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“What Is Normal?”: A Qualitative Exploration of Health Practitioners’ Reports of Treating Patients Presenting with Unpleasant Sexual Experiences "什么是正常?医疗从业者在治疗出现不愉快性经历的患者时的定性探索。
IF 2.9 2区 社会学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-09-23 DOI: 10.1007/s10508-024-02994-3
Rachael Sharman, Andrew Allen, Kirstyn van Niekerk, Alexandra Coles, Ramesh Manocha, Therese Foran

Sexual health, including sexual pleasure, is fundamental to holistic health and well-being, and is considered an area of priority health in Australia. Despite the importance of sexual functioning, women experience significant gaps in sexual well-being compared to men and often do not seek medical care or treatment. Health practitioners are central to the identification and treatment of sexual dysfunction, including fostering sexual well-being for patients. Despite this, minimal research has explored health practitioners’ experiences in treating reports of unpleasant sex. This study aimed to explore health practitioners’ experiences, responses, and confidence in treating patients presenting for unpleasant sexual experiences. An online, mixed-methods survey was completed by 96 participants. Thematic analysis identified 11 core themes. These themes included five patient centred themes (health risks, diverse sex acts, painful vaginal intercourse, relationship breakdown and violence, unwanted sex) and six health practitioner centred themes (communication and counselling, what is normal, ongoing care and follow up, emotional response, limited practical training, and highly prevalent). Participants described a complex sexual health landscape, with social contexts impacting women’s sexual experiences and engagement in treatment. Additionally, health practitioners reported the need for a biopsychosocial approach to understanding and responding to unpleasant sexual experiences for patients, while simultaneously reporting limited education in this area. Findings reflect the need for health practitioners to be cognisant of matters related to sexual function, consent, coercion, client engagement, and treatment pathways, identifying a need for greater education and holistic approaches to sexual healthcare across medical settings.

性健康(包括性快感)是整体健康和幸福的基础,在澳大利亚被视为优先保健领域。尽管性功能非常重要,但与男性相比,女性在性健康方面却存在很大差距,而且往往不寻求医疗保健或治疗。保健医生是识别和治疗性功能障碍,包括促进患者性健康的核心。尽管如此,很少有研究探讨医疗从业人员在治疗性不快报告时的经验。本研究旨在探讨医疗从业人员在治疗出现不愉快性经历的患者时的经验、反应和信心。96 名参与者完成了一项在线混合方法调查。主题分析确定了 11 个核心主题。这些主题包括 5 个以患者为中心的主题(健康风险、多样化性行为、阴道性交疼痛、关系破裂和暴力、不想要的性行为)和 6 个以医疗从业人员为中心的主题(沟通和咨询、什么是正常、持续护理和随访、情绪反应、有限的实践培训和高度普遍性)。参与者描述了一个复杂的性健康环境,社会环境对妇女的性经历和参与治疗产生了影响。此外,医疗从业人员表示需要采用生物-心理-社会方法来理解和应对患者不愉快的性经历,但同时也表示这方面的教育有限。研究结果表明,医疗从业人员需要认识到与性功能、同意、胁迫、客户参与和治疗途径有关的问题,并确定需要在各种医疗环境中加强性保健方面的教育和整体方法。
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引用次数: 0
Condom Acquisition, Errors, and Breakage among U.S. Cisgender College Students. 美国同性大学生的安全套获取、错误和破损情况。
IF 3.8 2区 社会学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-09-20 DOI: 10.1007/s10508-024-02998-z
Scott M Butler,Sara B Oswalt,Charmayne M L Hughes,Charlotte Petonic Robbins,Beth Sundstrom
High rates of sexually transmitted infections and unplanned pregnancy continue to plague young adults in the USA with low condom use a contributing factor. To better understand condom acquisition, errors, and breakage among US cisgender college students, a survey was conducted across six structurally diverse institutions of higher education in 2019-2020 prior to the COVID-19 pandemic. Students who had used external condoms in the last year (N = 1584) were asked about specific on- and off-campus locations of condom acquisition and practices related to condom use. Findings indicate that students most frequently acquired condoms off-campus with location differences between genders and relationship status. Condom errors were common, with no consistent patterns related to gender, but unpartnered students were more likely than those in relationships to experience condom errors. Multivariate logistic regression indicated that relationship status, applying condom on wrong side, adding condom after sex started, removing condom during sex, condom slipping off, and problems with fit were predictors for condom breakage. The study results provide guidance for healthcare and sexuality education professionals working with college students to better address the differing needs of college students regarding condom acquisition and correct condom use.
性传播感染和意外怀孕的高发率继续困扰着美国的年轻人,而安全套使用率低是其中的一个因素。为了更好地了解美国顺性别大学生的安全套获取、错误和破损情况,我们在 COVID-19 大流行之前,于 2019-2020 年在六所结构不同的高等教育机构开展了一项调查。调查询问了去年使用过外用安全套的学生(N = 1584)在校内外获取安全套的具体地点以及与安全套使用相关的做法。调查结果表明,学生最常在校外购买安全套,不同性别和恋爱状况的学生在购买地点上存在差异。安全套使用错误很常见,与性别没有一致的模式,但无伴侣的学生比有伴侣的学生更容易出现安全套使用错误。多变量逻辑回归表明,关系状况、将安全套戴错一侧、在性爱开始后添加安全套、在性爱过程中取下安全套、安全套滑落以及贴合问题都是预测安全套破损的因素。研究结果为从事大学生工作的医疗保健和性教育专业人员提供了指导,以更好地满足大学生在获取安全套和正确使用安全套方面的不同需求。
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引用次数: 0
Validation in Spanish and English of the Transgender Inclusive Behavior Scale 用西班牙语和英语验证变性人包容性行为量表。
IF 2.9 2区 社会学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-09-19 DOI: 10.1007/s10508-024-02982-7
Laura Alonso-Martínez, Davinia Heras-Sevilla, María Fernández-Hawrylak, Johannes Hönekopp, Simon Forrest, Shanna Katz Kattari

