An exploratory investigation of body esteem, body dissatisfaction and body change behaviours in sexual minority young adults from a risk and protective perspective

ABSTRACT

Body image, body change behaviours, and risk and protective factors for body esteem, were documented by sexual orientation in young adults aged 18–25 years. Cross-sectional data from My World Survey 2 Post Second Level (MWS2-PSL) were used. The sample consisted of 1,975 heterosexual, 256 gay, 169 bisexual, 89 questioning men and 4,521 heterosexual, 167 lesbian, 781 bisexual, 356 questioning and 121 pansexual women. Body esteem, body dissatisfaction and body change behaviours as well as sexual minority stress risk (discrimination) and protective factors (resilience) were analysed across groups using Chi Square Tests and Analyses of Covariance. Multiple regressions identified relationships between body esteem, body change behaviours and risk and protective factors. Heterosexual men exhibited higher body esteem and body satisfaction than sexual minority men. Bisexual women demonstrated the lowest body esteem, while pansexual women exhibited lower body satisfaction versus heterosexual, lesbian and questioning women. Body change behaviours did not differ among women, but weight loss attempts were elevated in gay and bisexual men. Comfort with sexuality, resilience and social support were positively associated with body esteem. Risk and protective factors for body esteem varied by sexual orientation, highlighting the importance of examining these constructs separately across sexual minority subgroups.

KEYWORDS:

• Body image
• sexual minority
• body change behaviours
• body esteem
• protective
• resilience

Introduction

Body image is a multifaceted construct that refers to the thoughts, feelings and behaviours one has about one’s body (Grogan, 2016). It incorporates constructs like body dissatisfaction, which is defined as a discrepancy between one’s actual and ideal appearance (Grogan, 2016); and body esteem, which refers to an individual’s perceptions and degree of satisfaction with their physical appearance, weight, shape and how their body is viewed by others (Mendelson et al., 2001). These body image constructs are strongly and reciprocally associated with psychological wellbeing, as well as body-related behaviours (i.e. behaviours and cognitions related to dieting or exercise, weight loss or muscle building attempts; Pennesi & Wade, 2016). For example, body dissatisfaction, which is prevalent among young adults, is predictive of lower psychological wellbeing, risky health behaviours (e.g. disordered eating, exercise avoidance, excessive exercise) as well as eating disorders (Cruz-Sáez et al., 2018; Al Sabbah et al., 2009; Stice & Shaw, 2002). Body esteem is a key predictor of global self-esteem in young people, with higher body esteem associated with higher levels of psychological functioning, identity development and lower disordered eating (Hoare & Cosgrove, 1998; Nelson et al., 2018). Research has increasingly emphasised the importance of understanding facets of positive body image (i.e. appreciation and respect for one’s body), given unique associations with resilience, mental wellbeing and positive health behaviours (e.g. physical activity, intuitive eating; Andrew et al., 2015; Koller et al., 2020; Tylka & Wood-Barcalow, 2015). Despite the adverse effects associated with body dissatisfaction and the potential of positive body image perceptions to buffer against such effects, existing literature does not provide clear insights into the relationship between sexual orientation and these body image constructs (Meneguzzo et al., 2018), or the risk and protective factors of body esteem in sexual minority young adults.

1.1 Disparities in body image and body change behaviours in sexual minority young adults

Sexual minority groups (i.e. those who report same-sex attractions and/or identify as lesbian, gay, bisexual, pansexual, asexual, or questioning) are shown to be differentially affected by body image concerns versus heterosexual counterparts (e.g. M. A. Morrison et al., 2004; Parker & Harriger, 2020). The minority stress model (MSM; Meyer, 2003) posits that sexual minority groups may be at greater risk of negative body image because of their experiences of stigma, discrimination and victimisation, which adversely impact their health. These experiences may also result in internalised homonegativity/binegativity and/or concealment of sexual identities, which further contribute to poor mental health outcomes (Meyer, 2015).

Indeed, sexual minority men (gay and bisexual) have been shown to exhibit lower body appreciation and greater body dissatisfaction versus heterosexual men (M. A. Morrison et al., 2004; Alleva et al., 2018). They also tend to hold higher drives for muscularity (reflecting desires to attain muscular mesomorphic ideals) and drives for thinness (reflecting desires to attain lean physiques), both of which are linked with body dissatisfaction and disordered body change behaviours (M. A. Morrison et al., 2004; He et al., 2020). Furthermore, compared with heterosexual cisgender men, gay, bisexual and ‘unsure/mostly heterosexual’ men tend to exhibit more disordered eating/weight loss attempts, more risky body change behaviours, such as steroid/supplement use to build muscle mass and lose weight, as well as higher rates of eating disorders compared with heterosexual men (Brady et al., 2019; Feldman & Meyer, 2007; Hazzard et al., 2020; Laska et al., 2015).

Research comparing body image and body-related behaviours in sexual minority and heterosexual women is inconsistent (Parker & Harriger, 2020). Some studies find that lesbian and bisexual women exhibit more (M. A. Morrison et al., 2004), less (Alvy, 2013; Dahlenburg et al., 2020; He et al., 2020), or the same levels (Beren et al., 1996; Davids & Green, 2011; Henn et al., 2019; Meneguzzo et al., 2018; Striegel‐Moore et al., 1990; Yean et al., 2013) of body satisfaction, drive for thinness and drive for muscularity as heterosexual women. Although meta-analyses report slightly greater levels of body satisfaction in lesbian versus heterosexual women, effect sizes are small and publication bias may have resulted in an overestimation of these differences (M. A. Morrison et al., 2004; Dahlenburg et al., 2020). The few population-based studies that have been conducted with large samples tend to report elevated risk for body dissatisfaction in sexual minority women versus heterosexual women (Mason et al., 2018; Parker & Harriger, 2020). In particular, bisexual women are thought to experience unique body image pressures (Dotan et al., 2021; Hazzard et al., 2020) and exhibit greater body image concerns than both lesbian (Steele et al., 2019) and heterosexual women (Hazzard et al., 2019; Meneguzzo et al., 2021); however, many studies fail to distinguish between lesbian and bisexual women, which may explain inconsistent findings in the literature related to body image.

Research also tends to find higher levels of disordered eating in sexual minority women compared with heterosexual women (Katz-Wise et al., 2017; Koh & Ross, 2006). Polimeni et al. (2009) found that bisexual women and ‘mainly heterosexual women’ were more likely to engage in unhealthy weight control practices such as cutting meals and using laxatives. Other studies report that lesbians, as well as bisexuals and ‘mostly heterosexuals’ are at elevated risk of weight loss attempts and risky body change behaviours, such as using weight loss supplements (Austin et al., 2013; Hadland et al., 2014; Matthews-Ewald, Zullig & Ward, 2014).

