Beyond LGBTQ+: Centering QT2S lived experiences in body image research

This critical narrative review examines body image within Queer, Trans, Two-Spirit (QT2S) communities, centering how race, gender, community norms, and dominant beauty ideals shape embodied experience. While body image research has grown in recent decades, it continues to privilege white, cisheteronormative perspectives, leaving critical gaps in understanding QT2S lived realities.

A structured search was conducted across PubMed, PsycINFO, CINAHL, and targeted journals to identify peer-reviewed, full-text English-language articles published between 2019 and 2024. Studies were eligible if participants identified as QT2S and body image constructs (e.g., dissatisfaction, appreciation, embodiment) were examined. Twenty-five studies met inclusion criteria. Data were analyzed through thematic synthesis, informed by Intersectionality, Queer of Color Critique, and Gender Performativity.

Across diverse study designs, three overarching themes emerged: (1) Exclusion and belonging across social contexts, (2) Socialization of body ideals, and (3) Media surveillance, and the internalized gaze. Findings highlighted how structural discrimination, intra-community dynamics, and media surveillance reinforce Eurocentric and cisnormative ideals, while also shaping strategies of resistance and resilience.

QT2S body image concerns cannot be reduced to individual pathology but must be understood as outcomes of structural and cultural systems of regulation. This review identifies persistent underrepresentation of QT2S communities, the erasure of two-spirit identities, and the need for culturally responsive, intersectional frameworks to guide future research, clinical practice, and public health interventions.