The Transgender Inclusive Behavior Scale (TIBS) seeks to measure transgender-inclusive behavior, specifically actions and language use that support transgender people. The TIBS was developed in the United States. This study aimed to develop a Spanish version of the TIBS and confirm the structure of the English version to explore the psychometric properties and evaluate the construct validity in new contexts. We examined predictors of transgender-inclusive behavior by conducting a comparative analysis between participants from Spain and the United Kingdom. The study involved 1,110 university students, with 545 participants hailing from Spain (375 women, 162 men, and 8 non-binary individuals) and 565 participants from the United Kingdom (368 women, 178 men, and 19 non-binary individuals). Exploratory and confirmatory factor analysis were conducted to investigate and validate the factorial structure of the TIBS. The factor analysis results for the 15 items on the scale confirmed a three-dimensional structure in both languages. The scale score reliability was excellent with a Cronbach’s alpha (α) = .95 in the British sample and with an α = .89 in the Spanish sample. Being a woman, being lesbian, gay, bisexual, trans, queer, intersex, and/or asexual, and being non-religious were the strongest predictors of inclusive behaviors towards transgender people in both countries. The correlations found indicated that people with lower sexual risk behaviors, and lower sexist, homophobic, and transphobic attitudes also presented higher inclusive behaviors towards trans people. These findings support the development of community strategies to increase the social inclusion of transgender people. The TIBS is a useful measure to track their success.