1.2 Correlates of body image and body change behaviours in sexual minority young adults

The MSM has identified several correlates that may be distinctly related to these body image and body change behaviours in sexual minority young adults. Sexual minority young adults who report higher levels of stigma and discrimination are shown to be at increased risk of body dissatisfaction and disordered eating (Bell et al., 2019; Henn et al., 2019). Furthermore, bullying and harassment have been shown to be associated with higher rates of disordered eating in sexual minority youth (Thapa & Kelvin, 2017). Concealment/shame around sexual identity are also associated with an increased risk of disordered eating in sexual minority men and women (Bayer et al., 2017; Wang & Borders, 2017).

Experiences of stigma and discrimination may also inhibit engagement in behaviours that can promote healthy body image. According to Mereish and Poteat (2015), sexual prejudice is pervasive in athletic settings, thus sexual minority men and women may be less likely to be physically active, attend gyms or participate in team sports and may be less likely to experience the protective benefits of these activities on body image (Mereish & Poteat, 2015).

The MSM has also identified protective factors, including high levels of social support and resilience which can buffer against minority stress experiences (Meyer, 2015) and can promote positive body image at least in sexual minority women (Burnette et al., 2019). Social support is thought to improve body image perceptions by fostering a sense of acceptance of one’s appearance, while also mitigating the negative effects of minority stress and related appearance biases (i.e. being treated differently because of one’s appearance; Burnette et al., 2019; Snapp et al., 2015). Similarly, resilience may promote greater body appreciation by reducing reactivity to rejection and appearance bias among sexual minority youth (Zimmerman, 2013). Additionally, comfort with one’s sexuality has been found to correlate with reduced engagement in risky health behaviours and improved overall wellbeing (Anderson, 2013) and could promote body esteem among sexual minorities.

1.3 The importance of identifying unique correlates of body esteem in sexual minority young adults

Research indicates that risk and protective factors related to the MSM are not uniform across all sexual orientation subgroups (Parker & Harriger, 2020). For example, gay men uniquely report that experiences of childhood victimisation may encourage pursuit of a stronger muscular physique to compensate for sense of danger/inferiority (Hunt et al., 2016). Furthermore, gay and bisexual men may feel pressured to conform to lean and muscular ideals to exert their masculinity and distance themselves from homonegative stereotypes of being skinny, lonely/weak, and ‘feminising’ stereotypes associated with having an overweight/obese BMI (Badenes-Ribera et al., 2018). Furthermore, bisexual women are hypothesised to exhibit poorer body image than lesbian and heterosexual women because they face unique pressures of ‘negativity’ and struggle to negotiate the middle ground of sexuality and to gain acceptance from heterosexual and lesbian women (Brewster et al., 2014).

Despite unique predictors of body image concerns across sexual orientation cohorts, the literature is limited in providing insight into subgroups or risk/protective factors because it is constrained by small sample sizes and research designs which integrate individuals regardless of orientation into an overall minority group, or analyse a single subgroup (e.g. lesbians only; Mason et al., 2018). The Institute of Medicine’s (2011) report on sexual minority health strongly recommends that sexual minority groups are assessed separately, given the important differences between minority subgroups with regard to mental health, yet only a handful of underpowered studies have done this with regard to body image (e.g. Davids & Green, 2011).

Given the growth and diversification of sexual minority communities in recent years, it is important to identify risk/protective factors for body image, especially among less studied cohorts including bisexuals, questioning individuals and pansexuals. To our knowledge, no studies have investigated body image in pansexuals who are defined as individuals who hold attractions for individuals of all gender and sexual orientation types (Smalley et al., 2016). Pansexuals may occupy a unique space given their potentially distinct appearance subcultures (i.e. expression and recognition of sexuality through dress and appearance) and attraction to all genders/sexes. Additionally, while questioning individuals have been identified as a distinct cohort who may be at risk of disordered eating, body image has not been well explored among young adult cohorts (Diemer et al, 2016).

Furthermore, while risk factors for body dissatisfaction and maladaptive body change behaviours are well documented in sexual minority young adults, less is known about the factors associated with body esteem or healthy body-related behaviours. While some studies have identified predictors of low body esteem (i.e. restrictive eating, appearance-related teasing, negative affect, low self-esteem) and high body esteem (i.e. low dietary restriction and high self-esteem) in general adolescent samples (Barker & Galambos, 2003; Lacroix et al., 2020), and other studies have found that high quality relationships with parents are predictive of higher body esteem in LGB adolescent girls (Rezeppa et al., 2021), few studies have identified correlates of body esteem in sexual minority young adults.

Additionally, risk and resilience frameworks emphasise the importance of considering protective factors (i.e. assets that enable successful adaptation to life stresses) alongside risk factors to inform intervention efforts (Zimmerman, 2013). While discrimination, bullying, concealment and shame have been identified as risk factors for negative body image among sexual minority groups, there is a need to identify whether resource factors such as social support, resilience and comfort with one’s sexuality can promote higher levels of body esteem. There is also evidence to suggest that engaging in physical activity and participating in sports is beneficial for body image as it fosters a greater focus on functionality - an aspect of positive body image (Bassett-Gunter et al., 2017; Sabiston et al., 2019); however, few studies have investigated sports participation or muscle building behaviours in sexual minority groups. Identifying behavioural factors that predict high body esteem, could yield meaningful prescriptions for strengths-based promotion of positive body image.

Finally, little is known about body image or body related behaviours in sexual minority young adults in Ireland. Extant literature on body image in sexual minority young adults in the Irish context is limited to qualitative studies with gay men that were conducted in the mid-2000s (e.g. T. G Morrison et al., 2006). Ireland has undergone considerable social change with regard to sexual diversity and identity in recent years. A recent national study that found that Irish people generally held positive attitudes towards LGBTI individuals, yet elevated levels of LGBTI-focused bullying and higher levels of mental health difficulties were found among LGBTI young adults in Ireland (Higgins et al., 2016). The potential influence of this unique cultural context on body image and body change behaviours in sexual minority young adults requires further exploration.

1.4. The current study

This exploratory study sought to address these gaps by comparing body esteem, body satisfaction, body change behaviours and risk and protective factors for body esteem across male and female sexual orientation subgroups in a large, national sample of young adults in Ireland. It also investigated relationships between body esteem and body-related behaviours as well as MSM risk (bullying, discrimination) and protective factors (resilience, comfort with sexuality, social support) across sexual orientations.

We hypothesised that sexual minority men would exhibit lower body esteem, greater body dissatisfaction and increased engagement in body change behaviours (except for sports participation), compared with heterosexual men. Given mixed findings in the literature, and the limited literature on sexual minority subgroups, particularly pansexual and questioning individuals, no directional hypotheses were proposed about body image and body change behaviours in heterosexual versus sexual minority women, or across male and female sexual minority subgroups. However, we did hypothesise that body related behaviours, such as muscle building, weight loss, and taking steroids/supplements, and MSM risk factors (bullying, discrimination) would be negatively associated with body esteem. We also hypothesised that body esteem would be positively associated with sports participation as well as MSM protective factors (resilience, comfort with sexuality, social support), particularly in sexual minority individuals.

