GENDER AND BDD ACROSS THE LIFE SPAN BDD AND GENDER: THERE ARE SOME INTERESTING DIFFERENCES BETWEEN MEN AND WOMEN WITH BDD
There are some interesting differences between men and women with BDD. I’ve found that women are more likely to have an eating disorder, whereas men are more likely to have a problem with alcohol or drugs. Men are more likely to be single. While the sexes are generally similar in the number and areas of bodily concern, men are more likely to think that their body build is. too small, skinny, or not muscular enough, whereas women are more likely to dislike their weight and hips, thinking they’re too large and fat. While men and women are equally likely to have hair concerns, men are more prone to fear that they’re losing their hair. All of the people who worried about excessive body hair were women, whereas all of those with genital concerns were men. Men are more apt to use a hat for camouflage, whereas women are more likely to turn to cosmetics for cover.
These results are interesting because some of them echo normal appearance concerns and behaviors. Research findings indicate that women generally think their bodies are too large, whereas men tend to worry that theirs are too small. A study of college students, for example, found that 85% of the women wanted to lose weight, whereas only 40% of the men wanted to lose weight and 45% actually wanted to gain it. In the general population, concerns about balding are relatively common among men but not women, and women are more likely to use cosmetics than men.
Several treatment findings are also interesting. I’ve found that men and women are equally likely to seek nonpsychiatric treatment such as surgery or dermatologic treatment for their BDD concerns. They’re also equally likely to receive these kinds of treatment. This finding differs from what we know about the general population, in which women are more likely to receive cosmetic treatments than men.
The only other study that to my knowledge has investigated gender differences in BDD was done in Italy in a smaller series (58 people). This study, like mine, found that BDD was generally similar in women and men. And like my findings, women were more likely to have the eating disorder bulimia nervosa, and men were more likely to be concerned with their genitals. Unlike my results, however, the Italian study found that women were more likely to focus on their breasts/chest and legs, check mirrors, and camouflage, whereas men were more likely to focus on their height and excessive body hair. Certainly, we need more research on gender similarities and differences in BDD, not only in clinical settings but also in the general population and in different cultures.
I’m sometimes asked how many people with BDD are homosexual. I systematically assessed this in my series of 200 people with BDD and found that 5% were homosexual and 3% were bisexual. This percentage is somewhat higher than in the general population, but it indicates that the vast majority of people with BDD are heterosexual.