变性人包容性行为量表(TIBS)旨在测量变性人的包容性行为,特别是支持变性人的行动和语言使用。TIBS 是在美国开发的。本研究旨在开发西班牙文版的 TIBS,并确认英文版的结构,以探索其心理测量特性并评估其在新环境下的构建有效性。我们通过对西班牙和英国的参与者进行比较分析,研究了跨性别包容行为的预测因素。这项研究涉及 1110 名大学生,其中 545 名参与者来自西班牙(375 名女性、162 名男性和 8 名非二元个体),565 名参与者来自英国(368 名女性、178 名男性和 19 名非二元个体)。为了研究和验证 TIBS 的因子结构,我们进行了探索性和确认性因子分析。量表中 15 个项目的因子分析结果证实了两种语言的三维结构。在英国样本中,量表得分信度非常高,Cronbach's alpha (α) = .95,在西班牙样本中,α = .89。在这两个国家,身为女性、女同性恋、男同性恋、双性恋、变性人、同性恋者、双性人和/或无性恋者以及无宗教信仰是预测变性人包容性行为的最有力因素。发现的相关性表明,性风险行为较低、性别歧视、仇视同性恋和变性者的态度较低的人对变性者的包容性行为也较高。这些发现支持制定社区战略,以提高变性人的社会包容性。TIBS 是跟踪其成功与否的有效措施。
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引用次数: 0
Pelvic Floor Disorders Due to Anal Sexual Activity in Men and Women: A Narrative Review 男性和女性肛门性行为导致的盆底障碍:叙述性综述
IF 2.9 2区 社会学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-09-17 DOI: 10.1007/s10508-024-02995-2
Avital Bar Chen, Leonid Kalichman

Recent evidence shows that consensual anal penetrative intercourse has become more prevalent, not only limited to gay, bisexual, and other men who have sex with men but also for women who are in a sexual relationship with men. The aim of this review was to study the influence of consensual anal intercourse on pelvic floor function and the role of pelvic floor physical therapy treatment in preventing or treating consensual anal intercourse-induced anodyspareunia and/or fecal incontinence. We reviewed 68 references that showed that anal penetrative intercourse is a risk factor for anodyspareunia and fecal incontinence in both men and women. This risk of anal intercourse may increase with emotional discomfort, an overactive pelvic floor, lack of lubrication, frequency of anal penetrative intercourse, and hard practice (BDSM: bondage and discipline, dominance and submission, sadism, and masochism). It seems that pelvic floor physical therapists play an essential role in preventing and treating pelvic floor dysfunctions due to anal intercourse, which can lead to anodyspareunia and fecal incontinence; the treatment includes education, pelvic floor training with and without biofeedback, electric stimulation, manual therapy, and dilatators. Further studies are warranted to enhance our understanding of the causes and treatment efficacy of pelvic floor dysfunctions due to anal penetrative intercourse.

最近的证据显示,双方同意的肛门插入式性交越来越普遍,不仅限于男同性恋、双性恋和其他男男性行为者,还包括与男性有性关系的女性。本综述旨在研究双方同意的肛交对盆底功能的影响,以及盆底物理治疗在预防或治疗双方同意的肛交引起的肛门失禁和/或大便失禁中的作用。我们查阅了 68 篇参考文献,发现肛交是导致男性和女性肛门失禁和大便失禁的风险因素。肛交的风险可能会随着情绪不适、骨盆底过度活跃、缺乏润滑、肛门插入性交的频率和硬性练习(BDSM:捆绑和管教、支配和服从、虐待狂和受虐狂)而增加。看来,盆底物理治疗师在预防和治疗因肛交导致的盆底功能障碍方面发挥着至关重要的作用,肛交功能障碍可导致肛门失禁和大便失禁;治疗方法包括教育、盆底训练、生物反馈或非生物反馈、电刺激、人工疗法和扩张器。我们有必要开展进一步的研究,以加深对肛交导致盆底功能障碍的原因和治疗效果的了解。
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引用次数: 0
Another Myth of Persistence? 坚持的另一个神话?
IF 2.9 2区 社会学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-09-16 DOI: 10.1007/s10508-024-03005-1
Alex Byrne
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引用次数: 0
The Power to Flirt: Power within Romantic Relationships and Its Contribution to Expressions of Extradyadic Desire 调情的力量浪漫关系中的权力及其对性外欲望表达的贡献
IF 3.8 2区 社会学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-09-16 DOI: 10.1007/s10508-024-02997-0
Gurit E. Birnbaum, Yaniv Kanat-Maymon, Kobi Zholtack, Rafael Avidan, Harry T. Reis

