Intimate Justice: A Critical Analysis of Sexual Satisfaction

Loneliness Within a Romantic Relationship: Do Gratitude and Forgiveness Moderate Between Loneliness and Relational and Sexual Well-Being?

Loneliness has a detrimental effect on relational and sexual well-being. Recent research indicates that gratitude and forgiveness are two qualities that may buffer negative factors in relationships. We examine whether these two qualities may moderate the negative association between loneliness and relational and sexual well-being. Using data from a nationally representative study of newlywed couples (N = 1,614) in the U.S. (CREATE), we evaluated whether actor and partner gratitude and forgiveness moderated the negative association between loneliness and sexual and relational well-being. Results indicated that both the husband's and wife's gratitude and forgiveness moderated the negative association between loneliness and relational well-being, but we found no moderation effect for sexual well-being. These findings may indicate that while gratitude and forgiveness protect the marriage relationship from feelings of loneliness, the sexual relationship is not protected from loneliness through forgiveness and gratitude alone. This study provides initial evidence that when spouses experience loneliness, forgiveness and gratitude may create pro-relational motivation attitudes and behaviors within the marriage relationship. Therapeutic implications are discussed.

Development and validation of the sexual distress scale: results from a collectivistic culture

BACKGROUND

Literature lacks a comprehensive measure of sexual distress that could be applied to both clinical and non-clinical populations, regardless of the gender and relational status of the respondents. The current study, therefore, developed and validated Sexual Distress Scale (SDS).

METHOD

The development and validation of the SDS involved two consecutive studies with a total of 656 participants (men = 300, women = 356; Mage=22 years) from Pakistan. The studies included exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and assessments of convergent and divergent validity.

RESULTS

The SDS demonstrated high reliability in both the studies (α = 0.911 & 0.946). Item-total correlations ranged from 0.670 to 0.878 (p < 0.01). EFA revealed a single-factor structure consisting of 8 items. CFA confirmed this structure, projecting a good comparative fit index (CFI = 0.913). The scale's convergent validity was established through significant positive correlations with depression (r = 0.845, p < 0.01), anxiety (r = 0.847, p < 0.01), and stress (r = 0.786, p < 0.01). Divergent validity was established through significant inverse correlations with life satisfaction (r = -0.972, p < 0.01) and emotional expressivity (r= -0.935, p < 0.01). Compared to women, men experienced significantly higher levels of sexual distress (p < 0.01; Cohen's d = 0.448).

CONCLUSION

The study bridges a substantial knowledge gap in the measurement of sexual distress. The findings highlight the impact of sexual distress on psychosocial health. The study opens avenues for further research and targeted interventions in sexuality, especially within the collectivistic cultures.

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.

Development and Validation of a Brief Measure of Sexual Wellbeing for Population Surveys: The Natsal Sexual Wellbeing Measure (Natsal-SW)

Sexual wellbeing is an important aspect of population health. Addressing and monitoring it as a distinct issue requires valid measures. Our previous conceptual work identified seven domains of sexual wellbeing: security; respect; self-esteem; resilience; forgiveness; self-determination; and comfort. Here, we describe the development and validation of a measure of sexual wellbeing reflecting these domains. Based on the analysis of 40 semi-structured interviews, we operationalized domains into items, and refined them via cognitive interviews, workshops, and expert review. We tested the items via two web-based surveys (n = 590; n = 814). Using data from the first survey, we carried out exploratory factor analysis to assess and eliminate poor performing items. Using data from the second survey, we carried out confirmatory factor analysis to examine model fit and associations between the item reduced measure and external variables hypothesized to correlate with sexual wellbeing (external validity). A sub-sample (n = 113) repeated the second survey after 2 weeks to evaluate test-retest reliability. Confirmatory factor analysis indicated that a "general specific model" had best fit (RMSEA: 0.064; CFI: 0.975, TLI: 0.962), and functioned equivalently across age group, gender, sexual orientation, and relationship status. The final Natsal-SW measure comprised 13 items (from an initial set of 25). It was associated with external variables in the directions hypothesized (all p < .001), including mental wellbeing (0.454), self-esteem (0.564), body image (0.232), depression (-0.384), anxiety (-0.340), sexual satisfaction (0.680) and sexual distress (-0.615), and demonstrated good test-retest reliability (ICC = 0.78). The measure enables sexual wellbeing to be quantified and understood within and across populations.

A Psychometric Study of a Trait and State Assessment of Sexual Pleasure - The Amsterdam Sexual Pleasure Inventory

We studied the Amsterdam Sexual Pleasure Inventory's (1.0) psychometric properties. The ASPI, a revised self-report battery designed to measure domains of state and trait sexual pleasure in diverse gender, sex, and relationship populations, is based on a recently proposed conceptual framework of sexual pleasure. We collected quantitative (n = 1371) and qualitative data (n = 637) using a cross-sectional multi-method design targeting the general (German-speaking) population. After pre-processing, we conducted analyses on a sample of n = 706 participants. The theory-based 5-factor exploratory structural equation model and the principal component analyses of the two general exploratory index-scales showed good and acceptable structural validity evidence respectively. Measurement invariance was confirmed separately for male and female participants and for those with sexually functional-scoring and dysfunctional-scoring levels. Coefficient omega indicated that all scales, except those of one facet, showed acceptable to very good internal consistency. The ASPI's convergent and discriminant associations with sexological and psychological constructs demonstrated good overall construct validity. Participants understood the items as intended and felt that the ASPI covered relevant facets of sexual pleasure. The ASPI might help understand how individuals differ in experiencing sexual pleasure and how different contexts enable some people to experience pleasure while disadvantaging others.

The Mediating Role of Sexual Boredom in Women's Sexual Desire and Satisfaction

Sexual boredom in women is associated with various levels and dimensions of sexual desire, as well as lower sexual and relationship satisfaction. However, the directionality of these relationships remains unclear. This study aimed to investigate whether sexual boredom mediates the relationship between partner and attractive-other sexual desire and sexual and relationship satisfaction in a sample of 1155 Portuguese women in long-term monogamous relationships. Participants, aged 18-66 years (M = 31.60, SD = 5.65), were involved in cohabiting relationships of 1 year or more. Linear regression analysis and Structural Equation Modeling were conducted, revealing that sexual boredom emerged as a stronger predictor of sexual and relationship satisfaction compared to dimensions of sexual desire. Additionally, sexual boredom partially mediated the relationship between partnered sexual desire and satisfaction and fully mediated the relationship between attractive other-related sexual desire and satisfaction variables. Notably, sexual boredom explained up to one-third of sexual satisfaction (32%) and slightly less of relationship satisfaction (27%). These findings underscore the importance of addressing sexual boredom in long-term relationships to promote women's sexual health. Furthermore, they suggest that experiencing sexual desire for attractive non-partners is not indicative of sexual and relationship dissatisfaction unless accompanied by sexual boredom.

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.

