Sexual Orientation Disparities in Mental Health Vulnerabilities: Exploring Body Image Dissatisfaction and Desired Changes in Physical Attributes among Cisgender Heterosexual, Homosexual, and Bisexual Men in Taiwan.

Purpose: Little is known about Asian cisgender men's body image dissatisfaction (BID) and its variation among heterosexual, homosexual, and bisexual men. This study aimed to explore and better understand their specific BID concerns regarding various body parts and desired changes in physical attributes (DCPA), shedding light on the intersection of BID and sexual orientation among Asian men.

Materials and methods: A cross-sectional anonymous survey was conducted among participants recruited through the popular online forum, PTT, which attracts a large youth population in Taiwan. The inclusion criteria were: cisgender men; aged 18 years or older; Taiwanese citizens. The prevalence and levels of BID for nine specific body parts and prevalence of DCPA were compared by sexual orientation. Pairwise mean differences and multivariable logistic regression models, adjusting for age and body mass index, were estimated for subgroup comparisons.

Results: Of 632 participants, 376 self-identified as heterosexual, 185 as homosexual, and 71 as bisexual. The overall BID score and four body-part BID scores (i.e., facial features, skin, muscles, and penis) significantly differed by sexual orientation, with homosexual and bisexual men exhibiting higher BID than heterosexual men. Further DCPA analysis found significant sexual orientation differences regarding 27 DCPA items. Homosexual men most often reported desiring to change 18 of these DCPA, whereas bisexual men most often endorsed the remaining nine DCPA (e.g., an upward curve of the penis, a larger glans).

Conclusions: These findings reveal sexual orientation disparities in BID and DCPA, providing valuable insights for addressing body image concerns among Asian men.