Cognitive-behavioral treatment for adolescents who sexually offend and their families: individual and family applications in a collaborative outpatient program

This article describes an outpatient treatment program for adolescent sexual abusers that was established by a mental health agency in collaboration with a specialized probation program in the juvenile court. Individualized treatment is based on a comprehensive clinical assessment with the youth and guardian, for which examples are provided. Given the heterogeneity of this population, we describe several treatment strategies directed to various individual or family clinical targets, including psychiatric disorders, sexual deviance and sexuality, normal adolescent development and adaptive skills, and parent and family relationships. Ongoing collaborative and coordination issues are also reviewed. The integration of mental health and probationary services provides a balanced approach to the community management and treatment of the low-risk, primarily first-time, adolescent sexual offender.     

Adolescents' Need to Talk About Sex and Sexuality in an Urban Mental Health Setting

Summary

For many adults, adolescent sexuality is problematic. For adolescents, it may be problematic, powerfully alluring, or simply a part of becoming an adult. Either way, and irrespective of whether they have ever had sex, young persons seeking mental health counseling in an urban mental health clinic express a strong desire to talk about sex and sexuality. Significant gender and age differences are noted in desire to talk about sexuality and mediated by involvement in sexual risk behaviors. Having experienced forced sex is directly related to desire for counseling about sex and sexuality. The findings presented in this article compel clinicians to engage all adolescents in meaningful dialogue about sex and sexuality.     

A Latent Class Analysis of Behavioral and Psychosocial Dimensions of Adolescent Sexuality: Exploring Race Differences

Adolescent sexuality is a multidimensional concept involving sexual behavior as well as aspects of youth’s sexual self-concept and sexual socialization. The current study used latent class analysis (LCA) to examine patterns of adolescent sexuality, with data from a nationally representative sample of youth (Add Health; n = 13,447), incorporating information on behavioral and psychosocial dimensions of adolescent sexual experiences. LCA results highlighted that youth may exhibit similar sexual behaviors but vary on psychosocial dimensions, including sexual self-efficacy, knowledge, and views about sex. Sociodemographic characteristics, family factors, mental health, and substance use emerged as predictors of membership into different latent classes of sexuality. Given persistent racial differences in sexual outcomes and sexually transmitted infection (STI) rates, the current study also examined how adolescent patterns of sexuality may help mediate racial differences in sexual outcomes by young adulthood. Results suggested that racial differences in adolescent patterns of sexuality help mediate racial differences in the number of sexual partners by young adulthood but not differences in STI diagnosis. Findings highlight the need for research on multiple aspects of adolescent sexuality to understand linkages with later outcomes and group differences.     

Sexual Debut and Mental Health Among South Korean Adolescents

Numerous studies have demonstrated the negative influence of sexual debut during adolescence on mental health outcomes. This article contributes to this literature by investigating whether sexual debut has negative effects on mental health among South Korean adolescents and whether the timing of adolescent sexual debut matters. Drawing on longitudinal data from a nationally representative survey, we first predicted mental health outcomes at one year after high school graduation using first sexual intercourse that had occurred before the outcomes were measured. In a second statistical model, adolescent sexual debut was defined as first coitus that had occurred before high school graduation. Sexual debut was associated with an increase in problematic aggressive behaviors for both genders. In contrast, only girls experienced a rise in depressive symptoms after becoming sexually active. For girls, having sex before high school graduation was correlated with worse mental health outcomes to the extent that sexual debut even enhanced the risk of suicidal ideation. We concluded that the negative effects of sexual activity among South Korean adolescents are attributable mainly to the sexually conservative atmosphere and gendered sexuality in that country.     

Sexual Behaviors in Mexico: The Role of Values and Gender Across Adolescence

Adolescent sexuality research has expanded to include noncoital behaviors, but there is limited knowledge about individual factors such as cultural values associated with these sexual behaviors outside of industrialized nations. Thus, we examined associations between Latino values (familism, sexual guilt, and importance of female virginity) and three sexual behaviors (making out, oral sex, and vaginal sex), among adolescents ages 12–19 (53% female) in Mexico. Findings indicate that sexual guilt and importance of female virginity were consistently associated with all sexual behaviors. Some associations differed by gender and school level. For instance, sexual guilt was a better predictor of high school girls’ oral and vaginal sex. This study expands our understanding of adolescent sexuality in Mexico.     

Indirect Over-Time Relations Between Parenting and Adolescents’ Sexual Behaviors and Emotions Through Global Self-Esteem

The present study examined indirect over-time relations between parenting and adolescent sexuality through global self-esteem. Three waves of online questionnaire data were collected among a community sample of 1,116 Dutch adolescents (M = 13.9 years at baseline). Participants rated the quality of their relationship with parents, their global self-esteem, and their experience with various sexual behaviors. Sexually experienced adolescents (n = 168) evaluated their sexual experiences using six emotions. Path model results showed that a higher-quality relationship with parents at T1 predicted higher levels of self-esteem at T2, which in turn predicted less experience with sexual behaviors and more positive sexual emotions at T3. The indirect over-time path from relationship quality through self-esteem to adolescents’ sexual emotions was significant; the indirect path to adolescents’ experience with sexual behaviors was not significant at the .05 level. No significant age or gender differences were found in the path models. The findings indicate that self-esteem plays an important role in adolescent sexuality and that parents can contribute to positive sexual experiences of adolescents indirectly—through the enhancement of self-esteem—by fostering a high-quality relationship with their children. Implications for theory, future research, and strategies to promote healthy and positive youth sexuality are discussed.     

