An Event-Level Analysis of the Sexual Characteristics and Composition Among Adults Ages 18 to 59: Results from a National Probability Sample in the United States

Exploring Attention-Deficit/Hyperactivity Disorder (ADHD) Symptomatology in Relation to Women's Orgasmic Consistency

This well-powered, pre-registered online study examined differences in orgasmic consistency among women both with and without ADHD symptomatology while controlling for sexual assertiveness and sexual attitudes, constructs yet to be explored in this context. A convenience sample of 815 (Mage = 28.93, SDage = 9.23) cisgender females, at least 18 years of age and sexually active with at least one partner over the last 6 months, completed this study online through the survey platform Qualtrics. No preexisting ADHD diagnosis was required. Study hypotheses were confirmed, revealing that ADHD symptomatology predicted orgasmic consistency, and most notably, that greater inattentive ADHD symptomatology was associated with lower consistency of orgasm. Exploration of medication use for ADHD symptom management revealed only a significant effect of medication use on orgasmic consistency in women who did not currently meet the criteria for ADHD symptomatology. Finally, when comparing women of sexual minority orientations to the sexual majority, results indicated only a significant difference in orgasmic consistency rates among women who did not meet the ADHD symptomatology criteria. Given that women who struggle with difficulties in consistently achieving orgasm are more likely to experience negative relationship satisfaction, self-esteem, and sexual satisfaction outcomes - as well as increased rates of emotional distress - our results have significant implications for the sexual health and well-being of women with ADHD symptomatology. This is particularly true for those with the inattentive ADHD symptomatology subtype.

Sexual and Affectionate Behaviors and Satisfaction for Adults in Romantic Relationships: A Latent Profile Analysis

Engaging in both sexual and affectionate behaviors with a romantic partner is often beneficial for adults' sexual and relationship satisfaction and promotes relationship stability. However, prior research has primarily examined either adults' sexual or affectionate behaviors, and has yet to explore patterns of sexual and affectionate behaviors and their associations with sexual and relationship satisfaction. In the current paper, we used a person-centered approach and latent profile analysis to identify specific profiles of adults' physical behaviors in same-gender and mixed-gender relationships, and examined associations of these profiles with sexual and relationship satisfaction. Adults (N = 336, 85.4% LGBTQ+; 45% women, 30% men, 38.6% gender-diverse; Mage = 29.07 years) who were currently in a committed romantic partner relationship for at least six months completed online surveys. We found that a 3-profile solution best fit the data and identified the following profiles: Infrequent Physical Behaviors, Affection-focused Behaviors, and Comprehensive Physical Behaviors. Adults in the Infrequent Physical Behaviors profile were less sexually and relationally satisfied than adults in the other profiles. Adults in the Comprehensive Physical Behaviors profile were more sexually satisfied than the two other profiles. Further, profiles did not differ for mixed-gender compared to same-gender or gender-diverse couples. Our findings have implications for understanding the diversity in adults' physical behavior patterns, including how clinicians might better support adults' sexual and relationship satisfaction.

The Intimate and Sexual Costs of Emotional Labor: The Development of the Women's Sexual Emotional Labor Assessment

Emotional labor, the act of suppressing or altering one's feelings to enhance another person's well-being, is predominantly performed by women, especially within intimate relationships. Despite its impact on well-being, research on its role in sexuality remains limited. We developed the Women's Sexual Emotional Labor Assessment (WOSELA), a 12-item scale based on themes identified by past qualitative studies. To ensure its reliability and validity, we conducted three studies with women partnered with men, as well as heterosexual single women from the UK and the USA (N = 831). Drawing on exploratory factor analysis in Study 1, four subscales were identified: faking orgasm, performing desire, tolerating discomfort or pain, and partner-referenced sexual satisfaction. Confirmatory factor analyses in Study 2 (pre-registered) provided support for the WOSELA in its current form. In Study 3 (pre-registered), we demonstrated the validity of the WOSELA by establishing significant negative correlations with sexual agency, sexual communication, and sexual pleasure. Our results further show that the WOSELA was not significantly related to positive-partner-oriented sexual responsiveness. The WOSELA offers a unique tool to explore the role of emotional labor in sustaining the pleasure gap, as well as in broader power dynamics within intimate relationships and its impact on women's well-being.

What Are Americans' Favorite Aspects of Partnered Sex? Findings From a U.S. Nationally Representative Survey

Using data from an online, cross-sectional U.S. nationally representative survey, we analyzed participants' responses to an open-ended item that asked them to look back on their entire lives and to describe their favorite aspects of being sexual with a partner. These text responses (n = 2755) were grouped into 22 codes, the most common of which were closeness/intimacy, specific sex acts, feels good, love/caring, satisfying/pleasing a partner, and orgasm. The present study extends the existing literature on positive aspects of sexuality.

"I Just Really Didn't Know What I Was Walking into": Scary Sexual Experiences in a Campus-Representative Survey of Undergraduate Students

Sexual pressure, coercion, and violence are prevalent globally and disproportionately affect girls, women, sexual minorities, and gender minorities. Using quantitative data and open-ended responses from a cross-sectional campus-representative online survey of undergraduate students, we aimed to (1) assess the percentage of students, by gender, who reported having had a scary partnered sexual experience since age 14 and (2) characterize the kinds of sexual experiences that participants described as scary. A weighted total of 721 college student participants who reported ever engaging in oral, vaginal, or anal sex during their lifetime were included in the analytic sample. Of these, 225 reported experiencing at least one scary sexual experience (31.2%). Women and gender non-conforming students were significantly more likely to have experienced a scary sexual situation (47.2% women, 13.6% men, 60.1% TGNB+ students, p < .001). Those who reported having experienced a scary sexual experience were also more likely to report a non-heterosexual identity and more likely to live in an off-campus apartment. In examining open-ended responses from 174 participants, the scary sexual experiences were categorized as: wouldn't stop or accept a no; lack of power/control; pressure, coercion, or manipulation; unwanted roughness; explicit sexual assault; force; drunk, drugged, or unconscious; anxiety, panic attack, or PTSD; restrained or difficulty leaving; escalated quickly; condom/contraception-related; isolated or tricked; demeaning language; incest or child abuse; miscellaneous. Findings from the study have implications for sexual violence prevention professionals, as experiences that are scary but that don't meet legal definitions of sexual assault or campus definitions of sexual misconduct may be underreported. Additionally, study findings have implications for sexuality educators, who are well-positioned to describe to college students the kinds of sexual situations that are problematic and ways to mitigate harm.

The Gender Gap in Partnered Orgasm: A Scoping Review of Evidence with Graphical Comparisons

This article provides a review and visualization of findings over the last 30 years related to the orgasm gap between men and women in heterosexual encounters. We describe and compare techniques commonly used for measuring orgasm occurrence and frequency patterns, and we summarize the contrast in orgasm rates shown in these studies across different behavior sets and social contexts. Of central importance, women's orgasm rates increase dramatically with the inclusion of behaviors that provide specific stimulation to the clitoris, revealing this gap is largely driven by social dynamics rather than strictly biological mechanisms. Disparities between men and women are especially pronounced in contexts with low levels of partnered sexual experience, partner familiarity, and relationship commitment. Women are also more likely to experience orgasm when masturbating or partnered with women than when partnered with men. Ultimately, we echo calls for a biopsychosocial approach to sexual enjoyment and well-being, and we provide recommendations for future research, including increased precision in measurement and reporting, diversifying sampling concentrations, and assessing life course trajectories.

