the roles of family friends and romantic-sexual partners in the body image of sexual minority men

8/15/2019 The Roles of Family Friends and Romantic-Sexual Partners in the Body Image of Sexual Minority Men

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Journal of Counseling & Development ■

April 2016 ■

Volume 94150

© 2016 by the American Counseling Association. All rights reserved.

Received 05/11/14Revised 05/19/15

Accepted 05/21/15DOI: 10.1002/jcad.12072

Growing evidence has indicated that sociocultural factors,

including interpersonal experiences with family members,

friends, and intimate partners, affect the body image de-

velopment of men (Ambwani & Strauss, 2007; Boroughs

& Thompson, 2002; Bottamini & Ste-Marie, 2006; Carlin,

2008; Drummond, 2005; Fawkner, 2005; Galli & Reel, 2009;

Harvey & Robinson, 2003; Morgan & Arcelus, 2009; Ryan

& Morrison, 2009; Sira & White, 2010). Cash (2002) identi-

fied interpersonal experiences as one of four highly salient

factors that influence body image investment and evaluation,

along with cultural socialization, physical characteristics,

and personality attributes. Interactions with family members,friends, peers, and strangers communicate expectations re-

garding the meaning of a person’s body, both verbally and

nonverbally. Sexual minority men, defined for this study as

men who identify as bisexual or gay, are believed to be more

strongly affected by body image disturbances and associated

consequences compared with their heterosexual peers (Bor-

oughs & Thompson, 2002; Chaney, 2008; Drummond, 2005;

Feldman & Meyer, 2007; Harvey & Robinson, 2003; Morgan

& Arcelus, 2009; Wiseman & Moradi, 2010). Researchers

have called for an in-depth investigation of body image as it

relates to men’s experiences with family and friends (Ryan

& Morrison, 2009) and romantic relationships (Ambwani &Strauss, 2007; Tantleff-Dunn & Gokee, 2002).

Unfortunately, the extant data consist of fragmented

findings drawn primarily from heterosexual samples. Gay

culture, with its strong emphasis on a lean, somewhat mus-

cular appearance as a critical factor in social acceptance

R. Lewis Bozard Jr. and J. Scott Young, Department of Counseling and Educational Development, University of North Carolina atGreensboro. R. Lewis Bozard Jr. is now at Care and Counseling Center of Georgia, Decatur, Georgia. Correspondence concerningthis article should be addressed to R. Lewis Bozard Jr., Care and Counseling Center of Georgia, 1814 Clairmont Road, Decatur,GA 30033 (e-mail: [email protected]).

The Roles of Family, Friends,and Romantic/Sexual Partners in theBody Image of Sexual Minority Men

R. Lewis Bozard Jr. and J. Scott Young

The purpose of this study was to explore the roles of family, friends, and romantic/sexual partners in the body image

development of sexual minority men. Data were analyzed using consensual qualitative research methodology. Romantic/

sexual partners, family, and friends were all found to play influential roles in body development, with romantic/sexual

partners being the most significant and friends being the least significant. Implications for counselors and counselor

educators, as well as suggestions for future research, are provided.

Keywords : bisexual, body image, gay, male, sexual minority

and attraction of sexual partners, exerts pressure on sexual

minority men to achieve unrealistic standards of appearance

(Boroughs & Thompson, 2002; Chaney, 2008; Drummond,

2005; Harvey & Robinson, 2003; Morgan & Arcelus, 2009).

Gay and bisexual men may experience cognitive dissonance

as they seek acceptance from partners, potential partners, and

sexual minority friends who simultaneously transmit strict

gay cultural ideals regarding body appearance. Furthermore,

because of heteronormative cultural biases, sexual minority

men sometimes experience strained relationships with their

families of origin and their peers (Sullivan, 1999). Thus, the

purpose of this study was to examine the influences that fam-ily, friends, and romantic/sexual partners exert in the body

image development of college-age sexual minority men.

Body Image DevelopmentAmong Sexual Minority Men

Numerous clinical risks related to body image disturbances

among sexual minority men have been reported. These risks

include a greater likelihood to use health-compromising

anabolic steroids (Dillon, Copeland, & Peters, 1999); a

greater pressure to be thin, and therefore diet, compared with

straight men (Morgan & Arcelus, 2009); a greater occur-rence of anorexia, bulimia, or nonspecified eating disorders

(Feldman & Meyer, 2007); and an increased risk of suicide

(Eaton, Lowry, Brener, Galuska, & Crosby, 2005; Kim, 2009;

Whetstone, Morrissey, & Cummings, 2007). Complicating

matters, depression and low self-esteem, risk factors for body


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The Body Image of Sexual Minority Men

image disturbances, are experienced by gay men at higher

rates and are thought to be exacerbated by the challenges of

navigating their sexual identity, particularly at the early stages

of the coming-out process (Harvey & Robinson, 2003; Petrie

& McFarland, 2009).