2. Method

2.1 Sample

A convenience sample consisting of 9,285 young adults aged 18–25 years, was drawn from the post-second level subset of the national cross-sectional study My World Survey 2 (MWS2-PSL). Data from were collected from 12 third-level institutions (i.e. Universities, Institutes of Technology, Colleges of Education) across Ireland. Additionally, fifteen organisations identified as potentially employing individuals of this age group in Ireland were contacted using convenience sampling, of which three agreed to participate in the research. Organisations were selected for recruitment if they offered graduate, apprenticeship and/or other training programmes for young people in Ireland.

2.2 Procedure

Ethical approval was received from the university’s ethics committee. Registrars (or equivalent) of third level institutions and managers of identified organisations were contacted about the research. If registrars/managers were agreeable to the study, a designated member of staff in the institution/organisation sent an email to all registered students/employees informing them of the study and inviting them to participate. The email contained a weblink to the survey, which was hosted on Qualtrics. Participants were required to provide electronic consent before proceeding to the survey. On completion, participants were thanked and fully debriefed.

2.3 Measures

2.3.1 Gender and sexual orientation

Items pertaining to gender and sexual orientation were developed in consultation with the Transgender Equality Network Ireland (TENI), BeLonGTo LGBTI Youth Services and a Youth Advisory Panel. Participants indicated their gender, with options including male, female, other (e.g. non-binary), not sure/questioning and prefer not to say. Participants were asked whether this gender matched the sex assigned to them at birth – if participants responded ‘no’, participants were identified as non-cis-gender (i.e. transgender). Participants indicated their sexual orientation, by indicating which of the following options they identified as: heterosexual, lesbian, gay, bisexual, pansexual, asexual, not sure/questioning, prefer not to say or other. Participants also rated their comfort with their sexuality on a scale ranging from 1 (very uncomfortable) – 10 (very comfortable).

2.3.2 Body image outcomes

Body Esteem was measured using the 10-item Appearance subscale of the Body Esteem Scale for Adolescents and Adults (BESAA; Mendelson et al., 2001). Responses were obtained using 5-point Likert scales ranging from ‘never (0)’ to ‘always (4)’. Negative items were reverse scored. Scores range from 0 to 40 and higher scores indicate higher body esteem. Cronbach’s alpha for this sample was α = .85, 95% Confidence Interval (CI) [.84, .85], indicating good reliability.

Body dissatisfaction was measured by asking participants to indicate how satisfied they were with their bodies on a 5-point Likert scale (singular) ranging from ‘very dissatisfied (1)’ to ‘very satisfied (5).

2.3.3 Body change behaviours

Muscle building. Participants were asked to indicate ‘yes’ or ‘no’ if they had ever tried to ‘bulk up’ or maintain muscle mass. If they indicated yes, participants were asked about how they built muscle and were given options to select if they engaged in exercise, and/or took supplements/steroids and/or engaged in other methods to build muscle mass (participants could select more than one response option).

Weight loss. Participants were also asked whether they had ever tried to lose weight or avoid gaining weight. If they responded yes, participants were asked whether they tried to lose weight by engaging in exercise, eating less food/lower calories/food low in fat, taking supplements/steroids or engaging in other methods to lose weight (participants could select more than one response option).

Physical activity. Participants were also asked if they engaged regularly (at least once a week) in sports and regularly attended the gym in the last 6 months.

2.3.4. Protective factors for body image

Social support was measured using the 12-item Multidimensional Scale of Perceived Social Support (MSPSS: Zimet et al., 1988). This scale measures perceived social support from family (4-items), friends (4-items), and significant others (4-items) using a 7-point Likert scale ranging from ‘very strongly disagree (1)’ to ‘very strongly agree (7)’. Higher scores indicate higher levels of support. A Cronbach’s alpha score of α = .93 95% CI [.92, .93] was obtained for this sample, indicating internal consistency.

Resilience. The 6-item Brief Resilience Scale (BRS; Smith et al., 2008) assessed resilience, with response options ranging from ‘strongly disagree (1)’ to ‘strongly agree (5)’. Higher scores indicated greater resilience. Cronbach’s alpha for this sample was α = .88, 95% CI [.87, .88],

2.3.5 Risk factors for body image

Minority Stress. Participants indicated ‘yes/no’ whether they had ever been bullied and ‘yes/no’ whether they had ever been treated unfairly because of their identity (i.e. sexual orientation, ethnicity, race, minority group status).

2.4 Statistical analysis plan

Data were screened for normality, outliers, and missing data and descriptive statistics were conducted on demographic characteristics Analyses were performed separately for men and women since previous research has shown that the variables associated with body esteem often differ depending on gender (Barker & Galambos, 2003). ANCOVAs assessed differences in body esteem, and ‘risk/protective’ factors for body esteem (social support, resilience), across sexual orientation groups controlling for age and ethnicity. Values of p < .01 were reported as statistically significant. Data were mostly normally distributed, but as the ‘degree of comfort with sexuality’ was not normally distributed, Kolmogorov-Smirnov tests were conducted for this variable. Chi square tests of Independence evaluated the likelihood of reporting body dissatisfaction, body change behaviours (i.e. weight loss, muscle building, gym attendance, sports participation) and MSM risk factors (bullying, discrimination), across male and female sexual orientations. Chi Square tests were layered by gender. Chi values of p < .01 and standardised residuals ± 2 were reported as significant (Agresti, 2007).

Pearson (parametric variables) and Spearman correlations (non-parametric variables) evaluated associations between body esteem and study variables across sexual orientation groups where correlations of .1 = small, .3 = medium and .5 = large (Cohen, 1992). Seven multiple regressions assessed which variables were predictively associated with body esteem. Separate regressions were conducted for each sexual orientation group. Age and ethnicity were controlled for in regression models. Assumptions of multicollinearity (correlation coefficients <.80, Variance Inflation Factor (VIF) <10) and homoskedasticity (lack of conical shape in scatterplot of residuals) were tested prior to analyses. Values of p < .05 were reported as statistically significant. Analyses were conducted using SPSS version 26.

3. Results

Although 9, 283 participants responded to the survey, participants with >70% missing (n = 357), Cis-gender men who identified as lesbians (n = 2) and cis-gender women who identified as gay (n = 5) were excluded. We also excluded individuals who did not provide data on gender and/or sexual orientation, gender minority participants (2.5%), ‘asexuals’ (.9%), individuals who ‘preferred not to indicate their sexual orientation’ (.5%), ‘others’ (.9%) and ‘pansexual men’ (.6%) as the sample sizes for these groups were too small to facilitate robust analyses. Statistical analyses were conducted on N = 8, 435 participants (see, Table 1 for sample demographic characteristics). Data were organised by gender (male/ female) and sexual orientation; men were organised by four sexual orientation categories (heterosexual, gay, bisexual and questioning) (see, Table 2) and women were organised by five categories (heterosexual, gay, bisexual, questioning and pansexual) (see, Table 3).