The Prioritization of Women's Orgasms During Heterosex: A Critical Feminist Review of the Implications for Women's Sexual Liberation

Orgasm is considered by many to be an essential part of women's ideal sexual experiences. As a result, sexual liberation narratives have often advocated for the prioritization of women's orgasms - particularly during heterosex - framing them as a central indicator of "good," healthy, liberated sex. However, scholars have increasingly critiqued these narratives, arguing that they result in an orgasm imperative that has negatively impacted women's sexual lives. Perspectives that promote the prioritization of women's orgasm and those that warn against the negative repercussions strive for the same thing - to draw attention to women's sexuality in ways that will lead to more pleasurable, enjoyable, and equitable sex for women overall. Yet, together, they offer contradictory messages about the role that women's orgasms can or should play in women's sexual liberation. For example, one could argue that it perhaps makes sense to prioritize women's orgasms given that they often are highly pleasurable for women, center a unique form of embodied pleasure, and offer a supposedly clear objective for women and their men partners. On the other hand, such narratives frame women's orgasm absence as abnormal, concede to men's sexuality in problematic ways, and constrain more comprehensive possibilities for women's sexual pleasure. In this critical feminist review, I offer a summative outline of these and other contradictions, focusing on how narratives prioritizing women's orgasms can have simultaneous benefits and negative repercussions when it comes to (1) women's sexual pleasure, (2) the medicalization/pathologization of women's orgasms, and (3) heterosex norms.

Sexual Self-Esteem and Orgasm Consistency: Exploring the Unique Roles of Body Image and Genital Image

We explored the unique roles that body and genital image play in behavior-specific orgasm consistency, beyond overall sexual self-esteem. US adults (N = 599; 64% women) completed questionnaires online. Hierarchical regression analyses predicted orgasm consistency during receptive oral sex and penile-vaginal intercourse (PVI) with additional clitoral stimulation (WAS) and with no additional clitoral stimulation (NAS) for the woman. Body image, genital image, and gender were entered in later steps to assess model improvement above sexual self-esteem. Models accounted for age, sexual and racial minority identities, and current relationship status. Results indicated that genital image improved all models and predicted higher orgasm consistency across all behaviors for men and women. For orgasm during receptive oral sex and PVI-NAS, sexual self-esteem was no longer significant once genital image was included. Genital image was a stronger predictor of women's versus men's orgasm during PVI-NAS; no significant gender differences were found for oral sex and PVI-WAS. Body image was not significant in any models, contrary to expectations, suggesting role overlap with sexual self-esteem. Genital image appears to play a unique role in sexual pleasure beyond overall sexual self-esteem and body image.

Exploring the Orgasm Gap Across Racial/Ethnic Groups: A Descriptive Analysis

Orgasm gaps between heterosexual men and women, and for women across sexual orientations, are well-established in research. However, no large-scale assessments of orgasm frequency by race/ethnicity exist. Here, we analyzed 10 years of cross-sectional Singles in America survey data between 2011 and 2021 to investigate the orgasm gap at the intersection of gender and racial/ethnic identity (i.e. White, Black, Hispanic/Latino, and Asian) for heterosexual participants (N = 27,347). White and Hispanic/Latino men reported greater orgasm frequency than Black and Asian men. Hispanic/Latino women reported the greatest orgasm frequency, and Asian women reported the lowest, with White and Black women's frequencies in between. The orgasm gap between men and women was largest for White (d = 0.89) and Asian (d = 0.86) groups, although Asian participants reported a lower orgasm frequency than White participants overall. The orgasm gap was smaller for Hispanic/Latino participants (d = 0.66), because Hispanic/Latino women reported a greater orgasm frequency than other racial/ethnic groups of women. The orgasm gap was smaller for Black participants (d = 0.61), because Black men reported a lower orgasm frequency than some other racial/ethnic groups of men. This descriptive study serves as an important starting point for future research on orgasm experiences across racial/ethnic groups.

Feasibility Cues during a Sexual Encounter Impact the Strength of Heterosexual Women's Orgasm Goal Pursuit

The "orgasm gap" for women who have sex with men remains a pressing gender equity issue. Recent research found that women who pursued orgasm as a goal were more likely to have one. The current research replicated this relationship between orgasm goal pursuit and orgasm frequency for heterosexual women, and found that this relationship did not exist for heterosexual men (Study 1). Then, across two experimental studies, we examined how heterosexual women vary their orgasm goal pursuit across sexual encounters. In Study 2, women who read that a hypothetical sexual encounter would be "quick" reported less intent to pursue orgasm than women who were told they could "take their time" or received no time information. In Study 3, women who read that their hypothetical sexual partner seemed selfish reported less intent to pursue orgasm than women who were given a non-selfish partner or no partner information. Importantly, these effects were mediated by women's perceived orgasm likelihood in the scenario. These results suggest that women shift their pursuit of orgasm depending on cues which signal whether orgasm will be feasible. This research used self-regulation theory to understand women's motivations for pursuing orgasm during sexual encounters with men, with implications for reducing the orgasm gap.

Orgasm Consistency in Mixed-Gender Couples: Actor, Partner, and Discrepancy Effects from Dyadic Response Surface Analysis

The potential link between orgasm consistency (i.e., the percentage of time an individual experiences orgasm during sexual interactions with a partner) and sexual satisfaction in mixed-gender sexual relationships remains underexamined in the literature. We combined two dyadic samples (N = 725 couples) and utilized Dyadic Response Surface Analysis (DRSA) to examine how both partners' orgasm consistency and their discrepancy of orgasm consistency predict both partners' sexual satisfaction. We found that partners' discrepancy in orgasm consistency was not uniquely connected to higher sexual satisfaction for either women or men; rather, the overall consistency of orgasm was connected to better sexual satisfaction for both partners. In addition, there was some evidence tentatively suggesting that men were more likely than women to report lower sexual satisfaction if his partner was orgasming more consistently than he was, as opposed to her reporting lower sexual satisfaction from him orgasming more consistently than she was; though this appears to be a rare scenario as only 5.9% of couples had women who orgasmed more consistently than men. This study may assist educators and clinicians as they help couples consider the sexual scripts surrounding orgasm consistency, and how they can attend to each others' desires in a way that maximizes sexual satisfaction for both partners.

