1. Reconsidering Social Determinants
2012 BC Gay Men’s Health Summit
November 1 & November 2, 2012
Vancouver, British Columbia
Defined Body or Defined by my Body?
Reconsidering Gay Men and Body
Image
DAVID J. BRENNAN, PHD
Factor-Inwentash Faculty of Social Work
University of Toronto

2. QUESTIONS
 Is there a connection between the social
determinants of health and body image for gay
men? (marginalization?)
 Do gay visual media portray images of certain
body types in a way that excludes people?
 Do these images help to get men’s attention to
our messaging?
 Do these images engender feelings of body
dissatisfaction, depression, low self-esteem and
exclusion?

3. GAY MEN TEND TO HAVE BETTER BMI AND
LESS FAT THAN STRAIGHT MEN

6. NORTON, Matt (2011): WHY MAG COVERS
LIKE THIS SET GAY MEN TO FAIL
I found myself distracted. How was
this dude so perfect? I’m off to the
gym… For me, the gym’s always been
a great place to think. So I got to
thinking. I’m not an irrational
person. I know that boy on the
cover is airbrushed. Either that
or he has no pores. What am I
doing here benching my own body
weight at 8.15 on a Sunday morning?
It kept happening – finding myself in
the gym as a result of the bloody
coffee table dude. This wasn’t
aspiration. This was obsession.

7. HALF OF GAY MEN “WOULD DIE A YEAR
EARLY” FOR THE PERFECT BODY
Centre for Appearance Research at University
of the West of England, Bristol
A study says 48% of gay
men would sacrifice a year
or more of their lives in exchange
for a perfect body.
The research suggests 10% of
gay men would agree to die more than 11
years earlier if they could have their
ideal body now.
Gay men in the study used speech that
implicitly or explicitly reinforces or
endorses the traditional western
standard of male attractiveness: tall,
lean, muscular, toned body with clear
skin and a full head of hair.

8. MARO (2006): GAY MEN AND BODY IMAGE:
DECONSTRUCTION OF GAY MEN IN MEDIA
A typical male model appeared in advertisements
targeting gay men is an athletic young white man
with six-pack abs. Why white? Why athletic body with
six-pack abs?

9. BRENNAN, CRAIG, THOMPSON (2010):
FACTORS ASSOCIATED WITH A DRIVE FOR
MUSCULARITY AMONG GAY AND BISEXUAL MEN
 This study recruited participants (n=400) at
Toronto’s 2008 LGBT festival.
 A drive for muscularity is associated with a
younger age, an increased risk for disordered
eating, and increase in depression symptoms,
sexual risk, and increase in internalized
homonegativity.

10. BRENNAN, CRATH, HART, GADALLA, GILLIS (2011):
BODY DISSATISFACTION AND DISORDERED EATING
AMONG MEN WHO HAVE SEX WITH MEN IN CANADA
 Data collected at “Pride Toronto
2008”; N = 383.
 13.6% reported disordered
eating.
 About 10% among general
population are male.
 Though binge eating is not
measured as a disorder and is
likely to be higher.
 Younger men report
significantly higher DES.

11. BRENNAN, CRATH, HART, GADALLA, GILLIS (2011)
BODY DISSATISFACTION AND DISORDERED EATING
AMONG MEN WHO HAVE SEX WITH MEN IN CANADA
 MSM in the sample who
reported childhood sexual
abuse (CSA) were more
than twice as likely to
report DES.
 Results from this study
also corroborated the
association between
depression and DES.
 Our results suggest that
White identifying men
might be at greater risk for
DES than either Asian or
Black identifying men.

12. GUADAMUZ, LIM, MARSHAL, FRIEDMAN,
STALL & SILVESTRE, 2012
 50% of Pittsburgh HIV-negative cohort were
obese/overweight. However, over 8 years that
level did not rise.
 Obesity was not associated with sexual risk,
substance use or depression.

13. VARANGIS, LANZIERI, HILDEBRANDT,
FELDMAN, 2012
 Lean muscular men are preferred by gay men
 The dating context matters. Gay men rated lean
and muscular men in the context of a short term
relationship as more attractive than for a long
term relationship.
 Those who had lower body fat themselves were
more discriminating in terms of body fat and
muscularity.

