Sexual Well-Being in Older Women: The Relevance of Sexual Excitation and Sexual Inhibition

The aim of this study was to use the dual control model of sexual response (DCM) to investigate variation in sexual well-being among women 50 years of age and older. Data from 185 women 50 years of age and older (M = 59.46, SD = 6.96) were used to examine the relationships between sexual excitation (SE) and sexual inhibition (SI) and their lower-order factors to indicators of sexual well-being (i.e., sexual functioning, satisfaction, distress, frequency of sexual activity, and breadth of sexual behavior). Possible moderating factors were also explored. Independently, SE and SI were associated with the majority of the indicators of sexual well-being, and the directions of associations were consistent with the tenets of the DCM. SE and SI lower-order factors were significant predictors of sexual function, satisfaction, and frequency of sexual activity. Sexual distress was predicted more strongly by SI factors and breadth of sexual behavior by one SE lower-order factor (arousability). Partner physical and mental health and participant’s own mental health were identified as moderating variables of these associations. Findings of this study are discussed considering the contribution of the DCM to understanding the role of diversity in older women’s sexual well-being.     

Bisexual Stigma,Sexual Violence,and Sexual Health Among Bisexual and Other Plurisexual Women: A Cross-Sectional Survey Study

Bisexual women experience higher rates of sexual victimization relative to heterosexual and lesbian women, and worse sexual health outcomes. Though these health disparities are well documented in the literature, few empirical data have been published on what factors are driving these disparities. Further, research documenting sexual victimization and health of plurisexual (i.e., attracted to more than one gender) women group all participants as bisexual. We do not know whether these experiences are similar across subgroups of plurisexual women. The current study reports on data from a cross-sectional survey, analyzing the relationships between bisexual-specific stigma and sexual violence, as well as other sexual health outcomes, across a sexually diverse group of plurisexual participants. Findings indicate that bisexual stigma is a significant predictor of lifetime sexual violence (odds ratio [OR] = 1.99, p = .015) and verbal coercion (OR = 2.60, p = .004), but not other outcomes. There are differences across sexual identity categories, with bisexual participants being less likely to report sexual violence and verbal coercion, and less likely to access sexually transmitted infection/human immunodeficiency syndrome testing, compared to other plurisexual groups. Our findings support that bisexual stigma is an important factor to consider in understanding sexual violence disparities experienced by bisexual and other plurisexual women.     

Self-Perceptions of Sexual Attractiveness: Satisfaction With Physical Appearance is Not of Primary Importance Across Gender and Sexual Orientation

Research on self-perceived sexual attractiveness has predominantly focused on the importance of physical appearance, overlooking nonphysical traits that may contribute to these self-perceptions. The present study examined and compared the importance of a variety of traits for self-perceived sexual attractiveness. Self-identified heterosexual, gay, and bisexual men (N = 1,801) and heterosexual, lesbian, and bisexual women (N = 1,092) completed an online questionnaire examining self-perceived sexual attractiveness, body esteem, sexual esteem, adherence to gender norms, and sexual experience. Body esteem and sexual esteem were significant predictors of self-perceived sexual attractiveness, regardless of gender and sexual orientation. Adhering to a masculine gender norm was a significant predictor among all groups (to varying extents) but heterosexual women. Adhering to a feminine gender norm was a significant predictor among heterosexual men and bisexual women. Finally, sexual experience was a significant predictor for all men and bisexual women. Furthermore, while body esteem was a predictor across all groups, for most individuals it did not appear to be of primary importance, with either sexual esteem or masculinity proving to be of greater importance. These findings suggest the need to consider traits related to both physical and nonphysical factors for improving an individual's self-perceived sexual attractiveness.     

Sexual Compulsivity and Sexual Behaviors Among Gay and Bisexual Men and Lesbian and Bisexual Women

Within the existing body of research, the information pertaining to sexual compulsivity (SC) among women, both homo- and heterosexual, remains rather limited in comparison to men. The aim of this study was to assess the prevalence of SC in a community sample of gay and bisexual men and lesbian and bisexual women and to identify differences in sexual practices based on classification as sexually compulsive within gender. Supporting previous research, the findings indicated that gay and bisexual men were significantly higher in SC when compared to lesbian and bisexual women. Similarly, sexually compulsive gay and bisexual men were more likely to report drug use with sex than their non-sexually compulsive peers, suggesting that “party n' play” may play a larger role for men with SC. In addition, the findings demonstrated empirical support for the proposition that lesbian and bisexual women with symptoms of SC were more likely to engage in specialized sexual behaviors in comparison to their non-sexually compulsive peers. These data suggest that SC manifests differently in gay, lesbian, and bisexual men and women.     