Relationship between Solitary Masturbation and Sexual Satisfaction: A Systematic Review

Masturbation is a healthy sexual behavior associated with different sexual functioning dimensions, which highlights sexual satisfaction as an important manifestation of sexual wellbeing. This review aims to systematically examine studies that have associated masturbation with sexual satisfaction, both in individuals with and without a partner. Following the PRISMA statement, searches were made in the APA PsycInfo, Medline, Scopus, and Web of Science databases. The search yielded 851 records, and twenty-two articles that examined the relation between solitary masturbation and sexual satisfaction were selected. In men, a negative relation between masturbation and sexual satisfaction was observed in 71.4% of the studies, 21.4% found no such relation, and 7.2% observed a positive association. In women, 40% reported no relation, 33.3% a negative relation, and 26.7% a positive one. The negative association between solitary masturbation and sexual satisfaction is consistent with the previously proposed compensatory role of masturbation, especially for men. In women, compared to men, the complementary role of masturbation in relation to sexual relationships is observed to a greater extent and is associated more closely with sexual health. The importance of including different parameters beyond the masturbation frequency in future studies to explore its relation with sexual satisfaction is emphasized. This systematic review is registered in PROSPERO (CRD42023416688).

Sexual pleasure during college students' most recent partnered sexual experiences

ObjectiveWe explored college students' sexual pleasure using a new self-report measure, the Body, Emotions, Sensations, Touch/Trust (B.E.S.T.) Scale of Sexual Pleasure. Participants: Data were from 3997 randomly sampled students with a partnered sexual experience. Methods: Students completed an online survey about their most recent partnered sexual experience. Data was collected in January 2020. Results: Students find the nonphysical aspects of partnered sex (e.g., emotions, trust, connection with partners) as pleasurable as physical aspects (e.g., behaviors engaged and received, bodily sensations). Self-reported arousal, wantedness, and emotional intimacy were the strongest correlates of male, female, and transgender/gender non-binary students' sexual pleasure. Few sexual behaviors were associated with sexual pleasure and only one - cuddling for women - was associated with greater sexual pleasure. Conclusions: Students find their partnered sexual experiences pleasurable. Students' sex may be more pleasurable when they feel ready for sex, desire sex, and feel close to their partners.

From distal to proximal to interactive: behavioral and brain synchrony during attraction, courtship, and sexual interaction-implications for clinical assessments of relationship style and quality

INTRODUCTION

Synchronous behaviors between individuals are nonverbal signs of closeness and common purpose. In the flow from initial attraction to intimate sexual interaction, attention and synchrony move from distal to proximal to interactive and are mediated by sensitized activation of neural systems for sexual motivation, arousal, and desire and those that recognize and mimic common facial and body movements between individuals. When reinforced by sexual pleasure and other relationship rewards, this results in the strengthening of attraction and bonding and the display of more common motor patterns. As relationships falter, nonverbal behaviors likely become asynchronous.

OBJECTIVES

To define behavioral, romantic, and sexual synchrony during phases of attraction and how their disruption can be observed and utilized by clinicians to assess individual relationship styles and quality.

METHODS

We review the literature on behavioral and attentional synchrony in humans and animals in an effort to understand experiential and innate mechanisms of synchrony and asynchrony and how they develop, as well as implications for attraction, relationship initiation, maintenance of romantic and sexual closeness, and relationship disintegration.

RESULTS

Evidence is presented that behavioral synchrony and the neural mechanisms that underlie it are vital to relationship formation and satisfaction.

CONCLUSION

Behavioral synchrony helps to create feelings of sexual and romantic synergy, cohesion, and arousal among individuals. Asynchrony is aversive and can spark feelings of discontent, aversion, and jealousy. Thus, observing patterns of nonverbal sexual and romantic synchrony between individuals offers insights into the potential quality of their relationships.

The Role of Mutual Masturbation within Relationships: Associations with Sexual Satisfaction and Sexual Self-Esteem

Objectives

We explored mutual masturbation among women and men and investigated associations with sexual satisfaction and sexual self-esteem.

Methods

117 women and 151 men (Mage = 29.7 years), mostly heterosexual, all in current relationships, completed an online survey covering experiences of solo and partnered sexual activities, feelings about mutual masturbation, sexual self-esteem, and sexual satisfaction.

Results

Mutual masturbation was common among both genders. Men reported significantly higher positive feelings about mutual masturbation than women. Recent mutual masturbation was positively associated with sexual satisfaction but not with sexual self-esteem.

Conclusions

These findings have implications for sex and couple therapy and research.

Orgasm and Faking Orgasm: Heterosexual Interactions in China

This article examines the prevalence and correlates of orgasm and faking orgasm in the last year among a representative sample of Chinese men and women. Existing research on orgasm in China has largely been confined to medical research. To our knowledge, no published studies have examined faking orgasm in a Chinese context. These data come from the Chinese Health and Family Life Survey (CHFLS) conducted in 1999 and 2000. We used multivariable logistic regression to identify independent correlates of orgasm and faking orgasm among 1496 women and 1497 men, ages 20-64. In accounting for orgasm and faking orgasm in China, we found evidence that men and women are trying to manage social expectations and to act in accordance with gender expectations, consistent with research in other countries. Results provide insight into how specific sexual practices (e.g., oral sex) and interactional pressures (e.g., insecurity) are correlated with orgasm and faking orgasm. Findings pave the way for future research on the presence of gender inequality as evidenced through lower orgasm rates among women and higher rates of faking orgasm. These findings have implications for how we conceptualize and study gendered and interactional components of sex, which are often overlooked in research and programmatic efforts in China.

Associations between Relationship Status, Anxiety, Sexual Function, and Sexual Satisfaction in Lesbian, Gay, and Bisexual People

Objectives

The purpose of this study was to describe associations between relationship status, anxiety, and sexual function and satisfaction in lesbian, gay, and bisexual (LGB) adults.

Methods

Linear regression determined associations between sexual function, relationship characteristics and anxiety in 979 LGB participants.

Results

Relationship status was not related to sexual interest in gay men. Partnered relationship status was associated with higher sexual satisfaction for gay men, lesbians, and bisexual women. Anxiety symptoms were negatively associated with sexual interest, satisfaction, and orgasm pleasure for gay men but not associated with sexual outcomes in lesbian women.

Conclusion

Using a nationally representative sample of LGB adults, differences were found in factors related to sexual function and satisfaction by gender and sexual orientation.

