Elsevier

Body Image

Volume 30, September 2019, Pages 145-149
Body Image

Brief research report
Testing the Tripartite Influence Model among heterosexual, bisexual, and lesbian women

https://doi.org/10.1016/j.bodyim.2019.07.001Get rights and content

Highlights

  • The Tripartite Influence Model is supported among bisexual and lesbian women.

  • Bisexual women may experience more peer appearance pressures than lesbian women.

  • Thin-ideal internalization may be particularly harmful for bisexual women.

Abstract

This cross-sectional study explored similarities and differences between heterosexual, bisexual, and lesbian women in levels of, and relationships between, the following constructs using a Tripartite Influence Model framework: family, peer, and media appearance pressures, thin- and muscular-ideal internalization, and eating disorder (ED) pathology. Self-identified heterosexual (n = 1,528), bisexual (n = 89), and lesbian (n = 278) undergraduate women completed the Sociocultural Attitudes Towards Appearance Questionnaire-4 and the Eating Disorder Examination-Questionnaire. Sexual orientation differences in appearance pressures, appearance-ideal internalization, and ED pathology were examined via analysis of variance tests. Relationships between these variables were examined with multi-group path analyses, controlling for age, race/ethnicity, and body mass index. Compared with lesbian women, heterosexual and bisexual women reported higher levels of peer appearance pressures. Paths from peer appearance pressures and thin-ideal internalization to shape/weight overvaluation and body dissatisfaction were strongest for bisexual women. Overall, results indicate notable similarities between heterosexual, bisexual, and lesbian women. However, preliminary evidence for potential differences highlights the importance of examining variation in ED risk between sexual minority subgroups.

Introduction

Sexual minorities (i.e., individuals who do not identify as heterosexual or who report attraction to or sexual behavior with individuals of the same or multiple genders) are at elevated risk for a wide range of mental health problems, including anxiety, depression, and suicidality (Plöderl & Tremblay, 2015). Although evidence regarding the relationship between sexual orientation and eating disorder (ED) pathology among women has been mixed (Calzo, Blashill, Brown, & Argenal, 2017), findings from a recent systematic review indicate that sexual minority women report higher rates of EDs, binge eating, and purging, but lower levels of established risk factors for EDs (e.g., body dissatisfaction) compared to their heterosexual peers (Meneguzzo et al., 2018). Thus, etiological processes contributing to ED risk might differ between sexual minority and heterosexual women.

Sociocultural theories offer a framework for understanding how inter- and intra-personal experiences could differentially contribute to ED pathology among sexual minority women. The Tripartite Influence Model posits that appearance pressures from family, peers, and media lead to disordered eating via thin-ideal internalization (Thompson, Heinberg, Altabe, & Tantleff-Dunn, 1999). This model has been supported empirically among samples of primarily heterosexual women (e.g., Girard, Rodgers, & Chabrol, 2018; Lovering, Rodgers, George, & Franko, 2018; Rodgers, Chabrol, & Paxton, 2011), but the extent to which the model holds for sexual minority women is unclear.

Some researchers have speculated that many lesbian women reject the mainstream thin ideal, making them less vulnerable to harmful effects of thinness pressures than heterosexual women (Brown, 1987). Consistent with this view, sexual minority women have reported comparable levels of family, peer, and media thinness pressures but lower thin-ideal internalization than heterosexual women (Huxley, Halliwell, & Clarke, 2015; Yean et al., 2013). Although evidence indicates substantial variability in levels of muscular-ideal internalization among women (Schaefer et al., 2015), limited work has examined this construct among sexual minority women.

To our knowledge, only one study has tested the Tripartite Influence Model among sexual minority and heterosexual women (Huxley et al., 2015). Findings suggested thin-ideal internalization is a stronger predictor of restrained eating for sexual minority women than heterosexual women; however, all sexual minority women (i.e., those identifying as bisexual or lesbian) were combined into one group. Because sexual minority subgroups represent unique populations, the Institute of Medicine (2011) report on sexual minority health recommended examining sexual minority subgroups separately. Emphasizing the importance of this recommendation, research has consistently found that bisexual individuals experience worse mental health outcomes than their gay, lesbian, or heterosexual peers (Taylor, 2017), and women attracted to both sexes have been found to exhibit greater ED pathology than those only attracted to one sex (Shearer et al., 2015). A possible explanation for these findings is that discrimination toward bisexual individuals comes not only from heterosexual communities, but also from gay/lesbian communities (Taylor, 2017). Therefore, distinguishing between sexual minority subgroups when examining associations between sociocultural factors and ED risk is an important area of study.

The current study builds upon previous work by using cross-sectional data to examine similarities and differences between heterosexual, bisexual, and lesbian women in (a) levels of appearance pressures, thin and muscular-ideal internalization, and ED pathology and (b) a variation of the Tripartite Influence Model in which family, peer, and media appearance pressures lead to thin- and muscular-ideal internalization, which in turn lead to ED pathology. Both thin- and muscular-ideal internalization were assessed, as both thinness and muscularity have been acknowledged as integral to societal appearance ideals for women and are both detrimental to well-being when internalized (Betz & Ramsey, 2017; Robinson et al., 2017; Uhlmann, Donovan, Zimmer-Gembeck, Bell, & Ramme, 2018).

Section snippets

Participants

Participants were 1,895 undergraduate women who identified as heterosexual (n = 1,528), bisexual (n = 89), or lesbian (n = 278). Participants were recruited from undergraduate research pools at five universities across the United States (University of South Florida, Michigan State University, University at Albany – State University of New York, University of California – Los Angeles, and University of North Carolina at Chapel Hill) for a study described as an online study examining appearance

Results

After Bonferroni adjustments, ANOVA tests indicated differences by sexual orientation for age and peer appearance pressures (see Table 1). Compared with lesbian women, both heterosexual and bisexual women were older (medium effect size) and reported higher levels of peer appearance pressures (small-to-medium effect size).

In single-group path analyses, modification indices suggested including a bivariate association between thin-ideal internalization and muscular-ideal internalization

Discussion

Results of this cross-sectional study supported the Tripartite Influence Model among bisexual and lesbian women and indicated both shared and divergent processes across these groups. In contrast to some previous research (Meneguzzo et al., 2018), lesbian, bisexual, and heterosexual women in the current study reported similar levels of dietary restraint, shape/weight overvaluation, and body dissatisfaction. Further, all groups endorsed comparable levels of family and media appearance pressures

Acknowledgment

This work was supported by the National Institute of Mental Health (grant number T32 MH082761).

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