Table 1. Sample demographic characteristics.

	Sample included in analyses (N = 8, 435)
	No.	%
Gender
Male	2, 489	29.4
Female	5, 946	70.6
Sexual Orientation
Heterosexual, i.e. straight	6, 496	75.4
Lesbian	167	1.9
Gay	256	3.0
Bisexual	950	11.0
Pansexual	121	1.4
I’m not sure/questioning	445	5.2
Ethnicity
White Irish	6, 460	76.8
Any White background other than Irish	980	11.7
Black or Black Irish	115	1.4
Mixed background	190	2.3
Asian or Asian Irish	478	5.7
Other	165	2.0
Irish Traveller/Roma	22	.2
Age (Range 18–25)	M = 20.35	SD = 1.90

Table 2. Body image, body change behaviours, risk/protective factors for body image across male sexual orientation categories.

Male
	Heterosexual (n = 1,975)	Gay (n = 256)	Bisexual (n = 169)	Questioning (n = 89)
Body Image	M (SD)	M (SD)	M (SD)	M (SD)	df	F/ χ^2
Body Esteem	22.15(6.75)	18.4 (7.06)	17.9 (6.38)	17.87(6.82)	3, 1671	34.60***	1 > 2,3,4
	% (SR)	% (SR)	% (SR)	% (SR)
Body dissatisfaction					6	82.6***
Dissatisfied	29.4 (−3.1)	49.1 (4.0)	49 (3.2)	54.8 (3.1)
Neutral	26.5 (.1)	24.8 (−.5)	25.8 (−.1)	28.8 (.4)
Satisfied	44.1 (2.7)	26.1 (−3.3)	25.2 (−2.9)	16.4 (−3.2)
Body Change Behaviours	% (SR)	% (SR)	% (SR)	% (SR)
Bulk up attempt	67.7 (2.1)	41.9 (−4.1)	58.3 (−.8)	49.3 (−1.5)	3	67.27***
Bulk up using exercise	56.8 (1.8)	36.7 (−3.7)	51.5 (.4)	40.4 (−1.7)	3	43.75***
Bulk up using steroids	5.4 (.8)	4.7 (−.2)	3 (−1.2)	1 (−1.6)	3	5.05
Weight loss attempt	57.5 (−1.2)	68.3 (1.7)	72.2 (2.0)	57.5 (−.2)	3	20.3***
Weight loss using exercise	43.1 (−.4)	45.3 (.4)	52.1 (1.6)	36 (−1.1)	3	7.51
Weight loss by eating less	39.5 (−2.0)	56.6 (3.5)	55.6 (2.6)	41.6 (−1.0)	3	40.20***
Weight loss using supplements	3.5 (−.2)	4.3 (.6)	3 (−.4)	4.5 (.5)	3	0.83
Sports participation	45.6 (3.3)	18.8 (−5.2)	26 (−2.8)	21.9 (−2.5)	3	86.8***
Attend gym	43.4 (2.4)	24 (−3.7)	29.1 (−2.0)	24.7 (−2.0)	3	46.39***
Risk factors	% (SR)	% (SR)	% (SR)	% (SR)
Been bullied	57.6 (−1.2)	64.4 (.8)	72.9 (2.0)	71.2 (1.2)	3	18.2***
Been discriminated against	17.4 (−4.9)	63 (11.7)	33.1 (2.3)	15.2 (−1.4)	3	220.04***
Protective factors	M (SD)	M (SD)	M (SD)	M (SD)
Resilience	19.34 (5.06)	18.80 (5.43)	18.18 (5.05)	18.33 (6.21)	3, 1671	2.85
Social support	59.58 (14.48)	58.78 (14.24)	55.96 (14.79)	53.91 (14.58)	3, 1671	5.55**	1 > 3,4
Comfort with sexuality	9.19 (1.34)	7.66 (2.02)	6.78 (2.37)	5.69 (2.34)	3	H = 489.68***	1 > 2,3,4 2,3 > 4

Note: M = mean, SD = standard deviation, % = percentage, SR = standardised residual of chi square. Bolded numerical values indicate standardised residuals ≥ ± 2. 1 = Heterosexual, 2 = Lesbian, 3 = Bisexual, 4 = Questioning, H = The H Statistic for Kruskal Wallis test.

*** = significant p < .001,

** = significant p < .01.

Table 3. Body image, body change behaviours, risk/protective factors for body image across female sexual orientation categories.

Female
	Heterosexual (n = 4, 521)	Lesbian (n = 167)	Bisexual (n = 781)	Questioning (n = 356)	Pansexual (n = 121)
Body Image	M (SD)	M (SD)	M (SD)	M (SD)	M (SD)	df	F/ χ^2
Body Esteem	17.9 (7.06)	17.53 (7.08)	16.73 (7.49)	16.9 (7.3)	16.63 (6.85)	4, 4170	5.59***	1 > 3
	% (SR)	% (SR)	% (SR)	% (SR)	% (SR)
Body dissatisfaction						8	31.01***
Dissatisfied	44.9 (−1.6)	46.7 (1.0)	53.4 (2.6)	51.7 (1.3)	52.6 (0.9)
Neutral	25.3 (1.0)	22.8 (.4)	20.7 (−2.1)	23.7 (−.3)	29.8 (1.1)
Satisfied	29.8 (1.2)	24.8 (−.9)	26 (−1.4)	24.6 (−1.4)	17.5 (−2.2)
Body Change Behaviours	% (SR)	% (SR)	% (SR)	% (SR)	% (SR)
Bulk up attempt	20.2 (−.7)	25.5 (1.3)	21.8 (.6)	22.3 (.6)	24.6 (0.9)	4	4.69
Bulk up using exercise	18 (−.7)	22.8 (1.3)	19.2 (.5)	20.2 (.8)	23.1 (1.2)	4	5.34
Bulk up using steroids	0.8 (.4)	1.2 (.7)	0.3 (−1.5)	0.2 (.3)	0 (−0.9)	4	4.08
Weight loss attempt	87.8 (−.3)	89.3 (.1)	91.5 (.9)	87.2 (−.2)	90.2 (0.3)	4	9.54
Weight loss by exercising	64.3 (.7)	58.1 (−.9)	59.9 (−1.2)	36.5 (0)	60.3 (−0.4)	4	8.02
Weight loss by eating less	70.4 (−.8)	70.7 (−.1)	75.9 (1.5)	74.2 (.6)	81.8 (1.3)	4	18.02
Weight loss using supplements	6.8 (−.2)	6.6 (−.1)	7.6 (.7)	6.7 (−.1)	9.1 (0.9)	4	1.54
Sports participation	28.8 (2.1)	26.2 (−.2)	18.6 (−4.3)	24 (−1.1)	12.3 (−3.0)	4	45.90***
Attended gym	39.9 (3.1)	18.8 (−3.6)	27.9 (−4.1)	28.4 (−2.6)	23.7 (−2.3)	4	81.65***
Risk factors % (SR)		% (SR)	% (SR)	% (SR)	% (SR)
Been bullied	53 (−2.3)	58.8 (.5)	69.7 (4.6)	60 (.9)	74 (2.4)	4	76.95***
Been discriminated against	17 (−.6)	63.2 (10.4)	39.2 (.4)	22 (.1)	49 (5.7)	4	333.83***
Protective factors	M (SD)	M (SD)	M (SD)	M (SD)	M (SD)
Resilience	17.53 (4.9)	16.20 (4.65)	16.16 (5.05)	16.70 (4.66)	15.7 (4.50)	4, 4170	14.71***	1 > 3,5,2
Social support	63.08 (14.36)	58.94 (14.62)	61.24 (14.00)	59.59 (13.68)	60.02 (12.38)	4, 4170	11.92***	1 > 2,3,4
Comfort with sexuality	9.17 (1.28)	7.20 (2.01)	7.25 (2.17)	6.27 (2.26)	7.28 (2.13)	4	H =1312.34***	1 > 2,3,4,5. 2, 3, 5 > 4.