The Impact of Household Context on Self-Perceived Changes in Solo and Partnered Sexual Behaviors During the COVID-19 Pandemic: Findings from a U.S. Probability Survey

To understand how household context factors impacted self-reported changes in solo and sexual behaviors in U.S. adults during early stages of the COVID- 19 pandemic, we conducted an online, nationally representative, cross-sectional survey of U.S. adults (N = 1010; aged 18-94 years; 62% response rate) from April 10-20, 2020. We used weighted descriptive statistics with Wilcoxon rank sign tests to understand the population prevalence and significance of self-reported changes (five-point scale: much less to much more) in 10 solo and partnered sexual behaviors. Ordinal regression was used to assess the impact of household predictor variables-including number of children at home, number of adults in home, partnership status (unpartnered, partnered and not living together, partnered and living together) and employment status (not working, employed not as essential worker, employed as essential worker). All models were adjusted for gender, age, sexual orientation, race/ethnicity, and residence location (urban, suburban, rural).All solo and partnered sexual behaviors showed some amount of significant change-increased activity for some and decreased for others-for U.S. adults during the pandemic. Not living with a partner was broadly associated with decreased affectionate partnered sexual behaviors; unpartnered adults reported increased sexting. Individuals not employed reported increased oral sex and increased consumption of sexually explicit materials as compared to non-essential workers. Number of children at home and household size were not significantly linked to self-reported behavior change. Ongoing sexual health-focused research should continue to focus on understanding how adults manage opportunities and constraints to their sexual lives in the context of a still-going pandemic. While many aspects of social life look more "normal" (e.g., many people have returned to their in-person offices and children are largely back in school), new and more-infectious strains of COVID-19 have proven that the pandemic may still yet impact daily living. Lessons learned from COVID need to include sexual health planning both for any future strains of COVID, as well as for future public health emergencies.

Sexual Repertoire, Duration of Partnered Sex, Sexual Pleasure, and Orgasm: Findings from a US Nationally Representative Survey of Adults

In a confidential U.S. nationally representative survey of 2,525 adults (1300 women, 1225 men), we examined participants' event-level sexual behaviors, predictors of pleasure and orgasm, and perceived actual and ideal duration of sex, by gender and age. Event-level kissing, cuddling, vaginal intercourse, and oral sex were prevalent. Sexual choking was more prevalent among adults under 40. While women and men reported a similar actual duration of sex, men reported a longer ideal duration. Participants with same-sex partners reported a longer ideal duration than those with other-sex partners. Finally, findings show that gendered sexual inequities related to pleasure and orgasm persist.

Does Pornography Misinform Consumers? The Association between Pornography Use and Porn-Congruent Sexual Health Beliefs

Pornography may contribute to sexual health illiteracy due to its often fantastical and unrealistic depictions of sex. This cross-sectional study investigated whether pornography use was associated with holding porn-congruent sexual health beliefs among a sample of 276 Australian and Singaporean university students (Mage = 23.03, SDage = 7.06, 67.9% female, 47.8% Australian). The majority of participants (95.5% of males and 58.9% of females) reported viewing pornography in the past six months. Perceived realism of pornography and prior sexual experience were tested as potential moderators of the relationship between pornography use frequency and sexual health beliefs. Pornography use frequency showed no zero-order association with sexual health beliefs in the overall sample (although a significant zero-order association was observed among female participants). However, a significant positive association between porn use and porn-congruent sexual health beliefs was found in the overall sample, after controlling for demographic variables. Neither perceived realism nor sexual experience were found to act as moderators. Interestingly, prior sexual experience showed a significant zero-order association with sexual health beliefs, such that prior sexual experience was associated with holding porn-congruent beliefs. Perceived realism was unrelated to porn-congruent sexual health beliefs. The study provides some preliminary support for pornography having a misinformation effect on the sexual health knowledge of consumers.

Does Clitoral Knowledge Translate into Orgasm? The Interplay Between Clitoral Knowledge, Gendered Sexual Scripts, and Orgasm Experience

Despite some efforts to enhance clitoral knowledge to increase women's sexual pleasure, a gendered orgasm gap persists. We aimed to provide contemporary data on people's knowledge about the clitoris and investigate its association with the experience of sexual pleasure. Heterosexual participants (n = 573; 64.2% women) took a quiz on clitoral knowledge and answered sexuality-related questions. Participants answered only 50% of the nine quiz items correctly. Clitoral knowledge predicted sexual pleasure and orgasm in women, mediated via reduced endorsement of gendered sexual scripts. Our results highlight the importance of clitoral knowledge and its interplay with societal barriers for the experience of pleasure.

Women’s techniques for pleasure from anal touch: Results from a U.S. probability sample of women ages 18–93

The study purpose was to assess, in a U.S. probability sample of women, the specific ways women have discovered to experience pleasure from anal touch. Through qualitative pilot research with women that informed the development of the survey instrument used in this study, we identified three previously unnamed, but distinct, anal touch techniques that many women find pleasurable and that expand the anal sexual repertoire beyond the more commonly studied anal intercourse behaviors: Anal Surfacing, Anal Shallowing, and Anal Pairing. This study defines each technique and describes its prevalence among U.S. adult women. Weighted frequencies were drawn from the Second OMGYES Pleasure Report—a cross-sectional, online, national probability survey of 3017 American women’s (age 18–93) sexual experiences and discoveries. Participants were recruited via the Ipsos KnowledgePanel^®. Data suggest that 40% of women find ‘Anal Surfacing’ pleasurable: sexual touch by a finger, penis, or sex toy on and around the anus. Approximately 35% of women have experienced pleasure using ‘Anal Shallowing’: penetrative touch by a finger, penis, or sex toy just inside the anal opening, no deeper than a fingertip/knuckle. Finally, 40% of women make other forms of sexual touch more pleasurable using ‘Anal Pairing’: touch on or inside the anus that happens at the same time as other kinds of sexual touch such as vaginal penetration or clitoral touching. These data provide techniques that women can and do use to explore the anus as a pleasurable region for touch—which can enable women to better identify their own preferences, communicate about them and advocate for their sexual pleasure.

The Impact of the COVID-19 Pandemic on Sexual Health in Cis Women Living in Germany

BACKGROUND

Preliminary research shows a substantial impact of the COVID-19 pandemic on women's sexual health, whereby empirical work on sexual well-being of minoritized sexual identities is still rare.

AIM

The objective of this study was to explore sexual health in heterosexual, lesbian and bisexual cis women during the first wave of COVID-19 pandemic in Germany.

METHODS

An anonymous nationwide online survey was conducted among cis women during the first nationwide lockdown in Germany from April 20th to July 20th, 2020. The questionnaire was distributed via e-mail, online chats and social-media platforms.

OUTCOMES

Demographic variables and self-report measures from the Sexual Behavior Questionnaire (SBQ-G) "before the pandemic" and "since the pandemic" were collected.

RESULTS

A total of 1,368 cis women participants were included: heterosexual women (n = 844), lesbian women (n = 293), bisexual women (n = 231). Results indicate overall decrease in frequency of sexual contacts and masturbation during the COVID-19 pandemic. Regarding differences before and during the pandemic lesbian women showed significant changes in sexual arousal whereas heterosexual women showed significant changes in all dimensions except capability to enjoy sexual intercourse. The data of bisexual women showed significant changes in almost all dimensions except for frequency of sexual intercourse and sexual arousal. Results of the multiple regression analysis revealed that being younger than 36 years-old, and being in a relationship as well as being heterosexual (compared with being lesbian) is positively associated with general satisfaction with sexual life during the pandemic.

CLINICAL IMPLICATIONS

The findings suggest that during a pandemic sexual and mental health care for (cis) women should be provided and address the specific needs of sexual minority groups.