Measuring Sexual Intelligence for Evaluating Sexual Health

The current paper reports four consecutive studies that were conducted to link sexual health with a new construct of sexual intelligence by developing and validating a new scale to measure sexual intelligence. Sexual intelligence was defined as "the ability to perceive, understand and respond to sexual needs and desires in a personal and social context." Sexual Intelligence Scale (SIS), comprising of 8 items in English and 2 factors (sexual knowledge & sexual behavior), was developed and validated by involving 959 respondents in the process of 4 consecutive studies. The validity of SIS was tested step by step for its face, content, factorial, convergent, discriminant, and predictive validities. The reliability was measured through internal consistency and item-total & item-scale correlations. The study found significantly higher levels of sexual intelligence in men as compared to women. Sexual intelligence, moreover, had significant positive correlations with age, education, emotional intelligence, social intelligence, sexual health, and satisfaction with life. Sexual health was linked with sexual intelligence and the SIS was accepted as a reliable and valid tool to measure sexual intelligence.

"No one told me how this could be pleasurable" A Qualitative Focus Group Study into Experiences and Needs of Transgender People in Addressing Sexuality in the Context of Gender-Affirming Medical Care in The Netherlands

Various studies show that transgender people may experience diverse challenges to attaining sexual well-being. Receiving gender-affirming medical care (GAMC) may influence one's sexual experiences, but there is little insight into the way sexuality is addressed in GAMC. We conducted a qualitative focus group study among transgender individuals on their experiences and needs related to the way sexuality is addressed in the GAMC context. We included 28 participants (aged 21-60) who were assigned to six groups based on their GAMC trajectories and treatment goals. Each group convened twice for two hours (12 focus groups in total). We analyzed the data using reflexive thematic analysis and identified three main themes. Regarding sexuality in GAMC, participants articulated the need for 1) personalized and balanced information, 2) insight into the experiences of others, and 3) the opportunity for support and guidance concerning sexuality by a healthcare provider. This study highlights the necessity to improve information provision and guidance to promote sexual well-being of people receiving GAMC. Such information ought to transcend cis- and heteronormative sexual assumptions and needs to be tailored to an individual's experiences. Finally, GAMC organizations and their healthcare providers should foster an environment where questions and concerns related to sexuality can be discussed.

Explanations for Gender Differences in Preferences for Submissive Sexual Fantasies

Women have a stronger preference for sexual submission than men do. In the current studies, we investigated gender differences in fantasies about sexual submission. Replicating previous research, in two studies we found that women expressed a stronger affinity for fantasies about sexual submission than men did. However, controlling for age and several sociocultural factors made the relationship between gender and preference for sexual submission non-significant-that is, we could statistically eliminate the gender difference. These analyses suggest the multiple factors that may influence sexual preferences and the multiple ways that gender differences in preference for submissive sexual fantasies can be eliminated by easily assessed demographic and contextual differences in the experiences of women and men.

Sexual satisfaction of postmenopausal women: An integrative review

A prerequisite for interventions for sexual satisfaction in postmenopausal women is a clear, objective measurement of the concept. Despite the large number of studies on the sexual satisfaction of postmenopausal women, there is no clear definition of sexual satisfaction in menopause. This study was conducted to investigate the concept of sexual satisfaction in postmenopausal women. The present study was carried out using an integrated review of data obtained from secondary sources, utilizing Whittemore and Knafl's method of bibliographic search. A literature search was performed without any data limitations in journals and international databases. The primary inclusion criterion was relevance to sexual satisfaction in postmenopausal women. The full texts of all these articles were evaluated using the checklists of the MMAT and PRISMA. Data were analyzed using MAXQDA 10 software using a constant comparison method. Meaning units were identified and coded. The codes were classified into subgroups and categories according to the characteristics, antecedents, and consequences of sexual satisfaction in postmenopausal women. During the integrative review of the 62 articles and three books, 580 codes about sexual satisfaction in menopause were extracted. The codes were grouped into three main attributes, five main antecedents, and three main consequences of sexual satisfaction in postmenopausal women. Four attributes, symptoms, or components were identified for the concept. These attributes were as follows: Change in sexual objective and subjective dimensions of sexual satisfaction after menopause, conditional sexual consent, change in behavior, and sexual function. These dimensions distinguish sexual satisfaction in menopause from other conditions. The concept of sexual satisfaction in menopause is a subjective (emotional interaction) and objective (physical interaction) experience that is conditioned by the fulfillment of expectations and the reconstruction of sexual relations while also being influenced by the change in sexual capacity during menopause.

Sexual satisfaction, an indicator of sexual health and well-being? Insights from STI/HIV prevention research in European men who have sex with men

INTRODUCTION

Although sexual health has been holistically defined to include sexual satisfaction, it has been largely absent in health services and sexual and reproductive health and rights programmes in many parts of the world. We propose sexual satisfaction as a useful indicator, as one of the proxy measures for sexual health and well-being and as a component of well-being in general.

METHODS

The Sialon II project is a multicentre biological and behavioural cross-sectional community-based survey implemented across 13 European cities during 2013-2014 among men who have sex with men. Sexual satisfaction was explored using one single item: 'How satisfied are you with your sex life?' A multivariable multilevel logistic random-intercept model was estimated to identify factors associated with reporting positive sexual satisfaction versus negative sexual satisfaction.

RESULTS

Age, the number of partners and self-reported HIV status were not significantly associated with sexual satisfaction in the multivariate model. Participants reporting an insertive role or reported both an insertive and receptive role during the last anal intercourse were more likely to be sexually satisfied, compared with a receptive role. Participants reporting anal intercourse with a condom were more likely to be satisfied than those declaring no anal intercourse in the last 6 months, but no significant association was found compared with anal intercourse without condom. Knowledge of HIV-serostatus concordance with the last sexual partner was positively correlated with sexual satisfaction. Having had sexual intercourse with non-steady partners only in the last 6 months was negatively correlated. The more positive participants perceived their work/school, parents and friends/acquaintances' attitudes towards gay or bisexual persons, the higher the odds they were satisfied with their sexual life.

CONCLUSION

Using a single item on sexual satisfaction in a bio-behavioural study, our analysis has shown that it is associated with individual, interpersonal and social/structural factors and has proven its usefulness as a sexual health indicator among men who have sex with men.

Turkish women's perception of low sexual desire, its causes and consequences: an online qualitative survey

Background The nature of sexual desire is complex, and little phenomenological consensus exists about its meaning. Low sexual desire (LSD) is a commonly reported sexual difficulty among women, but it is less frequently associated with sexual distress. The aim of this qualitative study is to explore women's understanding of sexual desire, and their perceptions of factors that may contribute to LSD, its effects and their methods of seeking help. Methods The research employed a questionnaire with 12 open-ended questions, developed by the researchers based on sexual script theory. Data were collected from 165 heterosexual Turkish women who reported LSD, recruited through social media platforms between August and October 2021. The data were analysed using a contextual form of thematic analysis to identify and explore patterns. Results The ages of the participants ranged from 20 to 63years. The majority of participants held a Bachelor's degree (81.2%) and in a relationship (78.8%). Three main themes emerged from the study: (1) gendered messages concerning sex, (2) multi-level sexual desire, and (3) minimisation. The research revealed that women's sexual desire is often ignored and repressed, and has negative consequences if not expressed in socially acceptable contexts. The causes of LSD in women go beyond personal factors, and include relational and social influences. Women experiencing LSD report distressing effects on their relationships and general wellbeing, yet they tend not to seek help. Conclusions Our findings contribute to a deeper understanding of the factors impacting women's sexual desire and the barriers to seeking help.