Note: M = mean, SD = standard deviation, % = percentage, SR = standardised residual of chi square. 1 = Heterosexual, 2 = Lesbian, 3 = Bisexual, 4 = Questioning, 5 = Pansexual. Bolded numerical values indicate standardised residuals ≥ ± 2. H = The H Statistic for Kruskal Wallis test.

*** = significant p < .001,** = significant p < .01

Data were not missing completely at random and the level of missingness per item ranged from 2.2%-22.2%, with greater missingness occurring towards the end of the survey, potentially indicating respondent fatigue. Although missing data were treated with multiple imputation, results from analyses using imputed and non-imputed data were almost identical, and given that SPSS cannot provide pooled estimates for ANCOVAs and Chi square tests, we opted to report the results of non-imputed data for all analyses.

To satisfy assumptions of multiple regression (ie., absence of multicollinearity), ‘muscle building through exercise’ was removed from models (VIF>10, collinearity diagnostics >50) and steroid/supplement use for weight loss and muscle gain were merged into a single ‘steroid/supplement use’ variable. Assumptions of homoscedasticity were met.

Body image

Heterosexual men exhibited statistically significantly higher levels of body esteem versus gay, bisexual and questioning men. No differences were observed in body esteem levels across sexual minority men. Sexual minority men were also more likely to report dissatisfaction with their bodies. There were no statistically significant differences in body esteem between lesbian, questioning or heterosexual women. Bisexual women exhibited lower levels of body esteem versus heterosexual women and were more likely to report body dissatisfaction. Pansexual women were less likely to report body satisfaction.

Body change behaviours

Heterosexual men were more likely, and gay men were less likely to have attempted to build muscle mass. Bisexual men were more likely to report a weight loss attempt or efforts to avoid gaining weight, while both bisexual and gay men were more likely to report restricting food intake to lose weight. Heterosexual men were more likely to regularly participate in sports, and attend the gym versus gay, bisexual and questioning men. No effects for use of supplements/steroids for weight loss and/or muscle gain, and exercising to lose weight were observed.

No statistically significant effects for muscle building attempts, muscle building strategies (e.g. via exercise, steroid use), weight loss attempts or exercising/taking supplements to lose weight were observed across female sexual orientation groups. Heterosexual women were more likely, while bisexual and pansexual women were less likely, to participate in sport. Heterosexual women were also more likely to attend the gym versus sexual minority women.

Risk factors

Bisexual men were more likely to report being bullied, while gay and bisexual men were more likely to have experienced discrimination because of their identity. Bisexual and pansexual women were more likely to report being bullied, while lesbian and pansexual women were more likely to have experienced discrimination.

Protective factors

Heterosexual men reported statistically significantly higher levels of social support than bisexual and questioning men, while heterosexual women reported statistically significantly higher levels of social support than lesbian, bisexual and questioning women. There were no statistically significant differences in resilience levels across sexual orientation categories in men; however, heterosexual women exhibited greater resilience levels than lesbian, bisexual and pansexual women. Both heterosexual men and heterosexual women showed higher levels of comfort with their sexuality than all sexual minority groups; however, all sexual minority groups (gay/lesbian, bisexual, questioning) showed higher levels of comfort with their sexuality than questioning men and women.

Predictors of body esteem

Correlates of body esteem for men and women are presented in supplementary materials. For heterosexual men, sports participation, social support, resilience and comfort with sexuality were positively associated with body esteem (see, Table 4). Bullying (p < .01) and steroid/supplement use (p < .05) were negatively associated with body esteem in heterosexual men. For gay men, resilience, social support and comfort with sexuality were positively associated with body esteem. Weight loss by eating less and steroid/supplement use were negatively associated with body esteem in bisexual men, while regular gym attendance and resilience were statistically significantly positively associated with body esteem. Sports participation (p < .01) and social support (p < .05) were positively associated with body esteem, while muscle building was weakly negatively associated (p < .05) with body esteem in questioning men.

Table 4. Multiple regression of risk and protective factors for high body esteem across sexual orientations in men.

	Heterosexual		Gay		Bisexual		Questioning
	(Adjusted r^2 = .25)		(Adjusted r^2 = .34)		(Adjusted r^2 = .36)		(Adjusted r^2 = .35)
	ß	CI (LB-UB)	ß	CI (LB-UB)	ß	CI (LB-UB)	ß	CI (LB-UB)
Demographic
Age	0.29**	(0.12, 0.46)	0.37	(−.11, .85)	0.48	(−0.13, 1.07)	1.11*	(.10, 2.12)
Ethnicity (Non-White Irish)	1.68***	(0.85, 2.51)	1.38	(−0.85, 3.61)	2.69*	(0.12, 5.25)	0.10	(−5.08, 5.30)
Body change
Muscle building	0.18	(−0.57, 0.94)	0.21	(−1.65, 2.07)	−1.68	(−3.92, 0.56)	−3.99*	(−7.42, −.55)
Weight loss	−0.75	(−2.45, .96)	0.52	(−3.98, 5.01)	2.12	(−2.42, 6.65)	7.95	(−1.45, 17.36)
Weight loss by exercise	−1.10	(−2.44, .22)	−0.65	(−3.18, 1.89)	−0.03	(−3.18, 3.13)	−3.58	(−8.81, 1.66)
Weight loss by eating less	−0.61	(−1.73, .51)	−1.80	(−5.60, 2.00)	−5.81**	(−9.14, −2.48)	−5.68	(−13.55, 2.18)
Supplement/steroid use	−1.15*	(−2.29, −.01)	0.11	(.94, −2.99)	−5.16**	(−8.99, −1.33)	−4.10	(−10.21, 2.01)
Gym attendance	0.22	(−0.51, .95)	−1.44	(−3.77, .90)	3.76**	(1.36, 6.16)	3.48	(−0.62, 7.58)
Sport participation	1.42***	(0.74, 2.10)	1.50	(−0.83, 3.83)	−0.16	(−2.37, 2.05)	5.26**	(1.48, 9.04)
Risk
Discrimination	−0.30	(−1.22, .63)	−1.22	(−3.16, .71)	−1.23	(−3.41, .95)	−1.33	(−6.16, 3.50)
Bullying	−1.18**	(−1.85, −.50)	−0.20	(−2.21, 1.81)	1.64	(−.76, 4.03)	−1.33	(−4.81, 2.16)
Protective
Comfort with sexuality	0.38**	(0.13, .63)	0.56*	(0.10, 1.02)	0.36	(−.09, .81)	0.48	(−0.26, 1.22)
Resilience	0.40***	(0.33, .47)	0.44***	(0.25, .62)	0.38**	(0.16, 0.59)	0.05	(−0.24, .34)
Social Support	0.09***	(0.07, .11)	0.11**	(0.04, .18)	0.02	(−.05, .09)	0.13*	(0.02, .24)