STRENGTHS & LIMITATIONS

This is the first study to describe sexual behavior in heterosexual, lesbian and bisexual women during the COVID-19 pandemic in Germany. Limitations, however, include the fact that the data described were obtained at only one time point so there is a possibility of recall bias, and that the results cannot be generalized because of the underrepresentation of women over age 46.

CONCLUSION

This study examined the impact of the COVID-19 pandemic and resulting social constraints on the sexual health of particular groups of lesbian and bisexual women, which may improve preparedness for future public health and policy crises. Batz F, Lermer E, Hatzler L, et al. The Impact of the COVID-19 Pandemic on Sexual Health in Cis Women Living in Germany. J Sex Med 2022;19:907-922.

How Inclusion of Other in the Self Relates to Couple's Sexuality and Functioning - Results from the German Health and Sexuality Survey (GeSiD)

Closeness, in the sense of inclusion of other in the self, has been found to be an important factor for relationship well-being, satisfaction and pair-bonding. In the past ten years, the self-expansion theory has also been incorporated into sex research, although studies are still very scarce and not without limitations. The present research aimed at further elucidating the relevance of relational factors for couple's sexuality, and to clarify the role inclusion of other in the self plays for sexual satisfaction and sexual distress. A broadly representative sample of 3,046 men and women aged 18 to 75 was taken from the German Health and Sexuality Survey (GeSiD). Throughout analyses, inclusion of other in the self and love were positively related to sexual satisfaction. Furthermore, inclusion of other in the self was negatively related to how strongly someone was distressed by experiencing sexual problems. Closeness seems to have a compensatory role especially for women with sexual problems, protecting them from experiencing sexual distress. In future research, couple's sexual satisfaction should not be compartmentalized from relational aspects. Results clearly promote the Inclusion of Other in the Self Scale as an interesting tool for both research and treatment.

Heterosexual Young Adults’ Experience With and Perceptions of the Orgasm Gap: A Mixed Methods Approach

The “orgasm gap” refers to the finding that cisgender men, on average, have more orgasms than cisgender women during heterosexual partnered sex. In the current research, we replicated evidence for several orgasm discrepancies across sexual contexts and assessed men’s and women’s perceptions of the orgasm gap. Our sample consisted of 276 heterosexual, cisgender, sexually active undergraduate students (56.52% women; M age = 18.84). We assessed participants’ self-reported orgasm frequencies with a familiar partner, with a new partner, and during masturbation, as well as participants’ perceptions of their partners’ orgasm frequencies. We found evidence for orgasm discrepancies between young men and women within contexts and for women across contexts. Additionally, men perceived the size of the orgasm gap to be smaller than women perceived it to be. We used qualitative analyses to assess participants’ perceptions of driving forces behind the orgasm gap and their responses could be grouped into five overarching themes: Sociocultural Influence, Women’s Orgasm Difficulty, Biology, Men’s Fault, and Interpersonal Communication. This qualitative data can inform education and advocacy efforts focused on improving orgasm outcomes for young women, particularly by disproving prominent biological justifications for orgasm difference and addressing relevant sociocultural concerns. Additional online materials for this article are available on PWQ’s website at http://journals.sagepub.com/doi/suppl/10.1177/03616843221076410 .

Changes in Penile-Vaginal Intercourse Frequency and Sexual Repertoire from 2009 to 2018: Findings from the National Survey of Sexual Health and Behavior

Solo and partnered sexual behaviors are relevant to health, well-being, and relationships. Recent research shows that sexual frequency has declined in the U.S. and in other countries; however, measurement has been imprecise. We used data from 14- to 49-year-old participants in the 2009 and 2018 waves of the National Survey of Sexual Health and Behavior (NSSHB), a confidential U.S. nationally representative survey that is conducted online. We aimed to: (1) assess changes in frequency of past-year penile-vaginal intercourse and (2) examine combinations of past-year sexual behaviors for each of the two waves. We hypothesized that we would observe lower frequency of penile-vaginal intercourse (PVI) from 2009 to 2018 and that we would observe greater engagement in sexual repertoires involving non-coital partnered behaviors (e.g., partnered masturbation, oral sex) in 2018 as compared to 2009. Participants were 4155 individuals from the 2009 NSSHB (Adolescents: 406 females, 414 males; Adults: 1591 women, 1744 men) and 4547 individuals from the 2018 NSSHB (Adolescents: 416 females, 411 males; Adults: 2007 women, 1713 men). Compared to adult participants in the 2009 NSSHB, adults in the 2018 NSSHB were significantly more likely to report no PVI in the prior year (28% in 2018 vs. 24% in 2009). A similar difference in proportions reporting no PVI in the prior year was observed among 14-17-year-old adolescents (89% in 2018 vs. 79% in 2009). Additionally, for both adolescents and adults, we observed decreases in all modes of partnered sex queried and, for adolescents, decreases in solo masturbation.

Sexual Variety in Norwegian Men and Women of Different Sexual Orientations and Ages

The purpose of this study was to examine Norwegians' reports of seven varied sexual acts. Data were obtained from a questionnaire survey of a probability-based web sample of 2,181 men and 1,967 women aged 18-89 years. Among seven acts of sexual variety, the most common sexual experiences were trying to watch pornography with a partner, engaging in sex in unusual places, and using sex toys. Older age was negatively associated with all sexual behaviors. Regarding more unorthodox acts of sexual variety, heterosexual men's sexual preferences involved having and desiring group sex, whereas heterosexual women's sexual experiences and desires involved having sex in unusual places. Lesbian, gay, bisexual (LGB) individuals generally showed greater curiosity or experience of having group sex and engaging in BDSM (bondage, discipline, dominance and submission, and sadomasochism) activities than heterosexual adults. However, while LGB men had a high preference for group sex activities, LGB women had more positive attitudes toward BDSM activity. Individuals appear to accumulate more acts of sexual variety over time, thus making the incorporation of sexual variety a function of age. This study supports the idea that sexual variety has expanded among those born from 1960 onwards.

Porn Sex versus Real Sex: Sexual Behaviors Reported by a U.S. Probability Survey Compared to Depictions of Sex in Mainstream Internet-Based Male-Female Pornography

Using data from a 2014 U.S. nationally representative probability survey and a 2014 content analysis of 2562 male-female videos from two popular pornographic websites, this study aimed to: (1) compare the prevalence of survey respondents' event-level sexual behaviors with those depicted in mainstream pornography online videos; (2) compare event-level condom use with condom use prevalence in pornographic videos; (3) compare event-level orgasm with prevalence of orgasms in pornographic videos; and (4) assess whether respondents' partnered use of pornography was associated with the sexual behaviors in which they report engaging. We found that kissing, male orgasm, female orgasm, and condom use were significantly less prevalent in the pornographic videos than in survey respondents' most recent sexual experiences. Conversely, penile-anal intercourse and fellatio were significantly more prevalent in the pornographic videos than in participants' reports of their most recent sexual experience. There were no significant differences between the prevalence of cunnilingus or sex toy use represented in the videos as compared to survey respondents' reports. Finally, we found that individuals who reported partnered pornography use during their most recent sexual experience were more likely to report having engaged in oral sex, penile-anal intercourse, and sex toy use and were also more likely to report female orgasm during their most recent sexual experience.

