Exploring and Measuring the Perceived Impact of Visible Difference upon Romantic Relationships Nicholas David Sharratt A thesis submitted in partial fulfilment of the requirements of the University of the West of England, Bristol for the degree of Doctor of Philosophy Faculty of Health and Applied Sciences, University of the West of England November 2020 Table of Contents i. Abstract .......................................................................................................................... 9 ii. Acknowledgements and Dedications .......................................................................... 10 iii. Abbreviations ............................................................................................................... 11 1. Introduction ................................................................................................................. 13 1.1. Introduction to this Thesis ...................................................................................... 13 1.2. Overview of this Chapter ........................................................................................ 13 1.3. Intimacy and Romantic Relationships ..................................................................... 13 1.3.1. Intimacy and Romantic Relationships ............................................................. 13 1.3.2. The Benefits of Intimate, Romantic Relationships .......................................... 16 1.3.3. Attraction and Attractiveness ......................................................................... 18 1.3.3.1. Attraction and Visible Difference ............................................................. 20 1.3.3.2. Under Represented and Minority Groups ............................................... 22 1.3.4. Relationship Theory ........................................................................................ 23 1.4. Visible Difference .................................................................................................... 28 1.4.1. Defining Visible Difference .............................................................................. 28 1.4.2. The Psychosocial Impact of Visible Difference................................................ 29 1.4.3. Predicting Psychological Distress .................................................................... 30 1.4.4. Theories of Visible Difference ......................................................................... 32 1.4.5. Visible Difference and Functionality ............................................................... 34 2. Visible Difference and Romantic Relationships: Literature Review ........................... 37 2.1. Literature Search Method ....................................................................................... 37 2.2. Visible Difference and Romantic Relationships: The Literature ............................. 38 2.2.1. The Impact of Visible Difference upon Romantic Relationships ..................... 39 2.2.2. Who is Susceptible? ........................................................................................ 42 2.2.2.1. Relationship status. .................................................................................. 42 2.2.2.2. Sex. ........................................................................................................... 43 2.2.2.3. Location and severity of visible difference. ............................................. 44 2.2.3. The Nature of the Romantic and Intimate Challenges Experienced ............... 45 2.2.3.1. Attractiveness as a partner. ..................................................................... 46 2.2.3.2. Concealment. ........................................................................................... 48 2.2.3.3. Fear and avoidance. ................................................................................. 49 2.2.3.4. Positive Adjustment ................................................................................. 50 2.3. Summary ................................................................................................................. 51 3. Mixed Methods in this Thesis ...................................................................................... 53 3.1. Introduction to this Section .................................................................................... 53 2 3.2. Paradigms and Epistemologies ............................................................................... 54 3.3. Pragmatism ............................................................................................................. 55 3.3.1. The Philosophy of Pragmatism ....................................................................... 55 3.3.2. Reconfiguring Epistemological Dualisms ........................................................ 56 3.3.3. Pragmatism and this Thesis ............................................................................ 57 3.4. Mixed Methods Research in this Thesis.................................................................. 58 3.4.1. The Dimensions of Mixed Methods Research in This Thesis .......................... 60 3.5. Summary ................................................................................................................. 61 4. A Qualitative Exploration of Visible Difference and Intimate, Romantic Relationships: Methodology ........................................................................................ 62 4.1. Introduction ............................................................................................................ 62 4.2. Participants ............................................................................................................. 62 4.2.1. Inclusion and Exclusion Criteria ...................................................................... 62 4.2.2. Methods of Recruitment ................................................................................. 63 4.2.3. Process ............................................................................................................ 63 4.2.4. Response Rates ............................................................................................... 64 4.2.5. Characteristics of Participants ........................................................................ 64 4.3. Data Generation ...................................................................................................... 65 4.3.1. Semi-structured interviews ............................................................................. 65 4.3.2. Interviews or Focus Groups? ........................................................................... 65 4.3.3. The Medium of Participation .......................................................................... 67 4.3.3.1. Face-to-face interviews. ........................................................................... 67 4.3.3.2. Telephone interviews. .............................................................................. 68 4.3.3.3. Skype ........................................................................................................ 69 4.3.3.4. E-mail and messenger .............................................................................. 69 4.3.4. Data Generation Summary ............................................................................. 70 4.4. Ethics ....................................................................................................................... 71 4.4.1. Medium of Participation ................................................................................. 71 4.4.2. Informed Consent ........................................................................................... 71 4.4.3. The Nature of Participation............................................................................. 72 4.4.4. Anonymity ....................................................................................................... 72 4.4.5. The Consent Process ....................................................................................... 72 4.4.6. Participant Distress ......................................................................................... 73 4.5. Saturation and Sample Size..................................................................................... 73 4.6. Data Analysis ........................................................................................................... 75 4.6.1. Thematic Analysis............................................................................................ 75 4.6.2. Process of Analysis .......................................................................................... 78 4.6.3. Member-checking ........................................................................................... 81 3 4.7. Summary ................................................................................................................. 82 5. Qualitative Study: Analysis .......................................................................................... 83 5.1. Introduction ............................................................................................................ 83 5.2. Appearance Attracts and Detracts .......................................................................... 84 5.2.1. Looking To Love............................................................................................... 85 5.2.2. The Discounted Self ........................................................................................ 92 5.2.2.1. Deficient