14. RACISM, HOMOPHOBIA & BODY IMAGE
AMONG ETHNORACIALIZED
GAY/BISEXUAL MEN
David J. Brennan1; Peter A. Newman1; Clemon George2; Trevor A. Hart3;
Andre Cenranto4; Kenta Asakura1; Ishwar Persad5
1-University of Toronto, Factor-Inwentash Faculty of Social Work; 2University of Ontario
Institute of Technology; 3-Ryerson University; 4-AIDS Committee of Toronto; 5-Centre for
Addiction and Mental Health

16. IMAGINE MEN’S HEALTH:
COMMUNITY ADVISORY COMMITTEE
 Shazad Hai, MSM Outreach Coordinator, Alliance for South
Asian AIDS Prevention.
 Daniel Le, Gay Men’s Health Promoter, Asian Community
AIDS Services
 David Lewis-Peart, MSM Outreach Coordinator, Black
CAP.
 Marco Posadas, Bathhouse Counselor Initiative
Coordinator, AIDS Committee of Toronto.
 Tavinder Channa, Community Member
 Dexter Roberts, Community Member
 Siva Gunarathnam, Gay Men’s Outreach Coordinator,
AIDS Committee of Toronto
 Anthony Chen, Medical doctor
 Gerardo Betancourt, HIV Prevention Program
Coordinator, Centre for Spanish Speaking People
 Marco Gomez, Policy consultant

17. STUDY BACKGROUND
 Purpose: To examine the relationship between racialized
identity, sexual orientation identity, and body image among
ethnoracialized gay and bisexual men in Toronto, Canada.
 Multi-phase, mixed-methods study: Phase 1: Focus groups &
interviews (n=61); Phase 2: Survey (n=410)
 Community Collaboration: Roles of Community Advisory
Committee (CAC).
 4 ethnoracial communities: East/Southeast Asian;
Black/Caribbean/African; Hispanic/Latino/Brazilian; and
South Asian.

18. FINDINGS
 Three main themes emerged across four ethnoracialized communities.
(1) Body Image Idealization in GBM Culture
(2) Negotiating a Racialized Body Image
(3) Negotiating Impact of Body Image on Relationship
with Self and Others

19. 1. BODY IMAGE IDEALIZATION IN GBM CULTURE
1A: Influences on Body Image
“Look at the cover of the publication. Like… [local gay
magazines] …who usually gets profiled on the cover is …a
Caucasian male, lots of muscles…And I understand…you’re
selling magazines, but for the rest of us, who don’t fit that
profile, and don’t have a good strong sense of self, I can see
how damaging that could be. How you don’t think when you
look in the mirror that “I’m hot”, because …you never see
yourself reflected anywhere.”
[Black/African/Caribbean, > 30]

20. 1. BODY IMAGE IDEALIZATION IN GBM CULTURE
1B: Hot Body Type in Toronto
“There’s two (hot body types for GBM in Toronto)… (One) is
the white male, mid-20’s, extremely cut, bigger; doesn’t have to
be too big, but has to be very fit. And the other one is the older,
muscled, bear, hairy; doesn’t matter if you have a gut, because
that’s a new trend that’s been going on for the last couple of
years, against having abs and everything. But at the same time
you still have to be defined in the right places, even though you
have a gut.”
[East/South East Asian, > 30]

21. 1. BODY IMAGE IDEALIZATION IN GBM CULTURE
1C: Personal Description of Hot Body Type
I don’t want somebody who is too good looking, and I don’t
want somebody who is like too muscular, I just want an
average looking person. To me that’s sexy. I don’t like the
built perfect shape anymore. It’s not attractive to me. I like
normal person. And, if a person has a little flaw, like let’s say
a little larger nose or a little characteristic about your face, I
find that more intriguing. So, body image comes down to, I
guess, personal preference again. I don’t necessarily need
six-pack abs to turn me on.
[East/Southeast Asian, > 30 ]

22. 2. NEGOTIATING RACIALIZED BODY IMAGE
“Sexually...if I am being fetishized I don’t really like
that and I wouldn’t really have sex with someone if
that’s what’s going on. Socially... we live in a White
supremacist society, unfortunately. So, of course,
there’s going to be...a lot of not necessarily
discrimination all the time but you can just sense it.”
[South Asian, < 30]

23. 2. NEGOTIATING RACIALIZED BODY IMAGE
2A: Negotiation of Internalized Racism Related to Body
Image
“I’ve tried to work on this...that every time I try and think of
dating another Filipino guy, I feel like I’m dating my
brother... It’s strange, because…it’s either we’re too much
alike... like I’m with my brother, [or] because I feel like I
know too much of their cultural norms. So it’s a very
strange situation, having that same kind of body type.”
[East/Southeast Asian, > 30]