Sexual Self Discrepancies, Sexual Satisfaction, and Relationship Satisfaction in a Cross-Sectional Sample of Women Who Experience Chronic Vaginal Pain during Sexual Intercourse

One out of three women may suffer from chronic vaginal pain during intercourse, a complex health issue that leads to lasting psychological, sexual, emotional, and relational difficulties even after initial relief. Women who experience this pain condition may compare their sexual selves to the societal norm of being pain-free. Comparisons that do not align with one's actual sexual self result in sexual self-discrepancies and may cause emotional distress. Sexual self-discrepancies may hinder sexual and relationship satisfaction for women who experience chronic vaginal pain during sexual intercourse. This mixed-method study examined the sexual self-discrepancies women reported and the degree to which their sexual self-discrepancies were related to their sexual and relationship satisfaction. Results from this cross-sectional study showed that the majority of participants experienced sexual self-discrepancies and that they experienced a significant inverse correlation between sexual self-discrepancies and sexual satisfaction. In multivariate models, sex frequency was the strongest predictor of sexual satisfaction. There were no correlations between sexual self-discrepancies and relationship satisfaction. Future measurement research should examine the role of sex frequency in the experience of sexual satisfaction. Education on maximizing pleasure and minimizing pain may aid women to cope with the negative impact of pain.

"What's Something You've Heard About Sex, But Are Unsure If It's True?": Assessing Middle and High School Students' Sex Education Questions

PURPOSE

Comprehensive sex education (CSE) encourages safer sex behavior for teens and young adults. However, young people recognize a gap between sex education as taught in the classroom and the reality of their sexual experiences. Thus, CSE should take into account the perspectives of its target population.

METHODS

The current project assesses young people's sexual uncertainties by analyzing open-ended responses that were anonymously submitted during in-person sex education sessions. These education programs were administered in middle and high schools in New York State by facilitators from Planned Parenthood Hudson Peconic, Inc. The authors analyzed 1,335 responses from a racially diverse sample of students between the ages of 10 and 21, with 75% of participants between 15 and 17 years old.

RESULTS

Using content analysis, the authors identified 49 recurring content codes in participants' responses, which were organized into 16 categories. Most responses centered around pregnancy, sexually transmitted infections, and how to prevent these outcomes. However, responses also highlighted topics that are not always covered with nuance and transparency, if at all, in sex education (e.g., withdrawal, effectiveness of condoms and other contraception, anal and oral sex). Additionally, gender analyses indicated that girls made greater reference to pain, while boys made greater reference to pleasure, which has implications for girls' development of a positive sexuality.

DISCUSSION

These results should be interpreted with a social equity lens to inform the development of needs-driven, target-based CSE programming.

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.

Surgical outcomes, motivations, sexuality, and urinary function of metoidioplasty with semi-rigid prosthesis

Background

Preliminary results of a specific semi-rigid prosthesis for metoidioplasty (ZSI® 100D4; Zephyr Surgical Implants, Geneva) have been reported, suggesting a safe procedure that may enhance the metoidioplasty outcomes by stiffening and increasing protrusion of the constructed neo-phallus.

Aim

The objective of the present study was to report the updated surgical results of metoidioplasty with implantation of the ZSI®100D4, along with a comprehensive evaluation of the outcomes including, motivations, sexuality, and urinary function.

Methods

All individuals who underwent a metoidioplasty with implantation of the ZSI®100D4 between August 2017 and January 2021 with at least 1 year of follow-up were included and their data retrospectively collected. They were contacted by telephone between November 2020 and May 2022 and invited to answer a questionnaire exploring motivations, satisfaction with genitals and sexual life, as well as urinary and sexual function.

Results

Twenty-one individuals were included and followed-up during a median [IQR] period of 19.5 months [12.8-24.2]. Most individuals (n = 13; 62.0%) had a post-operative complication, the most frequent was wound dehiscence (n = 6; 28.6%). Three urinary fistula (14.3%) were reported, all managed conservatively (Clavien-Dindo grade 2) with a prolonged urinary diversion. Among the 18 individuals who answered the questionnaire, 16 (88.9%) were sexually active, and 11 (61.1%) were engaged in a sexual relationship. The total median [IQR] self-esteem and relationship questionnaire score was 92 [91-97]. The reported urinary symptoms of delay, intermittency, lagging drops and spraying were mostly never or rarely reported. The satisfaction regarding overall genital aspect was highly favorable as 15 (83.3%) individuals reporting being very satisfied or satisfied, although 5 (27.8%) reported being dissatisfied with the size of their genitals.

Conclusion

Implantation of a semi-rigid prosthesis in a metoidioplasty seems a safe procedure, with no reported complications related to the prosthesis. Overall, satisfaction regarding genitals, sexual and urinary function are favorable.

Hormonal Contraception Use and Sexual Frequency across Young Women's Intimate Relationships

We examined whether hormonal contraception (HC) use predicts sexual frequency throughout and across young women's intimate relationships. From 2008-2012, the Relationships Dynamics and Social Life Study collected weekly surveys over 2.5 years, and included 893 women (aged 18-19 at baseline) who reported 2,547 intimate relationships across 32,736 weeks. Three-level logistic multilevel models assessed the weekly probability of sexual intercourse based on 1) weekly HC use (vs. nonuse) and 2) duration of HC use, both accounting for several relational and individual characteristics, including relationship duration. Women had more frequent sexual intercourse when they were using HC than when they were not (predicted probabilities .65 vs .41). The weekly probability of sexual intercourse increased sharply within the first month of HC initiation (by about 27 percentage points), remained high for several months, then began to slowly decline (yet remained above that of nonuse). When separated by method type, similar trajectories were found for the pill, ring, and IUD/implant; following the initial increase, steeper declines in intercourse frequency were found for the contraceptive injectable, eventually dropping below pre-initiation levels. Findings signify the immediate influence of reduced pregnancy fears in facilitating sexual intercourse among young women, which may decline as HC use continues long-term.

