culture + environment creating health + wellbeing engaged research

Shame, Stigma and Colorectal Health for Bottoms

Wellcome Centres Collaborative Seed Funding Award

Principal Investigator (PI): Dr Richard Vytniorgu (Wellcome Centre for Cultures and Environments of Health, University of Exeter)

Joint PI: Dr Jaime Garcia-Iglesias (Centre for Biomedicine, Self and Society, University of Edinburgh)



Bottoms are men who have sex with men who prefer to engage in receptive anal intercourse (‘bottoming’). Bottoms have developed as a well-established identity category in gay communities, associated with specific forms of pleasure or power (Vytniorgu, 2022; Hoppe, 2011). However, these men may also experience stigma and shame around their sexual practices related to masculinity, body image and desirability (Ravenhill & de Visser, 2018; Moskowitz & Garcia, 2019).

When bottoming becomes painful, difficult, or impossible due to colorectal conditions (acute such as haemorrhoids, anal warts, or chronic such as IBS), these experiences of shame and stigma are likely to escalate, or compound with feelings of inadequacy. These feelings may prevent bottoms from accessing adequate/timely care or develop care relationships with healthcare providers (Finneran et al., 2021). Little research has considered the most effective ways of providing support for these men.

Our project will identify and begin to network with colorectal clinicians, primary care providers (GPs and nurses), and LGBTQ practitioners, counsellors, and activists, to map some of the key challenges affecting the care of men who bottom and may experience shame and stigma associated with accessing colorectal healthcare.

We are interested in hearing from anyone who works in these and related sectors, who would be keen to talk to us as we begin to develop longer-term research objectives and funding priorities.


Who we are

Project lead, Dr Richard Vytniorgu, is a literary and cultural analyst in the field of gender and sexuality, who currently works on narratives of belonging, gender nonconforming experience, and gay bottoms in Western and non-Western contexts and media. He is experienced in arts-health research collaborations (such as The Beat of Our Hearts and Consider Eating Disorders in Men), and is especially keen to identify opportunities for developing arts-based training for healthcare providers around shame and stigma among men who bottom and wish to access colorectal healthcare.

Project co-lead, Dr Jaime Garcia-Iglesias, is Mildred Baxter Postdoctoral Fellow at the Centre for Biomedicine, Self and Society at the University of Edinburgh. He holds a PhD in Sociology and has a background in literature and cultural studies. He specializes in the intersections of sexuality, internet and health, with previous work focused on PrEP use, intimacy online, and HIV prevention. He has also worked on the role that literature and fiction play in negotiating health and sexuality, with a focus on contemporary literature from the United States.


Next steps

We would love to hear from anyone interested in discussing issues around shame and stigma faced by men who bottom in colorectal healthcare settings, including in primary care contexts.

Please email Richard or Jaime: r.r.o.vytniorgu@exeter.ac.uk and jgarcia6@exseed.ed.ac.uk

We aim to hold an online workshop in partnership with independent animation and creative studio, Woven Ink, with non-clinical stakeholders, later in the summer, and to meet with clinical stakeholders at the end of the summer / early autumn 2022.



Watch this space for outputs associated with the project.