Studies of adolescent and young adult men from primar-

ily heterosexual samples have found that both negative and positive effects on body image may emerge through interper-

sonal experiences (e.g., peer comments, teasing, pursuit of

romantic relationships, visual body comparison), although

findings have been inconsistent (Ata, Ludden, & Lally, 2007;

Bottamini & Ste-Marie, 2006; Carlin, 2008; Galli & Reel,

2009; Hoyt & Kogan, 2001; McCabe & Ricciardelli, 2003;

Olivardia, 2001; Pope, Phillips, & Olivardia, 2000; Ric-

ciardelli, McCabe, & Banfield, 2000; Ryan & Morrison, 2009;

Sira & White, 2010). A few studies involving sexual minority

participants have discovered connections between interper-

sonal relationships and male body image development, yet

the nature of the influences has not been specifically explored,

especially for the sexual minority participants. In their qualita-

tive study of 12 Irish men (11 heterosexual, one gay), Ryan

and Morrison (2009) found that the acquisition of sexual part-

ners was one influence on body image. In a qualitative study

of 15 men ages 18 to 24 years ( M = 21 years; eight straight,

seven gay), Morgan and Arcelus (2009) found that gay bars

and clubs, locations where patrons often seek sexual partners,

constituted especially unhealthy environments for body im-

age, and they also found that media influence, gay bars, and

the feeling of being judged primarily on physical appearance

greatly affected gay participants. Adams, Turner, and Bucks

(2005) qualitatively explored young adult men’s experiences

of body dissatisfaction in the United Kingdom; their studyconsisted of seven heterosexual men, five gay men, and two

bisexual men. Adams et al. observed that most participants’

definitions of body dissatisfaction included references to how

they were perceived by others. For some participants, simply

being seen by others was sufficient enough to elicit concern.

Also, feedback from romantic/sexual partners, regardless if

it was an affirmation or rejection, was particularly salient.

In view of the pressure exerted through gay culture to attain

a lean, muscular appearance, sexual minority men are likely

to experience cognitive dissonance as they seek social accep-

tance through interpersonal relationships and simultaneously

receive messages that their bodies do not meet cultural ideals

from some of the same interpersonal relationships. Therefore,this study sought to specifically investigate the influences of

family, friends, and romantic/sexual partners on body image

development among sexual minority men.

Method

Researchers have noted the value of qualitative methodol-

ogy to fully capture the complex, subjective, perceptual, and

experiential nature of male body image issues (Bottamini &

Ste-Marie, 2006; Chaney, 2008; Filiault, 2007; Galli & Reel,

2009; Morgan & Arcelus, 2009; Ridgeway & Tylka, 2005). We

chose consensual qualitative research (CQR) as the method of

qualitative inquiry. Although we considered other qualitative

approaches, we selected CQR for its relatively higher level of

rigor, including the use of multiple researchers and an audit

process to promote the trustworthiness of the findings. CQR provided an effective means to collect rich descriptions from

a minority population regarding a topic that had not been

explored with such depth and to then identify key findings

using a collaborative process that allowed us to draw from the

varied expertise and common agreement of multiple review-

ers. Before the commencement of the research, approval was

granted by the university’s institutional review board.

Participants

The participants were eight men associated with two univer-

sities (a small, private liberal arts university and a medium-

sized, public university) in the southeastern United States. Asample size of eight to 15 participants has been suggested

to promote both representation of multiple perspectives and

accommodation for unexpected variability, which could

affect the process of analysis and grouping of data (Hill,

Thompson, & Williams, 1997). Participant selection criteria

included the following: (a) self-identifying as a bisexual or

gay man; (b) being 18 to 30 years old; (c) having the ability

to identify experiences affecting body image development

that occurred in family, friend, and romantic/sexual partner

relational contexts; (d) being willing to describe these expe-

riences for the purposes of the investigation; and (e) being

either currently enrolled in college or previously enrolled

within 6 months before the interview. Six of the study participants self-identified as gay and two self-identified

as bisexual, with ages ranging from 19 to 26 years ( M =

22 years, SD = 2.20). Six participants identified as White/

Caucasian and two as Black/African American. Participants

were asked to consider their thoughts and feelings about their

bodies on most days in the past month and then rate their

current body image on a 10-point Likert-type scale ranging

from 1 ( I completely dislike my body) to 10 ( I completely like

my body). Participant responses ranged from 3 to 7, with a

mean of 5.43 (SD = 1.72). Three participants’ responses were

on the lower (negative) end of the scale, four participants’

responses were on the higher (positive) end of the scale, and

one participant gave no response.

Researchers’ Backgrounds and Biases

The research team consisted of the first author, who was

a doctoral student, and two faculty members of the first

author’s doctoral committee, one of whom is the second

author. No members of the research team had previous

direct experience in the use of CQR, but all participated in

CQR training conducted by the first author and consulted


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with two additional faculty members who had extensive

experience in CQR methodology. To reduce subjective

bias, we part icipated in a bracketing exercise before data

collection and analysis (Hill et al., 2005), in which we

discussed our experiences, perspectives, and expectations

regarding the phenomenon under investigation (Hill et

al., 1997). We all reported at least minimal personal and professional experience with body image disturbances and

expressed the expectation that sexual minority men might

be more likely than straight men to experience problems

related to their body image. The second author reported

minimal previous familiarity with gay culture, whereas the

other two team members, including the first author, had

extensive experience with sexual minority populations.

The first author and the nonauthor faculty member were

highly familiar with body image research. The nonauthor

faculty member had previously conducted research related

to body image. We all expected that family, friends, and

romantic/sexual partners could potentially play significant

roles in body image development.

Measures

Demographic questionnaire. Participants completed a brief

demographic questionnaire. This questionnaire included

items pertaining to sex, age, ethnicity/race, education, sexual

identity, and follow-up contact.

Psychosocial history form. Participants completed a male

body image psychosocial history form before the interview.