Not Who You Are, But Who You Are With: Re-examining Women's Less Satisfying Sexual Debuts

Gender differences in appraisals of first intercourse are among the largest in sexuality research, with women indicating less satisfying "sexual debuts" than men. Dispositional or "actor-level" explanations for this gender gap are pervasive, yet research has largely examined heterosexual debuts in which actor gender and partner gender are confounded. We assessed whether women's less satisfying sexual debuts are better explained by actor gender or partner gender, comparing experiences of women who debuted with men (WDM) with those of men and women who debuted with women (MDW, WDW). Retrospective accounts of sexual debut were collected from 3033 adults. At first intercourse, we found that WDW had equal physical and emotional satisfaction to MDW, and more satisfaction than WDM, suggesting satisfaction gaps owing to partner gender, not actor gender. This pattern did not extend to a comparison event (first masturbation), where WDW and WDM had similar satisfaction, but less satisfaction than MDW, suggesting an actor gender gap. To identify sources of satisfaction gaps, we probed for corresponding differences in the circumstances of sexual debut. Sexual circumstances were more strongly implicated than nonsexual ones, with relative deprivation of glans stimulation explaining relative dissatisfaction at first intercourse, but not first masturbation, and orgasm explaining it at both. Findings challenge the view that the satisfaction gap at first intercourse reflects an inherent difference between genders. Indeed, they demonstrate similarities when partner gender does not differ and suggest strategies for ensuring equal sexual satisfaction-and equal sexual rights realization-at (hetero) sexual debut.

Sexual Satisfaction of Midlife Women Living With HIV in Canada: A Prospective Cohort Analysis

BACKGROUND

Although sexual activity and function decline in older women living with HIV, positive dimensions of sexual health, such as satisfaction, are relatively unexplored. We evaluated the prevalence of sexual satisfaction for midlife women with HIV and assessed its relation to women's physical, mental, and sociostructural experiences.

SETTING

We studied women in the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS) over 3 survey waves (2013-2018).

METHODS

We included women living with HIV aged ≥45 years who reported ever having consensual sex. Sexual satisfaction was assessed using an item from the Sexual Satisfaction Scale for Women and was dichotomized into satisfactory ("completely/very/reasonably satisfactory") and not satisfactory ("not very/not at all satisfactory"). Probable depression was based on CES-D ≥10. Multivariable logistic regression and fixed effects models determined correlates of sexual satisfaction. Reasons for sexual inactivity and alternate forms of sexual expression were also explored.

RESULTS

Among 508 midlife women, 61% were satisfied with their sexual lives at baseline. Women with probable depression had lower odds of sexual satisfaction than those without (aOR: 0.44; 95% CI: 0.27 to 0.71) and worsening depressive symptoms over time were associated with poorer sexual satisfaction ( P = 0.001). Increased sexual activity was associated with higher sexual satisfaction (aOR: 2.75; 95% CI: 1.54 to 4.91); however, 51% of women reporting sexual satisfaction were sexually inactive. Sexually inactive women engaged in alternate forms of sexual expression such as self-pleasure (37%) and intimate relationships without sex (13%).

CONCLUSION

Midlife women with HIV have high rates of sexual satisfaction, even in the absence of sexual activity. Depressive symptoms were closely associated with sexual dissatisfaction, alerting providers to the importance of screening for depression and sexual health together.

Sexual Pleasure Matters - and How to Define and Assess It Too. A Conceptual Framework of Sexual Pleasure and the Sexual Response

Objective

Sexual pleasure is central to current understandings of sexual function, health, and wellbeing. In this article, we suggest that we lack a sufficiently specific, yet encompassing, definition of sexual pleasure and that we therefore lack comprehensive assessments of sexual pleasure. We introduce a definition of sexual pleasure and position it centrally in an adapted framework of the sexual response. In the framework, we include a taxonomy of rewards which can be retrieved from sex and thereby aim to capture the multifaceted nature of sexual pleasure.

Methods/Results

Through narrative review, we arrive at the definition, framework, and taxonomy by integrating theories of sexual motivation and response with the literature on sexual pleasure and basic rewards. We position this literature within theories of affect and personality which allows us to differentiate between the experience of and the tendency to experience sexual pleasure (i.e., state versus trait sexual pleasure). We discuss how this conceptualization of sexual pleasure could be reflected in self-report assessments to quantitatively assess sexual pleasure.

Conclusions

The framework may aid to understand the role of the diverse facets of sexual pleasure in sexual function, health, and wellbeing and contribute to giving sexual pleasure the center position it deserves in sex research and therapy.

Evaluating the Subjective Orgasm Experience Through Sexual Context, Gender, and Sexual Orientation

The subjective orgasm experience (SOE) is the psychological perception of orgasm sensations and closely related to sexual health. Here, SOE was studied through the context in which it is experienced (sexual relationships and solitary masturbation), gender, and sexual orientation. For this purpose, data were collected from 4255 people (1927 men and 2328 women) of different sexual orientations (heterosexual = 1545; bisexual = 1202; and gay = 1508) who completed two versions of the Orgasm Rating Scale (ORS) for both contexts (i.e., sexual relationships and solitary masturbation) along with a socio-demographic questionnaire. Results showed that the ORS in the context of solitary masturbation is an instrument invariant by gender and sexual orientation. Significant differences in SOE were found by context: it was more intense in the context of sexual relationships (vs. solitary masturbation); by gender: women (vs. men) reported greater intensity; and by sexual orientation, with heterosexual people (vs. gay and bisexual people) having a more intense experience.

Sexual Minorities within Heterosexuality: Psychosocial Characteristics of and Attitudes toward the "Fourth Love" in China

Objective

Within the context of gender diversity, the concept of heterosexuality is also changing, emerging as a diversified sexual orientation and identity. This study aims to challenge the orthodoxy about heterosexuality by exploring the psychosocial characteristics and attitudes toward "fourth love" in China.

Method

Two studies initially explored the current status of fourth love as a sexual minority. In Study 1, The Sex-Role Inventory and the Marital Attitude Scale were used to assess fourth-love (N = 144) and traditionally heterosexual participants' (N = 145) gender roles and marriage attitudes. In study 2, the Attitudes Toward the Fourth Love Scale was developed to assess college students' (N = 315) attitudes toward fourth-love men and women.

Result

Fourth-love women often identify with masculine gender roles and significant differences were found between fourth-love and traditionally heterosexual women their gender roles. Fourth-love men identified with a neutral gender role, while there are significant differences between fourth-love men and traditionally heterosexual women in masculine gender roles. Fourth-love people's marriage attitudes were more negative than those of traditionally heterosexual people, especially for women. Various demographic factors influenced college students' attitudes toward the fourth love.

Conclusion

As a sexual minority within the umbrella of heterosexuality in China, fourth-love individuals require further research attention and increased support.

Sexual boredom and sexual desire in long-term relationships: a latent profile analysis

BACKGROUND

Research suggests a general link between sexual boredom and sexual desire, but its understanding is currently very limited.

AIM

To identify distinct (latent) groups of women and men in long-term relationships based on their reported levels of sexual boredom and sexual desire.

METHODS

Latent profile analysis (LPA) was conducted in an online sample of 1223 Portuguese participants aged 18 and 66 years (mean ± SD, 32.75 ± 6.11), using indicators of sexual boredom and partner-related, attractive other-related, and solitary sexual desire to categorize participants. Multinomial logistic regression analysis was carried out to explore predictors and correlates of the latent profiles.

