Many people struggle with body dysmorphia, which the Cleveland Clinic defines as “a mental health condition that disrupts how you see and feel about your own body and appearance.” Unfortunately, this condition is a common symptom among people struggling with eating disorders, although it’s not technically considered in that category. It’s also a problem for individuals in the LGBTQIA2S+ community (further referred to in this article as LGBTQ). 

What is Body Dysmorphic Disorder?

While many people believe they have appearance flaws, individuals with body dysmorphic disorder (BDD) are overwhelmed by perceived flaws that no one else seems to notice—so much so, the perception interferes with normal life. 

“You may find that negative thoughts about your body are hard to control. You may even spend hours each day worrying about how you look. Your thinking can become so negative and persistent, you may think about suicide at times,” Johns Hopkins Medicine states. 

Causes and risk factors include various biological, environmental, and psychological concerns. Frequently, individuals who’ve been bullied and teased excessively “create or foster feelings of inadequacy, shame, and fear of ridicule.” Other potential risk factors include:

• A family history of BDD or another mental health disorder
• Different personality disorders, such as avoidant personality disorder and obsessive-compulsive disorder
• People with personality traits such as introversion, narcissism, and perfectionism
• Life experiences, including trauma, such as emotional, mental, physical, or sexual abuse
• Imbalance of brain chemicals

The terms “body dysmorphia” and “body dysmorphic disorder” are often interchangeable, but the former is also a symptom related to other mental health and eating disorders. Johns Hopkins states that both women and men are affected by BDD, which usually starts in adolescence. And it’s more common that we realize: about 1 in 100 people have BDD. 

Body Dysmorphia in the LGBTQ Community

A 2022 study reported a “greater body image disturbance in gay men than in heterosexual men regarding cognitions, emotions, behaviors, and perception as well as higher eating disorder and body dysmorphic disorder pathology.” Unfortunately, body dysmorphia is prevalent in other areas of the LGBTQ community as well, accompanied by various other conditions. 

The Trevor Project indicates that approximately 80 percent of LGBTQ youth feel body dissatisfaction, and those numbers increase among individuals who identify as questioning, nonbinary, and transgender. 

The organization also states something more troubling: people with body dysmorphia report higher rates of anxiety, depression, and suicide ideation and attempts. In fact, according to the Trevor Project’s 2022 National Survey on LGBTQ Mental Health, as many as 20 percent of study respondents attempted suicide, and 60 percent of youth “who wanted mental health care were unable to get it.”  

In June 2023, USAToday reported that “the queer community today faces unique societal pressure to look a certain way thanks to the ongoing influence of social media in the microcosm of LGBTQ spaces, both online and in real life.” 

The article interviewed numerous individuals who struggle with various aspects of pressure both from peers and others. As one source put it, “We’re all overcompensating for not being able to fit into that culture that originally rejected us,” he says. “We’re extremely judgmental of each other’s physical appearance.” 

The National Eating Disorders Association developed a specific page to help support anyone within this community develop a healthier relationship with appearance: I Love My LGBT Body. 

Symptoms and Treatment of BDD – Common symptoms of BDD include:

• Frequently looking in mirrors—or, avoiding them completely
• Abnormal worry about a specific body area, such as your face or stomach 
• Overexercising
• Constantly comparing your looks with other people’s
• Consulting healthcare providers about appearance changes or going through multiple plastic surgery procedures
• Seeking validation from others about your appearance
• Not believing others’ opinions when they say your appearance is fine
• Overgrooming as an attempt to conceal flaws
• Picking at your skin with fingers or tweezers to make it look smooth
• Deliberately hiding parts of your body with clothing or accessories
• Avoiding social activities, especially during the day
• Feeling anxious, ashamed, or depressed about your appearance or perception of it
• Suicidal thoughts or attempts

Many qualified professionals and disorder centers provide comprehensive treatment for BDD. Based on a person’s individual history, age, and extent of the problem, possible methods include cognitive behavioral therapy, short-term medication, or a combination of the two. However, health equity continues to be an underlying factor, and it can be challenging for people in the LGBTQ community to receive non-biased treatment.

We See You

The skilled professionals at Cottonwood de Tucson respect the human dignity of every person we work with, and we feel privileged to offer support in our safe space of inclusion. While we acknowledge collective challenges, we also strive to celebrate each individual’s background and provide customized, whole-person health solutions for body dysmorphia and other mental health issues, eating disorders, and co-occurring conditions. Reach out to our admissions team to learn how we can help you.

If you or someone you love has suicidal thoughts, please call the National Suicide and Crisis Lifeline at 988 or an LGBTQ-specific hotline.