A qualitative study of body image, body positivity, and sexuality in women

BACKGROUND: Extensive quantitative research has demonstrated direct relationships between body image and sexual health outcomes in women. However, these methods may be less able to explicate how women themselves connect the two spheres of their lives. Qualitative methodologies can offer insight into nature of the mutual influence between sexual health and body attitudes.

METHODS: As part of a larger mixed-methods study, 19 women were interviewed twice on body image and sexual health topics. Interviews were digitally-recorded, transcribed verbatim and analyzed using critical qualitative methods. The analytic goal was to explore the meanings women made of sexual health experiences and explicit or implicit connections between their sexual health and body image.

RESULTS: Women who expressed that their bodies had inherent personal and social value expressed more comfort with their sexual bodies, ability to selectively choose sexual partners, and less sexual dissatisfaction and regret. Women who did not value their bodies because of body insecurity articulated how their body size and appearance hindered them from having sexually healthy lives. Participants specifically mentioned lack of sexual agency with partners and engagement in unwanted sexual activity.

CONCLUSIONS: Body positivity served as a buffer against harmful sexual experiences for women in this study. Conversely, a high level of investment in attaining body standards was articulated to be directly related to negative sexuality outcomes. A “sexual health at every size” perspective which promotes acceptance of all body sizes may be a means for practitioners and providers to directly and indirectly improve sexual health outcomes in women.