OUTCOMES

Sexual boredom was assessed by the Sexual Boredom Scale, while sexual desire was measured with the Sexual Desire Inventory.

RESULTS

As compared with women, men reported higher levels of sexual boredom and sexual desire. LPA indicated 3 profiles in women and 2 profiles in men. Among women, P1 was characterized by above-average sexual boredom, below-average partner- and attractive other-related sexual desire, and very low solitary sexual desire; P2 by below-average sexual boredom, attractive other-related sexual desire, and solitary sexual desire and above-average partner-related sexual desire; and P3 by above-average sexual boredom, attractive other-related sexual desire, and solitary sexual desire and below-average partner-related sexual desire. In men, P1 was characterized by high sexual boredom, above-average partner-related sexual desire, and high attractive other-related and solitary sexual desire and P2 by below-average sexual boredom and above-average partner-related, attractive other-related, and solitary sexual desire. The latent profiles did not differ according to relationship duration. Overall, the sole consistent correlate of the latent categorization was sexual satisfaction.

CLINICAL IMPLICATIONS

In women, above-average levels of sexual boredom were linked to below-average levels of partner-related desire, which suggests likely benefits of helping the couple to minimize or cope better with their sexual routines. In men, participants in the 2 profiles did not differ in partner-related sexual desire, suggesting that clinical interventions dealing with male sexual boredom should investigate factors beyond the current relationship.

STRENGTHS AND LIMITATIONS

This study explored different facets of sexual desire and used LPA, rendering advantages over previous research. The male sample has lower statistical power than the female sample.

CONCLUSION

Patterns of sexual boredom and sexual desire among individuals in long-term monogamous relationships are distinct and consistently related to sexual satisfaction in women and men and to relationship satisfaction among only women, which have important clinical ramifications.

"Feeling It": Links between elements of compassion and sexual well-being

Introduction

Compassion may be a particularly important component of a sexual relationship as it facilitates needed self-awareness, understanding, and connection to frame deeply intimate expressions of sexual emotion and vulnerability. Given the lack of research on how broad concepts of compassionate elements may be linked to sexual well-being, we examine how mindfulness (an ability to maintain awareness in the present moment), compassionate relational attitudes (i.e., accessibility, responsiveness, and engagement), and compassionate relational behaviors (i.e., forgiveness and gratitude), are linked to sexual well-being (sexual harmony, orgasm consistency, and sexual frequency), and sexual mindfulness (a state of being mindful during sex) for oneself and one's partner.

Methods

We constructed an actor partner structural equation model with newly married couples (n = 2,111) and regressed sexual outcomes at time 1 and time 2 on each partner's compassionate attitudes, behaviors and mindfulness reported at time 1.

Results

Results showed that cross-sectionally, nearly all elements of one's compassion related to one's own sexual well-being for both partners. Strongest paths included positive significant relations for women between mindfulness and non-judgment and from compassionate relational attitudes and behaviors to sexual harmony. Men's compassionate behaviors were positively related to their own sexual awareness. Perhaps more importantly, women's and men's compassionate behaviors had significant effects on their partner's sexual well-being longitudinally.

Discussion

Implications include an emphasis on compassion as a key mechanism that can increase sexual satisfaction and strengthen relationships, particularly in the critical time of early marriage where patterns of interconnectedness are being established.

Exploring the Relationship between Early Adaptive Schemas and Sexual Satisfaction

Rationale

Early maladaptive schemas (EMS) develop from unmet core emotional needs during childhood and adolescence. EMS influence the way individuals perceive themselves and others, while also sharing associations with various sexual difficulties. Contrastingly, Early Adaptive Schemas (EAS) develop when core emotional needs are met. Yet, the potential influence of EAS on sexual wellbeing remains underinvestigated.

Objective

The current study assessed the relationship between EAS and sexual satisfaction as a primary component of sexual wellbeing.

Method

The study design was an online, cross-sectional survey. Participants included 732 adults (Mage = 32.05, SDage = 9.30), who completed self-report questionnaires assessing sexual satisfaction and EAS.

Results

Two, three-step hierarchical regressions evaluated the effect of EAS on sexual satisfaction, controlling for several potentially confounding variables. Results indicated that the only EAS that was associated with sexual satisfaction in both men and women was Realistic Expectations. EAS of Social Belonging and Success were associated with sexual satisfaction for women alone, whereas Self-Compassion was for men.

Conclusion

Findings provide preliminary evidence that EAS are associated with sexual satisfaction. As such, schema therapy may be a useful therapeutic framework for improving sexual satisfaction, when indicated.

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.

Genital Self-Image, Sexual Function, and Quality of Life Among Individuals with Vulvar and Non-Vulvar Inflammatory Dermatoses

Vulvar inflammatory dermatoses (VID; e.g., lichen sclerosus, lichen planus, vulvar dermatitis) can significantly impact sexual function. Both vulvar and non-vulvar inflammatory dermatoses (NVID; i.e., skin conditions not impacting vulvar skin, such as non-genital psoriasis and eczema/dermatitis) have yet to be fully characterized with regard to impact on genital self-image. A 20-min web-based survey was distributed September-November 2020 through social media ads, support groups, and online research recruitment services. Individuals in the USA over age 18 who were assigned female at birth and self-reported having been diagnosed with an inflammatory dermatosis were eligible. The primary outcome was the Female Genital Self-Image Scale (FGSIS). Secondary outcomes included the Female Sexual Function Index (FSFI), the Skindex-16 (a skin-related quality of life measure), the PROMIS Global-10 (assessing global physical/mental health), and sexual behavior histories. Participants (n = 348) reported mean age of 43.1 ± 15.5 (range = 19-81). Nearly one-third (n = 101; 29.0%) reported VID, 173 (50%) had NVID, and 74 (21%) experienced both vulvar and non-vulvar symptoms; they were analyzed as part of the VID group. The mean FGSIS score among participants with VID was 16.9 ± 4.1 and was significantly (p < .01) lower than that of participants with NVID (M = 21.2 ± 4.3), indicating lower genital self-image. Mental health (as measured by PROMIS-Global 10) was also impaired in VID. Rates of sexual dysfunction were high in both groups (> 60%). Findings suggest that in VID, lower genital self-image is correlated with poorer sexual function, quality of life, and global physical and mental health. Additional recommendations for VID management are proposed.

