Piotr Nowicki Alexithymia and sexual satisfaction among homosexual men: the mediating role of body image dissatisfaction and fear of intimacy

Abstrakt

Backgroung

Alexithymia – a multidimensional trait marked by difficulty identifying and describing emotions and an externally oriented thinking style – has been linked to poorer emotion regulation, interpersonal difficulties, and reduced relational security. Emerging work also suggests associations with sexual functioning, yet the pathways remain unclear. Two candidates are body image dissatisfaction and fear of intimacy: homosexual men show elevated vulnerability to negative body image (e.g., pressures toward muscularity) and may experience minority-stress–related threats to self-esteem, which can heighten avoidance of emotional and physical closeness. Negative body image can disrupt attention during sexual activity and undermine comfort with bodily exposure, while alexithymic deficits may further impede intimacy. Building on these strands, a serial mediation model was tested in which alexithymia relates to lower sexual satisfaction via body image dissatisfaction and, subsequently, fear of intimacy.

Participants and Procedure
The sample comprised 216 homosexual men aged 18–30 years (M = 26.73, SD = 5.84) who completed online questionnaires. Analyses were conducted using serial multiple mediation (PROCESS, Model 6; Hayes, 2022) with bootstrapping (5,000 resamples; 95% BC CIs)

Results
Alexithymia was associated with lower sexual satisfaction both directly and indirectly. Body image dissatisfaction (a₁b₁ = −.10, 95% CI [−.18, −.04]) and fear of intimacy (a₂b₂ = −.12, 95% CI [−.20, −.05]) each significantly mediated this association. In addition, the sequential indirect effect was significant (a₁d₂₁b₂ = −.09, 95% CI [−.15, −.04]). After including the mediators in the model, the direct effect was no longer statistically significant, which is consistent with a pattern of full mediation.

Conclusions
Findings indicate that lower sexual satisfaction in young homosexual men is attributable to alexithymia’s indirect effects operating through body image dissatisfaction and heightened fear of intimacy, consistent with full mediation. These results highlight emotional awareness and body-related self-perceptions – together with intimacy avoidance – as actionable targets for assessment and intervention. The serial mediation framework offers a concise account of mechanisms underpinning sexual difficulties in sexual minority populations and can inform focused clinical strategies.