The World Association for Sexual Health's Declaration on Sexual Pleasure: A Technical Guide

This article provides technical guidance on the content, meaning, and application of the World Association of Sexual Health (WAS) Declaration on Sexual Pleasure to various stakeholders and practitioners working in the area of sexuality, sexual health, and sexual rights. A growing body of work shows that sexual pleasure is integral to broader health, mental health, sexual health, well-being and rights and indeed can lead to improvements in health. Yet, more research is needed to identify the best ways to incorporate sexual pleasure to achieve sexual health for different outcomes and populations. In the first part of this article, we deconstruct each statement from the WAS Declaration on Sexual Pleasure and provide key evidence from the literature supporting these statements. In the latter part of the article, we provide guidance on how to include sexual pleasure as a fundamental part of sexual health and sexual rights work. We include a series of case studies and highlight key actions and principles for advocacy, implementation, and quality assurance in terms of law and policy, comprehensive sexuality education, health care services and dissemination of knowledge. This technical document seeks to inspire our partners and collaborators to embark on a journey toward a pleasure-based approach to sexual health and sexual rights. Our hope is that the literature, guidance and case studies provided here can ignite ongoing advocacy and collaboration to embrace sexual pleasure in all settings.

In Pursuit of Pleasure: A Biopsychosocial Perspective on Sexual Pleasure and Gender

Objective: Various sources of evidence suggest that men and women differ in their experience of sexual pleasure. Such gender differences have been attributed to men's higher innate sex drive, supported by evolutionary psychology perspectives and gender differences in reproductive strategies. Method: This paper presents biopsychosocial evidence for gender similarities in the capacity to experience pleasure, and for substantial gender differences in opportunities for sexual pleasure. Results: We conclude that sexual activity, in most cultures, is less pleasurable and associated with greater cost for heterosexual women than for heterosexual men, even though they do not differ in the capacity for sexual pleasure. Conclusion: Since gender differences in experienced sexual pleasure are not a biological given, a more critical discourse of sexual pleasure might create awareness of current inequalities, help lift restrictions for women's opportunities for pleasure, and could reduce gender differences in the cost of sex. That would truly serve sexual justice around the globe.

Pleasure During Adolescents' Most Recent Partnered Sexual Experience: Findings from a U.S. Probability Survey

Compared to studies on sexually transmitted infections and pregnancy prevention, sexual pleasure has received limited attention in the adolescent sexual development literature. In the present study, we used data from 157 adolescents (66 females; 14 to 17 years old), with a partnered sexual experience in the past 12 months to explore adolescents' sexual pleasure. First, we examined adolescents' perceptions of pleasure during their most recent partnered sexual experience. We then used information about those sexual experiences to identify correlates of sexual pleasure. Adolescents' reports of sexual pleasure were mixed. Although 17.8% reported their sexual experience was extremely pleasurable and 36.5% reported it was quite pleasurable, 26.6% indicated moderate pleasure, 13.1% a little pleasure, and 3.3% reported no pleasure. Sexual pleasure was primarily associated with aspects of sexual experiences that reflected socioemotional intimacy and desire. Specifically, cuddling with partners, emotional intimacy, and wantedness were all associated with greater sexual pleasure. Additionally, adolescents found sex more pleasurable when it occurred with a friend, but less pleasurable when it involved genital rubbing. Most sexual behaviors, having experienced orgasm, and the situational context of sexual experiences were not associated with sexual pleasure. Thus, specific sexual behaviors and orgasm may have less impact on sexual pleasure than feelings of emotional intimacy and desire. The diversity of perceived sexual pleasure and its associations with intimacy and desire suggest that, during adolescence, partnered sexual experiences are not primarily motivated by anticipated physical pleasure.

Exercise-Induced Orgasm and Its Association with Sleep Orgasms and Orgasms During Partnered Sex: Findings From a U.S. Probability Survey

Prior research has described women's experiences with exercise-induced orgasm (EIO). However, little is known about men's experiences with EIO, the population prevalence of EIO, or the association of EIO with other kinds of orgasm. Using U.S. probability survey data, the objectives of the present research were to: (1) describe the lifetime prevalence of exercise-induced orgasm (EIO) and sleep orgasm; (2) assess respondents' age at first experience of EIO as well as the type of exercise connected with their first EIO; (3) examine associations between lifetime EIO experience and orgasm at respondents' most recent partnered sexual event; and (4) examine associations between lifetime EIO experience and sleep orgasms. Data were from the 2014 National Survey of Sexual Health and Behavior (1012 men and 1083 women, ages 14 years and older). About 9% of respondents reported having ever experienced exercise-induced orgasm. More men than women reported having experienced orgasm during sleep at least once in their lifetime (66.3% men, 41.8% women). The mean age for women's first EIO was significantly older than men (22.8 years women, 16.8 years men). Respondents described a wide range of exercises as associated with their first EIO (i.e., climbing ropes, abdominal exercise, yoga). Lifetime EIO experience was associated with lifetime sleep orgasms but not with event-level orgasm during partnered sex. Implications related to understanding orgasm and recommendations for clinicians and sex educators are discussed.

A first radiotherapy application of functional bulboclitoris anatomy, a novel female sexual organ-at-risk, and organ-sparing feasibility study

OBJECTIVE

The bulboclitoris (clitoris and vestibular bulbs) is the primary organ responsible for female sexual arousal and orgasm. Effects of radiotherapy on the bulboclitoris are unknown, as its structure/function has yet to be described in radiotherapy, and it overlaps only partially with the external genitalia structure. Our aim was to: describe bulboclitoris structure, function and delineation; compare volume of and dose delivered to the bulboclitoris vs external genitalia; and, compare bulboclitoris-sparing IMRT (BCS-IMRT) to standard IMRT (S-IMRT) to determine reoptimization feasibility.

METHODS

Our expert team (anatomist, pelvic radiologist, radiation oncologist) reviewed bulboclitoris anatomy and developed contouring guidance for radiotherapy. 20 female patients with anal cancer treated with chemoradiation were analyzed. Sexual organs at risk (OARs) included the external genitalia and the bulboclitoris. Volumes, dice similarity coefficients (DSCs) and dose received using S-IMRT were compared. Plans were reoptimized using BCS-IMRT. Dose-volume histograms (DVHs) for PTVs and all OARs were compared for BCS-IMRT vs S-IMRT.

RESULTS

Bulboclitoris structure, function and delineation are described herein. The bulboclitoris occupies 20cc (IQR:12-24), largely distinct from the external genitalia (DSC <0.05). BCS-IMRT was superior to S-IMRT in reducing the dose to the bulboclitoris, with the greatest reductions in V30 and V40, with no significant changes in dose to other OARs or PTV 1/V95.

CONCLUSION

The bulboclitoris can be contoured on planning imaging, largely distinct from the external genitalia. Compared with S-IMRT, BCS-IMRT dramatically reduced dose to the bulboclitoris in anal cancer planning. BCS-IMRT might safely reduce sexual toxicity compared with standard approaches.

