Frailties of Memory: Implications for Therapists Treating Gender Dysphoric Youth
Therapists working with gender-questioning teens often encounter disparate narratives. Teens typically report memories consistent with their transgender identity, often recounting specific childhood events. Many parents, however, have different recollections of their teen's childhood. As sound, ethical care is predicated on reality, therapists face the difficult task of navigating these often-contradictory narratives. We present relevant scientific literature on memory and well documented cognitive mechanisms and reflect on past therapeutic controversies to help clinicians understand the complexity of memory and why it may be prudent for therapists to consider not only their patients' accounts of their pasts, but also that of their patient's parents.
"Not Offending Is Easy. The Double Life, the Secrets, the Loneliness Are the Hardest Parts I Needed Help with": Understanding the Treatment Needs of People with Attractions to Children
People with sexual attractions to children are often subject to heavy stigmatization, and several studies have started to look at how this affects their mental health. This is likely due to a conflation with offending and sexual risk within society, which translates into academic work on the topic. In this context, little is known about how the experiences of non-offending individuals with attractions to children inform their treatment needs in non-forensic contexts. We conducted anonymous semi-structured interviews with large sample of 31 non-offending adult men who are attracted to children, recruited through online forums. The results focus on two superordinate themes central to interpersonal and intrapersonal experiences, and the effects of these on both everyday functioning ("Living with a sexual interest in children"), and perceived treatment needs ("Establishing treatment targets"). These findings hold significance for the effective design and delivery of both preventative and healthcare-related support services, particularly in relation to early intervention and assisting this population in living full lives with their sexual attractions.
"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.
Romantic Love and Sexual Frequency: Challenging Beliefs
Common conceptions of romantic love suggest that romantic love is associated with increased sexual activity with more frequent sex in the earlier stages of a romantic relationship. To our knowledge, no studies have investigated individual-level factors and sexual frequency using a validated measure of romantic love. This study tested a number of hypotheses about the factors associated with sexual frequency among 720 sexually active young adults experiencing romantic love from the Romantic Love Survey 2022. We hypothesized that relationship duration, the intensity of romantic love and obsessive thinking about a loved one, commitment, and hypomanic-like features would be associated with sexual frequency. Using hierarchical linear regression, controlling for known covariates, we found no significant associations between any of our variables of interest and the sexual frequency and our entire model of 14 well-reasoned predictors explained only 4.06% of the variation in sexual frequency. The findings are surprising and highlight how little is currently known about sexual activity and sexual desire among individuals experiencing romantic love.
Exploring the Associations of Personality and Sexual Health Using the DSM-5 Alternative Model for Personality Disorders
This study explored the relationships between sexual health indicators (i.e., sexual satisfaction, distress, and function) and the DSM-5 Alternative Model for Personality Disorders, a promising dimensional framework for assessing personality pathology. A sample of 489 participants seeking help in private practice clinics completed self-report measures of sexual satisfaction, distress, and function, as well as dyadic adjustment, psychological distress, romantic attachment, personality impairment, and pathological personality facets. Results first showed that participants reaching the cutoffs for a personality disorder had significantly higher sexual distress and lower sexual function compared to participants without a personality disorder. Second, path analyses controlling for psychological distress, dyadic adjustment, and romantic attachment revealed that, for women, the Criterion B Intimacy Avoidance facet was consistently linked with higher sexual distress and lower sexual satisfaction and function. For men, result patterns were more complex, linking Criterion B Separation Insecurity with high sexual distress, and Separation Insecurity and Intimacy Avoidance facets with low sexual function. In addition, Criterion B Irresponsibility, Rigid Perfectionism, as well as Criterion A Intimacy impairment were linked with higher sexual satisfaction. These findings improve our understanding of the links between personality and sexual health and provide support for considering personality difficulties in sexual health interventions.