The questionnaire consisted of eight items that the first author

developed by drawing from the Adonis Complex Question-

naire (Pope et al., 2000) and Pope et al.’s (2000) list of ques-

tions related to symptoms for muscle dysmorphia, eatingdisorders in men, and body dysmorphic disorder .

Semistructured interview. We asked the participants

a series of questions developed from the existing litera-

ture, with primary attention to the overarching research

question, “How do sexual minority men describe the

relationship between their body image development and

their experiences involving (a) family, (b) friends, and (c)

romantic/sexual partners?” Specifically, we asked the par-

ticipants the following questions, with additional follow-up

questions based on individual responses: (a) “What do you

think about body image as a concern of men?” (b) “What

struggles related to body image, if any, have you witnessed

bisexual and gay men experience?” (c) “Have you notedanything that seems different or unique about male body

image as experienced by bisexual and gay men?” (d)

“What factors do you think may influence the body image

of sexual minority men?” (e) “This research project is

intended to focus on the experiences of bisexual and gay

men. Which term do you use to identify yourself? How

would you briefly describe what you mean when you say

that you are bisexual/gay?” (f) “Considering your own life

experiences, how might you generally describe your body

image?” (g) “Describe a specific experience that occurred

within the context of family, friends, or romantic/sexual

partners that related to your body image development in

a significant way” (h) “How did this experience relate to

your thoughts and feelings about your body?” (i) “What

role, if any, did the type of relationship (i.e., family, friend,and romantic/sexual partner) play in the significance of this

experience?” (j) “Is there another specific experience that

occurred within the context of family, friends, or romantic/

sexual partners that related to your body image develop-

ment in a significant way? Tell me about it” (k) “Thinking

about all of the experiences you have described, which

experience, or experiences, was most influential? How?

Have the roles of family, friends, and romantic/sexual

partners in your body image changed over time at different

stages of your life? How?” (l) “Thinking about all of the

experiences you have described, what role, if any, did your

sexual identity play relative to your body image?” and (m)

“Is there anything else about this topic or this interview

that you would like to share?” We repeated the question “Is

there another specific experience that occurred within the

context of family, friends, or romantic/sexual partners that

related to your body image development in a significant

way?” unlimited times to capture all relevant experiences.

Procedures for Data Collection

The study applied convenience and snowball sampling,

which have been recommended for marginalized and stig-

matized social groups such as sexual minority men (Filiault

& Drummond, 2009; Patton, 2002). The call for participants

was publicized through e-mail announcements via universityelectronic mailing lists; face-to-face announcements made by

the first author at regularly scheduled meetings of a campus

lesbian, gay, bisexual, and transgender (LGBT) organization;

one-on-one personal discussions with LGBT students and

allies; and social media, including Facebook announcements

asking readers to communicate the call to people who might

be eligible to participate, which were posted by the first author

on pages of LGBT student groups and on his own Facebook

page. These audiences and participants were asked to consider

participating or to share news of the opportunity to participate

with potential participants within their social networks. In the

announcements, the first author directed potential participants

to access a recruitment letter posted online using SurveyMon-key. At least 5 days before the interview, we e-mailed copies

of the informed consent form, the demographic questionnaire,

the male body image psychosocial history form, and the inter-

view questions for review only to individuals who agreed to

participate. The participants completed the informed consent

form, the demographic questionnaire, and the male body im-

age psychosocial history form before the interview, and they

gave these materials to the first author at the beginning of


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the interview session. Experiences contributing to male body

image development occur over a span of years and are uncom-

monly discussed by most men. We hoped that the opportunity

to recall events in advance of the interview would enhance the

quality of responses overall. The first author conducted and

audiotaped the face-to-face interviews. Interviews ranged in

duration from 33 to 69 minutes.

Data Preparation and Analysis

The first author transcribed and double-checked the interviews

for accuracy. Then, he assigned sequential numbers and dis-

tributed them without identifying information to the research

team members before the team analysis meetings. We met

twice to code the findings, with a time lapse of no longer than

2 months between an interview and our final analysis of it.

We independently completed initial coding of the transcripts

before each meeting. Then, we reached consensus through a

discussion of the tentative coding during analysis meetings so

that all members agreed with the final results. Our coding of

the data followed standard CQR procedures, which involves

three primary steps: (a) identifying and coding domains in

which to cluster data, (b) identifying core ideas that constitute

the essence of participants’ described experiences, and (c)

conducting cross-analysis of data to locate categories that

are applicable across participant cases (Hill et al., 1997). In

the final step, we assembled the cross-analysis, core ideas

into categories (Hill et al., 1997). A faculty member, who

had direct experience as a CQR researcher and auditor and

who had published multiple studies using CQR methodology,

served as our external auditor and reviewed and verified the

findings immediately upon completion of the process (Hill

et al., 1997).

Evaluation of the Results

Hill et al. (1997) outlined three essential criteria for evaluat-

ing results of CQR: (a) trustworthiness of the method, (b)

coherence of the results, and (c) representativeness of the

sample. This study ensured trustworthiness through care-

ful monitoring of the processes of data collection and data

analysis, including appropriate interview development,

minimization of bias, consensual process, auditing, and

accurate reporting of findings. Triangulation, or the col-

lection of data using multiple sources, is a prime means

for the pursuit of coherence and promotes reliability and

internal validity (Creswell, 2007; Hill et al., 1997). In thisstudy, we attained triangulation by comparing the individual

participant data between the verbal information collected

during the interview and the written information collected

on the psychosocial history form. Similar responses across

sources suggest that the data are trustworthy, whereas a pat-

tern of contradictory responses suggest that the data may be

unreliable. All participants were found to present consistent

information. Representativeness is closely related to the

concept of transferability and is considered to be a measure

of external validity in qualitative inquiry (Creswell, 2007).

