Gay Men & Body Dysmorphia

What is body dysmorphia?

We all strive to be accepted. This natural part of the human experience is universal to everyone—not just gay men. One very important factor in determining how others accept us is how we look. There’s just no way around it. We are bombarded with messages daily that dictate what is considered attractive—and what is not. In general, I would agree that gay men are faced with particularly harsh beauty standards. And it shows. Gay gyms are packed. So many gay men take steroids or other supplements to enhance muscle growth and burn fat. More and more folks are losing weight drastically with Ozempic. If you ask some gay men, many will say that having some sort of body dysmorphia is just an inevitable part of the gay male experience.

Do I have Body Dysmorphic Disorder?

Body dysmorphic disorder (known as BDD) takes preoccupation with appearance to the extreme. We are unfortunately judged pretty harshly for our appearance in our culture. But folks with BDD overestimate the severity of this judgement. For example: if someone with BDD gains 5 pounds, they may feel convinced that everyone in noticing and judging their weight gain. Conversely, someone without BDD who has gained a few pounds has the awareness that: a) their weight gain is likely unnoticeable to anyone but them, and b) even if others do notice the weight gain, they are not being judged for it. BDD sufferers truly have a distorted self-perception—one that causes constant negative intrusive thoughts, obsessive mirror checking and often disordered eating. Some folks will BDD are preoccupied with specific flaw or appearance in general. Most gay men who have body insecurities don’t fit the criteria for BDD per se--but some do. Just because some men don’t fit the diagnostic criteria doesn’t mean they don’t suffer significantly.

The consequences

Most folks with BDD don’t seek therapy. Unfortunately, they often seek the exact treatments they don’t need. They seek treatments to alter their appearance. Sadly, these treatments only exacerbate their condition. These can include botox, laser treatments, filler, etc. Those are the milder options. If BDD goes untreated for to longer, folks will begin seeking more extreme methods to alter their appearance such as plastic surgery. In fact, many will seek surgery on the same perceived flaw over and over again in an obsessive, but futile, effort to correct the imperfection. Think of Michael Jackson’s nose and you’ve got the idea. It is very common when you live in a city like Los Angeles or Miami to encounter folks who have had extremely excessive—and typically unflattering—cosmetic procedures.

Consider a detox

BDD warps our self perception, so much so that we often end up decreasing, rather than enhancing, our appearance. To start healing, you need to detox. Take 6 months off from any appearance-altering procedure. No surgery, fillers, lasers, weight loss drugs, steroids, etc. Don’t start any new diets or workout plans. The idea is to return to your most natural appearance. You don’t have to commit to forging those things forever, but you need a significant break.

Get back in touch with reality

This exercise is more jarring—but it’s effective. Get a picture of yourself from before you started any cosmetic procedures. Juxtapose that with a picture of yourself now. Now you’re going to do some market research. Gather 10 friends and show them the photos. Ask for their honest opinion: which photo looks better? Let them know they have your permission to be completely candid with you. I promise you that your friends will pick the before picture. This often comes as a shock, as BDD sufferers are convinced their aesthetic alterations have been positive. It’s very important to break that delusion.

Healing and self-acceptance

Luckily, beauty standards for gay men have become more varied recently. For years we celebrated the same body standard. Often a ripped white guy in a speedo. Now we see a variety of body types celebrated. This shift toward inclusively has been very therapeutic for gay men who no longer feel pressure to force their bodies to morph into a shape that may be unnatural for them.

Then, for many gay men, therapy will involve examining their value systems. You may need to ask yourself why you’ve tied so much of your self-worth to your appearance in the first place. And, more importantly, if you’d like to spend your life hating yourself for your flaws or celebrating your natural, authentic aesthetic.

It is very important to work with a mental health professional if you’re struggling with these issues—particularly if you have legitimate BDD. There is a very clear distinction between body insecurities and BDD. If you do have BDD, there are certain treatment protocols you must follow to get better. Treating more generalized insecurities will have a different approach. As always, consult with a professional who specializes in gay male psychology to get the best result.

Want to learn more about the psychology of gay men? Check out my blog for the Weho Times.