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Body Image Concerns of Gay Men: The Roles of Minority Stress and
Conformity to Masculine Norms
Sara B. Kimmel and James R. Mahalik
Boston College
The authors hypothesized that gay men’s experiences of minority stress and their conformity to
masculine norms would be associated with increased body image dissatisfaction and masculine body
ideal distress. For this cross-sectional study, 357 gay males completed a Web-based survey, and 2
multiple regression analyses indicated that minority stress factors (i.e., internalized homophobia, ex-
pected stigma for being gay, and experiences of physical attack) were associated with body image
dissatisfaction and masculine body ideal distress, accounting for 5% and 13% of the variance, respec-
tively. Gay men’s conformity to masculine norms was not associated with body image dissatisfaction but
did uniquely explain an additional 3% of variance in masculine body ideal distress scores. The utility of
the minority stress model, how traditional masculinity may contribute to gender-related presenting
concerns, suggestions for developing and evaluating remedial and preventive interventions, limitations,
and future research issues are discussed.
Keywords: minority stress, gay men, body image, masculinity
Gay men tend to report greater body dissatisfaction, body-
related distress, eating-disordered behavior, and poorer body im-
age than do heterosexual men (Beren, Hayden, Wilfley, & Grilo,
1996; French, Story, Remafedi, & Resnick, 1996; Lakkis, Ric-
ciardelli, & Williams, 1999; Russell & Keel, 2002; Siever, 1994).
One theoretical framework that might be useful in explaining body
dissatisfaction in gay men is Meyer’s (1995) minority stress
model. The model posits that, “gay people, like members of other
minority groups, are subjected to chronic stress related to this
stigmatization” (p. 38), and describes internalized homophobia,
expectations of stigma, and prejudicial events such as violence as
distal and proximal sources of stress. Internalized homophobia is
the degree to which a gay man internalizes the antigay sentiments
of the larger heterosexual society and represents an internal form
of stress (Gonsiorek, 1993; Meyer, 1995, 2003). Expectations of
stigma represent the gay man’s anticipation that he will be rejected
and discriminated against by society because of his sexual orien-
tation (Meyer, 1995, 2003). Experiencing prejudicial events such
as antigay attacks is another factor contributing to minority stress
affecting gay men. Such victimization is seen as interfering with
the perception of the world as meaningful and orderly and leading
to victims’ sense of the world as insecure and of themselves as
vulnerable (Garnets, Herek, & Levy, 1990). Research supports that
these factors predict mental health distress for lesbian, gay and
bisexual men and women (Cochran & Mays, 1994; D’Augelli &
Hershberger, 1993; Diaz, Ayala, Bein, Jenne, & Marin, 2001;
Herek, Gillis, & Cogan, 1999; Meyer, 1995; Waldo, 1999).
One of our purposes in this study was to determine whether the
minority stress model may be useful in explaining gay men’s body
image concerns. Supporting this idea, some scholars speculate that
gay men who internalize homophobic attitudes and have greater
expectations of being stigmatized for being gay may desire a
powerful physique as a form of defense against the experience of
prejudice from others or may develop a negative body image as a
result of their own internalized shame (Williamson, 1999). Being
a victim of an antigay attack may also lead to a greater desire for
a more powerful physique as a mechanism through which gay men
can feel safer from and more powerful against future antigay
attacks and discrimination, as has been speculated to be true for
some lesbians (Crowder, 1998). In this way, experiences of mi-
nority stress may put gay men at greater risk for body image
concerns.
Because gay men’s experiences reflect both being gay and being
men, the second purpose of our study was to examine whether the
model should incorporate gay men’s conformity to masculine
norms as a factor contributing to mental health concerns for gay
men. Support for the idea of incorporating masculinity into under-
standing gay men’s body image concerns comes from scholars
who suggest that gay men may seek ways to compensate for
perceptions that they are less masculine. These scholars suggest
that desiring a powerful masculine physique is often a defensive
reaction to the dominant society’s stigmatization of them as “un-
manly” (Pope, Phillips, & Olivardia, 2000; Signorile, 1997). From
a gender role discrepancy strain perspective (Pleck, 1995), per-
ceiving oneself as violating gender role norms is stressful for
traditional men. Thus, we posited that traditionally masculine gay
men are more likely to overconform to cultural norms to be
physically powerful, leading to body image concerns, generally, as
well as to masculine body ideal distress, defined as stress from
failing to meet the ideal of muscular masculine body (Kimmel &
Mahalik, 2004). We hypothesized that gay men who experience
Sara B. Kimmel, Mental Health Services, Harvard University; James R.
Mahalik, Lynch School of Education, Boston College.
Correspondence concerning this article should be addressed to Sara B.
Kimmel, Harvard University, Mental Health Services, 75 Mt. Auburn
Street, Cambridge, MA 02138. E-mail: skimmel@uhs.harvard.edu or