Note. ß = Unstandardised beta coefficient, CI = Confidence intervals, LB = Lower Bound, UB = Upper Bound. * p < .05, ** p < .01, *** p < .001

For heterosexual women, weight loss attempts, weight loss by eating less, steroid/supplement use and bullying were statistically significantly (p < .001) negatively associated with body esteem (see, Table 5). Conversely, comfort with sexuality, social support, resilience and sports participation were statistically significantly positively associated with body esteem in heterosexual women. Among lesbian women, bullying was the only factor negatively associated with body esteem, while resilience was the only factor statistically significantly associated with body esteem in pansexual women. In bisexual women, muscle building attempts, comfort with sexuality, resilience and social support were positively associated with body esteem, while weight loss attempts and steroid/supplement use were negatively associated with body esteem. Weight loss, steroid use and gym attendance were negatively associated with body esteem in questioning women, while comfort with sexuality, weight loss through exercise (p < .05), resilience (p < .01) and social support (p < .001) were positively associated with body esteem in questioning women.

Table 5. Multiple regression of risk and protective factors for high body esteem across sexual orientations in women.

	Heterosexual		Lesbian		Bisexual		Questioning		Pansexual
	(Adjusted r^2 = .30)		(Adjusted r^2 = .18)		(Adjusted r^2 = .27)		(Adjusted r^2 = .28)		(Adjusted r^2 = .24)
	ß	CI (LB-UB)	ß	CI (LB-UB)	ß	CI (LB-UB)	ß	CI (LB-UB)	ß	CI (LB-UB)
Demographic
Age	0.40***	(0.29, .52)	−0.01	(−0.60, .57)	0.49**	(0.21, .78)	0.59*	(0.13, 1.06)	0.86*	(0.03, 1.70)
Ethnicity (Non White Irish)	2.41***	(1.86, 2.96)	2.35	(−0.53, 5.24)	0.31	(−97, 1.58)	2.04*	(−0.07, 4.01)	1.38	(−1.68, 4.45)
Body change
Muscle building	0.54	(−0.01, 1.08)	−1.33	(−4.17, 1.51)	2.52***	(1.20, 3.84)	0.69	(−1.23, 2.60)	1.28	(−2.00, 4.57)
Weight loss	−1.99***	(−3.03, −.96)	−4.98	(−10.67, .70)	−3.23*	(−6.18, −.28)	−6.38**	(−10.34, −2.41)	−6.47	(−15.71, 2.78)
Weight loss by exercise	0.40	(−0.19, 1.01)	−0.43	(−3.42, 2.56)	−0.32	(−1.66, 1.03)	2.53*	(0.51, 4.55)	−0.12	(−3.30, 3.07)
Weight loss by eating less	−2.44***	(−3.16, −1.73)	−1.36	(−5.45, 2.73)	−1.43	(−3.55, .62)	0.06	(−2.98, 3.04)	1.69	(−5.93, 9.30)
Supplement/steroid use	−3.55***	(−4.33, −2.77)	−3.57	(−8.6, 1.47)	−2.26*	(−4.18, −.33)	−5.06***	(−7.76, −2.35)	−3.03	(−7.92, 1.86)
Sport participation	0.79**	(0.31, 1.26)	2.30	(−0.50, 5.10)	−0.25	(−1.71, 1.20)	0.63	(−1.25, 2.51)	0.49	(−3.59, 4.67)
Gym attendance	−0.57*	(−1.03, −.11)	1.01	(−2.31, 4.34)	−0.75	(−2.03, .52)	−1.97*	(−3.80, −.13)	−0.21	(−3.59, 3.18)
Risk
Discrimination	0.47	(−0.22, 1.07)	0.67	(−1.91, 3.24)	−0.01	(−1.14, 1.11)	0.10	(−1.95, 2.15)	0.32	(−2.48, 3.13)
Bullying	−1.12***	(−1.54, −.69)	−2.66*	(−5.19, −.13)	−0.66	(−1.85, .53)	−0.34	(−1.92, 1.24)	−1.20	(−4.39, 1.99)
Protective
Comfort with sexuality	0.37***	(0.21, .53)	0.23	(−0.36, .82)	0.33*	(0.08, .57)	0.38*	(0.03, .72)	0.53	(−0.11, 1.17)
Resilience	0.40***	(0.35, .44)	0.15	(−0.14, .42)	0.43***	(0.32, .54)	0.28**	(0.10, .48)	0.63***	(0.31, .96)
Social Support	0.08***	(0.07, .10)	0.08	(−0.00, .17)	0.10***	(0.06, .14)	0.11***	(0.05, .17)	−0.03	(−0.14, .08)

Note. ß = Unstandardised beta coefficient, CI = Confidence intervals, LB = Lower Bound, UB = Upper Bound. * p < .05, ** p < .01, *** p < .00

4. Discussion

This study profiled body image and body change behaviours across sexual orientation subgroups in men and women. Consistent with the research, heterosexual men exhibited higher levels of body esteem and lower levels of body dissatisfaction than gay, bisexual and questioning men (Morrison et al., 2004; Alleva et al., 2018; Laska et al., 2015), while no differences in body dissatisfaction or body esteem were observed between gay and bisexual men (Davids & Green, 2011; He et al., 2020).

