Journal of Sex & Marital Therapy最新文献

In this study, data from 7,440 patients from six Ibero-American countries were analyzed, focusing on men who consulted for erectile dysfunction (ED). Participants were queried about infidelity in their relationships. Results showed a negative correlation between infidelity and the severity of ED, suggesting that the likelihood of infidelity decreases as the severity of ED increases. Additionally, alcohol consumption and age were identified as significant predictors of infidelity, with notable country-specific variations. No significant associations were found between infidelity and other variables such as comorbidities affecting erectile function, sexual activity frequency, or suspected hypogonadism, measured using the AMS questionnaire.

Sexual compliance (i.e., consenting to sex without initial sexual desire) can have both positive and negative consequences for well-being. This study explored predictors of perceived consequences of sexual compliance in cisgendered men and women from a population-based, Finnish sample (men n = 449, women n = 499, age M = 34.1, relationship duration M = 8.9). We drew upon existing literature and theoretical frameworks to select the following predictors; sexual approach and avoidance motives, sexual self-efficacy, avoidant and anxious attachment, sexual self-esteem, sexual assertiveness, symptoms of depression and/or anxiety, sexual distress, dyadic sexual communication, dyadic trust, and partner's sexual coercion. The predictors explained 31-38% of the variance in perceived positive consequences and 33-43% of the variance in perceived negative consequences of sexual compliance. Approach motives for sex had the strongest association with perceived positive consequences and having been sexually coerced by one's partner and sexual distress had the strongest associations with perceived negative consequences of sexual compliance. There were some variations in the predictors between genders, but the differing predictors had weak effects on the perceived consequences. Our findings can help clinicians identify focus areas when working with clients who experience a desire discrepancy in their intimate relationships.

Persistent Genital Arousal Disorder/Genito-Pelvic Dysesthesia (PGAD/GPD) is characterized by persistent or recurrent unwanted genital arousal, causing significant distress to the affected individual. Classified as a sexual dysfunction, PGAD/GPD is predominantly described in women and severely affect their quality of life with psychological repercussions. Despite its morbidity, PGAD/GPD remains unfamiliar to healthcare professionals. This article provides a narrative review of the disorder, addressing current literature on its pathophysiology, diagnosis, and treatment approaches from a biopsychosocial perspective. The aim is to increase awareness among healthcare providers, enabling appropriate management strategies for PGAD/GPD and improving patient overall well-being.

This paper critically examines the scientific and ethical underpinnings of gender-affirming care, particularly for minors. While major medical organizations endorse such interventions as medically necessary, the evidence supporting their long-term safety and efficacy remains limited. Research into hormonal, neuroanatomic, and genetic influences reveals a strong biological basis for gender identity, challenging social constructionist arguments. There is a lack of robust, long-term studies that definitively demonstrate the outcomes of gender-affirming medical treatments, such as puberty blockers or hormone therapy, for minors. Questions remain about how these interventions affect physical health (e.g., bone density, fertility) and mental well-being over decades. These gaps in the evidence, particularly for adolescents, raise ethical concerns about the appropriateness of irreversible medical treatments. This analysis highlights the tension between the social constructivist framework of gender and the medicalization of gender dysphoria. It explores the implications of rising desistance rates, co-occurring mental health conditions, and increasing non-binary identities within current clinical paradigms. Drawing on evidence from cases involving gender detransitioning, the impact of hormones, and neurological development in both straight, gay, and trans individuals, the paper underscores the importance of cautious, evidence-based approaches that prioritize psychological maturity and comprehensive mental health assessments. Ultimately, the paper advocates for rigorous longitudinal research, enhanced mental health evaluations, and the development of noninvasive therapeutic options in particular anda reevaluation of treatment models to ensure ethically sound and scientifically supported care for individuals experiencing gender dysphoria.

This study presents the development and validation of the Sexual Boredom Inventory (SBI), a 6-item measure assessing sexual boredom as a temporary, context-dependent state. Initial items were drafted from data obtained through qualitative analysis, and the SBI was tested using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) with a sample of adults reporting on their sexual experiences in the past month. A single-factor model was found to be the best fit, with four items dropped during refinement. The SBI demonstrated good internal consistency (Cronbach's α = .88) and evidence of discriminant validity, with significant negative correlations to sexual pleasure and well-being. Additionally, the SBI was positively correlated with attention difficulties and impulsivity, highlighting a link between sexual boredom and ADHD. Findings suggest that sexual boredom, as a transient experience, is associated with negative sexual outcomes. Further research should confirm these relationships and potential interventions. The SBI can serve as a valuable tool for assessing recent sexual boredom and differentiating it from other sexual concerns.

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

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

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.

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.

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.