Mapping Sexual Identity, Body Image, and Childbearing Desire of Hong Kong Chinese Young Lesbians: A Community-Based Cross-Sectional Study

Background and Purpose: Existing studies about female body image have predominantly focused on heterosexual women, but overlooked how Hong Kong lesbians respond to mainstream and lesbian subcultural norms to represent their bodies. In particular, in the Hong Kong Chinese context in which people tend to classify lesbians according to a gendered understanding of sexuality, some lesbians identify themselves with subcultural labels, namely TB (tomboy with a masculine gender style), TBG (tomboy’s girlfriend with a feminine gender style), and PURE (which denotes an androgynous gender style), while some refuse to label themselves. It is relatively unknown to what extent local lesbians’ body image and same-sex relationships are affected by these cultural ideologies. Moreover, there is currently no research on their childbearing desire. This research fills the gap by examining the associations between sexual identity, body image, and attitudes towards childbearing among local lesbians. It aims at sensitizing social workers and policy makers to alternative ways of bodily representation and non-heterosexual family formation.

Methods: By e-mail invitations through community-based LGBT organizations, a convenience sample of 438 Hong Kong Chinese lesbians were recruited to complete a cross-sectional online survey from December 2014 to March 2015. The age of participants ranged from 18 to 35 (mean=24.7, SD=4.60). Participants were well-educated, with 80.8% undergoing or having completed undergraduate studies. Validated measures, namely the Body-Esteem Scale and the Childbearing Importance Index, were employed to examine participants’ levels of body satisfaction and perceptions of childbearing. 

Results: Data shows that 45.4% of participants chose not to identify themselves with subcultural labels while 24% identified themselves as TB, 16.7% as TBG and 13.9% as Pure. Participants with no subcultural labels had a significantly higher level of esteem towards their Appearance of the Body-Esteem Scale compared to TB and PURE [F(3, 428)=4.89, p<0.005]. Meanwhile, according to its Attribution subscale, TBG had more positive feelings about Others’ Evaluations of their bodies compared to TB and participants with no labels [F(3, 428)=4.69, p<0.005]. Comparing the Childbearing Importance Index, TBG rated the importance of childbearing to themselves and to family significantly higher than TB did [p < 0.05].

Additionally, 91.5% of participants supported that lesbian couples should be legally allowed to receive assisted reproductive technology (ART) in Hong Kong. Among these supporters, more than half of them (53.3%) expressed childbearing desire while only 43.9% expressed their intention to seek ART to conceive. In this aspect, no significant differences were found among participants with different labels.  

Implications: This first quantitative survey of Hong Kong lesbians suggests that TB had a relatively low level of body esteem and childbearing desire due to gender non-conformity, while TBG considered their feminine body image more satisfying and childbearing more important. Despite diverse perceptions of childbearing, the majority of participants supported legislation on lesbians’ rights to reproduction in Hong Kong. This research helps social workers better understand the emotional burden of lesbians in relation to their body image and fertility plan. Further research is warranted to explore the needs of various types of local lesbians and obstacles they encounter.