In this study, we addressed representativeness by carefully

attending to the participant selection process (i.e., selecting

a relatively homogeneous group of participants); examining

the stability of the findings; and reporting the findings as

general, typical, or variant.

Results

A final consensus resulted in a list of six domains: (a)

relationship types affecting body image development, (b)

modalities of body image development experiences, (c)

romantic/sexual partner’s effects on body image develop-

ment, (d) family’s effects on body image development,

(e) longevity of the most influential experiences, and (f)

changing roles of relationships over time. Table 1 presents

the categories within each domain. Representativeness, or

frequency of occurrence, of categories was reported using

labels of general (applicable to all or most cases [n = 7–8]),typical (applicable to more than half of cases but not all [n =

5–6]), and variant (applicable to half or fewer of the cases,

but more than one [n = 2–4]; Hill et al., 2005). Categories

represented by only one respondent were considered rare and

were neither included in the table of findings nor assigned

a label. Domains containing general and typical categories

are presented in the following paragraphs.

TABLE 1

Domains and Categories WithGeneral and Typical Labels

Domain and Category

Relationship types affecting body image developmentRomantic/sexual partners and potential romantic/

sexual partnersFamilyOther relationshipsFriends

Modalities of body image development experiencesVerbal commentsObservation of another person’s body/self-comparison

Romantic/sexual partner’s effects on body imagedevelopment

Supported/complimented by partnerNegative comments from partnerPartner had own body concernsSex/cuddling

Body size (thin/overweight)Increased exercise

Family’s effects on body image developmentFelt supportedMother as the most influential family member

Longevity of the most influential experiencesLongevity

Changing roles of relationships over timeRoles do change over time

GeneralGeneralGeneralTypical

GeneralTypical

TypicalTypicalTypicalTypical

TypicalTypical

TypicalTypical

Typical

Typical

Label

Note. N = 8. General = applicable to all or most cases (n = 7–8);

typical = applicable to more than half of cases but not all ( n = 5–6).


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Relationship Types Affecting

Body Image Development

We specifically asked the participants to consider the roles

of romantic/sexual partners, family, and friends. This domain

(i.e., relationship types affecting body image development)

captured the relationship categories that participants identi-

fied as most influential in their body image development:romantic/sexual partners and potential romantic/sexual

partners (general category), family (general category), other

relationships (general category), and friends (typical cat-

egory). Romantic/sexual partners emerged as perhaps the

most influential of the relationship types, likely because of

their relational proximity and psychological importance.

Influences were both supportive and destructive in direction.

For example, one participant, a 24-year-old, White, gay man,

stated, “Until I really became sexually active I don’t think

[body image] mattered as much to me.” He described the

following experience:

There was a guy that I was really interested in doing some-

thing with. We messed around a little bit, but when it came

to what he considered as actually having sex, he was not

interested in that, and I immediately thought, “Is there some-

thing wrong? Is he not interested in this because he’s not in

the mood, or is he not impressed with the size of my penis?

What’s the issue here?”

A 21-year-old, White, gay man reported that his first sexual

partner, whom he found very attractive, directly affected his

body image development:

We had sex and, afterward, I made the stupid mistake of say-ing, “Well, how was it?” and he said, “Oh, well, you could use

more practice.” And for some reason, in my head, that didn’t

translate as exactly what he said. It was “You’re not attractive.”

Participants reported positive and negative experiences

with family members. For example, a 26-year-old, white, gay

participant reported that his mother complimented him by

saying, “You could be covered in shit and be more handsome

than blah blah blah,” while adding that “this is like a mother’s

bias.” However, his mother also expressed concerns that he

was too thin and should gain weight. Another participant, a

21-year-old, White, gay man explained,

[Family members are] more willing if they see that I’m try-

ing to restrict my diet or something like that, they’ll be like,

“You don’t need to worry about it. You can eat whatever you

want.” And so I feel more comforted around them as opposed

to gay individuals.

The influence of encounters with friends was reported by

interviewees as an important, although perhaps less direct,

influence on the body image development of participants.

A 26-year-old, White, gay man indicated that observing

the repulsive appearance of a friend who “never had clean

teeth” had influenced him for years, since adolescence, to

be conscious of the appearance of his own teeth. Similarly,

a 19-year-old, White, gay man, who perceived himself as

overweight, explained that a simple comment from a closefriend that he was “so skinny” produced a positive effect

that endured for days. In this way, even passing or indirect

influences of friends had an important and lasting impact on

the body image development of the participants, but likely

in a less personal manner than the influence of romantic/

sexual partners.

Although participants were asked specifically about the

influence of family, friend, and romantic/sexual partner rela-

tionships, some interviewees voluntarily added descriptions of

important influences from other relationships, including high

school teachers, college professors, and adolescent female

peers. A 21-year-old, White, gay participant described his

encounter with his high school drama instructor:

At the time, my one goal in life was to be an actor, and she

said, “It’ll never happen. . . . You’re not masculine enough.