Socioeconomics and Erotic Inequity: A Theoretical Overview and Narrative Review of Associations Between Poverty, Socioeconomic Conditions, and Sexual Wellbeing

Sexual health includes positive aspects of sexuality and the possibility of having pleasurable sexual experiences. However, few researchers examine how socioeconomic conditions shape sexual wellbeing. This paper presents the concept of "erotic equity," which refers to how social and structural systems enable, or fail to enable, positive aspects of sexuality. In part one, we use this concept to consider potential pathways through which socioeconomic conditions, especially poverty, may shape sexuality. Part two builds from this theoretical framework to review the empirical literature that documents associations between socioeconomics and sexual wellbeing. This narrative review process located 47 studies from more than 22 countries. Forty-four studies indicated that individuals who reported more constrained socioeconomic conditions, primarily along the lines of income, education, and occupation, also reported poorer indicators of sexual wellbeing, especially satisfaction and overall functioning. Most studies used unidimensional measures of socioeconomic status, treating them as individual-level control variables; few documented socioeconomics as structural pathways through which erotic inequities may arise. Based on these limitations, in part three we make calls for the integration of socioeconomic conditions into sexuality researchers' paradigms of multi-level influences on sexuality.

Fat, sexy, and human? Perceptions of plus-size sexualized women and dehumanization

Past research suggests that sexualized women are dehumanized and viewing sexualized images negatively impacts viewers' body image; however, plus-size women are mostly absent from this research. The current studies investigate how sexualization impacts dehumanization of plus-size women and participants' body image. In Study 1 (N = 277, M_age = 19.52, SD =1.77) men and women viewed images of plus-size and thin sexualized and non-sexualized women and rated the women on traits linked to dehumanization. Results indicated that sexualized thin targets were perceived as less human than plus-size sexualized and non-sexualized targets. Plus-size sexualized targets were also perceived as less human than plus-size non-sexualized targets. In Study 2 (N = 500, M_age = 18.98, SD = 1.51) we investigated the impact of viewing sexualized images on participants' feelings about their own body. Results indicated that sexualization, but not body size, impacted women's objectified body consciousness. Men's body esteem was impacted by the body size of the image. Perceived race of the image also impacted feelings of body control for both men and women. Taken together these results highlight that sexualization, at any body size, impacts women's views about themselves and sexualized women, at any body size, are dehumanized.

How &lt;i&gt;WEIRD&lt;/i&gt; and Androcentric Is Sex Research? Global Inequities in Study Populations

Previous researchers have noted the domination of Western, Educated, Industrialized, Rich, and Democratic (WEIRD) samples in fields like psychology. In this study we asked: how WEIRD and androcentric is contemporary sex research? We focused on two historically underrepresented groups in research, namely non-WEIRD and women/gender non-conforming samples. We analyzed 2,223 articles drawn from five leading journals in scientific sexuality research (&lt;i&gt;Archives of Sexual Behavior, Journal of Sex Research, Journal of Sex and Marital Therapy, Journal of Sexual Medicine&lt;/i&gt;, and &lt;i&gt;International Journal of Sexual Health&lt;/i&gt;). We coded the national context and gender of sampled populations for articles published between 2015 and 2019 in these journals. Results indicated that WEIRD populations dominate the published findings in sex research (ranging from 68% to 88%). Two journals had a higher number of studies that only included men as participants, and one a higher number of samples that consisted of only women, and very few included gender diverse samples (i.e., non-binary, trans*, intersex). Recommendations for improving the current research and publishing practices are discussed.

Frequency, Method, Intensity, and Health Sequelae of Sexual Choking Among U.S. Undergraduate and Graduate Students

Although sexual choking is now prevalent, little is known about how people engage in choking in terms of frequency, intensity, method, or potential health sequelae. In a campus-representative survey of undergraduate and graduate students, we aimed to: (1) describe the prevalence of ever having choked/been choked as part of sex; (2) examine the characteristics of choking one's sexual partners (e.g., age at first experience, number of partners, frequency, intensity, method); (3) examine the characteristics of having been choked during sex; and (4) assess immediate responses of having been choked including the extent to which frequency and method (e.g., hand, ligature, limb) of having been choked predicts the range of responses endorsed by participants. A total of 4254 randomly sampled students (2668 undergraduate, 1576 graduate) completed a confidential online survey during Spring 2021. The mean age of first choking/being choked was about 19, with more undergraduates than graduate students reporting first choking/being choked in adolescence. Women and transgender/gender non-binary participants were significantly more likely to have been choked than men. Participants more often reported the use of hands compared to limbs or ligature. Common responses to being choked were pleasurable sensations/euphoria (81.7%), a head rush (43.8%), feeling like they could not breathe (43.0%), difficulty swallowing (38.9%), unable to speak (37.6%), and watery eyes (37.2%). About 15% had noticed neck bruising and 3% had lost consciousness from being choked. Greater frequency and intensity of being choked was associated with reports of more physical responses as was use of limb (arm, leg) or ligature.

Sex-Positivity, Medical Mistrust, and PrEP Conspiracy Beliefs Among HIV-Negative Cisgender Black Sexual Minority Men in Atlanta, Georgia

Because the public health response to the disproportionate HIV burden faced by Black sexual minority men (BSMMM) has focused on sexual risk reduction and disease prevention, other vital components of sexual health (e.g., intimacy, pleasure, benefits of sex) have been often overlooked. Sex-positive describes a more open, holistic approach toward sex and sexuality that prioritizes these other components, though such an approach is rarely applied to BSMM's sexual health. For sex-positive BSMM, risk/preventive discourse may foster or exacerbate medical mistrust as a reaction to the dissonance between how these men view sexual health and how the medical establishment views it, which may discourage sexual healthcare-seeking. We assessed sex-positivity and its association with medical mistrust and PrEP conspiracy beliefs among 206 HIV-negative cisgender BSMM in Atlanta, Georgia. We performed exploratory factor analytic procedures on responses to a sex-positivity scale, followed by multivariable linear regressions to determine sex-positivity's associations with medical mistrust and PrEP conspiracy beliefs. We extracted two sex-positivity factors: sexual freedom (α = 0.90), reflecting openness toward casual sex and rejection of sexual mores, and essence of sex (α = 0.77), reflecting the intimate, relational, and pleasurable qualities of sex. Sexual freedom was independently associated with perceived provider deception (β = 0.19, CI = 0.04, 0.34). Essence of sex was independently associated with PrEP conspiracy beliefs (β = 0.16, CI = 0.02, 0.31) and marginally associated with perceived provider deception (β = 0.14, CI = - 0.00, 0.29). Healthcare providers and public health practitioners may cultivate greater trust with BSMM by incorporating a sex-positive approach into patient/participant interactions, clinical decision-making, and interventions. Improving access to sexual pleasure acknowledges BSMM's right to optimal, holistic sexual health.

The Peak of Pleasure: US Southern Black Women's Definitions of and Feelings Toward Sexual Pleasure

Sexual pleasure has been identified as a key component of sexual health by the World Health Organization, yet only 6.5% of articles on Black women's sexualities are sex positive. Historically in the United States (US), Black women's sexualities have been marked by silence, encouraging Black women to refrain from discussing their sexualities, particularly the positive aspects such as sexual pleasure. The purpose of the current study was to explore definitions of and feelings toward sexual pleasure among (N = 206) Black women living in the Southern US using intimate justice and sex positive frameworks and thematic analysis. Participants identified three foundational dimensions of sexual pleasure (1) mental, (2) physical, and (3) emotional and four facilitators of peak pleasure (1) partnered interactions, (2) liberation, (3) mind-body-soul awareness, and (4) orgasm. Foundational themes and facilitators of peak pleasure are intertwined. For example, a combination of emotional, mental, and physical themes serves as the foundation of sexual pleasure. However, the facilitator themes often, but not always, included one or more emotional, mental, and physical aspects. Overall, 42.2% (n = 87) of the quotes included a combination of foundational themes, meaning two or more were reported in the same quote. Ultimately, Black women defined sexual pleasure in hedonic and eudemonic ways and had positive feelings about sexual pleasure. Implications for sexuality education and clinical practice are discussed.