The Interplay of Worry and Relationship Satisfaction to Understand Sexual Distress: An APIM Study with Heterosexual Couples Using Cross-Sectional Data
The current study takes an integrative approach, considering individual transdiagnostic processes and relationship outcomes. It assumes an interdependence approach and aims to test a dyadic model to analyze the impact of worry and relationship satisfaction on heterosexual couples' sexual -distress, an essential factor for diagnosing sexual dysfunction. The current study recruited 103 couples from the community to complete an online survey containing the Female Sexual Distress Scale-Revised, the Penn State Worry Questionnaire - Abbreviated, and the Global Measure of Relationship Satisfaction. The results show that women's and men's worries are associated with their own sexual distress, and men's relationship satisfaction has an effect on their own and their partner's sexual distress. These results highlight the critical role of cognitive processes in shaping the experience of sexual distress and reinforce the importance of taking an integrative perspective that considers relationship (satisfaction), individual (worry) and social factors (gender) in interventions to treat sexual distress.
Sexual Life Experiences of Infertile Individuals: A Meta-Synthesis Study
This study aims to systematically interpret and synthesize the evidence obtained from qualitative research conducted on the sexual experiences of infertile individuals. This study is a meta-synthesis study. A thorough literature review was conducted between February and March 2024 across five electronic databases: PubMed, Web of Science, CINAHL, EBSCO, and Science Direct Embase. This article includes 12 studies published in English since 1990 that have examined the sexual experiences of individuals who have been diagnosed with infertility. This research adhered to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. The Critical Appraisal Skills Programme tool for qualitative research was used to evaluate the quality of all included articles. To synthesize the data, deductive and interpretation techniques according to Sandelowski and Barroso's approach have been used. The sexual experiences of individuals who have been diagnosed with infertility were summarized under four main themes: "Reconceptualising Sexuality," "Change," "Coping with Sexual Problems" and "Unmet Need for Information on Sexuality." It has been revealed that individuals diagnosed with infertility need more information and support about sexual health. Health professionals might help these individuals cope with sexual health problems by providing counseling services.
Whether and What to Tell: A Qualitative Study of HIV Disclosure Among Heterosexually Married Men Who Have Sex with Men in China
In China, HIV transmission increasingly affected men who have sex with men (MSM) and those in heterosexual marriages. This study addressed a critical gap in understanding HIV and sexual orientation disclosure within conventional heterosexual marriages, framed within a family-oriented cultural context. Heterosexually married MSM living with HIV (HIV+ MMSM) faced complex identity dynamics and interactions between "gay circles" and marital life. Such disclosure was fraught with potential repercussions, including accusations of "marriage fraud", HIV-related stigma, and divorce. This descriptive qualitative study, conducted in 2022, aimed to explore the common factors influencing HIV status disclosure to wives among Chinese HIV+ MMSM. Sixteen semi-structured interviews were conducted to analyze the factors related to the disclosure process model. Four key themes emerged: (a) concern for wives' well-being, (b) perceived marriage strength, (c) the degree of social support they had, and (d) a desire to maintain their status in a heterosexual society. The decision to (non)disclose was shaped by both approach-focused and avoidant-focused goals related to these four themes. The findings underscored the need for culturally sensitive strategies that balance family dynamics, stigma reduction, and HIV care management, emphasizing tailored approaches to effectively support this population.
Coping with sexual violence as a post-assault formed couple: A dyadic phenomenological interview analysis
Increasing evidence shows that survivors of sexual violence frequently experience relationship difficulties following their victimization. Little is known regarding how couples which formed post-assault cope with the impact of the prior assault. Hence, the aim of the current study was to gain insight into post-assault formed couples' experiences in coping with the impact of sexual violence. To this end, an interview study was conducted with five female survivors and their male partners who began their romantic relationship post-assault. A dyadic phenomenological interview analysis revealed that sexual victimization is a dyadic stressor but is not always considered as such by the couple. In addition, disclosure is described as a potential bonding experience. Flexibility and creativity from both partners are required as they adapt to the post-assault impact. In addition, meaningful communication and considering the perspective of one's partner seemed to be key to dyadically cope successfully. The current study also identified challenges couples had to manage, including caregiver burden and role confusion. Results suggest that interventions supporting couples in their continuous efforts toward mutual understanding can foster trust and growth.