You’re too small. You don’t have enough muscle.” And at the

same time that I was realizing that the gay community values

that kind of masculinity, so I was hearing this from someone

I really trust at the same time as my minority culture was

telling me, oh yeah, she’s right, you should be like that. . . . I

absolutely thought she knew everything . . . and the fact that

she was an authority figure very specifically.

Relationships outside the types explicitly solicited in the in-terviews clearly had the potential to be influential, sometimes

in a negative manner and sometimes in a positive direction,

such as a college professor who identified as gay and was a

source of inspiration to one of the participants.

Modalities of Body Image

Development Experiences

Participants described a range of types of experiences through

which other people affected body image development. Verbal

comments (general category) and observation of another

person’s body/self-comparison (typical category) emerged as

the most significant mechanisms through which other people

affected body image development. All participants identifiedverbal comments by others about their bodies as a direct influ-

ence on their body image development. Comments about a

range of body features, including body size (thin/overweight),

muscularity, eyes, and general attractiveness, were observed.

For example, as a 26-year-old, White, gay participant walked

past three female peers during high school, he overheard one

of the girls comment, “Oh my God, he’s so pale,” which caused

this individual to become “very self-conscious” about his


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complexion; become “even more self-conscious about girls

in general;” and consider, but ultimately refuse, to purpose-

fully tan. A 21-year-old, White, gay man revealed the strong

impact of verbal criticism when he related a comment that a

partner made while they were cuddling after having not seen

each other for a period of time. The partner stated, “Wow!

You’ve gained some weight.” The participant described hisreaction as follows: “I immediately shut down and withdrew

emotionally because I don’t like to be told negative things

about the way I look. I think I’m especially sensitive to criti-

cism.” He developed a preoccupation with losing weight and

became more self-conscious about his appearance. Overall,

participants wanted positive feedback about their bodies and

experienced significant emotional distress when negative

verbal feedback was provided, even from nonintimate sources.

Seeing another man’s body, then engaging in self-comparison,

was an important influence reported by participants. A 21-year-

old, Black, bisexual participant emphasized the importance of

sharing a bedroom with his more athletic brother as a teenager.

He found that comparing himself against his brother, in both

positive and negative directions,

really did shape a lot of my opinions of myself and there are

times I felt like it influence[d] my future, my sexual relations

in college and my choices of boyfriends and partners and other

things. At the same time it’s also helped me to realize that I

can achieve things . . . because I was like, “Oh, well, obvi-

ously my brother was able to do this and look at him now.”

The fact is that I can do that. I can be like that.

Another participant, a 26-year-old, White, gay man, favorably

compared his penis size with those of his partners, which produced a heightened self-confidence about his own body.

Across participants, the comparison of one’s body with others

was a common occurrence that resulted in either enhanced

self-esteem or disillusionment.

Romantic/Sexual Partner’s Effects

on Body Image Development

The domain of romantic/sexual partner’s effects on body

image development captured the aspects of the participants’

relationships with their partners that were most significant for

them. The categories consisted of (a) supported/complimented

by partner, (b) negative comments from partner, (c) partner

had own body concerns, (d) sex/cuddling, (e) body size (thin/overweight), and (f) increased exercise. All categories were

typical. Partner influences were mediated through a wide

range of methods from positive and negative comments to

nonverbal actions and modeling/observation.

Positive comments from partners produced affirming and

motivational developmental experiences. Contexts ranged

from hookup scenarios to dating relationships and longer

term romantic/sexual partnerships. One 24-year-old, White,

gay participant stated, “Someone that I was with commented

a lot on I have a nice ass, so I would do what I could to make

it better.” Regarding his ex-boyfriend, a 19-year-old, White,

gay man explained, “He was always very supportive. He still

is. If I ever really talk to him he’s always really nice. That was

part of the reason I fell in love with him.”

Although participants frequently named romantic/sexual partners as supportive, they also identified romantic/sexual

partners as making negative comments with potentially

detrimental effects. The 24-year-old, White, gay participant

who reported a compliment on his buttocks as positive also

reported that negative comments from partners led him to

increase his exercise regimen and to focus on enhancing his

appearance after the comments caused him to believe that

his body was deficient. In fact, some participants initiated

or intensified their exercise programs as a result of experi-

ences with romantic/sexual partners. A 21-year-old, White,

gay man stated, “Afterwards, I went to the gym a lot more

often. So [my partner’s comments] definitely influenced my

further behavior and caused me to look at myself more often

and try to lose weight.”

A partner who had his or her own body image concerns also

affected some of the participants. A 21-year-old, White, gay

man explained that an ex-boyfriend “was very conscious about

his own body and he made sure that he looked good and was fit

and everything. Coming from him, it was even more of a direct

insult because that’s something that really matters to him.”

Physical intimacy produced a common context for romantic/

sexual partners’ influence on body image. One participant de-

scribed how a partner grabbed the participant’s body and then

commented that the participant had gained weight. Another par-

ticipant became self-conscious about his body after a new sexual partner lost interest during an episode of physical intimacy and

did not provide an adequate explanation of his loss of interest

to the participant.

Several participants were concerned about their body size

along the spectrum of thin to overweight. One participant

disliked being seen as a “bear” (i.e., a gay subculture term

denoting a man who has a large build and is usually older) by

a potential partner. Another participant, with a history of dis-

ordered eating and feeling negative about being overweight,

had a potential partner grab his chest and make insulting

remarks that insinuated he was fat.

