Guest Blog Post: Body Shame with Molly Maffeo
I’m Molly Maffeo, LCPC, a licensed therapist in Illinois specializing in LGBTQIA+ clients—especially transgender and gender-diverse individuals—and those navigating body image and eating disorder challenges. I train clinicians to provide affirming care, including writing letters of readiness for gender-affirming medical treatment, and serve as Lead Supervising Therapist and Community Outreach Specialist at Harper Grace Counseling. I am also the author of Body Love: A Comprehensive and Trans-Affirming Workbook for Improving Body Image and Managing Eating Disorder Symptoms, a guide to reclaiming a compassionate relationship with your body.
Understanding Body Shame in Therapy Through a Social Justice and Religious Trauma-Informed Lens
In therapy spaces, feeling uncomfortable in one’s body is often viewed through a lens of body image disturbance, body dysmorphia, or body dysphoria. While each experience is unique to each individual, the common thread is the belief that one’s body is unworthy of love and acceptance. Feeling unworthy is one of the most painful emotional experiences people carry. While it may feel deeply personal, the roots of these beliefs are anything but new—stretching all the way back to the 14th century.
The 14th century is the earliest documented time we see individuals restricting their food intake in a way that resembles modern disordered eating. This comes from religious leaders using scare tactics tied to the concept of the Seven Deadly Sins—specifically gluttony. This led to eating being viewed through a morality lens rather than a basic human need. When people began to view eating as a moral failure, we began to see individuals restricting their food intake in hopes of being recognized as more holy and closer to God. Over centuries, systems of power have shaped our beliefs about who can be considered attractive, worthy, moral, and acceptable. These patriarchal structures consistently target marginalized populations including women, BIPOC individuals, and gender-diverse people. These standards were not accidental; they were intentionally constructed through systems of social control, colonialism, and racism.
One of the clearest examples is the story of Sarah Baartman, a South African woman who was bought and sold by multiple European traders and exploited in early 19th-century Europe. She was displayed in so-called “freak shows” and circuses for European audiences. Not only was she egregiously mistreated, but white European women were simultaneously receiving and internalizing messages about how different their bodies must look in order to appear civilized and “not like a savage.” These narratives reinforced racial hierarchies while also creating restrictive beauty standards for women.
Diet culture made its way into the United States in the early 20th century, gaining significant traction around the 1920s—just after women secured the right to vote following the 19th Amendment to the United States Constitution. It is difficult to ignore the timing: as women gained greater political influence, cultural pressures increasingly focused on controlling women’s bodies. This period also coincided with the rise of life insurance policies and the search for standardized ways to evaluate health risk. During this time, the Body Mass Index became widely adopted in medical settings as a quick way to categorize bodies.
However, BMI can be deeply misleading. There are many medical conditions in which weight gain is a symptom rather than a cause. When weight becomes the primary focus, individuals may blame themselves for health issues that are not within their control. This can discourage people from seeking medical care, contribute to medical dismissal, and leave many suffering silently with shame that is not theirs to carry. Finally, it is important to distinguish between dysmorphia and dysphoria. Body Dysmorphic Disorder refers to distress related to perceived flaws in appearance—often features that others may not see or would not consider significant. Dysphoria, on the other hand, refers to a deeper incongruence in which someone does not feel at home within their body. While gender dysphoria is often discussed in relation to transgender individuals, rigid gender norms within society can intensify this experience.
Strict expectations about how men and women “should” look, behave, and present themselves create pressure for everyone. For transgender and gender-diverse individuals, these norms can widen the gap between how they are perceived and how they understand themselves. Cisnormative standards can therefore exacerbate dysphoria and contribute to feelings of isolation and exclusion.
Understanding the historical and systemic roots of body dissatisfaction can be an important step in reducing shame. When we recognize that these standards were constructed through systems of patriarchy, white supremacy, and social control, we can begin to challenge them rather than internalize them.
About Molly
Website: https://www.harpergracecounseling.com/
Email: molly@harpergracecounseling.com
Psychology Today: https://www.psychologytoday.com/us/therapists/molly-kathleen-maffeo-lombard-il/471716