Introduction: Body image concerns are found to be heightened in Sexual and Gender Minorities (SGMs) compared to heterosexual and cisgender people. Minority-specific stressors, such as violence and discrimination, are hypothesized to be a determinant of this disparity. Methods: Following PRISMA guidelines, a screening of three scientific search engines (Web of Science, EBSCO, and PUBMED) was conducted up to January 2024. The screening analyzed 2148 records and full texts of 73 reports. Three research questions were explored: relations between minority stress and body image, specific considerations for LGBTQ + individuals, and differences between identity categories. Ultimately, 29 studies were included. Results: Minority stress was consistently associated with body image concerns, such as body dissatisfaction and shame. Mediating factors included internalization of cultural standards of appearance, self-esteem, and body surveillance. Specific considerations included an ambivalent role of LGBTQ + communities, differing body image ideals, and additional roles of gender minority stress and transgender congruence in trans people. Differences included bisexual people showing higher body image concerns and gender-based divergences regarding thinness-based and muscle-based dissatisfaction. Some methodological concerns and gaps are present in the available literature. Conclusions: Minority stress appears to consistently heighten body image concerns, showing an impact on several psychological characteristics. Specificities and differences are present for LGBTQ + identities. More research is needed, particularly on intrapsychic and intersectional aspects. Policy Implications: Anti-discrimination policies promoted on an institutional, organizational, and social level may help prevent an important, pervasive risk factor for LGBTQ + wellbeing. Clinical interventions involving body image may benefit from considering the effect of minority stress.
The Relationship Between Minority Stress and Body Image—A Systematic Review of the Literature
Santoniccolo F.
;Trombetta T.;Paradiso M. N.;Rolle Luca
2025-01-01
Abstract
Introduction: Body image concerns are found to be heightened in Sexual and Gender Minorities (SGMs) compared to heterosexual and cisgender people. Minority-specific stressors, such as violence and discrimination, are hypothesized to be a determinant of this disparity. Methods: Following PRISMA guidelines, a screening of three scientific search engines (Web of Science, EBSCO, and PUBMED) was conducted up to January 2024. The screening analyzed 2148 records and full texts of 73 reports. Three research questions were explored: relations between minority stress and body image, specific considerations for LGBTQ + individuals, and differences between identity categories. Ultimately, 29 studies were included. Results: Minority stress was consistently associated with body image concerns, such as body dissatisfaction and shame. Mediating factors included internalization of cultural standards of appearance, self-esteem, and body surveillance. Specific considerations included an ambivalent role of LGBTQ + communities, differing body image ideals, and additional roles of gender minority stress and transgender congruence in trans people. Differences included bisexual people showing higher body image concerns and gender-based divergences regarding thinness-based and muscle-based dissatisfaction. Some methodological concerns and gaps are present in the available literature. Conclusions: Minority stress appears to consistently heighten body image concerns, showing an impact on several psychological characteristics. Specificities and differences are present for LGBTQ + identities. More research is needed, particularly on intrapsychic and intersectional aspects. Policy Implications: Anti-discrimination policies promoted on an institutional, organizational, and social level may help prevent an important, pervasive risk factor for LGBTQ + wellbeing. Clinical interventions involving body image may benefit from considering the effect of minority stress.
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