mahalik@bc.edu
Journal of Consulting and Clinical Psychology Copyright 2005 by the American Psychological Association
2005, Vol. 73, No. 6, 1185–1190 0022-006X/05/$12.00 DOI: 10.1037/0022-006X.73.6.1185
1185
greater minority stress comprising higher levels of internalized
homophobia, perceived stigma, and experience of antigay physical
attacks, and who report higher levels of conformity to masculine
norms, will report increased body image dissatisfaction and mas-
culine body ideal distress. We examined both general body image
dissatisfaction as well as distress associated with not meeting the
masculine body ideal to represent more adequately the construct of
body image concerns for gay men.
Method
Participants
Participants were 357 gay men who were mostly White (n ⫽ 312, 87%;
Latino n ⫽ 20, 6%; Asian American n ⫽ 8, 2%; multiracial n ⫽ 7, 2%;
African American or Black n ⫽ 4, 1%; Native American n ⫽ 2, 0.6%; and
Other n ⫽ 4, 1%) and averaged 34.85 years of age (SD ⫽ 12.38, range ⫽
18 – 74). Participants averaged being “out” about their sexual orientation
for 11.31 years (SD ⫽ 9.84, range ⫽ 0 months to 50 years). Most reported
being single (n ⫽ 191, 54%; partnered and living together n ⫽ 79, 22%;
partnered but not living together n ⫽ 49, 14%; or married, civil union or
ceremonially committed n ⫽ 37, 10%) and having a graduate degree (n ⫽
131, 37%; college degree n ⫽ 116, 33%; some college n ⫽ 92, 26%; high
school degree n ⫽ 13, 4%; or no high school degree n ⫽ 3, 1%).
Participants’ median income was $35,000.
Measures
The Body Image Ideals Questionnaire (BIQ; Cash & Szymanski, 1995)
assesses one’s degree of body image satisfaction by measuring the degree
of discrepancy between self-perceived physical attributes and idealized
physical attributes, while also considering the importance of each of these
physical ideals to the person. The measure consists of 22 items assessing
11 physical attributes (e.g., weight, facial features, muscle tone/definition,
overall appearance). For 11 items, participants rate how much they resem-
ble their personal physical ideal on a 4-point scale ranging from 1 (exactly
asIam)to4(very unlike me) and then rate how important that personal
ideal is to them on a 4-point scale ranging from 1 (not important)to4(very
important). A multiplicative composite score is derived by determining the
mean of the 10 Discrepancy ⫻ Importance cross-products (Cash & Szy-
manski, 1995). Composite scores can range from ⫺3, indicating congru-
ence across physical attributes, to 9, indicating discrepancies across phys-
ical attributes. Evidence for validity includes significant correlations with
the Body Areas Satisfaction Scale, the Situational Inventory of Body-
Image Dysphoria, the Appearance Schemas Inventory, the Bulimia Test
Revised, and the Eating Attitudes Test (Cash & Szymanski, 1995; Szy-
manski & Cash, 1995). Reported
␣
for the BIQ was .81 for men (Cash &
Szymanski, 1995). In the current study,
␣
was .87.
The Masculine Body Ideal Distress Scale (MBIDS; Kimmel & Mahalik,
2004) is an 8-item scale that measures the amount of distress one associates
with failing to meet the ideal of having a muscular masculine body. The
person rates how much distress they would experience if the items de-
scribed their current physical appearance, using a 4-point scale ranging
from 1 ⫽ not distressing at all to 4 ⫽ very distressing (e.g., “How much
distress would you experience if your pectoral muscles were flabby?”).
Scores can range from 8 to 32. Research reports the MBIDS to be
composed of one factor with scores related to greater general body dissat-
isfaction and greater conformity to traditional masculine norms, with a
coefficient alpha of .80 (Kimmel & Mahalik, 2004). In the current study,
coefficient
␣
was .89.
The Internalized Homophobia Scale (IHP; Martin & Dean, 1987) is a
9-item scale assessing the extent to which gay men are uneasy about their
homosexuality and seek to avoid homosexual feelings. Items include “How
often have you wished you weren’t gay?” and are answered on a 5-point
Likert-type scale ranging from 1 (never)to4(often). Scores can range from
9 to 36. The IHP scale has adequate internal consistency ratings (
␣
⫽ .79)
and was significantly correlated negatively with collective self-esteem,
importance attached to community involvements, disclosure of sexual
orientation to heterosexual friends, and satisfaction with the local gay/
bisexual community; men scored significantly higher than women, and
bisexuals scored significantly higher than homosexuals (Herek & Glunt,
1995). Higher IHP scores also significantly relate to demoralization, guilt,
sex problems, suicidal ideation/behavior and AIDS-related traumatic stress
response for gay men (Meyer, 1995). In the present study,
␣
was .86.
The Stigma Scale (SS; Martin & Dean, 1987) assesses expectations of
rejection and discrimination regarding homosexuality by using 11 items
(e.g., “Most people would willingly accept a gay man as a close friend”)
answered on a 6-point Likert-type scale (1 ⫽ strongly disagree,6⫽
strongly agree). Scores can range from 11 to 66. Higher scores on the SS
relate significantly (a) to psychological distress for gay men, including
demoralization, guilt, suicidal ideation, and behavior- and AIDS-related
traumatic stress response and (b) to the degree to which gay men disclose
their homosexuality to others (Meyer, 1995). Martin and Dean (1987)
reported
␣
as .86. In the present study,
