When it doesn’t get better: A qualitative study of eating disorders, sexual identity, and coming out in sexual minority men

Abstract

Introduction

This study explores the relationship between sexual identity, coming out, and eating disorders to more fully understand the high rates of eating disorders and body dissatisfaction among sexual minority men.

Method

A sample of 15 sexual minority men (14 gay, one queer) with a diagnosed eating disorder completed qualitative interviews about their experiences related to their sexual identity, coming out process, and eating disorder.

Results

Qualitative data analysis based on grounded theory strategies revealed that the majority of participants identified their coming out process as playing a notable role in their body dissatisfaction and eating disorder. After coming out, participants identified unique stressors from within the community of sexual minority men. Participants’ responses were categorized into four theoretical constructs: (1) The Mental Health Toll of the Closet, (2) The Mental Health Toll Out of the Closet, (3) The Mental Health Toll of Assimilating to the Gay Community, and (4) The Mental Health Toll of Gay Dating and Sex. The findings are contextualized based on three relevant theories: minority stress theory, intraminority gay community stress theory, and objectification theory.

Conclusion

This study found the process of coming out, as well as navigating stressors within the mainstream gay community, are critical to more fully understanding the disparities in eating disorders among sexual minority men.

Keywords:

• Gay men
• eating disorders
• sexual minority men
• LGBT mental health
• body dissatisfaction
• coming out

Acknowledgments

We would like to thank the courageous men who volunteered to be interviewed for this study. Without their bravery, we would not have gotten such a rich window into the ways sexual minority men are uniquely affected by body dissatisfaction and eating disorders. The authors would also like to thank Eating Recovery Center (ERC), for allowing us access to their patients. We especially want to thank Jeana Cost and Alan Duffy of ERC for their cooperation and assistance as we partnered with ERC to complete these interviews.

Ethics statement

All procedures performed were in accordance with the ethical standards of the institutional research board at Long Island University, CW Post.

Disclosure statement

The authors declare that they have no conflicts of interest.

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Data availability

The data generated during the current study are not publicly available due to the data containing information that could compromise the privacy of research participants, but are available from the corresponding author on reasonable request.