24. 2. NEGOTIATING RACIALIZED BODY IMAGE
2B: Racialization of Body Parts
“Being African, everybody thinks you have a 13 or 14-inch
penis...[and] you can shag for six hours, non-stop flight...They
don’t think you are a human being, you can have a normal size
dick… You get affected because...as you take it out, they say,
“You are black, you should have something bigger than that.”
So, it’s the disappointment...Of course, it affects you. It affects
your self-esteem.”
[Black/African/Caribbean, > 30]

25. 2. NEGOTIATING RACIALIZED BODY IMAGE
2C: Personal Experiences of Body Racialization
“I’m fairly decent looking. Many times I walk into a social
situation and I’d be like ‘why do I feel as if I’m being ignored?’
Why is it that people look at you, turn away the moment you
look at them? And I really do think that it’s a race factor...I think
that every race other than the White race...has a certain appeal
to it. I think that when you’re Black you’re exoticized because of
your virility, your endowment...your ability to put on muscle...
When you’re Asian it’s a different [body] type.”
[South Asian, < 30]

26. 2. NEGOTIATING RACIALIZED BODY IMAGE
2D: Negotiating Different Body Image Ideals across
Multiple Socio-Cultural Contexts
“I [find that men in Toronto] are running after short Asian
guys. So, personally I find it’s, oh, how come? ...I am tall... In
China,... tall is always considered good and desirable. But
here, short and small is considered more desirable...I’m
personally disappointed because....I’m not attractive or
desirable anymore (Laughter).”
[East/Southeast Asian, >30]

27. 3. NEGOTIATING IMPACT OF BODY IMAGE ON
RELATIONSHIP WITH SELF AND OTHERS
3A: Strategizing & Managing Pressures to Conform to
Body Ideal
“I’d skip meals. I’ve made myself vomit... so that I could look
good for the evening... When I used to drink, I would not eat
meals, because I was going to go out and party, because I
wanted to look good. So to the detriment of my health, I will do
that.”
[Latino/Hispanic/Brazilian, > 30]

28. 3. NEGOTIATING IMPACT OF BODY IMAGE ON
RELATIONSHIP WITH SELF AND OTHERS
3A: Strategizing & Managing Pressures to Conform to Body
Ideal
“I got invited to...Pride beach party...and I said no... I
can...imagine the expectation of body, you know, what it’s
going to be like to be in this space. And at this point...in my
life, I don’t need to be in those spaces to be validated...
I’ve…cocooned myself with a set of friends, community
people, that don’t have those issues around body... I
surround myself with my own that validates me, that I feel
that I can...express myself in whatever way I feel and not be
judged.
[Black/African/Caribbean, > 30 ]

29. 3. NEGOTIATING IMPACT OF BODY IMAGE ON
RELATIONSHIP WITH SELF AND OTHERS
3B: Impact of Body Image on Health
“When I get picked up, I feel accepted....I say, “wait a minute,
maybe I ain’t that bad looking.” So, my insecurities about my
body has led me to have promiscuous sex; it’s as simple as
that, just because I want to be accepted by somebody, and if
you go and you get picked up you feel that much better about
yourself.” [East/Southeast Asian > 30]

30. 3. NEGOTIATING IMPACT OF BODY IMAGE ON
RELATIONSHIP WITH SELF AND OTHERS
3B: Impact of Body Image on Health
“I’m HIV positive, I have Kaposi… (years ago) people looked at your
legs...the skinny body, they know you’re HIV positive, and they talk.
At first I didn’t think it would get to you, but it does get to you... So, I
had a major image problem. Even right now, although I’ve gained
back some weight...if I don’t open my big mouth all the time people
probably won’t guess that I’m positive… I look in the mirror and I
still see this skinny little HIV positive person… It’s the way that I
perceive myself, with very low self-esteem.”
[East/Southeast Asian > 30]

31. 3. NEGOTIATING IMPACT OF BODY IMAGE ON
RELATIONSHIP WITH SELF AND OTHERS
3C: Impact of Body Racialization on Relationship
with Others
“If you’re in a relationship with a Caucasian person, going into a
space that’s predominantly of colour, ...the reception...is...double-
edged...You’re either looked at as traitors, or envied. … ‘you’re in
this community and isn’t there anybody else in this community
that you could have found?’ The other way you’re a trophy... a
catch...the perception is either you didn’t try hard enough to meet
someone of your own race, [or] you don’t like your own race... A lot
of perceptions are thrown at you.”
[Black/African/Caribbean, > 30]

32. WHAT ABOUT PORN?

33. PORN IS CHANGING
 Increase in free, “amateur” websites.
 When it is not done in an expensive glossy,
Hollywood like context, does it change the body
bodies that are presented?