␣
was .89.
For a history of antigay physical attack, we used a single-item question
to assess whether participants had been physically attacked because of their
perceived sexual orientation: “Have you ever been physically attacked
because of your sexual orientation?” Meyer (1995) used a similar single
item question to determine gay men’s experiences of prejudice in his
research on minority stress and mental health in gay men. History of an
antigay physical attack was scored as 2 for participants who had experi-
enced an act of physical violence because of their sexual orientation and as
1 for those who had not. Previous research reported that experience of
prejudicial events within the past year significantly predicted four mea-
sures of psychological distress including demoralization, guilt, suicidal
ideation and behavior, and AIDS related traumatic stress response (Meyer,
1995).
The Conformity to Masculine Norms Inventory (CMNI; Mahalik et al.,
2003) was used to measure conformity to traditional masculine norms in
the dominant culture in U.S. society. The CMNI consists of 94 items
answered on a 4-point scale (0 ⫽ strongly disagree,3⫽ strongly agree)
with factor analysis indicating that the CMNI has 11 distinct factors labeled
as Winning, Emotional Control, Risk-Taking, Violence, Dominance, Play-
boy, Self-Reliance, Primacy of Work, Power Over Women, Disdain for
Homosexuals, and Pursuit of Status (Mahalik et al., 2003). Scores on the
CMNI range from 0 to 282. In this study, only the CMNI total score was
used after we subtracted the Disdain for Homosexuals subscale score from
the total to correct for the overlap in content between the CMNI total score
and the score for for the Internalized Homophobia scale described earlier.
Mahalik et al. (2003) reported that
␣
was .94 for the CMNI total score with
a test–retest coefficient over a 2- to 3-week period of .96. Mahalik et al.,
(2003) reported that CMNI scores significantly related positively to other
masculinity related measures, as well as to psychological distress, social
dominance, and aggression. In the present study,
␣
⫽ .91 for the CMNI
total score (corrected).
Procedure
Moderators of 33 gay Web-based discussion groups were contacted to
ask permission to post a description of the study. Of these, 12 never
responded, but 21 gave permission to post a description of the study, as
well as the Internet address of the survey. The study’s main purpose was
described as examining body image issues in the gay community. Partic-
ipants were not reimbursed for their participation.
Four hundred seventy-four respondents logged onto the Internet address.
Of those, 117 (25%) were eliminated: 4 (1%) because they identified their
gender as female; 10 (2%) because they logged onto the survey but did not
complete any of the survey information; 60 (13%) because they filled out
1186
BRIEF REPORTS
only the demographics portion of the survey; and 43 (9%) because they
identified their sexual orientation as bisexual, questioning, or “other.” The
357 retained for the analyses identified themselves as gay males and
completed the demographics section of the survey and the four structured
questionnaires.
Results
A comparison of means and standard deviations with other
samples using the measures in our study (see Table 1) indicated
that our sample was (a) within one half a standard deviation of
heterosexual men on the BIQ (Cash & Szymanski, 1995) and
MBIDS (Kimmel & Mahalik, 2004), (b) within half a standard
deviation of gay men on the IHP scale, (c) within one standard
deviation of gay men on the SS (Meyer, 1995), and (d) lower but
within one standard deviation of heterosexual men on the corrected
CMNI total (Mahalik et al., 2003).
To determine whether the variables met the assumption of
normality for general linear model analyses, all continuous vari-
ables were examined for skewness and kurtosis. Only IHP scores
were non-normal, but skewness was corrected from 1.57 to ⫺.60,
and kurtosis was corrected from 2.19 to ⫺.85 after we transformed
the original scores by using the inverse as suggested by Tabach-
nick and Fidell (2001). Because the inverse of the score was taken
in making the transformation, the directionality of the scores was
also inverted. Therefore, higher IHP scores now indicated lower
internalized homophobia as a result of the transformation.
We examined the demographic variables next to determine if
they covaried in relation to the criterion variables. Because Cau-
casians constituted most of the sample and five of the seven racial
groups contained fewer than 10 members, race was transformed
into a dichotomous variable (i.e., 1 ⫽ White, 2 ⫽ non-White).
Correlational analyses indicated that race, income, and education
were unrelated to the criterion variables but that age was nega-
tively related to MBIDS scores (r ⫽⫺.16, p ⫽ .001), with
younger gay men reporting more distress from failing to meet the
masculine body ideal.
Main Analyses
Two hierarchical regression analyses were conducted examining
BIQ and MBIDS scores, respectively (see Table 2). For both
analyses, age was entered in the first step, and the minority stress
model variables and the CMNI total score (corrected) were entered
in the second step. Examining body image dissatisfaction (BIQ
scores) indicated that age was not significant in the first step but
that the three minority stress model variables were significant in
the second step—internalized homophobia (