Sexual Orientation Moderates the Effect of Gender on Body Satisfaction: Results From a National Probability Sample

Body image concerns typically affect women more so than men, but there is reason to believe that this pattern may depend on sexual orientation. The present study examined differences in levels of body satisfaction among men and women who identified as heterosexual, plurisexual (bisexual and pansexual), gay, and lesbian, using data from a large-scale national probability sample from New Zealand (N = 17,005). As expected, heterosexual men reported higher body satisfaction than heterosexual women. Gay and plurisexual men reported lower body satisfaction than heterosexual men. Gay men also reported lower body satisfaction than lesbian women, and did not differ significantly from heterosexual and plurisexual women. Ratings of heterosexual, plurisexual, and lesbian women’s body satisfaction did not differ significantly. Results held when adjusting for a range of demographic covariates (including age and BMI), and highlight the importance of examining the psychological and health outcomes associated with poor body image among gay men. These findings emphasize the relevance of sexual orientation in understanding men’s body image-related issues.     

Mostly Heterosexual and Lesbian/Gay Young Adults: Differences in Mental Health and Substance Use and the Role of Minority Stress

Individuals mostly attracted to other-sex but also to same-sex partners are a distinct and common sexual orientation group with possibly increased levels of health problems. The current study examined whether mostly heterosexual individuals differed in mental health and substance use from lesbian/gay individuals and whether sexual minority risk and protective factors offer an explanation in a sample of 528 Dutch young adults (16 to 25 years old, M = 21.2 years). Mostly heterosexual participants reported higher levels of psychological distress, suicidality, drug use, and smoking than lesbian/gay participants and equal levels of binge drinking. They also reported higher levels of internalized negativity to same-sex attractions, less openness to family members and others, less community involvement, and lower numbers of lesbian/gay/bisexual friends. However, bootstrapped mediation analysis showed that the differences in minority stress risk and protective factors did not mediate most of the differences in mental health and substance use with one exception: higher levels of psychological distress were mediated by the higher levels of internalized negativity to same-sex attractions. The limited explanatory power of the minority stress factors combined with the elevated level of problems of mostly heterosexual individuals call for future studies examining other risk and protective factors.     

Traversing gender,sexual orientation,and race-ethnicity: Sexual victimization in a population-based sample of older adults

This research examined the intersectionality of gender, sexual orientation, and race-ethnicity, and its impact on lifetime sexual victimization among a population-based sample of older adults. Data for this study came from the 2011–2014 waves of the Behavioral Risk Factor Surveillance System. The final sample to be used for analysis included 8.862 individuals ages 50 years and over to examine whether and to what extent lesbian, gay, and bisexual older adults differ from heterosexual older adults in experiencing lifetime sexual victimization, and whether the effect of sexual orientation on experiencing lifetime sexual victimization differs across racial-ethnic groups. Logistic regression analysis revealed that lesbian women were 2.59 times more likely and bisexual women 2.15 times more likely both relative to heterosexual women to experience lifetime sexual victimization. When examining whether race-ethnicity imparts additional risk, the findings revealed that non-White heterosexual individuals were 29.6% less likely relative to White heterosexual individuals to experience lifetime sexual victimization, while non-White women, generally, were 2.29 times more likely relative to White men to experience lifetime sexual victimization. Our findings affirm the importance of the intersectionality of sexual orientation and gender when examining lifetime sexual victimization of older adults, adding to the emerging body of research that examines the complexities of older adult lives from multifaceted perspectives.     

Sexual Practices Among a Sample of Young Lesbian and Bisexual Women from Mexico: An Exploratory Study

Objective: To describe sexual practices in Mexican lesbian and bisexual women. Materials and method: An online survey was conducted with a nonprobabilistic sample of self-identified lesbian (n?=?768) and bisexual (n?=?371) women from the 32 states of Mexico. Results: Lesbians less frequently reported having had sex with a man than bisexual women. Preferred sexual practices with other women were external genital stimulation with fingers, internal genital stimulation with fingers, and oral genital stimulation. Most (～80%) participants did not use protection to prevent sexually transmitted infections. Conclusions: Our results can inform the design of promotion and prevention programs in sexual health aimed at sexual minority women.     

