Perceptions and Embodiments of Masculinities Amongst Men Who Use(d) Image and Performance Enhancing Drugs: a Mixed-Methods Approach During COVID-19 and Beyond

Abstract

The use of IPEDs (Image and Performance Enhancing Drugs) has become a growing area of concern for public health, particularly over the last decade (Santos and Coomber, 2017). The vast majority of the population consuming these substances are men, who are utilising them in the attempt to boost their physical appearance and/or performance (Sagoe et al., 2014). Historically, it was widely understood that men who use IPEDs do so predominantly for athletic pursuits, in order to improve sporting performance or for bodybuilding (Hope et al., 2021). However, recent years has seen a diffusion of these substances in society, with more non-sporting populations consuming them (Bates and Backhouse, 2019), often in the pursuit of achieving body image goals (Harris, Dunn and Alywn, 2016), and/or increasing muscularity (Bates et al., 2021). In this growing cohort, the role of masculinity plays an important role of influencing this consumption, with neoliberal masculine contemporary body image ideals reflecting an increasingly sexualised and fetishized version of the male form (Wykes and Gunter, 2004; Hakim, 2019). However, there have been limited studies exploring the role of idealised and contemporary masculinities in the uptake and continued use of these substances, as well as the cultures that surround them. This study presents one of the very first qualitative explorations of the perceptions of masculinities among men who use IPEDs. This research took place between 2019-2022, during the COVID-19 pandemic, and as such has also grounded its findings within the time context of the pandemic, and further seeks to observe how men’s use of IPEDs and other fitness behaviours were affected during this time. This thesis is therefore conducted in order to provide context and insight into the population of men who use IPEDs, and, ultimately, hopes to encourage drug policy and its makers to consider these thematic connections, and to reflect these in its development and implementation. The contribution made by this research work consists of two main studies, exploring six research objectives. The first aims to explore the objectives specifically relating to their presentation across online platforms. It consists of a netnographic investigation carried out across four major bodybuilding forums and focuses on the following areas of analysis: (1) Masculinities, (2) Motivations for use (of IPEDs), (3) Body goals (e.g., losing mass), (4) Attitudes towards women and/or sexuality, and (5) General attitudes towards IPED use. From this, five major thematic subthemes emerged and were analysed in a subsequent application to theory: (1) Workout routines, (2) IPED use in lockdown, (3) The body and body image, (4) Mental health, IPED use and COVID-19, and (5) Masculinities, sex, and sexuality. Additional data was collected during a follow up study, which provides further insight into the research aims and objectives, as well as further context to the themes observed during the netnographic study, by utilising first-person accounts from men who use IPEDs. This research consists of a cross-sectional survey comprising of 11 independent questions, providing mixed data types, including written word, original images, and Likert scales. The invites to participate in this study were disseminated across the platforms observed during the netnographic research component, as well as additional online forums and social media. 15 men participated in the survey during May 2021, and their responses were subject to deductive thematic analysis, which highlighted four prominent themes which were subsequently analysed: (1) IPED use, exploring uptake, side-effects, and the impact of COVID-19. (2) Body image amongst men who use(d) IPEDs, which explores body image goals and the impact of culture on body ideals. (3) Idealised masculinities amongst men who use IPEDs, which explores the connections of these idealisations to body image, themes of dominance and toxicity, heteronormativity, sexual performance, and capitalism. (4) Social media, IPEDs, masculinities and mental health, which explores the pressures on body image presented by social media, and its role in mental health amongst men who use IPEDs. The original contribution to knowledge focuses on the intersection of methodology types applied to this topic area, as well as the in-depth analysis of masculine gender identities and their contemporary influences. The main conclusions presented by this thesis, by research objectives, are (1) findings supported broader literature on key motivations for uptake of IPEDs amongst men, with predominant rationales being: muscle gain, body image, and strength. (2) An emphasis on traditional masculine identities was observed within the collected data, including language related to heteronormativity and sexism. Clear links were also made between men who consume IPEDs utilising muscularity as a tool to present and articulate visual expressions of masculinities. (3) A relationship between social and traditional medias and contemporary idealised forms of masculinities was observed and was further highlighted as a key influence on body image goals amongst men who use IPEDs. (4) An influential relationship was observed between capitalism, subcultural ideals, and the uptake of IPEDs, specifically in relation to societal body image norms. (5) COVID-19 was shown to significantly impact on both fitness behaviours and the consumption of IPEDs, including the rationales for uptake and continued consumption. Online platforms also presented as key areas for support and education for men who use IPEDs, with heightened importance in the COVID-19 pandemic. (6) COVID-19 did not exacerbate existing views relating to traditional masculinities, heteronormativity, and sexism, but did provide new language to be used within these contexts. Overall, a strong relationship between body image, idealised masculinities and online spaces emerged throughout this research. These factors were observed both in relation to influences of uptake of IPEDs, as well as acting as important avenues for the effective dissemination of support and education to men who consume IPEDs. Future studies should continue to explore the nuances of these relationships and the effective utilisation of online spaces for encouraging safe consumption.