34. DUGGAN AND MCCREARY (2004):
BODY IMAGE, EATING DISORDERS, AND THE
DRIVE FOR MUSCULARITY IN GAY AND
HETEROSEXUAL MEN: THE INFLUENCE OF
MEDIA IMAGES.
 Viewing and purchasing of muscle and
fitness magazines correlated positively
with levels of body dissatisfaction for
both gay and heterosexual men.
 Pornography exposure is positively
correlated with social physique
anxiety for gay men.

35. THE INFLUENCE OF PORN ON BODY IMAGE
 “Mainstream” gay male
pornography (i.e.,
imagery produced by
companies such as Bel
Ami, Falcon, and Studio
2000) is rife with
muscular, attractive
men (Duggan &
McCreary, 2004).
 Gay men may look at
pornographic imagery
and embrace the belief
that they need to
possess a similar
physique in order to
obtain sexual
gratification (Duggan &
McCreary, 2004).

36. THE INFLUENCE OF PORN ON BODY IMAGE
 It is plausible that heterosexual and gay
porn are distinct and, thus, possess different
implications vis-à-vis body image.
 For example, in gay pornography, the male
body likely receives more attention in terms
of close-ups than in heterosexual
pornography.
 Also, gay pornography may place
greater emphasis on the
attractiveness of the male body.

37. MORRISON, T., BEARDEN, A., HARRIMAN, R. (2006):
EXPOSURE TO SEXUALLY EXPLICIT MATERIAL
AND VARIATIONS IN BODY ESTEEM, GENITAL
ATTITUDES, AND SEXUAL ESTEEM AMONG A
SAMPLE OF CANADIAN MEN.
 The purpose of the study is to investigate
associations between exposure to pornography and
three forms of self-esteem: body, genital, and sexual.
 N = 188 male college students
 Male participants’ level of exposure to sexually
explicit material on the internet correlates inversely
with genital self-esteem and sexual esteem.
 Watching pornography may compound the negative
effects of social comparison by making salient the
gap between what one sees in porn and what one
does sexually.

38.  A Commentary on the
Role of Sexually Explicit
Media (SEM) in the
Transmission and
Prevention of HIV among
Men who have Sex with
Men (MSM)
 B. R. Simon Rosser, Jeremy A.
Grey, Michael Wilkerson, Alex
Iantaffi, Sonya S. Brady, Derek
Smolenski, and Keith J. Horvath.
 AIDS Behav. 2012 August ; 16(6):
1373–1381.

39. HOW DOES WATCHING PORN AFFECT GAY
MEN (OR MSM)
 Sexually explicit media (SEM)
 Ubiquitous (what apps are open on your phone?)
 Very acceptable to gay men

40. HOW DOES WATCHING PORN AFFECT GAY
MEN (OR MSM)
 For young gay men, it may correlate
with more partners (It does for
straight young men).
 For young men and older men,
learning about sexual
techniques…young gay men learning
about how to have anal sex.
 Affirmation of sexual desires and
interests.
 Older gay men reported SEM as
affirming. If true, young gay men
may report earlier sexual initiation
and particularly in anal sex.

41. ARE THERE ANY NEGATIVE EFFECTS OF SEM
FOR GAY MEN?
 Poorer body image, though really only two
studies.
 However, body image is associated with sexual
risk.

42. WHAT ABOUT SEM AND HIV RISK?

43. TWO STUDIES
 Morrison, Morrison and Bradley (2007) found no
differences between SEM exposure and sexual
risk. Small sample size (n=66).
 Stein, et al (2011). Those who reported watching
UAI 75-100% of the time were more likely to
report UAI than those who reported watching
UAI 0-25% of the time. Large (n = 751) NYC
based sample and all reported high risk for
inclusion.