"Don't Just Randomly Grab Someone's Neck during Intercourse!" An Analysis of Internet Articles about Choking/Strangulation during Sex

Sexual choking/strangulation has become prevalent among young U.S. adults, yet little is known about media articles that teach readers about choking. We conducted a content analysis of 27 Internet articles, examining how choking is described, information related to health risks and healthcare, and article accuracy. Most articles described choking in positive terms and indicated choking can be done safely or properly, even while acknowledging potential dangers. Only two articles indicated having undergone expert/medical review. Few gave information about signs that would warrant seeking healthcare. Sexuality professionals need to be aware of choking-related information and misinformation in online media articles.

Pornography and Women's Experience of Mixed-Gender Sexual Choking/Strangulation: Eroticization Mediates, Perceived Similarity Moderates

Sexual choking, which is a form of strangulation, can lead to various health consequences, including death. Recent surveys suggest that sexual choking is prevalent among young U.S. adults, a demographic also likely to view pornography. Pornography professionals, social commentators, and scholars have noted that mixed-gender choking is normative in contemporary pornography. Further, the pornographic portrayal of sexual choking is gendered; men choke women more often than women choke men. Guided by the sexual script acquisition, activation, application model (₃AM) of mediated sexual socialization, the present campus-representative probability study explored associations between heterosexual-identified women's pornography exposure and sexual choking behavior. The more frequently women viewed pornography, the more often they were exposed to pornographic depictions of sexual choking. Exposure to sexual choking, in turn, was associated with being choked by men, but not choking men. The link between choking exposure and being choked was mediated by the eroticization of choking (rather than reduced agency to stop rough sex) and became stronger the more women perceived themselves as similar to actors in pornography. These results suggest that women's experience of sexual choking is influenced by their use of pornography, but in an active and willing, rather than a passive and unwilling, manner.

Women Get Worse Sex: A Confound in the Explanation of Gender Differences in Sexuality

Gender differences in sexuality have gained considerable attention both within and outside of the scientific community. We argue that one of the main unacknowledged reasons for these differences is simply that women experience substantially worse sex than men do. Thus, in examinations of the etiology of gender differences in sexuality, a confound has largely been unacknowledged: Women and men are treated to different experiences of what is called "sexuality" and "having sex." We discuss four arenas in which women's experience of sexuality may often be worse than men's: (a) anatomical differences, (b) sexual violence, (c) stigma, and (d) masculine cultures of sexuality. Then we consider how each disparity might explain well-known gender differences in sexuality.

Variable Sexual Satisfaction in Pregnancy: A Latent Profile Analysis of Pregnant Wives and Their Husbands

Although not all couples achieve high levels of sexual satisfaction during pregnancy, evidence of variability in couple sexual satisfaction during pregnancy indicates that sexual dissatisfaction in pregnancy does not apply to all. Subsequently, the current study examined whether a nationally representative U.S. sample of wives and husbands (N = 523 couples) fell into subgroups in terms of their sexual satisfaction during pregnancy and to what degree biopsychosocial factors distinguish potential subgroups. Latent profile analyses, adjusted for pregnancy-related biological factors, indicated that couples could be classified into two subsets - a larger subset of couples where wives and husbands were satisfied with sex overall (79%) and a smaller subset where wives and husbands were neutral about satisfaction with sex (21%). Lower depressive symptoms among wives was associated with a greater likelihood of being in the more satisfied subset over the less satisfied subset - the only significant group membership predictor among a variety of other factors. Implications include notions that couples and practitioners should consider women's depressive symptoms throughout pregnancy in addition to the perinatal period, and that most U.S. newly married pregnant couples do well navigating sexual satisfaction challenges during pregnancy.

A Cluster Analysis on Sexual Boredom Profiles in A Community Sample of Men and Women

Research evidence of the attributes of sexual boredom is extremely limited. Understanding variability in the experience of sexual boredom may offer relevant insights for the field of human sexuality. This study aimed to explore the co-occurrence of sexual boredom and other sexuality-related dimensions. The sample consisted of 1021 participants aged between 18 and 75 years old (M = 32.68, SD = 8.79). A gender-stratified cluster analysis was performed to classify individuals regarding their scores on sexual boredom, general boredom, sexual sensation seeking, sexual desire, sexual excitation, sexual pleasure, and sexual satisfaction. A three-cluster solution was revealed for both men and women. Based on our findings, we put forward a profile for the sexually bored individual, who is more likely to be married or cohabiting with a partner, to have a boredom prone personality, to lack sexual sensation seeking, experience low sexual pleasure and satisfaction, and to present with sexual arousal and/or desire problems. Women dealing with sexual boredom might present low sexual desire for their partner but experience high sex desire for attractive others. Results are critically discussed and implications for sexual therapy explored.

The Heteronormativity Theory of Low Sexual Desire in Women Partnered with Men

Low sexual desire in women partnered with men is typically presumed to be a problem-one that exists in women and encourages a research agenda on causation and treatment targeting women. In this paper, we present a distinct way forward for research on low sexual desire in women partnered with men that attends to a more structural explanation: heteronormativity. A heteronormative worldview assumes that relationships and structures are heterosexual, gender (usually conflated with sex) is binary and complementary, and gender roles fit within narrow bounds including nurturant labor for women. We propose the heteronormativity theory of low sexual desire in women partnered with men, arguing that heteronormative gender inequities are contributing factors. We outline four hypotheses and their predictions related to: inequitable divisions of household labor, blurring of partner and mother roles, objectification of women, and gender norms surrounding sexual initiation. We discuss some mechanisms-social, physiological, and otherwise-for the heteronormativity theory, especially related to stress, objectification, and nurturance. We close by noting some limitations of our paper and the ways that the heteronormativity theory of low sexual desire in women partnered with men provides a rigorous, generative, and empirical way forward.

The Role of Gendered Entitlement in Understanding Inequality in the Bedroom

Five studies (using U.S. samples) examined whether men’s higher entitlement contributes to a sexual pleasure gap that disadvantages women. Participants indicated that men receive more sexual pleasure from their partners, whereas women provide more pleasure (Study 1a). Participants believed that men have more of a right to experience orgasm in both hook-up and relationship encounters and attributed higher negative affect to the male target than to the female target when the target did not experience an orgasm in a sexual scenario (Study 1b). In concert with the idea that pleasure is a privilege that men are perceived as being more entitled to, participants preferred men’s orgasm when forced to choose between the male and the female partner in an orgasm allocation task (Study 1c) and in an experiment (Study 2). Study 3 examined why people believe that men are more entitled to pleasure than women. Men’s higher sense of entitlement as an obstacle to gender equality in sexuality is discussed.