Power in non-romantic contexts makes people confident in their ability to attract potential partners, increasing their mating motivation and the likelihood of acting on this motivation. Four studies investigated whether perceptions of power within romantic relationships would also activate mating goals, intensifying desires for alternative partners. In Studies 1 and 2, participants underwent power manipulation and then described a sexual fantasy or evaluated photos of attractive strangers. Studies 3 and 4 used face-to-face interaction and daily experiences methods to examine the mechanisms underlying the link between power and extradyadic desires. Overall, high perceived relationship power was associated with increased interest in alternatives. Perceived relative mate value explained this association, suggesting that what determines whether power elicits extradyadic interest is not power perceptions alone but rather the feeling of having a higher mate value than one’s partner that accompanies elevated power and affects whether high-power individuals will prioritize their own needs in ways that may hurt their partners.

在非恋爱环境中,权力会让人们对自己吸引潜在伴侣的能力充满信心,从而增强他们的交配动机以及根据这种动机采取行动的可能性。有四项研究调查了在恋爱关系中对权力的感知是否也会激活交配目标,从而加强对其他伴侣的渴望。在研究 1 和研究 2 中,参与者先接受权力操纵,然后描述性幻想或评估有吸引力的陌生人的照片。研究 3 和研究 4 采用了面对面互动和日常体验的方法来研究权力与婚外性欲望之间的联系机制。总体而言,高感知关系权力与对替代品的兴趣增加有关。感知到的相对伴侣价值解释了这种关联,这表明决定权力是否会引起婚外恋兴趣的因素并不只是权力感知,而是伴随着权力提升而产生的比伴侣拥有更高的伴侣价值的感觉,这种感觉会影响高权力个体是否会以可能伤害伴侣的方式优先考虑自己的需求。
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引用次数: 0
Sexual Affectivity in Autism Spectrum Disorder: Bibliometric Profile of Scientific Production 自闭症谱系障碍中的性情感:科学著作的文献计量学概况
IF 3.8 2区 社会学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-09-13 DOI: 10.1007/s10508-024-02996-1
Jordi Torralbas-Ortega, Victòria Valls-Ibáñez, Judith Roca, Carme Campoy-Guerrero, Meritxell Sastre-Rus, Judith García-Expósito

The aim of the present study was to describe the scientific production on sexuality and affectivity of autistic people. The inclusion criteria were articles published in all languages from the year 2000 to 2023, excluding reviews, proceedings, and other works not considered original. The search was performed in the Web of Science Core Collection and RStudio was utilized to analyze the records, with the “Bibliometrix 4.1.0” package and the VOSviewer software. A total of 314 articles were included, from the USA, Australia, and parts of Europe. The production peak was found in the year 2020, the most cited articles referred to the children’s population, and the most important journals were specialized on the subject. As for the thematic content, 29 keywords emerged that were grouped into three clusters. In the first group, children associated with vulnerability and victimization were underlined, in which multifocal interventions were needed to prevent risk; in the second, we found adolescents and the need for sex education that is adapted and comprehensive; and lastly, adults who must be able to perform an adequate transition that eases the adaptation of neurodivergent individuals.

本研究旨在描述有关自闭症患者性和情感的科学成果。纳入标准是 2000 年至 2023 年期间以所有语言发表的文章,不包括评论、论文集和其他不被视为原创的作品。检索在科学网核心库中进行,并使用 RStudio 软件包 "Bibliometrix 4.1.0 "和 VOSviewer 软件对记录进行分析。共收录了 314 篇文章,分别来自美国、澳大利亚和欧洲部分地区。2020 年是文章生产的高峰期,被引用次数最多的文章涉及儿童群体,而最重要的期刊都是关于这一主题的专业期刊。在主题内容方面,29 个关键词被分为三组。在第一组中,强调了与易受伤害和受害有关的儿童,需要采取多方面的干预措施来预防风险;在第二组中,我们发现了青少年以及对适应性教育和全面性教育的需求;最后是成年人,他们必须能够进行适当的过渡,以缓解神经变异个体的适应问题。
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引用次数: 0
Rise in Gender Dysphoria Diagnoses and Legal Gender Changes in Sweden: 2005–2017 瑞典性别失调诊断和法定性别变更的增加:2005-2017 年
IF 2.9 2区 社会学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-09-12 DOI: 10.1007/s10508-024-02993-4
Emma Claesdotter-Knutsson, Mitchell J. Andersson, Matti Cervin, Carl Delfin, Anders Håkansson, Niroshani Broman

