Body image, sexual orientation and gender identity

While people who identify as lesbian, gay, bisexual and transgender (LGBT+) experience body image concerns in ways that are generally similar to those who identify as heterosexual, their experience and relationship with their bodies are likely to differ in specific ways.   

How does body image vary across the LGBT+ community?

Heterosexual men have been found to report higher levels of body appreciation than gay and bisexual men (123,124).

Some research suggests that sexual minority men may be more likely to internalise an appearance ideal that is centred around looking athletic (124) and that there may be a greater emphasis on physical appearance in the gay community, which can negatively affect body image (125) through pressure to match this ideal.

One review of the research (126) found that gay men are more likely than their heterosexual counterparts to experience a desire to be thin, which can sometimes manifest in higher levels of eating disorder symptoms. As in the wider research, studies focused on gay, and bisexual men have found a connection between higher levels of body dissatisfaction, an increased likelihood of experiencing depressive symptoms and increased sexual anxiety and poorer sexual self-efficacy (123)

Some research suggests that lesbian women have a similar level of concern around their body image as heterosexual women (127,128), though research is mixed on this point. One study suggested a small difference, finding that lesbian women may be slightly more satisfied with their bodies than heterosexual women (129). However, other studies find a similar level of concern between heterosexual and lesbian women regarding the perceptions of their bodies and their perceptions of what an ‘ideal’ body looks like (128). A similar pattern was found for women who identify as bisexual (130).  

In our survey, a higher proportion of individuals who identified as gay, lesbian or bisexual reported feelings of anxiety and depression because of their body image. Among adults who identified as gay, lesbian, bisexual or other, 53% felt anxious, and 56% felt depressed because of their body image compared to one-third (33%) of the adults who identified as heterosexual. 

Similarly, in our survey, one-third (33%) of adults who identified as gay, lesbian, bisexual or other reported experiencing suicidal thoughts or feelings because of concerns about their body image, compared to 11% of the adults who identified as heterosexual.  

Transgender people

Transgender people may experience distress due to the incongruity between their biological sex and gender identity. This can affect their body image, and research suggests that levels of body dissatisfaction in transgender people tend to be higher before undergoing gender confirmation treatments (131).

Feelings around one’s body can differ depending on the stage at which a person is on their transition journey (132). It should be noted that transitioning does not just refer to medical intervention, which is something that not all transgender people want or can have. It refers to the steps a person takes to live in the gender with which they identify, which could include things like telling friends and family or dressing differently.

There is a much larger body of literature around gender dysphoria and the psychological and physical effects of transitioning that are beyond the scope of the current report. Further information about, and support around, transitioning is available from organisations like the LGBT FoundationConsortium and TransUnite.  

Stigma and discrimination

The stigma, prejudice and discrimination that LGBT+ people face often lead to higher stress levels (133). This ‘minority stress’, which encompasses experiences of discrimination, harassment and victimisation, and more internalised feelings like shame, may contribute to the mental health problems reported within the LGBT community (133).  

This ‘minority stress’ may also be linked to body image. For young men who have sex with men, one study found that internalised negative attitudes towards homosexuality and sexual orientation predicted overall body dissatisfaction, muscularity, and body fat (134). Another recent study looking at the body image of non-binary and binary transgender people found that harassment or rejection was associated with lower levels of body appreciation by reducing self-esteem and satisfaction with life (135). This was reflected in our survey, where 40% of the adults who identified as gay, lesbian, bisexual or other said they felt shame because of their body image, compared to 18% of the heterosexual adults. Similarly, 54% of adults who identified as gay, lesbian, bisexual or other felt their self-esteem was negatively affected by their body image in the past year, compared to 37% of the adults who identified as heterosexual.

Read more on the Body Image report and related articles

Body image report: Introduction

Feeling unhappy with our appearance is a relatively common experience. The Mental Health Foundation conducted a survey with YouGov in March 2019 of 4,505 UK adults.

Body image in adulthood

As in childhood and adolescence, increased body dissatisfaction in adulthood has been linked to an increased likelihood of depressive symptoms, psychological distress (8) and disordered eating and eating disorders. Positive body image in adulthood has been linked to better overall wellbeing and quality of life.

Body image in later life

Body image and appearance, while often associated with younger people, are not exclusive to youth. Though our appearance and our relationship with our bodies change as we age, we do not stop valuing our bodies, and body image concerns can remain.

LGBTIQ+ statistics

Mental health statistics related to the LGBTIQ+ community.

123. Blashill AJ, Tomassilli J, Biello K, O’Cleirigh C, Safren SA, Mayer KH. Body Dissatisfaction Among Sexual Minority Men: Psychological and Sexual Health Outcomes. Arch Sex Behav. 2016 Jul 8;45(5):1241–7.  

124. Alleva JM, Paraskeva N, Craddock N, Diedrichs PC. Body appreciation in British men: Correlates and variation across sexual orientation. Body Image. 2018 Dec;27:169–78.  

125. Jankowski GS, Diedrichs PC, Halliwell E. Can appearance conversations explain differences between gay and heterosexual men’s body dissatisfaction? Psychol Men Masculinity. 2014 Jan;15(1):68–77.  

126. McCreary DR, Hildebrandt TB, Heinberg LJ, Boroughs M, Thompson JK. A review of body image influences on men’s fitness goals and supplement use. American Journal of Men’s Health. 2007;1(1):307–16.  

127. Kelly L. Lesbian body image perceptions: The context of body silence. Qual Health Res. 2007 Sep;17(7):873–83.  

128. Koff E, Lucas M, Migliorini R, Grossmith S. Women and body dissatisfaction: Does sexual orientation make a difference? Body Image. 2010 Jun;7(3):255–8.  

129. Morrison MA, Morrison TG, Sager CL. Does body satisfaction differ between gay men and lesbian women and heterosexual men and women? A meta-analytic review. Body Image. 2004 May 1;1(2):127–38.  

130. Smith ML, Telford E, Tree JJ. Body image and sexual orientation: The experiences of lesbian and bisexual women. J Health Psychol. 2017 Feb 1  

131. Owen-Smith AA, Gerth J, Sineath RC, Barzilay J, Becerra-Culqui TA, Getahun D, et al. Association Between Gender Confirmation Treatments and Perceived Gender Congruence, Body Image Satisfaction, and Mental Health in a Cohort of Transgender Individuals. J Sex Med. 2018 Apr;15(4):591–600.  

132. McGuire JK, Doty JL, Catalpa JM, Ola C. Body image in transgender young people: Findings from a qualitative, community based study. Body Image. 2016 Sep;18:96–107.  

133. Meyer IH. Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations: Conceptual Issues and Research Evidence. Psychological Bulletin. 2003;129(1):674–97.  

134. Siconolfi DE, Kapadia F, Moeller RW, Eddy JA, Kupprat SA, Kingdon MJ, et al. Body Dissatisfaction in a Diverse Sample of Young Men Who Have Sex With Men: The P18 Cohort Study. Arch Sex Behav. 2016 Jul 14;45(5):1227–39.  

135. Tabaac A, Perrin PB, Benotsch EG. Discrimination, mental health, and body image among transgender and gender-non-binary individuals: Constructing a multiple mediational path model. J Gay Lesbian Soc Serv. 2018 Jan 2;30(1):1–16

Body image and mental health

Body image issues can affect all of us at any age and directly affect our mental health. However, there is still a lack of much-needed research and understanding around this.
Learn more about body image and mental health
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