Written evidence submitted by Stonewall (MISS0058)
1. Stonewall welcomes the opportunity to respond to this Inquiry. Many lesbian, gay, bi and trans (LGBT) people experience poor and unrealistic body image, which can have a significant impact on their mental health and wellbeing. This can contribute to mental health challenges including anxiety and depression, which LGBT people are at higher risk of experiencing.
2. Stonewall is Britain’s largest LGBT organisation. We commission high-quality independent research into LGBT people’s experiences, including health and wellbeing. We work with over 750 employers – including the Department for Health and Social Care, NHS England and national media organisations – to support them to deliver LGBT-inclusive services.
The risk of poor body image to LGBT people
3. LGBT people are particularly vulnerable to experiencing poor body image, with 40 per cent of LGBT adults more likely to experience shame due to their body image, compared to 18 per cent of their non-LGBT counterparts (Mental Health Foundation). The ways in which poor body image is internalised and experienced varies across the LGBT community, with studies showing that many gay and bi men may feel pressured to look ‘thin’, ‘athletic’ or ‘muscular’ and lesbian and bi women pressured to resemble the ‘ideal’ female body-type (which is contingent across time and space). Trans people also experience these pressures, compounded by the profound psychological distress of gender dysphoria.
4. Poor body image can have a significant impact on the mental health of LGBT people. For example, research commissioned by Mental Health Foundation and YouGov (2019) found that:
5. Poor or unrealistic body image can be linked to eating disorders. Stonewall’s LGBT in Britain: Health Report (2018) found that:
What contributes to poor body image for LGBT people?
Social media & advertising
6. Research commissioned by the Mental Health Foundation and YouGov has shown that social media and commercial advertising cause significant social harm and mental health issues in relation to body image by perpetuating unrealistic notions of the ‘ideal’ body type:
Bullying, harassment and discrimination in everyday life
7. Everyday bullying, harassment and discrimination can have a significant impact on the health and wellbeing of the LGBT community, and may result in internalised feelings of shame which can fuel negative associations with body image (Mental Health Foundation; The LGBT Foundation). Many LGBT people experience abuse and discrimination due to their identity, both online and offline:
8. Any intervention by Government must therefore ensure that a strategy to tackle poor body image is inclusive of LGBT experiences.
9. Stonewall welcomes policies put forward in the Online Harms White Paper (and the Government’s initial response to the consultation on this), including the creation of a new statutory duty of care for online companies, and the creation of a new independent regulator with enforcement powers to hold online companies accountable to this new duty. We welcome the duty placed on companies to take action to address harmful content, including self-harm content which encourages eating disorders, and that services must respond quickly and remove content upon reporting (para 7.35).
10. It is also promising that the paper states that companies will be required to take steps to ensure that vulnerable users and users who search for content that encourages eating disorders are directed to and able to access support (7.35). We echo calls by the Mental Health Foundation that the paper should go a step further to also address harms relating to the promotion of unhelpful or idealised body image online. The independent regulator (Ofcom) should also improve practices on how social media platforms promote unhealthy body image.
11. We echo the Mental Health Foundation’s recommendation that ‘the Advertising Standards Authority should consider pre-vetting high-reaching adverts from high-risk industries – such as cosmetic surgeries and weight loss products and services – to ensure all advertising abides by its codes. It should also make greater use of its ability to proactively instigate investigations’.
12. NHS mental health services should train all staff on the mental health needs of LGBT people (including the relationship between anti-LGBT discrimination and unhealthy/unrealistic body image). Resources that are LGBT-inclusive and recognise this relationship should also be produced for patients who may need them.
13. It is encouraging that RSE statutory guidance states that by the end of secondary school, pupils should have knowledge of internet and safety harms, including ‘the impact of unhealthy or obsessive comparisons with others online, including through setting unrealistic expectations for body image’ (paragraph 103). The Government must adhere to its commitments and invest the full £6 million committed for 2019-20 in RSE implementation, and build on this investment as implementation continues. The accompanying implementation guide and resources should also be fully LGBT-inclusive.