ADVANCES IN KNOWLEDGE

The structure and function of the bulboclitoris, the critical primary organ responsible for female sexual arousal and orgasm, has yet to be described in the radiotherapy literature. Structure, function and delineation of the bulboclitoris are detailed, delineation and bulboclitoris-sparing IMRT were feasible, and sparing reduces the dose to the bulboclitoris nearly in half in female patients receiving IMRT for anal cancer, warranting further clinical study.

Prevalence and characteristics of choking/strangulation during sex: Findings from a probability survey of undergraduate students

In a random sample of undergraduate students, we aimed to: (1) establish the prevalence of choking and being choked; (2) examine demographic and situational predictors of being choked, and (3) examine demographic and situational predictors of choking someone. Participants: 4168 randomly sampled undergraduates at a large public U.S. university. Methods: A cross-sectional, confidential online survey. Results: We found that 26.5% of women, 6.6% of men, and 22.3% of transgender and gender non-binary participants reported having been choked during their most recent sexual event. Additionally, 5.7% of women, 24.8% of men, and 25.9% of transgender and non-binary participants reported that they choked their partner at their most recent event. Choking was more prevalent among sexual minority students. Conclusions: Choking is prevalent among undergraduate students; implications for college sexual health education are discussed.

Women's techniques for making vaginal penetration more pleasurable: Results from a nationally representative study of adult women in the United States

The study purpose was to assess, in a U.S. probability sample of women, the specific ways women have discovered to make vaginal penetration more pleasurable. Through qualitative pilot research with women that informed the development of the survey instrument used in this study, we identified four previously unnamed, but distinct, techniques women use to make vaginal penetration more pleasurable: Angling, Rocking, Shallowing and Pairing. This study defines each technique and describes its prevalence among U.S. adult women. Weighted frequencies were drawn from the Second OMGYES Pleasure Report—a cross-sectional, online, national probability survey of 3017 American women’s (age 18–93) sexual experiences and discoveries. Participants were recruited via the Ipsos KnowledgePanel®. Data suggest that 87.5% of women make vaginal penetration more pleasurable using ‘Angling’: rotating, raising, or lowering the pelvis/hips during penetration to adjust where inside the vagina the toy or penis rubs and what it feels like. Approximately 76% of women make vaginal penetration more pleasurable using ‘Rocking’: the base of a penis or sex toy rubbing against the clitoris constantly during penetration, by staying all the way inside the vagina rather than thrusting in and out. About 84% of women make vaginal penetration more pleasurable using ‘Shallowing’: penetrative touch just inside of the entrance of the vagina—not on the outside, but also not deep inside—with a fingertip, sex toy, penis tip, tongue, or lips. Finally, 69.7% of women orgasm more often or make vaginal penetration more pleasurable using ‘Pairing’: when a woman herself (Solo Pairing) or her partner (Partner Pairing) reaches down to stimulate her clitoris with a finger or sex toy at the same time as her vagina is being penetrated. These data provide techniques that are at women’s disposal to make penetration more pleasurable—which can enable women to better identify their own preferences, communicate about them and advocate for their sexual pleasure.

HIV Prevalence Among Women Who Exchange Sex for Money or Drugs-4 U.S. Cities

BACKGROUND

Limited data exist in the United States on the prevalence of HIV among women who exchange sex.

SETTING

We estimate HIV prevalence of women who exchange sex from a 2016 survey in Chicago, Detroit, Houston, and Seattle and compare it with the prevalence of HIV among women of low socioeconomic status (SES), who did not exchange sex, and women in the general population.

METHODS

Women who exchange sex were recruited via respondent-driven sampling among some cities participating in National HIV Behavioral Surveillance, interviewed, and offered HIV testing. We estimate HIV prevalence and, using prevalence ratios, compare it with the prevalence among women of low SES who did not exchange sex in the 2013 National HIV Behavioral Surveillance cycle, and to women in the general population estimated using 2015 National HIV Surveillance data.

RESULTS

One thousand four hundred forty women reported exchange sex in 2016. Aggregated HIV prevalence was 4.9% [95% confidence interval (CI): 2.7 to 7.1] among women who exchanged sex, 1.6% (95% CI: 0.3 to 2.8) among women of low SES who did not exchange sex, and 0.6% (95% CI: 0.5% to 0.6%) among women in the general population. HIV prevalence among women who exchanged sex was 3.1 times (95% CI: 1.6 to 5.9) as high as among women of low SES who did not exchange sex, and 8.8 times (95% CI: 7.0 to 11.1) as high as among women in the general population.

CONCLUSION

HIV prevalence was significantly higher among women who exchanged sex compared with women in the general population and women of low SES who did not exchange sex.

Partnered Sexual Behaviors, Pleasure, and Orgasms at Last Sexual Encounter: Findings from a U.S. Probability Sample of Black Women Ages 18 to 92 Years

The purpose of this study was to estimate the prevalence of sexual behaviors and experiences of Black women's partnered behaviors at their most recent sexual event. Data were from a subset of 980 Black women ages 18 to 92 who participated in the 2018 National Survey of Sexual Health and Behavior. Findings provide a sex-positive view of Black women and their partnered experiences, indicating a range of activities; most wanted their sexual experiences, experienced orgasms, and reported pleasurable experiences. These results provide a foundation for sexual health practitioners, educators, and therapists to improve societal knowledge about Black women's sexuality.

Sex-Ed without the Stigma: What Gay and Bisexual Men Would like Offered in School Based Sex Education

This study highlights the experiences of gay and bisexual men who live in Oklahoma with formalized sex education. Open-ended prompts were provided to individuals (N= 112) who completed an online questionnaire assessing their experience with sex education and what they would like to see offered. The majority of participants did not receive a formalized sex education and they want to see a comprehensive sex education program provided in public schools. A need exists for a more comprehensive and inclusive formalized sex education program to be provided in socio-politically conservative areas like Oklahoma.

High Emotional and Sexual Satisfaction Among Partnered Midlife Canadians: Associations with Relationship Characteristics, Sexual Activity and Communication, and Health

Despite midlife adults accounting for a substantial and growing segment of the population, few large-scale studies have investigated factors which distinguish highly satisfying relationships from less satisfying ones in midlife. In a subsample of partnered 40-59-year-old Canadians (705 men, 743 women), relationship characteristics, sexual activity and communication, and health were investigated individually and simultaneously as predictors of high emotional and sexual satisfaction. Though the vast majority of participants reported being at least somewhat satisfied in their current relationship, less than half reported high satisfaction. For men and women, high emotional and sexual satisfactions were strongly linked. Logistic regressions indicated that longer relationships, dating relationships, and greater subjective overall health predicted high emotional satisfaction for men, whereas older age, married or cohabiting relationships, and frequent sexual communication predicted high emotional satisfaction for women. All types of sexual activities (minus penile-anal intercourse) were bivariately related to high emotional and sexual satisfaction. More frequent partnered sexual activity predicted high emotional and sexual satisfaction for men and women in regression analyses. More frequent sexual communication predicted high emotional satisfaction for women and high sexual satisfaction for both men and women. Newer relationships were more sexually satisfying for men. Postmenopausal women were less likely to be highly sexually satisfied. Findings suggest that physical health conditions are not generally related to high levels of satisfaction in midlife couples and that frequently discussing sex and engaging in (any) sexual activity with a partner are key components of highly satisfying relationships.

