Article written for Carleton University’s J-School in the spring of 2023

[Unpublished]

Landon Liu, 24, experienced their most startling moment of gender dysphoria only a year and a half ago, after a muscle-building workout.

“I was just running back home from the gym actually. And I had a very, let’s just say, effective compression sports bra on and I was just running through the field and I actually, like, broke down crying at the end of the run because at that point, my chest was basically completely compressed and I just had this moment of like, ‘oh my gosh, I want to like exist like this all the time.’ ” said Liu. That was sort of like my egg-cracking moment.”

Liu, who identifies with both masculine and agender terms under the non-binary umbrella, currently works as a data analyst at the University of Ottawa, where they research food insecurity. Outside of their profession, Liu enjoys lifting and says they started “way, way before [coming] out initially.”

“I just had always felt like very small. When I was in high school, I probably weighed around, like, 100 pounds and I’m five three, so, I was pretty small as a person,” they say. “I really wanted to, like actually feel very strong in my own body. So, I started lifting early in university … After a while, I realized it was doing really great things in terms of like, I think just anchoring my mental health, which I think for a lot of people in university kind of goes up and down a lot.”

As someone who isn’t yet taking testosterone as hormone replacement therapy, Liu says lifting in the meantime has helped with their gender dysphoria — the sense of unease one feels due to the misalliance of biological anatomy with gender identity. Through certain regiments and workouts, Liu says they are able to focus on building a body they say is masculinizing.

“I’ve sort of figured out like, okay, the things I feel dysphoria about is specifically the fat distribution around my hips, which, functionally, I can’t really do much about without T [testosterone], but I can train my obliques, so they appear larger, and they fill out the sides, so I look a little bit more straight up and down, or building pecs so the chest is less overtly exposed” says Liu. “Some of us aren’t on T and some of us want to see faster results than just being on T.”

Unfortunately, for many transmasculine people, striving for the standard of masculinity through excessive muscle-building regimes and bulking diets can become an obsession and what’s called “muscle dysmorphia.”

Muscle dysmorphia, or MD, is a form of body dysmorphic disorder (BDD) that enables one to ascertain perceived flaws in their muscularity or leanness. The symptomatology of body dysmorphic disorders also falls within the obsessive-compulsive disorder category.

A recent study titled, “Muscle dysmorphia symptomatology among a national sample of Canadian adolescents and young adults,” which was published Jan.17, highlights the growing prevalence of behavioural patterns associated with the phenomenon. From the sample of those who were most at risk of for displaying MD, 18 per cent were transgender and gender non-conforming. The study also specifically points out reasoning for the higher representation in this demographic, saying gender dysphoria leads to the “desire to change their body to be more muscular (i.e., trans men may desire a more muscular and masculine body).”

Another study published in July 2021, “Community norms of the Muscle Dysmorphic Disorder Inventory (MDDI) among gender minority populations,” re-emphasizes the elevated presence of muscle dysmorphic practices and desires in transgender men, who showed to have the highest score in the study.

Rachel Rodgers, an associate professor of Applied Psychology at Northeastern University and director of the Applied Psychology Program for Appearance and Eating Research (APPEAR), co-authored many pieces of academic research on the subject of muscle dysmorphia, including the one published in January.

In relation to the study, she says “one of the tricky things is that we actually have very, very little data related to muscle dysmorphia, because it’s a diagnosis that has some difficulties in terms of its utilization. So, that was looking at a continuous symptom scale, and looking to see how adults were responding in terms of that continuous measure.”

According to Rodgers, the challenge in diagnosing a person with MD comes from the social aspect. “For example, the fact that, particularly among men, muscle-building exercises are so socially reinforced means that it’s a disorder that is based on behaviors that you can engage in it to quite a severe extent, without it being perceived by others as problematic.” She compares this to OCD and checking numerous times whether you’ve locked the front door, as without context that this is being done repeatedly and fanatically, it might be harder to differentiate from typical behaviour.

“Engaging in muscle-building exercise is broadly framed in society generally as being this really good thing. And therefore, you can be very invested in it without anybody saying, ‘hey, you know, I’m not sure about this, maybe we need to talk,’ ” she explains. “That creates a lot of barriers to people seeking help, which creates barriers to us diagnosing it.”