The finding that heterosexual men were more likely, and gay and bisexual men were less likely to report muscle building attempts, conflicts somewhat with the literature which suggests that gay men tend to exhibit similar if not greater drives for muscularity than heterosexual men (Calzo et al., 2013). Considering associations between the drive for muscularity and body dissatisfaction in men, it is also surprising that no associations between body esteem and muscle building attempts were observed, except among questioning men, where muscle building attempts were negatively associated with body esteem (Morrison et al., 2006). These unexpected findings may be attributable to how muscularity was measured; participants were asked ‘if they had ever tried to build or maintain muscle mass’, – this could be viewed as distinct from an internalised drive for muscularity that is typically associated with poorer body image outcomes in men (McCreary et al., 2004; T. G Morrison et al., 2006). It is also possible that muscle building may relate more to body dissatisfaction, than body esteem in men. Although findings suggest that muscle building attempts may be a risk factor for questioning men, future research should investigate muscle building behaviours alongside attitudes towards muscularity to parse out the influence of muscle-related behaviours and attitudes/intentions on body image in sexual minority young adults.

Bisexual and gay men were more likely to report weight loss attempts, aligning with Matthews-Ewald et al. (2014), where gay, bisexual, and unsure men were found to exhibit greater odds (30–60%) of dieting to lose weight and taking weight loss pills/supplements than heterosexual men. This supports research which suggests that pursuit of a lean male body is important for sexual minority men as a means of distancing themselves from ‘feminising’ or ‘stigmatising’ stereotypes associated with being overweight (Badenes-Ribera et al., 2018).

Contrary to research evincing higher levels of health risk behaviours in sexual minority men (Brady et al., 2019), gay, bisexual and questioning men did not exhibit higher than expected levels of risky body change behaviours (i.e. steroid/supplement use for muscle building or weight loss) than heterosexual men. In exhibiting lower muscle building tendencies, sexual minority men in this study may be protected from engaging in risky body change behaviours such as anabolic steroid use, which they typically exhibit an elevated risk of in the literature (Brady et al., 2019). Nonetheless, supplement/steroid use was strongly negatively associated with body esteem among heterosexual and bisexual men, as well as heterosexual, bisexual and questioning women, indicating the need to address this issue in these groups to promote body image and health outcomes. Although no differences in body esteem and body dissatisfaction were observed between heterosexual, lesbian, and questioning women, bisexual women demonstrated elevated levels of body dissatisfaction and lower levels of body esteem versus heterosexual women. This supports research reporting elevated levels of body image concerns in bisexual women versus lesbian and heterosexual women (Meneguzzo et al., 2021; Steele et al., 2019), and research indicating no difference between lesbian and heterosexual women, when bisexual women’s body image is analysed separately from lesbian women (Hazzard et al., 2020). It may be the case that the dual pressures of attracting male and female partners as well as negotiating the stigmatised space between sexual minority and heterosexual status may lead to higher levels of body image concerns in bisexual women (Brewster et al., 2014; Chmielewski & Yost, 2013).

The finding that questioning women and men did not exhibit heightened body image concerns conflicts with the few studies reporting elevated levels of body-related concerns in questioning adolescents versus heterosexual counterparts (Austin et al., 2013). However, few studies have explored body image especially in ‘questioning’ young adults, and it may be the case that the questioning adolescents studied within the literature, may be at greater risk of body image concerns than young adults, which might explain discrepant findings. It is also possible that ‘questioning’ individuals haven’t identified their sexual orientation and may feel less pressure to conform to group norms in terms of body ideals. Given the dearth of information on ‘questioning’ young adults’ body esteem, further research is warranted.

Pansexuals represent another sexual minority subgroup that have received almost no research attention in the body image literature; this study’s finding that pansexual women were less likely to be satisfied with their bodies, is an important exploratory finding. It may be the case that pansexual women may experience body dissatisfaction because they feel that their identities are culturally invisible or discriminated against in similar ways to bisexual individuals (i.e. bisexual erasure, binegativity; Hayfield, 2021; Mitchell et al., 2015). Indeed, pansexual women reported elevated levels of discrimination compared with other sexual minority female subgroups in this study. Alternatively, pansexual women may experience unique pressures associated with expressing their identities through appearance and/or negotiating multiple, intersecting identities, and possible pansexual appearance subcultures which may contribute to body image concerns (Hayfield, 2021). Given the dearth of research on this cohort, further research is required to support and extend on this finding.

Among women, no differences were observed in muscle building, weight loss attempts or supplement use across sexual orientations. There have been inconsistent findings observed in the literature with regard to muscle building and weight loss behaviours in sexual minority women (e.g. Henn et al., 2019). However, this study contrasts with those that have reported elevated weight loss attempts (Matthews-Ewald et al., 2014), drive for muscularity (Yean et al., 2019) and use of weight loss supplements among bisexual, lesbian and questioning women (Austin et al., 2013) versus heterosexual women. However, sexual minority women were less likely to attend the gym versus heterosexual women, while bisexual and pansexual women were less likely to participate in sport, which suggests that sexual orientation may still influence aspects of body-related behaviours (Mereish & Poteat, 2015).

This study also explored relationships between body change behaviours and body esteem across sexual orientations. Aligning with research observing negative relationships between dieting/restricting food intake and body image (Ackard et al., 2002), weight loss, especially weight loss by eating less, was negatively correlated with body esteem across most sexual orientation groups. Interestingly, weight loss through exercise did not negatively correlate or predict negative body esteem across most groups, suggesting that this may be a less problematic means of weight management.

It is unclear why muscle building attempts were positively associated with body esteem for bisexual women as elevated drives for muscularity have not been reported for bisexual women in the literature, and bisexual women were not found to exhibit higher levels of muscle building behaviours versus other female sexual orientation groups in this study. However, given that gym attendance was a positive predictor of body esteem in bisexual men, ‘muscle building/fitness’ may be part of a unique appearance subculture for bisexual individuals that is promotive of body esteem. Further research is required to investigate this.

Another interesting finding was that sports participation was a significant predictor of high body esteem in heterosexual men and women, both of whom reported greater sports participation versus other groups. This supports the notion that athletic contexts may be stigmatising spaces for sexual minorities and may preclude them from engaging in behaviours that could promote their body image and broader health outcomes (Mereish & Poteat, 2015; Vankim et al., 2016). However, sports participation was positively associated with body esteem among questioning men, suggesting perhaps that sports participation may be promotive for potentially less visible identities. Therefore, efforts to reduce stigma and increase sports participation among sexual minority groups may help to promote body image in these cohorts. Interestingly, gym attendance was negatively associated with body esteem in questioning women, suggesting that some athletic contexts may be less protective for body esteem in sexual minority groups; further qualitative research could help to understand if aspects of the gym setting (e.g. changing rooms) or gym activities (e.g. aesthetic focused exercise) contribute to this risk for lower body esteem in questioning women.

This study also investigated the influence of factors theoretically linked with minority stress on body esteem. Aligning with the MSM (Meyer, 2003); higher levels of bullying and discrimination (risk factors) and lower levels of social support and comfort with sexuality (protective factors) were observed in sexual minority versus heterosexual men and women. Resilience levels did not differ across male sexual orientation groups but were higher in heterosexual women versus sexual minority women.

