Rationales and Meaning-Making of Medical Anti-Aging Aesthetic Treatments Among Chinese LGBTQ+ Male Adults: A Phenomenological Study

Background: LGBTQ+ individuals with assigned male sex at birth often experience challenges related to aging, body image, and appearance, shaped by both biological changes and social norms rooted in cisnormativity and heteronormativity. In recent years, Chinese LGBTQ+ male individuals using medical anti-aging aesthetic treatments (MAAAT) have been trending, particularly among young adults, reflecting their increasing anxiety about aging and embodiment. MAAAT refers to physician-led surgical and non-surgical procedures for skin rejuvenation and mitigating visible signs of aging. As a gendered and ageist treatment, why do Chinese LGBTQ+ male individuals pursue and what are the outcomes or meaning of using it, remains understudied. Uncovering their lived experiences, particularly the rationales and meaning-making of MAAAT, can offer added insights into understanding their experiences of aging and sexual and gender identities, which will prepare mental health and healthcare professionals to provide competent care.

Methods: This study adopted an interpretive phenomenological and an art-based self-image representation approach to investigate their lived experiences. Purposive sampling was used in social media recruitment. Semi-structured interviewing and art-based self-image drawing/imagining were conducted via video conferencing tool from June to October of 2025. Interviews lasted 84 minutes on average, ranging from 54 minutes to two hours. Sixteen participants aged 21-39 joined this study (Mean=27.75). Twelve identified as men, three transgender women, and one bigender individual. Eleven described themselves as gay, two bisexual, one lesbian or same gender loving, one heterosexual or pansexual, and one self-loving, bisexual, or asexual. Interpretive phenomenological analysis was employed to facilitate understanding of the rationales and meaning of MAAAT. Audit trails, memoing, and member-checking were conducted to enhance trustworthiness.

Findings: The explicit and contextual rationales emerged, respectively: (1) Self-Optimization through Accessible and Gendered Physical Modification; (2) Ageist LGBTQ+ Culture in A Meritocratic Society. These rationales uncovered the multilayered dynamics underlying participants’ intention of pursuing MAAAT as a gendered but normalized approach to addressing perceived appearance deficits and identity confirmation needs, which were situated within discriminatory and competitive community and societal environments. The meaning of MAAAT converged into: (1) MAAAT Facilitated Self-Empowerment and Identity Affirmation; (2) MAAAT Prolonged the Peak Youthful State and Delayed Aging Compared to Peers; (3) MAAAT Enhanced Individual and Queer Community Capital. These findings suggest that MAAAT was beneficial in psychosocial empowerment, identity affirmation and coherence, counteracting aging-related visibility loss, sustaining social positioning, and enhancing bodily and symbolic capital.

Conclusion: MAAAT serves not merely as a tool for physical improvement but as a multidimensional strategy for buffering aging anxiety, identity governance, and social position maintenance. This study also connects aging appearance to identity control and bodily management to broader social stratification among the Chinese LGBTQ+ male populations, while agentive perspectives of aligning physicality with internal identities shifted prior research on punitive self-objectification. Recognizing the lived experiences and meaning of MAAAT among LGBTQ+ male individuals while promoting healthier management that resists ageism is recommended. Social workers can develop culturally and identity-affirming practices for body image, aging anxiety, and social pressures, while supporting agency and well-being in navigating normative expectations in this population.