Women's Sexual Satisfaction, Communication, and Reasons for (No Longer) Faking Orgasm: Findings from a U.S. Probability Sample

We aimed to assess, among a U.S. probability sample of adult women: (1) the prevalence of, and reasons given for, faking and no longer faking orgasm, (2) women's histories of sexual non-communication and reasons for non-communication, (3) associations between sexual non-communication and sexual satisfaction and faking orgasm, (4) associations between specific sexual communication and recent sexual satisfaction, and (5) associations between specific sexual communication and faking orgasm. Respondents were 1008 adult women ages 18-94 from the GfK KnowledgePanel (a nationally representative probability sample of non-institutionalized and English-speaking adults), who completed a confidential Internet-based survey. Although 58.8% of female respondents reported having ever faked/pretended orgasm, 67.3% of those who had ever faked orgasm no longer did. Women who continued to fake orgasms were more likely to indicate embarrassment talking about sex with their partner in explicit ways and were less likely to agree that they and their partner are able to talk specifically about what makes sex more pleasurable for them. More than half (55.4%) of women reported they had wanted to communicate with a partner regarding sex but decided not to; the most common reasons were not wanting to hurt a partner's feelings (42.4%), not feeling comfortable going into detail (40.2%), and embarrassment (37.7%). Greater self-reported sexual satisfaction was associated with more comfortable sexual communication. Study findings and implications for professionals are discussed in the context of adult sexual development and learning. This includes growing more comfortable talking with a partner about sexual preferences and sexual pleasure.

Pleasure, Power, or Both? Heteronormativity, Stigma, and the Intersections of BDSM and Anoreceptive Heterosexual Males

Despite the direct connection between anal sex and pleasure, the majority of academic literature frames anal sex in terms of homophobia and/or disease. In the large body of literature on anal sex, only two academic articles have been published on anoreceptive heterosexual males (ARHMs), despite evidence of this type of sexuality dating back to Ancient Egypt and Greece. A review of the literature suggests that the lack of empirical research on ARHMs is due to compulsory heteronormativity, which can instill sexual shame in those with nonconforming sexual preferences. Some ARHMs are BDSM-oriented, and given that BDSM behavior and identity are also stigmatized, BDSM-oriented ARHMs have an additional concealable status that is subject to prejudice. Skills such as higher level communication and self-reflection often inform BDSM interactions and relationship structures, therefore, BDSM-oriented ARHMs may have more opportunity to develop skills to offset shame and stigma, and may take pride as well as pleasure in subverting traditionally heteronormative anoreception roles.

"Fulfilling His Needs, Not Mine": Reasons for Not Talking About Painful Sex and Associations with Lack of Pleasure in a Nationally Representative Sample of Women in the United States

INTRODUCTION

Although much research has examined correlates of pain during sex, far less research has examined why women have sex despite having pain and why they avoid telling their partner.

AIM

The purpose of our study was to examine women's reports of painful sex, including location of pain, whether they told their partner, factors associated with not disclosing their pain, and their reasons for not disclosing.

METHODS

We used data from the 2018 National Survey of Sexual Health and Behavior, a probability-based online survey of 2,007 individuals ages 14 to 49 years. We limited our sample to adult women who reported a sexual experience that was painful in the past year (n = 382; 23.2%). The primary outcome in quantitative analyses was whether women told their partner they experienced pain during sex. Associations with social identities and sexual health were explored via logistic regression. Those who did not tell their partner about painful sex were asked why; their accounts were coded and analyzed qualitatively.

MAIN OUTCOME MEASURE

Women were asked, "To what extent was this sexual experience physically painful for you?" Those who reported any pain were asked, "Did you tell your partner that you were in pain during sex?" and, if applicable, "Why didn't you tell your partner that you were in pain during sex?"

RESULTS

Of those reporting pain during sex, most said it was "a little painful" (81.6%) and occurred at the vaginal entrance (31.5%), inside the vagina (34.4%), or at or around the cervix (17.4%). Overall, 51.0% (n = 193/382) told their partner about their pain. Adjusting for age and wantedness, women who reported little or no event-level sexual pleasure had nearly 3-fold greater odds of not telling a partner about painful sex (adjusted odds ratio = 3.24; 95% CI, 1.43-7.37). Normalizing painful sex, considering pain to be inconsequential, prioritizing the partner's enjoyment, and gendered interactional pressures were the predominant themes in women's narratives.

CLINICAL IMPLICATIONS

Providers should ask about painful sex, if the woman continues intercourse despite pain, and how she feels about this as a means of assessing any sexual and social pressures.

STRENGTHS & LIMITATIONS

Strengths include the use of social theory in nationally representative survey research to examine how contextual factors influence sexual health, but experiences were largely limited to heterosexual interactions.

CONCLUSION

Many women do not discuss painful sex with their partners, lack of pleasure is significantly more likely among this group, and gender norms and cultural scripts are critical to understanding why. Carter A, Ford JV, Luetke M, et al. "Fulfilling His Needs, Not Mine": Reasons for Not Talking About Painful Sex and Associations with Lack of Pleasure in a Nationally Representative Sample of Women in the United States. J Sex Med 2019; 16:1953-1965.

Daily diary study of adult men's and women's event-level sexual motivations and sexual behaviour

Background Understanding people's sexual motivations has long been of public health and health promotion interest. We used daily diaries to examine how adult men's and women's event-specific affective sexual motivations were linked to the types and combinations of sexual behaviours chosen in a given sexual event.

METHODS

Adult men (n=156) and women (n=192) completed thrice-daily electronic diaries assessing individual- and partner-specific attributes and non-coital or coital sexual behaviours. Sexual motivations were: interest in sex, feeling in love with partner, wanted to have sex and partner wanted to have sex. The outcome variable was: sexual behaviour type (no sex, one vaginal sex event, one vaginal sex event+any other sex types, multiple vaginal sex events, any other sex types). Mixed-effect multinomial logistic regression modelled the influence of each sexual motivation on sexual behaviour type (Stata; all p<0.05). 'No sex' was the referent in all models; all models controlled for gender.

RESULTS

Participants contributed 14856 total partner-associated diary entries. Most (54%; women: 56.5%, men: 51.2%) were associated with no sex; when sex occurred, the most common behaviour type was one vaginal sex event (13.1%) for women and other sex types (16.4%) for men. Wanting to have sex or perceiving a partner wanted to have sex were the strongest predictors of sexual behaviour type, and were associated with a greater number of reported sexual behaviours.

CONCLUSIONS

Event-specific sexual motivations are associated with the choice to have sex, and with variation in the chosen sexual behaviours.