To show that I understand his angst, I want to assure him that being skinny is a good thing; he should be happy he isn’t overweight; he’s only 24. But before I can respond, he asks “How old were you when you finally started bulk up?” exclaming, “I hate the way I look! I need more muscle definition in order to get a boyfriend.”
My client, like so many gay men, is convinced that without a gym-buff body, he is unlovable and doomed to be alone for the rest of his life. The objective truth is that he is a good-looking young man in excellent physical shape with a nice face, good hair and and fine taste in clothes. He just can’t see himself that way.
Gay men grow up in a world of childhood shame and parental rejection. Even though there has been marked improvement over the past 20 years, the societal message is that being gay is not okay. In his seminal book The Velvet Rage, author Alan Downs, PhD explains that “the trauma of growing up gay in a world that is run primarily by straight men is deeply wounding in a unique and profound way.”
Body dysmorphic disorder occurs when people compare themselves to the impossible, Hollywood body standard and believe they are defective because they look different than it. It is also one of the common ways that childhood trauma manifests in adulthood for gay men.