⫽⫺.12, p ⬍ .05),
stigma (

⫽ .15, p ⬍ .01), and physical attack (

⫽ .11, p ⬍
.05)—accounting for 6.1% of the variance in the full model. Gay
men who reported more body image dissatisfaction were more
likely to report greater internalized homophobia, greater expecta-
tions of stigma from others for being gay, and suffered an antigay
physical attack.
Examination of masculine body ideal distress (MBIDS scores)
indicated that age was significant in the first step (

⫽⫺.16, p ⬍
.01), accounting for 2.5% of the variance. In the second step, each
of the minority stress variables was significant—internalized ho-
mophobia (

⫽⫺.18, p ⬍ .001), stigma (

⫽ .21, p ⬍ .001), and
physical attack (

⫽ .14, p ⬍ .01)—along with conformity to
masculine norms (

⫽ .18, p ⬍ .001) accounting for 16% of the
variance in MBIDS scores. Gay men were more likely to report
distress from failing to achieve an ideal masculine body if they
were younger, reported greater internalized homophobia, greater
expectations of stigma for being gay, had suffered an antigay
physical attack, and were more conforming to traditional mascu-
line norms. For both analyses, no multicollinearity was evident
because none of the dimensions had more than one variance
proportion greater than .50 (see Tabachnick & Fidell, 2001).
Discussion
Results from this cross-sectional study indicated that all three
minority stress factors (i.e., internalized homophobia, stigma, and
an antigay physical attack) were significantly associated with both
body image dissatisfaction and masculine body ideal distress.
These findings support previous research documenting that minor-
ity stress helps to explain lesbian, gay and bisexual individuals’
mental health problems such as suicidal ideation, depression, anx-
iety, and substance use (e.g., Cochran & Mays, 1994; D’Augelli &
Hershberger, 1993; Diaz, Ayala, Bein, Jenne, & Marin, 2001;
Herek, Gillis, & Cogan, 1999; Meyer, 1995; Waldo, 1999). Results
also extend the applicability of the minority stress model to body
image concerns for gay men by supporting earlier scholars’ spec-
ulations that experiences of prejudice, internalized shame, and the
Table 1
Means, Standard Deviations, and Intercorrelations of Variables
MSD 12 345
1. BIQ 1.85 1.51 —
2. MBIDS 19.92 5.27 .47*** —
3. IHP 12.46 2.48 ⫺.13* ⫺.30*** —
4. Stigma 3.31 0.94 .20*** .27*** ⫺.30*** —
5. Attack 1.24 0.43 .10 .12* .09 ⫺.01 —
6. CMNI 98.32 20.43 ⫺.04 .24** ⫺.25*** ⫺.01 .06
Note. N ⫽ 357. BIQ ⫽ Body Image Ideals Questionnaire (Cash & Szymanski, 1995); MBIDS ⫽ Masculine
Body Ideal Distress Scale (Kimmel & Mahalik, 2004); IHP ⫽ Internalized Homophobia Scale (Martin & Dean,
1987); Stigma ⫽ Stigma Scale (Martin & Dean, 1987); Attack ⫽ history of an antigay physical attack; CMNI
⫽ total score of the Conformity to Masculine Norms Inventory (Mahalik et al., 2003) minus the Disdain for
Homosexuals subscale. Lower transformed IHP scores reflect higher levels of internalized homophobia.
* p ⬍ .05 (two-tailed). ** p ⬍ .01 (two-tailed). *** p ⬍ .001 (two-tailed).
1187
BRIEF REPORTS
desire to feel more powerful against antigay attacks may contribute
to gay men’s desire for a powerful physique (Crowder, 1998;
Williamson, 1999). Conformity to masculine norms did not cor-
relate with body image dissatisfaction but was associated with gay
men’s distress if their body did not meet the physically powerful
masculine ideal, as we hypothesized. This difference may be due
to the general nature of body image dissatisfaction assessed by the
BIQ, in which physical characteristics such as facial characteristics
were part of the overall score, whereas the MBIDS had a specif-
ically masculine focus. This finding also suggests that future
explorations about incorporating gay men’s conformity to mascu-
