The role of Minority Stress in Body Image - A Systematic Review

Introduction: Body image concerns, an important predictor of several physical and mental health issues, are found to be heightened in Sexual and Gender Minorities (SGMs) compared to het-erosexual and cisgender people. Minority-specific stressors, such as discrimination and violence, are hypothesized to be a determinant of this disparity. Objectives and methods: This systematic review aims to synthesize available scientific litera-ture regarding the role of minority stress in body image and specificities of SGMs. Following PRISMA guidelines, a screening of scientific search engines (EBSCO, PUBMED, Web of Science) was conducted up to January 2024. 2148 records were screened. 73 reports were retrieved after ap-plication of inclusion and exclusion criteria. 4 research questions were explored: role of minority stress on body image, mediating factors, specificities of SGMs and differences between identity categories. Results: 29 studies were included. Different aspects of minority stress were consistently as-sociated with body image concerns, such as body dissatisfaction and shame, body image disturb-ance and dysmorphic concerns. Several mediating factors between minority stress and body image concerns were identified, including internalization of cultural standards of appearance, self-esteem, and body surveillance. Specificities included an ambivalent role of LGBTQIA+ communities, dif-fering body image ideals and the additional roles of gender minority stress and transgender congru-ence in trans people. Some differences between identities were found: bisexual people, particularly women, showed higher body image concerns compared to other sexual minorities; differences be-tween men and women were found regarding thinness-based and muscle-based dissatisfaction. Conclusions: Minority stress appears to have an important effect on body image, consistently heightening body image concerns for SGMs. Anti-discrimination policies promoted on an institu-tional, organizational and public level may help prevent an important, pervasive risk factor for SGM wellbeing. Clinical interventions involving body image may benefit from considering the effect of minority stress, such as on self-esteem and body surveillance.