“I feel good, I feel comfortable, I feel at home”: Understanding the role of positive body image manifestations, body neutrality and functionality appreciation for trans men

Body image concerns are prevalent among trans men, yet research has primarily focused on appearance-based dissatisfaction rather than alternative frameworks. There is also limited research directly and purposefully exploring the experiences of trans men. This qualitative study explored how trans men navigate body image, gender congruence, and quality of life, using reflexive thematic analysis of semi-structured interviews with 20 participants from seven Global North countries. Findings highlight how societal masculinity norms initially reinforced body dissatisfaction and gender incongruence, leading participants to internalise rigid body ideals. However, over time, many redefined masculinity in ways that prioritised authenticity and self-acceptance, particularly through medical transition. Gender-affirming care played a key role in reducing distress associated with gender incongruence, enabling trans men to disengage from unrealistic body ideals. Many participants described a shift towards body neutrality and functionality appreciation, reframing their relationship with their bodies by focusing on what they could do rather than how they looked. These findings suggest that body image interventions and gender-affirming care may benefit from integrating approaches beyond appearance-based frameworks. Given the novelty of functionality appreciation and body neutrality in trans men’s body image research, future studies should explore their role in psychosocial well-being and long-term adjustment.