Evidence suggests the incidence of gender dysphoria (GD), a condition characterized by psychological distress caused by a mismatch between an individual’s gender identity and biological sex assigned as birth, has increased since the turn of the twenty-first century. We examined trends in the number of GD diagnoses and legal gender changes in Sweden using registry data from 5007 individuals diagnosed with GD between 2005 and 2017 (53.5% assigned female at birth). GD diagnoses increased substantially over time, especially in birth-assigned females and younger age groups. One-third of all subjects with GD legally changed their gender, with an increase of 1000% from 2005 to 2018. Generally, individuals who were assigned female at birth changed their gender earlier than birth-assigned males, and most did so within one year of GD diagnosis. Our findings highlight the need to analyze the causes and correlations of rapid changes in clinical presentation and to prepare healthcare systems for rising patient demand.

有证据表明,自进入二十一世纪以来,性别焦虑症(GD)的发病率有所上升,这种疾病的特点是个体的性别认同与出生时被分配的生理性别不匹配而导致的心理困扰。我们利用 2005 年至 2017 年间 5007 名被诊断为 GD 的患者(53.5% 出生时被指定为女性)的登记数据,研究了瑞典 GD 诊断数量和法定性别变更的趋势。随着时间的推移,GD 诊断人数大幅增加,尤其是出生时被分配为女性的患者和年龄较小的群体。三分之一的 GD 患者通过法律途径改变了性别,从 2005 年到 2018 年增加了 1000%。一般来说,出生时被分配为女性的人比出生时被分配为男性的人更早改变性别,而且大多数人是在确诊 GD 后一年内改变性别的。我们的研究结果突出表明,有必要分析临床表现快速变化的原因和相关性,并让医疗系统做好准备,以应对不断增长的患者需求。
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引用次数: 0
Group Comparisons of the Sexual Interests and Behaviors of Assigned Males and Their Association with Genital Ablation Fantasies 被指派男性的性兴趣和性行为及其与生殖器消融幻想的关系的分组比较
IF 3.8 2区 社会学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-09-10 DOI: 10.1007/s10508-024-02976-5
Jamie Agapoff, Thomas W. Johnson, Richard J. Wassersug, Erik Wibowo

We describe here the sexual histories and characteristics of 338 individuals with interests in castration (orchiectomy) and, more broadly, genital ablation (i.e., orchiectomy, penectomy, and/or nullification), recruited from the Eunuch Archive. We compared four groups: those who only fantasize about castration (Fantasy, n = 66), those who wish to be castrated in the future (Aspiring, n = 166), and those who have been castrated (Eunuchs) both with (n = 42) or without (n = 64) androgen replacement therapy (ART). In our sample, 35.6–53.8% had sexual fantasies of castrating someone, 83.3–90.8% had fantasies of being castrated, 20.6–33.3% had fantasies of removing someone’s penis, and 45.3–61.9% had fantasies of having a penectomy. The four groups had similar arousal by high-risk sex behaviors, anal sex play, attraction to people under 18, common sex behaviors, and fetishistic behaviors. Fantasy of being castrated by someone was associated with elevated high-risk sexual behaviors and attraction to individuals aged 18 to 49 after controlling for age, groups, and sexual attraction. In addition, after adjusting for age, groups, and sexual attraction, fantasy of castrating someone was associated with more attraction to individuals under the age of 18 and being aroused by interaction with a stranger, whereas fantasy of cutting off someone’s penis was associated with less tendency for common sexual behaviors and digital sex communication. Fantasy of being penectomized was associated with high risk and fetishistic sexual behaviors. These results support screening for high-risk behaviors in individuals who endorse an interest in genital ablation, with treatments focused on harm reduction.