Family’s Effects on Body Image DevelopmentThe domain of family’s effects on body image development

reported aspects of relationships with family members that

were significantly influential. Themes related to the family’s

effects were less diverse than those reported in relation to

romantic/sexual partners. Two typical categories emerged in

relation to the family: (a) felt supported and (b) mother as

the most influential family member. A 21-year-old, White,

gay man described how his family usually provided him


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with a comfortable space in which he did not need to feel

concerned about his body in the self-conscious way he did

while around gay individuals. A 24-year-old, White, gay par-

ticipant explained that, in contrast to the body-centric nature

of sexual situations,

a family or a friend relationship is more of a love for eachother as people, not for each other’s body. . . . You have that

relationship because of a bond based on love and the fact that

we’re born into the same family and things that we shared as

interests. . . . But there’s a lot more insecurity with a sexual

partner relationship.

Participants specifically named mothers, more than any

other, as an influential family member. Participants some-

times reported negative effects from their mothers, whereas

others identified the positive effects of this relationship.

A 19-year-old, White, gay man described a situation in

which his mother, after having a few alcoholic drinks,

grabbed his chin with her hand and said, “This is getting

larger after the past couple days,” which intensified the

participant’s self-consciousness about his perceived double

chin. A 21-year-old, Black, bisexual man had his mother

say to him in college, “Are you going to start working out

or something? You used to look really good. Now you’re

just there.” The participant explained that he experienced

“trash talk” as customary in his family context, and dur-

ing the interview, he seemed to dismiss the impact, yet

its significance is revealed in the fact that he recalled the

comment years later.

Longevity of the Most Influential Experiences

The domain of longevity of the most influential experiences

resulted from the analysis of aspects of each participant’s

single most influential body image development experience.

Longevity (typical category) emerged as the one category

common to most men’s influential experiences. Longevity was

noted both in terms of the activating experience and in terms

of the duration of the effects of the experience. A 21-year-old,

Black, bisexual man who shared a bedroom with his athletic

brother explained the long time span of the activating experi-

ence in the following way:

The one that’s most impactful would have to be my brother

just because of the longevity of it. . . . I’ve been dealing

with the contrasting [myself] with my brother all of my life

so it’s continuously there. And, since going to college, it’s

lessened, but it’s still there. I can go home and see him, then

you fall back into the general script of behavior and it just

reinforces itself.

A 21-year-old, White, gay participant who emphasized the

longevity of the effects of remembering observed, “Something

that someone does is more impactful than something someone

says, most of the time. It’s a lot less easy for me to forget.”

Comparing the lingering effects of negative and positive

experiences, a 19-year-old, White, gay participant observed

that “negative experiences carry through more than positive

do, that’s for sure. Definitely stay for longer.”

Changing Roles of Relationships Over Time

Participants frequently stated that the roles of other people

in their body image development changed over time, with

other people tending to exert less influence on body image

as participants grew older. The relative importance of the

various relationship types in affecting body image develop-

ment evolved over time as well. In this domain, one typical

category emerged: Roles do change over time. A 21-year-old,

White, gay participant summarized his experience, saying,

“There’s more of an internal locus of control as opposed to

somebody else dictating or outside of them dictating how

I feel about myself, which is definitely positive.” Another

participant, a 24-year-old, White, gay man, outlined a pro-

gression of changes from adolescence to young adulthood,

through which the primary interpersonal influence on his body

image evolved from family (meeting expectations) to friends

(seeking acceptance) to short-term romantic/sexual partners

(seeking sex; e.g., “Once I came out, it started to become

more of a focus of being considered attractive by those that

I wanted to have sex with”) to a long-term romantic/sexual

partner (pleasing that one person). Some participants reported

that the influences of all people, including family, friends,

and romantic/sexual partners, had declined in importance

over time. A 21-year-old, White, gay man expressed relief at

the singular focus of having one long-term romantic/sexual partner to please rather than “trying to get constant affirma-

tion from different sexual partners.”

Discussion

The purpose of this study was to explore the roles of inter-

personal relationships with family, friends, and romantic/

sexual partners in the body image development of college-age

sexual minority men. In line with Cash’s (2002) assertion, we

found that the participants identified interpersonal experi-

ences as influential for their body image. Furthermore, the

results are consistent with findings among general adolescent

populations (Ata et al., 2007; Ricciardelli et al., 2000) that parents and friends influence the body image development of

adolescent women and men. Our study suggested that experi-

ences with romantic/sexual partners may be more intensely

influential in body image development than experiences with

family and friends, especially in later adolescence and college-

age years. This valuing of romantic/sexual partners by the

sexual minority participants in this study is similar to that of

the mostly heterosexual population of Ryan and Morrison’s


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(2009) study of young Irish men and to that of Adams et al.’s

(2005) sexually inclusive study of young men in the United

Kingdom, which emphasized the pressure to use body appear-

ance to attract and retain sexual partners. In particular, the

current findings are consistent with Adams et al.’s statement

that “feedback from sexual partners was particularly salient”

(p. 278); however, the present study is the first to find theseresults among a population of gay and bisexual young adult

men. The greater number of partner-related categories that

were shared by more than half of the participants suggests a

greater universality of experiences involving romantic/sexual

partners than experiences involving family or friends. This

finding suggests the need for continued research with the goal

of better understanding the unique impact of romantic/sexual

partners on body image development within this population.

