The influence of emotion down-regulation on the expectation of sexual reward

Sexual Function in Post-surgical Transgender and Gender Diverse Individuals

Surgical treatment for gender dysphoria consists of facial, chest, and genital surgery. Chest and genital gender affirmation surgeries alter the form and function of the native organs. This can have a profound impact on sexual function for transgender and gender- diverse individuals. In this article, the authors will discuss the impacts that chest and genital gender affirmation surgeries can have on sexual function.

A Learning Experience? Enjoyment at Sexual Debut and the Gender Gap in Sexual Desire among Emerging Adults

Gender differences in experience of first intercourse are among the largest in sexuality research, with women recalling less pleasure and satisfaction than men. This "enjoyment gap" has not been considered in explanations of gender differences in sexual desire. Yet, reinforcement and incentive learning feature prominently in recent models of women's sexual desire, and nonhuman animal models demonstrate their impact at sexual debut. We examined whether women's lower sexual desire is explained by their gender or by gendered experience of enjoyment at sexual debut. Emerging adults (N = 838) provided retrospective accounts of physical (orgasm) and affective (satisfaction) enjoyment at (hetero)sexual debut. We replicated gender differences across behavioral, general, and multidimensional measures of trait sexual desire; however, they were contingent on experience and measurement method. When its cognitive multidimensional properties were appreciated, women's sexual desire varied with experience of orgasm at sexual debut and diverged from men's only when orgasm did not occur. Such effects were not observed for satisfaction, nor for men. Nor did effects of a control event - masturbatory debut - extend beyond solitary sexual desire. Findings underscore the importance of orgasm equality, and suggest its absence at sexual debut may play an unacknowledged role in differentiating sexual desire.

Sexual behavior and sexual health of transgender women and men before treatment: Similarities and differences

BACKGROUND

There is a lack of research on the sexual health of transgender individuals, as well as a paucity of data about overall sexual health indexes before treatment.

AIMS

This study aims to analyze the main issues involved in transgender individuals' sexual behavior (with and without a partner), overall sexual health indexes, and potential predictors of sexual health, comparing trans men and trans women on all the variables assessed.

METHODS

260 trans people were recruited at a transgender health clinic in Spain. Participants completed the Sexual Behavior Questionnaire for transgender people before receiving any treatment.

RESULTS

Overall results show that trans women have a more ego-dystonic and problematic experience of their sexuality. Regarding masturbation, there are no differences in its frequency between trans women and trans men, although there are differences in the reasons they do not masturbate. Regarding sexual behavior with a partner, trans women experience more difficulties than trans men, with significant differences in several areas (e.g., the percentage of transgender individuals who never allow their partners to touch their genitals). Regarding sexual health, we found differences between groups, with lower sexual desire, sexual arousal without orgasm, and overall sexual health in trans women. Likewise, different variables such as pain during sex, fantasies, and time with a steady partner seem to be associated with the different sexual health indexes.

CONCLUSION

Our results show a clear difference between trans women and trans men in most of the sexual aspects assessed, revealing greater gender dysphoria in trans women. We would recommend taking these data into account, as well as variables that may be associated with different sexual health indexes, when designing interventions for transgender people.

Evidence for Persistence of Sexual Evaluative Learning Effects

INTRODUCTION

Several studies demonstrated that genital arousal and enhanced positive affect toward neutral stimuli due to sexual conditioning did not extinguish during a brief extinction phase, but other studies showed contrasting results. Possible resistance to extinction of conditioned human sexual response has, however, not been studied using extensive extinction trials.

AIM

To study resistance to extinction of conditioned sexual response in men and women.

METHODS

Healthy sexually functional men (N = 34) and women (N = 32) participated in a differential conditioning experiment, with neutral pictures as conditioned stimuli (CSs) and genital vibrostimulation as unconditioned stimulus. Only one CS (the CS+) was followed by the unconditioned stimulus during the acquisition phase.

MAIN OUTCOME MEASURE

Penile circumference and vaginal pulse amplitude were assessed, and ratings of affective value and subjective sexual arousal were obtained. In addition, a stimulus response compatibility task was included to assess automatic approach and avoidance tendencies.

RESULTS

Men and women rated the CS+ as more positive than the CS- during all 24 extinction trials and demonstrated a slight tendency to approach the CS+ directly after the extinction procedure. Participants rated the CS+ as more sexually arousing than the CS- during 20 extinction trials. No evidence was found for conditioned genital sexual response.

CLINICAL IMPLICATIONS

Learned sexual evaluations may be difficult to modify through an extinction procedure; therefore, unwanted but persistent subjective sexual evaluations may be better targeted by interventions such as the deployment of emotion regulation strategies.

STRENGTH & LIMITATIONS

Extensive extinction trials were used; however, only relatively short-term effects within one experimental session were studied and there was no (unpaired) control condition.

CONCLUSION

The results provide evidence that conditioned sexual likes are relatively persistent, also at the behavioral level. Both S, Brom M, Laan E, et al. Evidence for Persistence of Sexual Evaluative Learning Effects. J Sex Med 2020;17:505-517.