The Activation of Incompetence Schemas in Response to Negative Sexual Events in Heterosexual and Lesbian Women: The Moderator Role of Personality Traits and Dysfunctional Sexual Beliefs

Personality traits and dysfunctional sexual beliefs have been described as vulnerability factors for sexual dysfunction in women, and have also been proposed as dispositional variables for the activation of incompetence schemas in response to negative sexual events. However, no study has tested the role of personality traits and dysfunctional sexual beliefs in the activation of incompetence schemas. The current study aimed to assess the moderator role of neuroticism, extraversion, and dysfunctional sexual beliefs in the association between frequency of unsuccessful sexual episodes and activation of incompetence schemas in heterosexual and lesbian women. An online survey was completed by 1,121 women (831 heterosexual; 290 lesbian). Participants completed the NEO Five-Factor Inventory (NEO-FFI), the Sexual Dysfunctional Beliefs Questionnaire—Female Version (SDBQ), and the Questionnaire of Cognitive Schemas Activated in Sexual Context (QCSASC). Findings indicate that neuroticism moderates the association between frequency of negative sexual events and activation of incompetence schemas in heterosexual women. Moreover, several sexual beliefs also act as moderators of the relationship between negative sexual episodes and the activation of cognitive schemas in both heterosexual and lesbian women. Overall, findings support the cognitive-emotional model of sexual dysfunctions, emphasizing the role of personality traits and dysfunctional sexual beliefs as facilitators of the activation of incompetence schemas in response to negative events in women.     

“I Want to Feel Like a Full Man”: Conceptualizing Gay,Bisexual, and Heterosexual Men’s Sexual Difficulties

Current understandings of sexual difficulties originate from a model that is based on the study of heterosexual men and women. Most research has focused on sexual difficulties experienced by heterosexual men incapable of engaging in vaginal penetration. To better understand men’s perceptions and experiences of sexual difficulties, seven focus groups and 29 individual interviews were conducted with gay (n = 22), bisexual (n = 5), and heterosexual (n = 25) men. In addition, the extent to which difficulties reported by gay and bisexual men differ from heterosexual men was explored. Data were analyzed using thematic analysis applying an inductive approach. Two intercorrelated conceptualizations were identified: penis function (themes: medicalization, masculine identity, psychological consequences, coping mechanisms) and pain (themes: penile pain, pain during receptive anal sex). For the most part, gay, bisexual, and heterosexual men reported similar sexual difficulties; differences were evident regarding alternative masculinity, penis size competition, and pain during receptive anal sex. The results of this study demonstrate the complexity of men’s sexual difficulties and the important role of sociocultural, interpersonal, and psychological factors. Limitations and suggested directions for future research are outlined.     

Behind Closed Doors: An Exploration of Kinky Sexual Behaviors in Urban Lesbian and Bisexual Women

This study of 347 urban, self-identified lesbian (n = 289) and bisexual (n = 58) women examined women's engaging in 4 kinky sexual behaviors: bondage/domination, sadomasochism, photo/video exhibitionism, and asphyxiation/breath play. A cross-sectional, brief-intercept survey was administered at 2 New York City gay, lesbian, and bisexual community events. Over 40% reported engaging in at least 1 of these behaviors, and 25% reported engaging in multiple behaviors. Bisexual women were more likely to have engaged in any kinky sexual behavior and photo/video exhibitionism. White women were more likely than women of color to have engaged in bondage/domination. Compared to older women, younger women were more likely to have engaged in photo/video exhibitionism and asphyxiation/breath play. Participants who were younger when they came out to others, and younger at their same-sex sexual debut, were more likely to have engaged in any and each of the behaviors compared to women who were older at those developmental events.     

The Effects of Sexual Orientation,Gender Identity,and Gender Role on the Mental Health of Women in Taiwan's T-Po Lesbian Community

SUMMARY

We obtained via the Internet a convenience sample of Taiwanese heterosexual (n = 287) and sexual minority females (n = 260). A significantly greater percentage of sexual minorities (lesbian and bisexual females) than heterosexuals reported they had used tobacco or alcohol. Relative to heterosexuals, sexual minorities were significantly more likely to report a serious suicide attempt. Overall, gender identity (masculine, feminine, and androgynous) and gender role (butch, femme, and pure or undifferentiated) were poor discriminators of lesbian mental health. Differences between sexual minorities and heterosexuals were more robust than were the variations in gender identities and gender roles among lesbian and bisexual women. We discuss the implications of these findings for further clinical research.     