Association of Body Image and Genital Self-Image with Female Sexual Function: A Systematic Review
The aim of this study was to identify, through a systematic review, how perceptions of genital and body self-image can influence the sexual function of young adult women. A systematic review was performed in which 704 studies were selected. After analyzing the articles, only 10 articles were included, from which the data for this research were extracted. The studies showed that there is an association between body and genital image and sexual function. However, those perceptions carry independent and distinct values depending on the associated condition and the audience being evaluated.
The Turkish Version of the Sexual Interest and Desire Inventory-Female (SIDI-F): Examination of the Validity, Reliability and Factorial Structure
The aim of this study is to investigate the validity and reliability of the Turkish version of the Sexual Interest and Desire Inventory-Female (SIDI-F). This methodological study was conducted with 268 women who met the sampling criteria between January and February 2024. Validity analysis was performed using the content validity index, convergent and divergent validity, exploratory factor analysis, and confirmatory factor analysis. Pearson product-moment correlation and Cronbach Alpha reliability coefficients were used for reliability analysis. To evaluate invariance of the inventory over time, test-retest measurements were conducted three weeks apart and showed no difference in mean scores ( > .05). Corrected item-total score correlations ranged from 0.303 to 0.846 in the positive direction and were statistically highly significant. Adjusted goodness-of-fit index > 0.85 and comparative fit index > 0.90 confirmed the construct validity of the Turkish SIDI-F. The Cronbach Alpha was found to be .88, indicating high internal consistency. The Turkish version of SIDI-F can be used as a measurement tool to determine the level of sexual interest and arousal.
Risk of Revictimization within Intimate Relationships among Women Survivors of Childhood Sexual Abuse: The Role of Cumulative Trauma and Self-Capacities Disturbances
Childhood sexual abuse, especially in the context of cumulative childhood interpersonal trauma (CCIT), is associated with an increased risk of revictimization by an intimate partner among women. The aim of the present study is to examine the role of self-capacities disturbances in the association between CCIT and revictimization by an intimate partner. The sample comprised of 247 adult women survivors consulting in sex therapy. Path analyses showed an indirect effect of self-capacities disturbances in the association between CCIT and revictimization (s = 1.49 and 1.62), demonstrating the importance of intervening in relational and affective difficulties among women survivors to prevent the risk of revictimization.
The Global Prevalence of Child Sexual Exploitation and Abuse in Schools between 2012 and 2022: A Systematic Review and Meta-Analysis
This review aimed to synthesize existing research on the prevalence of Child Sexual Exploitation and Abuse (CSEA) in schools, while also identifying key moderators that influence these rates.
She said, "Really, you're just going to have to suffer through it": The lack of discussion of perimenopause between women and healthcare professionals
Perimenopausal symptoms adversely impacting women's sexual health are often unacknowledged or even dismissed by healthcare professionals (HCP). Using semi-structured interviews with 23 women experiencing perimenopause, we aimed to understand how HCPs address women's sexual health needs and concerns during this transition. Thematic data analysis was employed with the reduction of data into themes. Several major themes were identified concerning participants' experiences with a HCP and sexual health, including insufficient sexual health information and preventative education; the lack of open discussion about sexual health; the need for enhanced support and treatment options; feeling dismissed by a healthcare professional; and sexual pleasure not addressed by healthcare professionals. Additionally, women expressed concerns regarding medical education and training in healthcare professionals on approaching sexual health conversations. There appears to be a need for more formal training, both within medical school and continuing medical education (CME), to address these important aspects of women's sexual and reproductive health.
