Body dysmorphia in gay male spaces: the double binds of knowing what you want and simultaneously rejecting it

Abstract

Body Dysmorphic Disorder (BDD) is a distressing mental health disorder with a prevalence of 2.4% among adults in the United States. While research has previously evaluated the impacts of age and gender differences, there has been a limited focus on the intersection of BDD symptomology and the experiences of sexual minority men. This dearth of research contributes to a lack of understanding, both socio-culturally and clinically, of the lived experiences of gay men with BDD. This qualitative study explored the lived experiences 10 self-identified gay men diagnosed with BDD to gain insight into possible intrapsychic and interpersonal factors that are at play for this population. Analysis, informed by a phenomenological approach, yielded three key themes of double binds experienced by the participants: My Armor is my Spotlight, Wanting Intimacy but Rejecting it, and Caught Between Cultural Expectations and Desires for Self.

LAY SUMMARY

Body Dysmorphic Disorder (BDD) is a mental health disorder diagnosed in a person who reports preoccupation with one or more perceived flaws or deformities in their appearance. While literature has explored the impacts of BDD with gender differences, scarce research has been done on the effect of sexual minority men. This study interviewed 10 self-identified gay men diagnosed with BDD to gain insight into possible psychological and interpersonal factors that are at play for this population and to better help them.

Keywords:

• Body dysmorphic disorder
• sexual minority men
• LGB community
• qualitative
• phenomenology
• gay male culture
• double binds
• intraminority stress

Disclosure statement

The authors declare that there is no conflict of interest.

Additional information

Notes on contributors

Casey Gamboni

Casey Gamboni is a licensed marriage and family therapist who received his PhD in Couple and Family Therapy from the University of Iowa in 2019. Dr. Gamboni is currently teaching and supervisory faculty at The Family Institute at Northwestern University and a director at Pinnacle Counseling, a private practice in the Chicago, IL area. His research and clinical specialties are sibling relationships, sexual minority populations, and emerging adults. He is currently publishing and presenting on topics focusing on the gay male population; exploring topics such as body dysmorphic disorder, social anxiety, and the significance siblings play in the coming out process.

Elise Parisian

Elise Parisian, is a recent graduate of The Family Institute at Northwestern University’s Marriage and Family Therapy program. Parisian is currently a clinical associate at a small private practice and is interested in the intersections of LGBTQIA + identities, media/culture, and relationships.

Heather Morgan-Sowada

Heather Morgan-Sowada is an Assistant Professor at Mount Mercy University within the graduate department of Marriage and Family Therapy. She is a licensed Marriage and Family Therapists who completed her Ph.D. in Couple and Family Therapy the spring of 2018 from the University of Iowa. Her master’s degree is in Marriage and Family Therapy from Mount Mercy University, which was completed in spring of 2012. Dr. Morgan-Sowada’s research and clinical specializations are in Body Dysmorphic Disorder, sexual/gender minority individuals, and the intersections of those two topics. Dr. Morgan-Sowada and colleagues were recently published in the Journal of Marriage and Family Therapy for their paper entitled: “It’s splendid once you grow into it:” Client experiences of relational teletherapy in the era of COVID-19 (Mar-2021).