Sexual orientation and self-employment: New evidence

Early studies and theory suggest sexual minorities are drawn towards the relative independence of self-employment to avoid discrimination in paid employment. However, recent evidence is mixed, suggesting that a higher propensity for self-employment (relative to heterosexual people) is found only among lesbian women relative to heterosexual women. This study overcomes the data limitations of prior research by using data pooled from 2007–2017 cycles of the Canadian Community Health Survey (CCHS) and multivariate logistic regression to provide new evidence on LGB self-employment. The results show that self-employment is particularly high for bisexual people, especially bisexual women—but not for gay men or lesbian women. Overall, this study examines the enduring but nuanced relationship between self-employment and sexual orientation and discusses countervailing factors related to socio-economic resources, gender, and family structure.     

Prevalence of Depression and Anxiety Among Bisexual People Compared to Gay,Lesbian, and Heterosexual Individuals:A Systematic Review and Meta-Analysis

Over the past decade, evidence has accumulated to suggest that bisexual people experience higher rates of poor mental health outcomes compared to both heterosexual and gay/lesbian individuals. However, no previous meta-analyses have been conducted to establish the magnitude of these disparities. To address this research gap, we conducted a systematic review and meta-analysis of studies that reported bisexual-specific data on standardized measures of depression or anxiety. Of the 1,074 full-text articles reviewed, 1,023 were ineligible, predominantly because they did not report separate data for bisexual people (n = 562 studies). Ultimately, 52 eligible studies could be pooled in the analysis. Results indicate that across both outcomes, there is a consistent pattern of lowest rates of depression and anxiety among heterosexual people, while bisexual people exhibit higher or equivalent rates in comparison to lesbian/gay people. On the basis of empirical and theoretical literature, we propose three interrelated contributors to these disparities: experiences of sexual orientation-based discrimination, bisexual invisibility/erasure, and lack of bisexual-affirmative support. Implications for interventions to improve the health and well-being of bisexual people are proposed.     

After Breast Cancer: Sexual Functioning of Sexual Minority Survivors

Research on sexual difficulties after cancer has neglected sexual minority women (SMW); for example, lesbian and bisexual women. Clinicians treating these women are therefore at a disadvantage as they lack information about sexual problems in this population. This study tested the hypothesis that SMW with breast cancer have poorer sexual function than SMW without breast cancer, distinguishing partnered from unpartnered women. Using convenience sample recruitment, we conducted a case-control study to compare survivors of breast cancers who are SMW, in other words, cases to controls, that is, SMW without cancer. Anonymous survey data were collected from 85 cases after they had completed active cancer treatment and 85 age- and partner-status matched controls with no history of any cancer. Participants' self-reported sexual frequency and sexual function measured by the Female Sexual Function Index were evaluated. Cases and controls did not differ in risk of sexual dysfunction or the level of overall sexual functioning; however, cases had lower sexual frequency and scored lower on desire and ability to reach orgasm, and higher on pain compared to controls. Results inform clinicians about sexual minority survivors' sexual domains affected by cancer. When discussing sexual problems and therapeutic options, sexual orientation should be ascertained.     

Brief Report: Sexual Wellbeing in Heterosexual,Mostly Heterosexual,and Bisexually Attracted Men and Women

Abstract

Objective: To assess differences in sexual wellbeing among men and women with exclusively heterosexual, mostly heterosexual, and bisexual attractions. Method: An anonymous online survey in a convenience sample of 597 young adults (394 women, 203 men; average age = 20.04) assessed patterns of sexual attraction, desire, sexual functioning, and sexual satisfaction using validated questionnaires. Results: Individuals with mostly heterosexual attractions reported significantly higher solitary sexual desire than exclusively heterosexual individuals (women: d?=?0.64; men: d?=?0.68). Partnered sexual desire did not differ between groups. Women with exclusively heterosexual attractions reported significantly higher sexual functioning and satisfaction than either mostly heterosexual or bisexually attracted women (functioning: d?=?0.29; satisfaction: d?=?0.47). Men with mostly heterosexual attractions reported significantly lower sexual functioning than either exclusively heterosexual or bisexually attracted men (d?=?0.40). Conclusions: There were significant differences between exclusively vs. mostly heterosexual individuals in several aspects of sexual wellbeing, supporting the assertion that mostly heterosexual may constitute a distinct orientation. Taken together with prior research showing higher rates of sexual dysfunction in bisexual women, these findings highlight sexual health disparities among nonmonosexual women. Efforts to support the sexual wellbeing of sexual minority individuals should include consideration of mostly heterosexual individuals, as this population may have unique sexual health needs.     