The Motives for Solo Masturbation Scale: Development and Preliminary Validation
Solo masturbation is prevalent across adulthood. However, there are conflicting findings regarding how masturbation is associated with well-being. Understanding individuals' motives for masturbating might help disentangle these conflicting findings; yet, existing measures are suboptimal for assessing motives for solo masturbation. In this study, 2960 adults (18-84 years old, = 32.62, = 11.36, 60.2% men, 36.8% women) who had engaged in solo masturbation within the past year responded to items, written based on existing literature, reflecting a wide range of motives for masturbating. Exploratory factor analysis revealed eight factors that warranted retention (Fantasy, Pleasure/Arousal, Compulsion, Improvement, Sexual Dissatisfaction, Coping, Efficiency, and Avoidance of Risky Sex), and this structure was confirmed using confirmatory factor analysis. Measurement invariance was established across men and women, and individuals in and not in a sexually active romantic relationship. The resultant measure comprises 24 items assessing eight distinct motives. Fit indices and scale reliabilities suggest this new measure of masturbation motives is psychometrically sound. Correlations with related constructs (e.g., sex drive, dissatisfaction with partnered sex, religiosity, depression, anxiety, and attitudes toward masturbation) provide preliminary evidence of validity. Suggestions for future investigations and further development of this new measure are discussed.
Psychometric Properties of the Attitudes Toward Polyamory Scale (ATP) in the Spanish Context
Given the potential discrimination faced by individuals in polyamorous relationships, understanding attitudes toward polyamory in society is crucial. To this end, instruments to measure attitudes toward polyamory with adequate psychometric properties are necessary. The aim of this study was to adapt the Attitudes Toward Polyamory Scale (ATP) to the Spanish context and analyze its psychometric properties in a sample of young adults. The sample comprised 1,162 individuals aged 18 to 35 years. Participants responded to sociodemographic questions and completed the Revised Sexual Opinion Survey (SOS) and the ATP. The findings indicate: (1) adequate reliability coefficients, (2) good fit statistics for the one-factor confirmatory model that verify results of exploratory factor analysis, (3) that homosexual and bisexual people have more favorable attitudes toward polyamory than heterosexual, (4) positive correlations between ATP scores, SOS scores, and political orientation (individuals with higher levels of erotophilia and a more left-leaning political orientation tend to hold more favorable attitudes toward polyamory), and (5) association between ATP scores and religion, with non-religious individuals showing more favorable attitudes toward polyamory than Catholics. In conclusion, the ATP demonstrates adequate psychometric properties in Spanish young adults.
Quantifying Circumcision Anesthesia Research: A Bibliometric Analysis Using VOSviewer
Circumcision anesthesia, aimed at mitigating pain and distress during the procedure, has evolved, reflecting advancements in medical science and societal attitudes toward pain management. This study conducts a comprehensive bibliometric analysis of circumcision anesthesia research, from historical origins to contemporary trends. The Web of Science collection database was used to search for all articles on circumcision anesthesia between 1980 and 2024. All fields were searched using "circumcision anesthesia" or "circumcision anaesthesia" as keywords. Countries, authors, journals, institutions, citation frequency, and journal metrics were extracted. The results were analyzed bibliometrically using the VOSviewer program. A total of 683 relevant publications between 1980 and 2024 were analyzed. The results showed that the USA had the highest number of publications, followed by Turkey. Original articles were the most common publication type, and the main research topics included pain management strategies, anesthesia techniques, and clinical outcomes. The article by Taddio et al. was the most cited article, with 738 citations, while "circumcision" and "pain" were the most common keywords used. Despite cultural and regional differences, this study highlights the growing acceptance of circumcision anesthesia as a vital aspect of medical practice and offers insights to guide future research efforts and clinical interventions. The findings contribute to a better understanding of the role of circumcision anesthesia in enhancing patient comfort and well-being during this standard surgical procedure.
