When it doesn’t get better: A qualitative study of eating disorders, sexual identity, and coming out in sexual minority men

Abstract

Introduction This study explores the relationship between sexual identity, coming out, and eating disorders to more fully understand the high rates of eating disorders and body dissatisfaction among sexual minority men. Method A sample of 15 sexual minority men (14 gay, one queer) with a diagnosed eating disorder completed qualitative interviews about their experiences related to their sexual identity, coming out process, and eating disorder. Results Qualitative data analysis based on grounded theory strategies revealed that the majority of participants identified their coming out process as playing a notable role in their body dissatisfaction and eating disorder. After coming out, participants identified unique stressors from within the community of sexual minority men. Participants’ responses were categorized into four theoretical constructs: (1) The Mental Health Toll of the Closet, (2) The Mental Health Toll Out of the Closet, (3) The Mental Health Toll of Assimilating to the Gay Community, and (4) The Mental Health Toll of Gay Dating and Sex. The findings are contextualized based on three relevant theories: minority stress theory, intraminority gay community stress theory, and objectification theory. Conclusion This study found the process of coming out, as well as navigating stressors within the mainstream gay community, are critical to more fully understanding the disparities in eating disorders among sexual minority men.