Supporting the Sexual Rights of Women Living With HIV: A Critical Analysis of Sexual Satisfaction and Pleasure Across Five Relationship Types

In the context of human immunodeficiency virus (HIV), a focus on protecting others has overridden concern about women’s own sexual well-being. Drawing on feminist theories, we measured sexual satisfaction and pleasure across five relationship types among women living with HIV in Canada. Of the 1,230 women surveyed, 38.1% were completely or very satisfied with their sexual lives, while 31.0% and 30.9% were reasonably or not very/not at all satisfied, respectively. Among those reporting recent sexual experiences (n = 675), 41.3% always felt pleasure, with the rest reporting usually/sometimes (38.7%) or seldom/not at all (20.0%). Sex did not equate with satisfaction or pleasure, as some women were completely satisfied without sex, while others were having sex without reporting pleasure. After adjusting for confounding factors, such as education, violence, depression, sex work, antiretroviral therapy, and provider discussions about transmission risk, women in long-term/happy relationships (characterized by higher levels of love, greater physical and emotional intimacy, more equitable relationship power, and mainly HIV-negative partners) had increased odds of sexual satisfaction and pleasure relative to women in all other relational contexts. Those in relationships without sex also reported higher satisfaction ratings than women in some sexual relationships. Findings put focus on women’s rights, which are critical to overall well-being.     

The Psychometric Properties of the Sexual Excitation/Sexual Inhibition Inventory for Women (SESII-W) Within a Dutch Population

According to the dual control model, sexual arousal is dependent on the disposition for both sexual excitation (SE) and sexual inhibition (SI; Bancroft, 1999 Bancroft , J. ( 1999 ). Central inhibition of sexual response in the male: A theoretical perspective . Neuroscience and Biobehavioral Reviews , 23 , 763 – 784 .[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). Individual variability in sexual inhibition and sexual excitation could partly explain individual differences in sexual arousability and the likelihood of experiencing sexual problems (Bancroft, Graham, Janssen, &; Sanders, 2009 Bancroft , J. , Graham , C. A. , Janssen , E. , &; Sanders , S. A. ( 2009 ). The dual control model: Current status and future directions . Journal of Sex Research , 46 , 121 – 142 .[Taylor &; Francis Online], [Web of Science ®] , [Google Scholar]). The Sexual Excitation/Sexual Inhibition Inventory for Women (SESII-W) is a questionnaire developed to measure the factors sexual excitation and sexual inhibition (Graham, Sanders, &; Milhausen, 2006 Graham , C. A. , Sanders , S. A. , &; Milhausen , R. R. ( 2006 ). The Sexual Excitation/Sexual Inhibition Inventory for Women: Psychometric properties . Archives of Sexual Behavior , 35 , 397 – 409 .[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). This study describes the validation of the Dutch version of the SESII-W in a sample of 445 women. Using confirmatory factor analysis, we determined that the eight lower-order factor model achieved adequate fit to the data. A decrement in fit was noted when the two higher-order factors SE and SI were included in the model. The measure demonstrated good construct validity, internal consistency, and test-retest reliability. Furthermore, the scores of women with sexual problems differed from those without sexual problems, providing evidence for the discriminant validity of the SESII-W.     

What is Sexual Satisfaction? Thematic Analysis of Lay People's Definitions

Sexual satisfaction is an important indicator of sexual health and is strongly associated with relationship satisfaction. However, research exploring lay definitions of sexual satisfaction has been scarce. We present thematic analysis of written responses of 449 women and 311 men to the question “How would you define sexual satisfaction?” The participants were heterosexual individuals with a mean age of 36.05 years (SD = 8.34) involved in a committed exclusive relationship. In this exploratory study, two main themes were identified: personal sexual well-being and dyadic processes. The first theme focuses on the positive aspects of individual sexual experience, such as pleasure, positive feelings, arousal, sexual openness, and orgasm. The second theme emphasizes relational dimensions, such as mutuality, romance, expression of feelings, creativity, acting out desires, and frequency of sexual activity. Our results highlight that mutual pleasure is a crucial component of sexual satisfaction and that sexual satisfaction derives from positive sexual experiences and not from the absence of conflict or dysfunction. The findings support definitions and models of sexual satisfaction that focus on positive sexual outcomes and the use of measures that incorporate items linked to personal and dyadic sexual rewards for both men and women.