The ways in which muscle dysmorphic practices affect those who are transmasculine boils down to the intersection of gender dysphoria and discrimination for not fitting into the ideals of masculinity. Rodgers says not only would this be a factor, but that there is a safety component to reaching this kind of physical appearance.

“We know that people who are transgender and gender non-conforming can experience high rates of stigmatization and trauma,” says Rodgers. “These behaviors can be used as a maladaptive coping mechanism when people are experiencing those things, and they can be perceived as something that might increase personal safety. I think there are also functional benefits too — that people might also think that they will be better able to defend themselves if they have previously found themselves in situations where they felt unsafe.”

Rodgers further discusses the deeper component that aids in cultivating muscle dysmorphia: the ideals of hegemonic masculinity, which “is very much tied to muscularity.”

“One of the things that is complex as a trans masculine young adult is the fact that the pursuit of muscularity is not only related to ideals around ideal appearance, but also ideals around who I wish to be in the world,” she explains. “It is never helpful to place the burden of resistance on people who are already experiencing challenges … it can be helpful to remember that those are social constructs and those are pressures that exist because they preserve structures of power and privilege, and we shouldn’t have to abide by them.”

Liu also relays this idea that while gender, to them, is a social construct, there is still the desire to meet those societal ideals. “As a trans masculine person, I still sometimes feel some of the pressure to hit certain boxes that have been laid up for men specifically … but I think that we are, as a society, sort of questioning at this moment, like, why do we expect men to be super jacked?” However, with more and more identifying outside of the gender binary, Liu says they are now “adding to the conversation and challenging those sorts of notions.”

In Statistics Canada’s 2021 census, it was found that 27,905 Canadians identified as transgender men and 41,355 identified as non-binary, showcasing the ever-present national trans community. With many within this demographic at risk for muscle dysmorphic mentality, a fitness centre located in Edmonton, Alberta provides a safe and inclusive haven, demonstrating sustainable and healthy fitness ideals while meeting the needs of the city’s transgender and gender non-conforming community.

Toni Harris and Zita Dube-Lockheart are co-owners of Action Potential Fitness and co-directors of Fitness Trans Formed, a program uniquely designed for those who self-identify outside of the cisgender identity.

“I’ve known that I had gender dysphoria since I was very small, but only recently came out and started my transition,” Toni shares. “There is no cookie cutter formula … I was on a quest to become less shapely and have a more male presenting figure. But I didn’t do things in a very healthy way … I decided to go to school to become a certified trainer, as I wanted to be able to help people to do what I had done but do it in a healthy way that was less harmful to themselves.”

As part of their training approach, Harris and Dube-Lockheart implement conversations around bodily self-perception. This way, they become aware when a client of theirs may be exhibiting harmful behaviours or ideas around fitness.

“We’ve seen quite a bit of that actually in our program,” says Harris. “A lot of the Fitness Trans Formed program was kind of roundtable discussions so that people could share their experiences, and we could start to help them to understand maybe if they had muscle dysmorphia, but nobody had ever talked to them about it … I think that awareness has helped a lot of them to kind of keep it under wraps and helping them to engage in safer fitness programming.”

“Cultivating a culture of inclusion is more of a philosophical approach than an actual list of checkboxes and actions, right? You have to really take it from the perspective that every body has the right to move safely, and to feel accepted and welcome in fitness spaces,” Dube-Lockheart continues. “And once you kind of accept that every body belongs, and I mean that very literally, then we start to look at how does each individual engage with their bodies, and how does that impact their exercise response?”

These kinds of spaces don’t exist in most places, especially those which take into account the variables that intersect when it comes to transgender and non-binary individuals in the fitness sphere. Muscle dysmorphic challenges in transmasculine youth, in addition, are rarely looked at through the lens of medical health.

“I think there’s never enough education. And I think that many health professionals are trained within really dominant medical models, where the predominant idea is, most people are not moving their bodies enough, most people are not doing the right things and we need people to be controlling their weight,” says Rodgers. “This is not a framework that I agree with, and it is the dominant one. I think, therefore, that a lot of these behaviors also get missed or approved of by health professionals who are kind of used to seeing the world through that lens, therefore, they also may not be looking at things in a different way.”