Minor-Attracted Men's Lived Experiences of Romantic Attraction
Studies of minor-attracted persons have mainly focused on their sexual attractions, and little is known about their romantic attractions. This online qualitative survey study collected 74 self-identified minor-attracted men's anonymous accounts of romantic attraction to minors. Using reflexive thematic analysis, three themes were identified and interpreted: (1) ; (2) ; (3) . Overall, romantic attraction to minors resembles romantic attraction to adults. Findings have implications for how conceptualization, assessment, and treatment of minor attraction may each consider both sexual and romantic domains.
Risk of Postpartum Sexual Dysfunction: A Link to Posttraumatic Stress Disorder Symptoms and Depression Symptoms
The aim of this study is to determine the association of the risk of postpartum sexual dysfunction (SD) with posttraumatic stress disorder (PTSD) and depression symptoms. This cross-sectional study was conducted by collecting data from eight different family health centers (n = 147). Data were collected with 'Descriptive Information Form', 'City Birth Trauma Scale (CityBiTS)', 'Edinburg Postpartum Depression Scale (EPDS)' and 'Female Sexual Function Index (FSFI)'. Data were evaluated with Chi-square test, Fisher's exact test, Student's t-test, Spearman's correlation and logistic regression analysis. The risk of SD in women between 6 and 12 months postpartum was 53.1%, and the risk of depression was 19%. Based on self-report data, 16.3% of women met all Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for PTSD in relation to birth-specific events. There was a negative correlation between the FSFI and the CityBiTS (r=-0.208) and EPDS total scores (r=-0.335). It was found that CityBiTS scores were not a significant factor affecting the risk of SD (p > 0.05), but an increase in EDPS scores increased the likelihood of SD (OR:1.22, p < 0.05). Half of the women are at risk of SD in the first postpartum year. As postpartum depression and PTSD symptoms increase, sexual function decreases.
Closeness Discrepancies and Relationship Quality in German Partnered Women and Men
The construct of inclusion of other in the self has been established as one of the most influential measures for relationship closeness in romantic relationships. It is regularly associated with relational well-being, sexual satisfaction, as well as mental health. However, the degree of closeness one desires in the present relationship is person-specific and can differ from the closeness one actually experiences. Exploring these discrepancies, the present study focused on the association between not enough closeness and too much closeness and relationship characteristics, parenting, and extradyadic sexual activity. Data from a population-based sample of 3,161 men and women from the German Health and Sexuality Survey were analyzed using structural equation modeling. Our results confirm closeness discrepancies as prevalent relationship phenomena, while identifying feelings of not enough closeness as much more problematic for the relationship.
Acceptance and Commitment Therapy for Hypersexuality: A Pilot Study
Hypersexuality refers to the inability to control sexual desire. Despite it has shown serious consequences for physical, psychological and social health, the evidence of available psychological interventions is still insufficient. In this open-label pilot study, an Acceptance and Commitment Therapy (ACT) intervention was conducted with adults with clinically significant levels of hypersexuality aimed to examine its feasibility and usefulness. The intervention consisted of eight weekly online individual psychological intervention sessions. Outcome self-report measures were administered at baseline, after the intervention and a 3 months follow-up. Behavioral and subjective informed changes in sexual practices were weekly assessed through self-monitoring. Twelve participants (M age = 38.8 ± 11.5 years, 83.3% male, 66.7% homo or bisexual) completed the intervention. The feasibility was found to be good, with all the participants completing the training and high levels of satisfaction. Hypersexuality, psychological flexibility, cognitive fusion and mindfulness scores significantly improved after the ACT intervention, with large effect sizes. Clinically significant changes in hypersexuality were found for the vast majority of participants, besides reductions in the time dedicated to planning and practicing sex and the sexualized drug use. Results indicate that ACT-based interventions may be considered feasible and potentially effective therapeutic alternatives for hypersexuality.