Furthermore, three participants spoke about their partner

relationships in terms of “investment.” In partner relation-

ships, usually of a physically intimate nature, the body is

fully exposed and subject to direct evaluation. Indeed, in the

domain of romantic/sexual partner’s effects on body image

development, one of the typical categories was sex/cuddling,

in which one may feel especially vulnerable because of the

heightened level of emotional and physical intimacy.

Although participants reported receiving negative comments

from their romantic/sexual partners, they also reported that a

different romantic/sexual partner or the same romantic/sexual

partner in a different context were sources of positive support and

encouragement. Half of the participants reported that short-term

romantic/sexual partners had become less important to their body

image and that long-term romantic/sexual partners had become

more important; thus, over time, the roles of partners may change.

The relationship context of a long-term romantic/sexual partnermay foster feelings of security and acceptance while decreasing

the frequency of seeking acceptance and affirmation from new

romantic/sexual partners amid the competitive gay culture with

its specific body ideals. Considering the college-age population

and the reports of several participants’ own college-age experi-

ences, the transition from short-term romantic/sexual partners,

acquired primarily for sex, to longer term romantic/sexual

partners, with a more holistic interest, is likely a developmental

transition in many cases.

Family appeared to be the next influential interpersonal

relationship. This finding is similar to that of Ryan and Mor-

rison (2009), who found that family members were influential

among their primarily heterosexual sample, but, in contrastwith Ryan and Morrison’s findings, our study found that peers

were less influential than family members. In comparison with

the domain dealing with romantic/sexual partners, in which

there were six typical categories, the family-related domain

produced only two typical categories: (a) felt supported and

(b) mother as the most influential family member. Although

there were negative exceptions, family relationships were

portrayed by multiple participants as a context in which they

could feel a comforting sense of familiarity with minimal

levels of judgment. Five participants reported that an effect

of their interactions with family pertaining to body image

development was feeling supported by family. Five partici-

pants described at least one influential experience involving

their mothers, whereas no other family relationship type was

named by more than one participant. Mothers in several casesmade remarks to their sons that negatively affected their body

image. This finding contrasts with Ata et al.’s (2007) earlier

finding that, among a general sample of adolescents, mothers

had a mostly positive impact on their sons. Further explora-

tion of the roles of specific family members could enhance

counselors’ understanding behind the high occurrence of

mothers in this study.

Among the three relationship types examined in this study,

experiences with friends were least likely to be discussed by

participants. Six participants identified friends as influential.

Although most studies, to date, have focused on peers rather

than friends, the current study purposefully sought feedback

about the role of friends as a more intimate form of relation-

ship. Previous studies (e.g., Bottamini & Ste-Marie, 2006;

Morgan & Arcelus, 2009; Ryan & Morrison, 2009) identi-

fied peers as a primary influence on male body image among

primarily heterosexual samples. In the present study, no

categories were identified within the friend-related domains

that were typical or general, indicating the lowest degree of

universality in participant experiences when compared with

romantic/sexual partners and family. Worthy of note is the

fact that proportionally more of the categories in the friend

domains were positive than in the family and romantic/sexual

partner domains. For example, several variant categories

indicated positive roles in body image development: (a) supportive toward his body image concerns, (b) positive com-

ments from friends, and (c) supporting public performance

involving display of his body. The following statement of a

19-year-old, White, gay participant could explain the link

between the positive-leaning categories in the friend do-

mains and the participants’ decision to less frequently name

friends as influential in comparison with romantic/sexual

partners and family: “It’s the negative [experiences]” that are

most influential overall. In other words, one might ask if the

predominantly positive nature of experiences with friends

mediates the lower reported incidence of friend experiences.

Future research could further explore this potential disparity

in the level and nature of influence exerted by friends/peers between the primarily heterosexual samples of previous stud-

ies and the sexual minority sample of this study.

When participants were asked to identify the single most

influential experience influencing their body image, three

participants reported the role of family in their most influ-

ential experiences and three participants reported the role of

romantic/sexual partners in their most influential experiences.

In contrast, no participant identified the role of friends in his


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most influential experience. Two participants said that their

most influential experience involved a professor or teacher.

The high levels of intimacy, both emotional and physical,

that are frequently present within family and romantic/sexual

partner relationships, in comparison with peer relationships,

may intensify the effects of body image experiences. Fam-

ily members and long-term romantic/sexual partners alsotend to be more consistently present in a person’s life than

friends, who are more easily dispensable. In this way, the more

enduring nature of relationships with family and long-term

romantic/sexual partners coalesces with the longevity factor

that was found to be a significant category.

Overall, the study produced eight domains and 78 cat-

egories pertaining to interpersonal relationships. Only 16

of the 78 categories were labeled as general or typical (i.e.,

endorsed by at least half of the participants and therefore

most salient to the findings). The universality of experiences

is found in the participants’ endorsements of the importance

of family, friends, and romantic/sexual partners—as well as

other interpersonal relationships—in their own body image

development. Although family, friends, and romantic/sexual

partners are important factors in the body image develop-

ment experiences of sexual minority men, the specific ways

in which these interpersonal relationships produce effects are

diverse and relatively unique within individuals. Furthermore,

family, friends, and romantic/sexual partners contribute to

body image development of sexual minority men in both

affirmative and destructive ways.