line norms into the minority stress model for gay men’s mental
health concerns should be limited to presenting concerns with a
strong gendered component (e.g., masculine body ideal distress).
The finding that conformity to masculine norms was associated
with masculine body ideal distress also (a) supports previous
findings that conformity to masculine norms related to the drive
for muscularity and masculine body ideal distress in heterosexual
samples (Kimmel & Mahalik, 2004; Mahalik et al., 2003); and (b)
extends research finding traditional masculinity to relate to an
array of physical and psychological health problems for gay men
(Carlson & Steuer, 1985; Simonsen, Blazina, & Watkins, 2000). In
addition, the finding gives some support to those who suggest that
gay men may seek ways to compensate physically for perceptions
that they are less masculine (Pope et al., 2000; Signorile, 1997) or
to fight against the stereotype that to be gay is to be effeminate
(Kurtz, 1999).
We believe the findings from this study have potential clinical
implications for both prevention and treatment efforts. Meyer
(2003) suggested that interventions for minority stress might aim
to change how situations are appraised and to developing strategies
to cope with stressful and adverse conditions such as discrimina-
tion and physical attacks. The focus of our study may enable
clinicians to help gay men to reduce their negative self-perceptions
and attitudes (i.e., internalized homophobia) and anticipations of
rejection and discrimination (i.e., expectations of stigma) and to
find coping strategies for prejudicial events such as antigay at-
tacks. This might take place in individual or group sessions or
might be a part of outreach programming to educate the gay
community about the potential connection between minority re-
lated stress and body image concerns. Understanding the connec-
tion between minority stress factors and body image concerns may
provide valuable insight and empowerment for gay men in treat-
ment for body image distress. Meyer (2003) also challenged cli-
nicians to work to change the objective properties of the stressors
by altering the stress-inducing environment and reducing exposure
to stress. Such interventions would work to reduce homophobia
and stigma toward gays in society and to make antigay violence a
thing of the past. “The former [strategy] places greater burden on
the individual, the latter, on society” (Meyer, 2003, p. 692).
The finding that conformity to traditional masculine norms
related to gay men’s masculine body ideal distress suggests to us
that gender issues may also be useful to explore with gay men.
Specifically, clinicians might explore directly with gay men their
range of feelings about being masculine in a heterosexist society.
For some gay men, being masculine may be important because it
makes them feel more accepted within the dominant heterosexual
society.
We note several limitations in the current study. First, the
sample was predominantly White and did not include bisexual
men, making it difficult to generalize these findings to gay men of
color or to bisexuals. Second, the sample was recruited online, and
some consideration must be given to how online data collection
may limit generalizability. However, a recent empirical analysis of
online research concluded that “the data provided by Internet
methods are of at least as good quality as those provided through
traditional paper and pencil measures” (Gosling, Vazire, Srivas-
tava & John, 2004, p. 102) and that findings from Web-based
research “generalize across presentation formats, do not appear to
be tainted by false data or repeat responders, and are, so far,
Table 2
Hierarchical Regression Analysis of the BIQ and MBIDS Scores
Variable
BIQ scores MBIDS scores
⌬R
2