As theorised, social support and resilience were positively associated with body esteem across most male and female sexual orientations. This supports and extends the findings of Burnette et al. (2019), who identified social support and resilience as protective factors for positive body image in sexual minority women. This study observed these relationships in men also, and for some groups (e.g. bisexual women, pansexual women, gay men, bisexual men, questioning men), these were the strongest significant predictors of body esteem, indicating that these psychosocial variables may be an important focus for promoting body esteem in sexual minority men and women – even more so than body change behaviours. Further aligning with MSM and associations between sexual identity concealment and body dissatisfaction/disordered eating (Ålgars et al., 2010), comfort with sexuality predicted body esteem for heterosexual and gay men, as well as heterosexual, bisexual and questioning women. Comfort with sexuality has not been widely investigated, particularly as a protective factor for body image, however findings suggest that this may be important for promoting body esteem in sexual minority young adults and warrants further research attention.

Contrary to the MSM, bullying was negatively predictive of body esteem in heterosexual, but not sexual minority men and women, except for lesbian women, where bullying was the only significant risk factor for body esteem. Similarly, experiences of discrimination did not predict body esteem in male or female sexual minority groups. It could be argued that these relationships were not observed, because we used a general measure of bullying and discrimination, rather than specifically sexual-minority related bullying and discrimination; however, studies that have used general measures of discrimination have found that body image concerns and disordered eating are related to discrimination experiences in sexual minority young adults (Mason et al., 2018; Wang & Borders, 2017). Our findings do concur with a recent study by Austen et al. (2020) who found that despite increased vulnerability to weight discrimination among sexual minority men, gay and bisexual men’s body satisfaction levels were not disproportionately affected by these vulnerabilities relative to heterosexual men.

Some of our findings (e.g. lower levels muscle building and risky health behaviours in sexual minority versus heterosexual men or associations between discrimination/bullying and body esteem in mostly non-sexual minority groups) may differ from those in the literature, because of differences in outcome variables (i.e. body esteem versus body dissatisfaction) and/or because of the cultural context of this study; most studies investigating body image in sexual minority groups have been conducted in the USA and Australia, which may differ culturally from Ireland. The few studies that have been conducted on young adult’s sexual minority body image in Ireland are limited to qualitative studies of gay men’s body image conducted in the mid-2000s (Ryan & Morrison, 2009). Higgins et al. (2016) report a recent cultural shift towards greater acceptance of sexual minority groups in Ireland, further evidenced by being the first country in the world to pass legislation for the right to same-sex marriage based on a constitutional referendum in 2015. This may have encouraged more favourable attitudes towards sexual minority young adults. Although sexual minority groups still reported higher levels of discrimination than heterosexual counterparts in this study, this discrimination may not be reflected towards sexual minority groups’ appearance in the same way it may in other cultural contexts. Qualitative studies could be valuable for identifying experiences of discrimination and bullying among sexual minority men and women in Ireland, and how these may/may not relate to body image. Further research is also required to identify potential cross-cultural differences in how body image and the risk and protective factors for body esteem are experienced by sexual minority individuals.

Limitations

While this study explored relationships between a range of risk and protective factors associated with the MSM and body image, these models explained only between 18–36% of the variance in body esteem across sexual minority subgroups. Additional risk/protective factors associated with the MSM, such as internalised bi/homonegative and concealment practices, and sociocultural factors such as appearance biases and sexual objectification (Noll & Fredrickson, 1998; Thompson et al., 1999) may be influential predictors of body image, but were not captured in this study (Parker & Harriger, 2020). Furthermore, while protective factors for body image, such as sports participation, were investigated, further insights may emerge through investigations of health-promoting behaviour, such as healthy eating among sexual minority groups.

Only one facet of body esteem, appearance-esteem was evaluated in this study. Weight esteem (attitudes specifically towards one’s weight/body size) and evaluative esteem (one’s perceptions of other people’s evaluations of one’s body) are additional facets of body esteem that may be expressed differently across sexual minority groups (Mendelson et al., 2001). As risk/protective factors have been shown to differentially predict these facets of body esteem (Frisén & Holmqvist, 2010), it is possible that the variables included in this study predict weight or evaluative esteem in sexual minority groups, even if they do not predict appearance esteem. Furthermore, body dissatisfaction, body change behaviours and experiences of bullying, discrimination and sexual orientation comfort were captured using single item questions, which may reduce the reliability of results.

Compared with literature on body image in sexual minority individuals, which typically relies on small convenience samples, this study contained a relatively large sample and broad representation of sexual orientations. However, sample size varied across groups and the differential sample sizes may have systematically impacted the reliability of statistical tests. There were relatively fewer sexual minority and male participants versus heterosexual and female participants, which may have limited power to detect effects in these groups. Additionally, the small number of ‘non-binary’ and ‘gender non-conforming’ individuals and ‘pansexual men’ in this sample precluded us from conducting analyses on these cohorts. Furthermore, individuals who do not identify as binary male and female genders (e.g. non-binary) can also identify as pansexuals, but due to small sample sizes, these cohorts were not evaluated in this study. Finally, this study used a cross sectional design which precludes inferences regarding temporality and causality and this was a convenience sample of young adults, who self-selected to partake, which may have introduced bias.

Suggestions for future research

In light of these limitations, future studies should seek to simultaneously investigate a broader range of risk and protective factors across sexual minority subgroups. Extending the resilience framework in this way, could help more accurately characterise the interaction between experiences of adversity and the adaptive use of resources to buffer against such experiences, across sexual minority subgroups. Future research should also endeavour to investigate body image in sexual minority groups using large, sufficiently powered samples. In recognition that gender and sexual orientations are often considered ‘fluid’ constructs (Smalley et al., 2016), it would be beneficial to explore broader constructs of gender and their interactions with sexual orientation in future research.

Conclusion

This was one of the first studies to document body image and body change behaviours in questioning and pansexual individuals. In focusing on body esteem, and protective factors for body image including sports participation, this study expanded the body image literature beyond focusing on risk factors only and provided important contributions for strengths-based approaches to promoting healthy body image in sexual minority groups. Adopting this risk and resilience perspective has allowed us to examine risk and protective factors as they affect sexual minority young adults’ body esteem in addition to how these factors may exist differentially among subgroups of sexual minority young adults. Contrary to expectations, experiences of bullying and discrimination were not associated with body esteem in sexual minority groups suggesting a potential need to consider other risk/protective factors for body esteem. Our findings indicate that addressing risky body-related behaviours and building psychosocial resources such as resilience may help to improve body esteem in sexual minority young adults, but that more targeted approaches addressing specific risk/protective factors may be also required to effectively promote body image among sexual minority subgroups.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/19419899.2022.2130084

Additional information

Funding

This work was supported by the Jigsaw, The National Centre for Youth Mental Health [R18321].