Reframing Sexual Health for Black Girls and Women in HIV/STI Prevention Work: Highlighting the Role of Identity and Interpersonal Relationships

While Black girls and women are disproportionately impacted by sexual health disparities, there continues to be an overwhelming focus on individual risk behaviors within prevention initiatives, which offers a fragmented narrative of the multidimensional nature of risk and plausibly limits effectiveness of prevention programs and attenuates reductions in disparities. Because sexual health is experienced within an individual's beliefs/values, interpersonal relationships, and behaviors and reflects larger social and cultural systems, it is important to critically examine common theories used to inform HIV/STI prevention interventions for Black women and girls. To fill this gap in the literature, we critique two commonly used theories in HIV/STI prevention interventions, namely the social cognitive theory and the theory of gender and power, by highlighting theoretical and practical strengths and weaknesses. We propose research implications that incorporate key strengths of the two theories while adding new concepts grounded in the intersectionality theory. The overall goal is to introduce a more comprehensive conceptual model that is reflective of and applicable to the multidimensional sexual experiences of Black girls and women within the evolving definition of sexual health and behavior.

Assessing Young Adults' Internal Feelings Related to Refusing Sexual Behavior

Young people describe refusing sexual activity as difficult or embarrassing; however, what specific internal feelings young adults associate with refusing sexual activity is unclear. We assessed the positive and negative internal feelings related to refusing different sexual behaviors using sentiment analysis. We also examined if positive and negative internal refusal feelings varied by gender and the intersection of gender and racial/ethnic identity. Young adults (n = 574, 481 women, 93 men, M = 19.2, SD = 1.43) from Canada and the U.S. completed an open-ended survey about how they felt about their experiences refusing sexual activity. Using sentiment analysis, responses were coded as either positive or negative and overwhelmingly, feelings associated with refusing sexual activity were identified as negative. Women and women of color reported more negative feelings than men and White women. However, there were some distinct positive feelings noted from young adults (e.g., feeling respected, comfortable). Young adults appear to internalize negative feelings about their refusals which may relate to social and cultural norms. Moving forward, sexual health programs could focus on normalizing and destigmatizing refusals so that young adults do not feel negatively about refusing sexual activity, with a particular emphasis on helping women and women of color to feel confident and empowered in their refusals.

Balancing the sexology scales: a content analysis of Black women's sexuality research

Existing research adopting a sex positive and intersectional framework for investigating Black women's sexualities is scarce. We conducted a 46-year (1972-2018) content analysis of sexualities research focussed on Black women. It sought to examine which sexualities topics were published most; whether the publications aligned with sex-positive, neutral or negative discourse; what methodologies were used; and differences in how various identities were investigated among Black women. Using human coding, we applied an integrative approach to the content analysis. Results found 245 articles meeting criteria. Approximately one-third of articles within the analysis focussed on the topic of sexually transmitted infections (STIs), HIV and sexual risk behaviours among Black women. Only 6.5% of articles utilised a sex-positive discourse. Quantitative articles were the most published methodology, and publications disproportionately overlooked Black women's intersectional identities. Implications for future research and practice are discussed.

"Sex isn't everything": views of people with experience of psychosis on intimate relationships and implications for mental health services

BACKGROUND

The experience of psychosis and associated discrimination can be a barrier to forming and maintaining romantic relationships. Sexual health interventions within mental health services often focus on contraception and reducing risk. There are no known studies that seek to understand what support, if any, people who experience psychosis want regarding psychosocial aspects of intimate relationships.

METHODS

To address this gap in the literature, qualitative data was collected to investigate how people with experience of psychosis conceptualise romantic relationships and what support they would like in this area of their lives. Semi-structured interviews were conducted with 10 mental health service users (four women, six men) with experience of psychosis. Interviews were analysed from a critical realist social constructionism perspective using thematic analysis.

RESULTS

Stigma was a prominent theme, described as impacting numerous aspects of romantic relationships. Power imbalance within services meant participants were wary of having conversations about relationships with professionals and identified a therapeutic alliance as a prerequisite. However, abusive relationships were highlighted as a needed area for support by services.

CONCLUSION

Services should be trauma-informed and help those in abusive relationships. The power and autonomy of people with experience of psychosis should be maintained in any discussions or interventions regarding intimate relationships. A strong therapeutic alliance is essential for any work in this area.

Too Common to Count? "Mild" Sexual Assault and Aggression among U.S. College Women

National estimates indicate that approximately 1 in 5 women will experience sexual assault during her time in college. However, measures of assault often exclude "mild" experiences, such as incidents of unwanted touching that were not preceded by force, incapacitation, or coercion. We aimed to document the characteristics of "mild" sexual assault and aggression that college women experience at large parties and bars. In addition, we considered women's descriptions of assaultive and aggressive incidents in the context of campus climate survey items to evaluate the potential for measurement gaps. Across six focus groups (N = 36) at a large, public university in the midwestern U.S., women described routine experiences of "mild" sexual assault and aggression, so common that often only imprecise counts of their frequency (e.g., "all the time") were possible. Our findings document the many forms and frequencies of "mild" assault and aggression in college women's lives, as well as the limits of campus climate surveys in measuring the mundane sexual mistreatment of women in campus life. We develop the term "sexualized aggression" to capture such mistreatment and situate this concept within the larger body of research on campus sexual violence.

Development and Evaluation of a Satisfaction Questionnaire About Therapeutic Textile Devices Used for Breast Cancer-Related Lymphedema

Background: There is a need for an appropriate instrument to measure the satisfaction of patients about therapeutic textile devices used for breast cancer-related lymphedema (BCRL). Methods and Results: A new satisfaction questionnaire about therapeutic textile devices used for BCRL was developed and psychometrically tested. An approach to criterion validity by contrast of hypothesis was made. Different average scores were expected depending on the type of therapeutic textile device: Kinesio taping, compression garment, and multilayer low-stretch bandage. Items were analyzed in nine phases: apparent validity, missing responses, internal consistency, factor analysis, reproducibility, confirmation of factor analysis, contrast of hypothesis, variability, and time for completion. One hundred fifty women were sampled in a consecutive order. A final questionnaire was drafted that fulfilled the validation hypothesis, including 20 items that explored 4 dimensions: mood, patient comfort, patient compliance, and perceived benefits. The total Cronbach's α was 0.87. The intraclass correlation coefficient was 0.93 for test-retest and 0.91 for inter-rater. Neither ceiling nor floor effects were observed. The average burden for the respondent and interviewer was 5.6 (standard deviation [SD] = 3.8) and 2.2 (SD = 1.3) minutes, respectively. Conclusion: This preliminary analysis supports the content validity, reliability, and validity of construct of the questionnaire.