我们在此描述了从太监档案中招募的 338 名对阉割(睾丸切除术)以及更广泛的生殖器切除术(即睾丸切除术、阴茎切除术和/或阉割)感兴趣的人的性史和特征。我们对四组人进行了比较:只幻想阉割的人(幻想,n = 66)、希望将来被阉割的人(渴望,n = 166),以及接受(n = 42)或未接受(n = 64)雄激素替代疗法(ART)而被阉割的人(太监)。在我们的样本中,35.6%-53.8%的人有阉割他人的性幻想,83.3%-90.8%的人有被阉割的性幻想,20.6%-33.3%的人有切除他人阴茎的性幻想,45.3%-61.9%的人有阴茎切除的性幻想。高风险性行为、肛交游戏、吸引未满 18 岁的人、普通性行为和恋物行为对这四个群体的唤醒作用相似。在控制了年龄、群体和性吸引力之后,被人阉割的幻想与高风险性行为和对 18 至 49 岁人群的吸引力升高有关。此外,在对年龄、群体和性吸引力进行调整后,幻想被人阉割与更多地吸引 18 岁以下的人和通过与陌生人互动而被唤起有关,而幻想切掉别人的阴茎与较少的常见性行为倾向和数字性传播有关。幻想被切除阴茎与高风险性行为和恋物性行为有关。这些结果支持对有生殖器切割兴趣的人进行高风险行为筛查,并将治疗重点放在减少伤害上。
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引用次数: 0
Examining Relations Between Sexualizing Media Exposure and Sexting Attitudes and Behaviors among U.S. Adolescents 研究美国青少年接触性媒体与 Sexting 态度和行为之间的关系
IF 2.9 2区 社会学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-09-09 DOI: 10.1007/s10508-024-02984-5
Jennifer Stevens Aubrey, Heather Gahler, Elizabeth A. Daniels, Hye Jeong Choi, Ashton Gerding Speno

Based on social cognitive processes (Bandura, 2009), sexualizing media likely provide adolescents with credible role models for their own sexualized self-presentation in other mediated contexts, such as sexting. A survey of 6,093 US adolescents was conducted (Mage = 15.27 years, SD = 1.37; 69.1% cisgender girls; 26.8% cisgender boys, 4.2% gender-minority participants) to examine relations between three types of sexualizing media exposure (reality television, music videos, pornography) and active sexting behaviors (i.e., requesting and sending). Among cisgender boys, exposure to sexually oriented reality television was positively related to active sexting behaviors, but this link was not found for cisgender girls or gender-minority participants. Music video exposure was related to active sexting behaviors only among cisgender boys and pornography consumption was positively related to active sexting behaviors among all gender groups. A positive outcome expectancy (i.e., sexting is fun) consistently mediated these relations. A negative outcome expectancy (i.e., sexting is risky) only mediated the relations between pornography consumption and active sexting behaviors among cisgender girls. Results are discussed in light of social cognitive theory (Bandura, 2009) and the 3AM Model (Wright, 2011).

根据社会认知过程(Bandura,2009 年),性化媒体很可能为青少年提供了可信的榜样,帮助他们在其他媒介环境中进行性化的自我展示,如色情短讯。我们对 6093 名美国青少年(年龄:15.27 岁,标准差:1.37;69.1% 为顺性女孩;26.8% 为顺性男孩,4.2% 为性别少数参与者)进行了一项调查,以研究三种类型的性化媒体接触(电视真人秀、音乐视频、色情图片)与主动性短信息行为(即请求和发送)之间的关系。在性别一致的男孩中,性导向真人秀与主动性短信行为呈正相关,但在性别一致的女孩或性别少数群体参与者中却没有发现这种联系。在所有性别群体中,音乐视频的接触仅与主动性短信息行为有关,而色情制品的消费与主动性短信息行为呈正相关。积极的结果预期(即sexting很有趣)始终是这些关系的中介。消极的结果预期(即发短信息有风险)只对顺性别女孩的色情消费和主动发短信息行为之间的关系起中介作用。研究结果将根据社会认知理论(Bandura,2009 年)和 3AM 模型(Wright,2011 年)进行讨论。
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引用次数: 0
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Archives of Sexual Behavior
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