Body Dysmorphia Doesn't Have to Win in the Bedroom

Feeling comfortable with our bodies can be a challenge for anyone. For people who experience body dysmorphic disorder, that challenge can become even more complicated.

Body dysmorphia can make you hyper-aware of your perceived flaws, leaving you anxious, self-conscious, and distracted, especially in intimate situations. These feelings can make enjoying sex seem like an impossible concept, but there are ways to navigate them and reclaim a sense of comfort and control.

What is Body Dysmorphic Disorder?

Body Dysmorphic Disorder (BDD), also referred to as Body Dysmorphia, is defined as ‘a mental health condition in which you can't stop thinking about one or more perceived defects or flaws in your appearance’.

Symptoms of BDD most commonly begin around age 12 or 13, and while it can be a long-term condition, it is very treatable. Although BDD manifests differently in everyone, some common areas of insecurity can be the skin and complexion, body size and shape, facial features, and even the appearance of our genitals.

Living with these insecurities can preoccupy our thoughts during everyday moments, such as going to school or work, as well as during our more personal moments, like in our sexual and romantic relationships. Because these worries feel ever-present, people who experience BDD are also more likely to experience depression, anxiety, OCD, eating disorders, and substance use issues.

Over recent years, researchers have found that social media has become a large risk factor for body dysmorphia. Anyone can find themselves comparing their own appearances to the highly filtered and edited images that they see online. This reinforces beauty standards that are not just unrealistic, but completely impossible.

How does body dysmorphia affect how we have sex?

How BDD interacts with sex is different for everyone.

‍For some people, BDD can contribute to compulsive or impulsive sexual behaviours. Essentially, this means taking part in sexual acts without fully thinking them through, or exploring how you feel about them. This could look like having sex with people you don’t really like in order to feel more attractive or valuable, or taking part in sexual acts that you don’t really want to do, just to please someone else. Unfortunately, these feelings of validation are almost always temporary, and can leave us feeling worse about ourselves than before.

On the other hand, some people experiencing BDD might avoid sex completely, or even feel scared of it.

They might feel afraid of being rejected, or judged, or having their insecurities highlighted and laughed at. In these moments, it’s hard to trust that people you’re connecting with  won’t make you feel this way, and so distancing yourself from sex feels like the safer option.

Even with trusted partner(s), intrusive thoughts about our appearances during intimacy can cause us to become distracted, dissociated, and even distressed. Thoughts related to BDD can pop up unexpectedly, turning pleasurable experiences into anxious ones. When this happens, it can feel like enjoyable sex is an unreachable goal, but this is far from true, and there are many ways to manage these thoughts to reclaim a sense of security.

How to enjoy sex when you’re experiencing body dysmorphia

While you can’t always control when intrusive thoughts might appear, there are lots of aspects of sex that you can control.

1. It’s important to make sure you trust your partner(s) – and accept that this can take time and effort. If you feel comfortable, it might be helpful to explain your insecurities to your partner(s), so they can try to avoid triggering you by focusing on the parts of your body that feel safe and comfortable. You can also try gently guiding their hands, positioning yourself in ways that feel more comfortable, and even using a safe word in case negative thoughts pop up. Whatever you need, it’s okay to ask for that.

2. You can also ask for reassurance if that’s something you need. Letting your partner(s) know that verbal affirmations help you feel more at ease can make a big difference. They might tell you what they like about your body and your personality, what turns them on, and how you make them feel, all of which help to shift your focus away from self-criticism and towards self-appreciation.

3. Setting the mood and your environment during sex can also allow you to soothe anxieties around your body. It’s okay to dim the lights, stay under the covers, or keep certain items of clothing on until you feel more comfortable taking the next step to full nudity. You’re allowed to take sex at your own pace, and no one should pressure you into anything you’re not comfortable with.  

4. Finally, there are steps you can take outside of intimacy to support how you feel during sex. One helpful change is being more mindful with your social media use. Try limiting your time spent on social media or curating your feed to include people who look like you, share your body type, or promote body neutrality and positivity rather than heavily edited images. Similarly, don’t stalk your partner’s ex online, or search for more details of their past sexual experiences - although it can be tempting, it’s not healthy, and it’s better to focus on your unique and personal experiences of intimacy rather than comparing them to anyone else’s.  

Although these independent actions and choices can help with managing your BDD, it’s important to remember that there is no shame in seeking professional support. Guidance from a therapist or counsellor can help you to build confidence, gain more personalized advice, and feel more at home in your body.

While BDD is complex and complicated, it doesn’t have to affect our sex lives forever. With the right support, some practical strategies, and a little bit of patience, you can enjoy intimacy that feels safe, real, and even fun.

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