Approach and Avoidance Biases Toward Sexual Stimuli and Their Association with the Dual Control Model of Sexual Response in Heterosexual Men

Many models of human behavior work in an interaction of a dual system. While one system usually represents controlled and reflective behavioral responses, the other system reflects automatic and impulsive actions. In the impulsive system, positive stimuli initiate approach reactions and negative cues avoidance reactions. Besides stimulus valence, the behavioral response triggered by the impulsive system is influenced by personality (e.g., the propensity to react with approach or avoidance biases in a specific situation). The present study applied a computerized Approach-Avoidance Task (AAT; Rinck & Becker, 2007) to assess automatic behavioral approach and avoidance biases toward sexual and neutral stimuli in heterosexual men (N = 40). Individual AAT-performance was furthermore related to sexual excitation (SES) and the two sexual inhibition factors (SIS1 and SIS2) as proposed by the Dual Control Model of sexual response (Bancroft & Janssen, 2000). Against our hypotheses, participants did not show a stronger approach bias toward sexually preferred (i.e., images of women) than sexually not preferred stimuli (i.e., images of men or children). However, stronger approach biases toward images of women were positively associated with sexual excitation and negatively correlated with sexual inhibition due to a threat of performance failure (SIS1) even after controlling for potential confounds (i.e., general behavioral activation and inhibition). The results support the importance of the influence of dispositional traits measured with the Dual Control Model of sexual response on approach and avoidance biases toward sexually preferred stimuli in heterosexual men.

Situating Human Sexual Conditioning

Conditioning is often thought of as a basic, automatic learning process that has limited applicability to higher-level human behavior. In addition, conditioning is seen as separable from, and even secondary to, "innate" processes. These ideas involve some misconceptions. The aim of this article is to provide a clearer, more refined sense of human sexual conditioning. After providing some background information and reviewing what is known from laboratory conditioning studies, human sexual conditioning is compared to sexual conditioning in nonhumans, to "innate" sexual responding, and to other types of human learning processes. Recommendations for moving forward in human sexual conditioning research are included.

The Influence of Emotion Upregulation on the Expectation of Sexual Reward

INTRODUCTION

Emotion regulation research has shown successful altering of unwanted aversive emotional reactions. Cognitive strategies can also downregulate expectations of reward arising from conditioned stimuli, including sexual stimuli. However, little is known about whether such strategies can also efficiently upregulate expectations of sexual reward arising from conditioned stimuli, and possible gender differences therein.

AIM

The present study examined whether a cognitive upregulatory strategy could successfully upregulate sexual arousal elicited by sexual reward-conditioned cues in men and women.

METHODS

Men (n = 40) and women (n = 53) participated in a study using a differential conditioning paradigm, with genital vibrostimulation as unconditioned stimulus (US) and sexually relevant pictures as conditional stimuli.

MAIN OUTCOME MEASURES

Penile circumference and vaginal pulse amplitude were assessed and ratings of US expectancy, affective value, and sexual arousal value were obtained. Also a stimulus response compatibility task was included to assess automatic approach and avoidance tendencies.

RESULTS

Evidence was found for emotion upregulation to increase genital arousal response in the acquisition phase in both sexes, and to enhance resistance to extinction of conditioned genital responding in women. In men, the emotion upregulatory strategy resulted in increased conditioned positive affect.

CONCLUSION

The findings support that top-down modulation may indeed influence conditioned sexual responses. This knowledge may have implications for treating disturbances in sexual appetitive responses, such as low sexual arousal and desire.

d-Cycloserine reduces context specificity of sexual extinction learning

BACKGROUND

d-Cycloserine (DCS) enhances extinction processes in animals. Although classical conditioning is hypothesized to play a pivotal role in the aetiology of appetitive motivation problems, no research has been conducted on the effect of DCS on the reduction of context specificity of extinction in human appetitive learning, while facilitation hereof is relevant in the context of treatment of problematic reward-seeking behaviors.

METHODS

Female participants were presented with two conditioned stimuli (CSs) that either predicted (CS+) or did not predict (CS-) a potential sexual reward (unconditioned stimulus (US); genital vibrostimulation). Conditioning took place in context A and extinction in context B. Subjects received DCS (125mg) or placebo directly after the experiment on day 1 in a randomized, double-blind, between-subject fashion (Placebo n=31; DCS n=31). Subsequent testing for CS-evoked conditioned responses (CRs) in both the conditioning (A) and the extinction context (B) took place 24h later on day 2. Drug effects on consolidation were then assessed by comparing the recall of sexual extinction memories between the DCS and the placebo groups.

RESULTS

Post learning administration of DCS facilitates sexual extinction memory consolidation and affects extinction's fundamental context specificity, evidenced by reduced conditioned genital and subjective sexual responses, relative to placebo, for presentations of the reward predicting cue 24h later outside the extinction context.

CONCLUSIONS

DCS makes appetitive extinction memories context-independent and prevents the return of conditioned response. NMDA receptor glycine site agonists may be potential pharmacotherapies for the prevention of relapse of appetitive motivation disorders with a learned component.