by 11,620 U.S. adults: self-perceived sex appeal of their body, nude appearance satisfaction, and the extent to which they believed that body image positively or negatively affected their sexual enjoyment and feelings of sexual acceptability as a partner. Men reported slightly less nude appearance dissatisfaction and fewer negative effects of body image on sexual enjoyment and sexual acceptability than women, but did not differ in reported sex appeal. Poorer sexuality-related body image was reported by people with higher BMIs, not in relationships, who had sex less frequently, among White compared to Black women and men, and among gay compared to heterosexual men. Data also revealed a subgroup of respondents who reported that their body image had a positive impact on their sex lives. The findings highlight a need for interventions addressing sexuality-related body image.

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

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

Appearance-ideal internalization, body dissatisfaction, and suicidality among sexual minority men

Sexual minority men (SMM) are disproportionately at risk for suicidality. Furthermore, SMM are at elevated risk for appearance-ideal internalization and body dissatisfaction, which are both associated with suicidality. Theoretical recommendations suggest including interaction terms between appearance-ideal internalization and body dissatisfaction when examining deleterious health outcomes. To test these interactions and examine whether appearance-ideal internalization or body dissatisfaction impart greater suicidality, the current study analyzed associations between specific forms of appearance-ideal internalization and suicidality among SMM, and whether body dissatisfaction moderated these associations. Participants were 171 SMM recruited for an eating disorder prevention program. Analyses examined the association between thin and muscular-ideal internalization with count of suicide risk, with body fat and muscularity dissatisfaction moderating these associations. Zero-inflated Poisson regressions revealed that the association between thin-ideal internalization and suicide risk was moderated by body fat dissatisfaction, such that thin-ideal internalization was associated with increased suicide risk at high levels of body fat dissatisfaction. Muscularity concerns were not significantly associated with suicidality, suggesting that thinness concerns may be more salient than muscularity for suicidality among SMM. Future research should replicate findings among larger SMM samples and extend the current design into non-SMM samples to examine if results generalize to other vulnerable populations.

Empirical Evaluation of Rainbow Reflections: A Comic Book Anthology on Body Image for Queer Men

Gay, bisexual, and queer (GBQ) men are at higher risk of negative body image. As having a negative body image is related to negative mood, sexual, and health outcomes, identifying and providing community-friendly tools for GBQ men is important. This paper describes the creation and evaluation of Rainbow Reflections, a comic anthology developed to promote awareness of and communication about body image. Rainbow Reflections includes comics from 38 trans- and cis-GBQ artists who drew inspiration from personal narratives based on pre-determined themes in the empirical literature and interactive inserts based on evidence-based practice. To evaluate Rainbow Reflections, 167 trans- and cis-GBQ men completed pre-post measures before/after viewing a selection of comics and responded to an open-ended question about their experience. Overall, participants rated the comic book positively, with a majority (61.1%) indicating that they would recommend the book to a friend. After viewing the comics, participants reported greater comfort with initiating conversations about body image, greater satisfaction with their bodies, and reported higher estimates of how common body image concerns are for queer men. Themes that emerged from open-ended responses included participants reflecting on personal struggles (~ 30%), relating with the stories of others (~ 22%), reflecting on the standards of queer men (~ 18%), recognizing cis-privilege (~ 11%), reflecting on others' struggles (~ 9%), negative feedback about the comics (~ 7%), and balancing masculine and feminine (~ 3%). Results of the study provide preliminary evidence for Rainbow Reflections as an effective community-friendly tool to promote awareness of and communication about body image for GBQ men.

Minority stress and body dysmorphic disorder symptoms among sexual minority adolescents and adult men

Body dysmorphic disorder (BDD) has a prevalence rate of 2.4 % among U.S. adults; however, little is known about BDD among sexual minority men. Minority stressors (fear of rejection, sexual orientation concealment, internalized homophobia, discrimination/prejudice) may be risk factors for BDD in this population. Thus, the purpose of the current study was to estimate the occurrence of BDD in a sample of sexual minority men and investigate associations between minority stressors and BDD. Participants were recruited via social media, and survey data were collected from 268 sexual minority adolescent boys and adult men (M = 24.59 years, SD = 5.37 years). Regression models included either positive BDD screen or levels of BDD symptoms as dependent variables and the four aforementioned minority stressors as explanatory variables. The occurrence rate of positive BDD screens was 49.3 %. Gay-related rejection sensitivity and sexual orientation concealment were uniquely associated with greater BDD symptoms, and sexual orientation concealment was uniquely associated with greater odds of positive BDD screens. Given the high occurrence of positive BDD screens in the current sample, compared to the national prevalence, sexual minority stressors may be worthy to explore in etiological models of BDD in this population.

Who is at risk? Gendered psychological correlates in Italian students’ sexual risk profiles

Recent research has shown that sexual risk behaviours are rising substantially among Italian youth, but this evidence is still undervalued in public discussion. Adopting a multidimensional perspective for sexual risk and addressing gender differences, the present study investigates if and how some individuals’ psychological characteristics—namely body satisfaction, self-esteem and body sensation-seeking—are associated with unsafe and risky sexual behaviours of Italian emerging adults. We exploited the survey SELFY—Sexual and Emotional LiFe of Youths—conducted in 2017 in Italy. Several key points may be highlighted from our study. First, we identify two clusters characterized by high sexual risk-taking behaviours, which include one third of our sample, a non-negligible proportion. Second, we prove that women are generally less inclined to adopt risk-taking behaviours in sexual life. Third, our findings show that body satisfaction, self-esteem and sensation seeking are differently linked to sexual risk taking among women and men. Body satisfaction is associated with a higher probability of adopting risky and promiscuous sexual behaviours among men, while the relationship is not significant among women. Sensation seeking shows a certain relevance in defining sexual risk profiles, especially for men. Overall, our research suggests that body image and self-worth could be relevant areas of intervention for sexual health programs targeting emerging Italian adults. Notably, communication and education strategies on these issues should be differentiated for women and men.

Behavioral medicine and behavioral health research and practice: An introduction to the Special Issue

The field of behavioral medicine continues to have a major impact on psychological science and public health. Presently, the field of behavioral medicine is undergoing rapid development and continues to evolve as a sub-discipline in allied disciplines. This Special Issue highlights emerging work that contributes to the evolution of behavioral medicine as pertaining to behavioral, psychosocial, and biomedical science integration to prevent, diagnose, and treat illness and disease. The present introductory article calls attention to research in behavioral medicine in the larger context of behavioral health research and practice and encourages continued research in this area. Research presented in this Special Issue covers a variety of topics, ranging from the role of cognition and emotion in behavioral disorders, development and refinement of novel technological and integrated interventions, substance use comorbidity, sexual health across special populations, and social determinants of health. This Special Issue is organized into three parts classified as transdiagnostic processes in health behavior and physical illness; personalization of health-specific therapeutic tactics in modern day healthcare in behavioral medicine; and social determinants of health and health disparities in behavioral medicine among special populations. It is hoped that this issue will alert readers to the significance of this work, illustrate the many domains currently being explored via innovative approaches, and identify promising and impactful areas for research.