Limitations

Several issues related to the sampling procedure produced

potential limitations. For one, we recruited the participants pri-marily through LGBT organizations and social networks. These

individuals are more likely to be public or semipublic about their

sexual orientation and may have higher levels of awareness and

advocacy concerning sexual minority concerns. Participants

who are more private about their sexual orientation or who are

not affiliated with an LGBT organization might have different

perspectives. The use of convenience and snowball sampling ap-

proaches can potentially limit diversity by involving participants

who are connected through common social networks. Further-

more, volunteers for a research study may self-select based on

factors such as higher levels of experience with the topic, desire

for notoriety, or desire to meet the interviewer.

In this study, for purposes of consistency, we recruited only bisexual and gay men for participation, but some definitions

of sexual minority would encompass other identities, such as

transgender, queer, questioning, and heteroflexible. Further-

more, the identity of bisexual includes many possibilities for

sexual attraction and experience, so a more diverse array of

bisexual participants might produce different views.

Limitations existed in the data collection and analysis

techniques. Use of self-reported data inherently raises

questions of subjectivity, limited self-awareness, and partici-

pant truthfulness. Although face-to-face interviews provide

some advantages over less personal techniques, the risk of bias

through social desirability, or the desire of the interviewee to

be seen in a positive light by the interviewer, is greater when

interviews occur in person (Hill et al., 2005). Also, because

we provided participants with the interview questions aheadof time, participants may have rehearsed their answers or

generated socially desirable responses (Mehta, 2011).

Implications for Counselors

and Counselor Educators

When treating college-age sexual minority men who struggle

with the effects of negative body image, counselors might

be vigilant for evidence of the presence of body image dis-

turbance, especially if commonly related conditions such as

disordered eating, excessive exercise, and low self-esteem

are present. In cases in which body image is assessed to be a

clinically significant concern for treatment, counselors should

ask the client about the roles that romantic/sexual partners,

family, friends, and important other people in the client’s life

may have played. Counselors are advised to be cognizant of

the fact that individuals who hold psychological relevance

are capable of influencing another person’s body image not

only through verbal comments but also through their actions

or by the client’s self-comparison.

In cases in which these relational influences have been

detrimental to body image development, treatment should

include identifying methods for the client to diffuse the impact

of the other person or persons; these methods include clinical

approaches such as cognitive behavior interventions, the devel-

opment of assertiveness skills, avoidance or new approachesto contexts in which the client feels negatively about his body,

and self-esteem enhancement (Cash, 2002). Furthermore, be-

cause romantic/sexual partners, family, and friends sometimes

play an encouraging or supportive role in promoting positive

feelings about one’s body, counselors may suggest that clients

solicit the help of romantic/sexual partners, family, or friends

in reimagining thoughts and feelings about their bodies.

Counselor educators who identify as a sexual minority may

knowingly or unknowingly assume a modeling role for their

students. Because two of the eight participants in the study

noted the effects of gay male instructors, one can assume that

bisexual and gay students may view bisexual and gay teachers

and professors as role models or may pay particular attentionto what they say. A basic orientation to sexual minority culture

and the forces within it that intensify body image concerns

could enhance students’ ability to understand and effectively

address the social context of bisexual and gay men. When

teaching sociocultural theory, counselor educators should be

sure to include romantic/sexual partners, family, and friends

as agents of influence in addition to the more frequently cited

role of the media.


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Suggestions for Future Research

In this study, we did not research the relative importance of fam-

ily, friends, and romantic/sexual partners in relation to other influ-

ences on body image development. Further research could enable

clinicians and researchers to understand the general importance

of family, friends, and romantic/sexual partners in comparison

with the importance of other influences, such as the media and pressure within gay culture to meet a specific body ideal.

Another subject for further research is the specific ex-

perience of bisexual men. With only two participants who

self-identified as bisexual, this study provides little basis for

determining whether there may be significant differences be-

tween the body image development of gay and bisexual men.

Furthermore, other sexual identities, beyond gay and bisexual,

could be included within the sexual minority population.

Several participants in this study noted that body appearance

ideals vary within gay culture, because particular subcultures

emphasize specific body appearance characteristics, such as

twinks (young and thin), bears (large build and usually older),and jocks (muscular). The variations within these subcultures

may ultimately make generalizations about sexual minority

men’s body image development difficult, impossible, or inap-

propriate. Therefore, further research is warranted to under-

stand the idiosyncrasies of body image development within

specific sexual minority subcultures and how family, friends,

and romantic/sexual partners relate to such development.

Numerous connections between body image and sexual rela-

tions appeared in this study. Factors such as sexual rejection,

self-evaluation of body image based on the success or inability

to attract sexual partners, and influential experiences with part-

ners during sex or cuddling suggest collectively that sex plays

an important role in the body image of sexual minority men.Further research is warranted to explore interactions between

sex and body image among bisexual and gay men, who often

live within the highly sexualized gay culture.

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i t s c o n t e n t m a y n o t b e c o p i e d o r e m a i l e d t o m u l t i p l e s i t e s o r p o s t e d t o a l i s t s e r v w i t h o u t t h e

c o p y r i g h t h o l d e r ' s e x p r e s s w r i t t e n p e r m i s s i o n . H o w e v e r , u s e r s m a y p r i n t , d o w n l o a d , o r e m a i l

a r t i c l e s f o r i n d i v i d u a l u s e .

the roles of family friends and romantic-sexual partners in the body image of sexual minority men

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