a
sR
2
⌬R
2

a
sR
2
Step 1 .002 .03**
Age .04 .001 ⫺.17** .027
Step 2 .065*** .16***
IHP ⫺.12* .012 ⫺.18*** .030
Stigma Scale .17** .026 .22*** .049
Attack .11 .012 .15** .025
CMNI ⫺.07 .004 .17*** .031
Full model
Multiple R .26 .43
Multiple ⌬R
2
.05 .18
F (5, 330) 4.56*** 15.34***
Note. N ⫽ 357.

a
⫽

for full, five-variable model evaluated at one-tail level. BIQ ⫽ Body Image Ideals
Questionnaire (Cash & Szymanski, 1995); MBIDS ⫽ Masculine Body Ideal Distress Scale (Kimmel & Mahalik,
2004); IHP ⫽ Internalized Homophobia Scale (Martin & Dean, 1987); Attack ⫽ history of an antigay physical
attack; CMNI ⫽ Total score of Conformity to Masculine Norms Inventory (Mahalik et al., 2003) minus the
Disdain for Homosexuals subscale. Lower transformed IHP scoresreflect higher levels of internalized homo-
phobia.
* p ⬍ .05. ** p ⬍ .01. *** p ⬍ .001.
1188
BRIEF REPORTS
consistent with results from traditional methods” (p. 102). Also,
our sample of gay men reported levels of body image concerns
similar to that of heterosexual samples, unlike other studies (e.g.,
Siever, 1994). This difference in findings may have occurred
because our measures and sampling method were different than
these studies (Beren et al., 1996; French et al., 1996; Lakkis et al.,
1999; Siever, 1994), but it also suggests that future research should
continue to examine prevalence of body image concerns in gay
samples. In addition, because of the small amount of the variance
accounted for in this study, future research might also investigate
other factors thought to relate to gay men’s body image, such as,
the gay community’s emphasis on slimness and youthfulness (Wil-
liamson, 1999).
Existing research indicates that minority stress relates to an
array of psychological health problems for gay men and that
traditional masculinity is associated with physical and psycholog-
ical health concerns (Meyer, 1995, 2003; Mahalik et al., 2003). We
extended these lines of inquiry to examine the problem of gay
men’s body image, and suggest that other mental and physical
health variables may also be influenced by minority stress and
masculinity. Research could examine how presenting concerns
such as gay men’s alcohol and drug use including anabolic steroid
use, unsafe sexual practices or other risk-taking behaviors, or gay
partner abuse may have their source in gay men’s experiences of
minority stress and their constructions of masculinity.
In conclusion, in this study, we sought to contextualize gay
men’s body image concerns by examining minority stress as an
explanatory model and to determine whether traditional masculin-
ity could explain unique variance in body image dissatisfaction
and masculine body ideal distress along with the minority stress
factors. Our findings supported the utility of the minority stress
model, examining both body image constructs, and traditional
masculinity for explaining unique variance for masculine body
ideal distress. We encourage researchers to continue to examine
other presenting concerns for gay men and to develop and evaluate
empirically informed remedial and preventive interventions to
improve the health of members of the gay community.
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Received July 13, 2004
Revision received January 24, 2005
Accepted February 7, 2005 䡲
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