44. PRELIMINARY SURVEY FINDINGS OF THE
IMAGINE MEN’S HEALTH STUDY
David J. Brennan1; Peter A. Newman1; Clemon George2; Trevor A. Hart3;
Andre Cenranto4; Kenta Asakura1; Ishwar Persad5
1-University of Toronto, Factor-Inwentash Faculty of Social Work; 2University of Ontario
Institute of Technology; 3-Ryerson University; 4-AIDS Committee of Toronto; 5-Centre for
Addiction and Mental Health

45. HAVE YOU EVER WATCHED PORN?
Response Chart Percentag Count
e
Yes 95% 388
No 5% 21
Total Responses 409

46. IN THE LAST 6 MONTHS, ON AN AVERAGE WEEK,
HOW MANY HOURS DID YOU WATCH PORN?
Chart Percentage Count
0-1 hours 28.4% 110
2-3 hours 32% 124
4-9 hours 23.3% 90
10-50 hours 14.7% 57
50+ hours 1.6% 6
Total Responses 387

47. Which type of porn do you prefer to Chart Percentage Count
watch?
Anal 74% 287
Bareback/Hardcore 65% 251
Orgy/Group Sex 55% 214
Oral/Blow Jobs 55% 215
Amateur 55% 212
Hunks/Jocks/Muscular 55% 215
Straight 47% 182
Interracial 46% 180
Latino 43% 168
Black 38% 148
Masturbation/Jerk off 36% 140
Bisexual 36% 139
Twink 28% 110
Fetish, BDSM, Kink 25% 98
Asian 25% 96
Mature 24% 95
Bear 24% 94
Toys 13% 49
Transsexual 9% 33
Other, please specify: 7% 29
Total Responses 388

48. "I OFTEN COMPARE MY APPEARANCE TO
THE PORN STARS/MODELS"
Response Chart Percentage Count
Completely disagree 31% 120
Somewhat disagree 20% 76
Neither agree or 20% 78
disagree
Somewhat agree 23% 90
Completely agree 6% 24
Total Responses 388

49. WE DO NOT KNOW YET!

50. TATE, H., & GEORGE, R. (2001): THE EFFECT OF
WEIGHT LOSS ON BODY IMAGE IN HIV POSITIVE
GAY MEN
 The purpose of this study was to
assess how body image may be
affected by HIV-related weight loss.
 Gay men with HIV avoided social
activities in the last two months due
to self-consciousness over their
appearance; family visits, meeting
new people and meeting up again
with people after weight loss.
 These results suggest that in gay
men, HIV-related weight loss causes
significant emotional and physical
problems.

51. HALKITIS, P., GREEN, K., WILTON, L. (2004):
MASCULINITY, BODY IMAGE, AND SEXUAL
BEHAVIOR IN HIV-SEROPOSITIVE GAY MEN
 For HIV-positive men attempt to maintain
their own health while at the same time
remain desirable by emphasizing the
physical definitions of masculinity.
 For these men, physical appearance and
sexual expression are the cornerstones of
their masculinity.
 Having a strong muscular body is essential
to HIV-positive gay men embracing this
ideal and has become increasingly
associated with other physical attributes
than enhance the masculine appearance.

52. BLASHILL, A., & VANDER WAL, J. (2011):
COMPONENTS OF BODY IMAGE IN GAY MEN
WITH HIV/AIDS
 Three groups of gay men were compared: AIDS
diagnosed, HIV positive (without an AIDS
diagnosis), and HIV negative.
 Results revealed that men with a diagnosis of
AIDS reported feeling unfit, out of shape, and in
worse health than men who were HIV positive
and HIV negative.
 Both men with AIDS and HIV reported being
more reactive to illness and more aware of signs
of physical sickness than men who were HIV
negative, above and beyond what
may be attributed to depression

53. SUMMARY
 Gay men take good care of their bodies and want
to look good and feel healthy (this is GOOD!)
 For some, body image issues come from
tremendous internal and external pressures. This
can impact health (depression, self esteem,
sexual risk).
 The media (including porn and SEM) has an
impact on body image. These media are rife with
racialized stereotypes. Age is also a factor.
 HIV - positive men have unique and powerful
stressors on body image.

54. QUERIES
 Can we talk about how to reduce the stress put
upon GBM by this imagery? Gay men want to see
sexy images but we also are impacted by them.
 How and where and when can we talk honestly
about these issues?
 Is it OK to just use specific body types all the
time in our outreach? It gets attention, but does
it inadvertently impact gay men’s health in other
ways?

56. David J. Brennan, MSW, PhD
david.brennan@utoronto.ca