Gender differences in sexual attitudes and behaviors: a review of meta-analytic results and large datasets

Gender differences in sexual attitudes and behaviors are typically believed to be large, yet recent evidence suggests that some gender differences in sexuality are much smaller than common knowledge would suggest. This article reviews gender differences in sexual attitudes and behaviors as reported by major meta-analyses and large datasets. In particular, this article reviews gender differences in heterosexual intercourse, masturbation, pornography use, attitudes toward premarital sex, and gender differences in same-gender sexuality. Evolutionary psychology, social cognitive learning theory, and social structural theory are explored as possible explanations for gender differences in sexuality.     

How Did Erectile Dysfunction Become “Natural”? A Review of the Critical Social Scientific Literature on Medical Treatment for Male Sexual Dysfunction

This article reviews the multidisciplinary social science literature assessing the social consequences of medical treatment for male sexual dysfunction. This literature applies medicalization theory and social constructionist approaches to gender to assert that Euro-American cultural ideals of masculinity and sexuality, as well as ageism and ableism, determine which sexual changes and experiences get defined as “dysfunction” and shape the marketing and use of medical treatments for those changes. These medical responses assuage the suffering of men who become unable to meet cultural ideals for sexuality but in the process make reductive norms for male sexuality seem biologically natural. In addition, the critical social science research suggests that an economic logic underlies the process of redefining diversity and change in men’s sexual function as medical pathology. However, comparative qualitative data on men’s and their sexual partners’ experiences of sexuality and aging across world regions suggest that people do not universally accept the narrow ideals of male sexuality embedded in medical discourse regarding men’s sexual dysfunction. The diversity in people’s sexual desires across the life course and their responses to sexual function change highlight the cultural nature of medical definitions of sexual dysfunction.     

Unfinished Business: Disentangling Sex,Gender, and Sexuality in Sociological Research on Gender Stratification

Focusing on two major strands of research on gender stratification, labor market inequality and health disparities, we argue that cisnormativity and heteronormativity obscure the rich variation in how people experience their own sense of gender and sexuality, as well as how others perceive them. Although researchers’ reliance on static notions of gender and sexuality is starting to shift, there is room for improvement, especially in the area of gender inequality. To highlight the advancements in researchers’ thinking, we spotlight exemplary work that incorporates gender expansive realities using empirically and/or theoretically grounded approaches. We conclude by outlining best practices to measure gender identity, sexual identity, gender expression, gender conformity, and other facets of gender and sexuality.     

Gender Differences in the Development of Sexual Excitation and Inhibition Through the Life Course: Preliminary Findings from a Representative Study in Flanders

The dual control model proposes that there are individual differences in the propensity for sexual excitation and sexual inhibition. Research to date has considered the effect of age on these traits as a simple linear effect, and studies examining gender differences in age effects are lacking. There are, however, indications that the associations of age with excitation and inhibition are nonlinear and that there might be gender differences in these associations. The aim of this study was to examine how these traits develop through an individual’s life and whether there are gender differences in this development. In this study we applied polynomial regression analyses to examine the interaction effects of age and gender on sexual excitation and inhibition. We used data from a representative cross-sectional survey on sexual health in Flanders (N = 1,825; mean age = 43.77; SD = 17.98). Most of the associations of excitation and inhibition with age were nonlinear, and there were substantial gender differences in these associations. This indicates that the interplay between age, gender, and excitation and inhibition should be taken into account in research on (dys)functional sexuality.     

“Bad Girls Rule”: An Interdisciplinary Feminist Commentary on the Report of the APA Task Force on the Sexualization of Girls

Feminist, critical, and postmodern scholars have long recognized sexuality as a site of power relations. The recently released Report of the APA (American Psychological Association) Task Force on the Sexualization of Girls is a welcome addition to ongoing feminist and activist conversations on how to intervene on issues of sexuality in the name of girls' and women's health. This article offers a critical interdisciplinary analysis of this influential APA report, expanding on and challenging several of its main claims. This article critiques the report as over-determining the negative impact of sexualization; offers other literatures as critical additions including feminist literature on media, consumer culture, gender, and the body, and earlier “pro-desire” feminist psychology scholarship; and critiques the task force's conflations of objectification and sexualization. The article concludes with a call for broadening feminist scholarship and activism across disciplinary boundaries to emphasize girls' and women's sexual agency and resistance, as well as sexual health and rights.     

Gender,Generational Status,and Parent–Adolescent Sexual Communication: Implications for Latino/a Adolescent Sexual Behavior

There is little research on how specific parent–adolescent sexual communication topics influence Latino/a youth's sexual behaviors, and how gender and generational status may moderate effects. This study examined effects of three different messages on intercourse and condom use among 1,944 Latino/as from the National Longitudinal Study of Adolescent Health (T1 mean age = 15.46; SD = 1.50). Results indicated discussing health consequences predicted higher odds of intercourse 1 year later across gender and generation groups. Birth control recommendation effects on subsequent intercourse and condom use differed by generational status and gender. Results indicated that message content is important for understanding effects of parent–adolescent sex communication on adolescents' behavior and underscored the need to consider gender and generational status in Latino/a parent–adolescent sexual communication studies.     

He Said,She Said: Gender Differences in Mother – Adolescent Conversations about Sexuality

This study examined gender differences in self‐reported and observed conversations about sexual issues. Fifty mother –adolescent dyads reported on their conversations about sexual issues and participated in videotaped conversations about dating and sexuality in a laboratory setting. Gender differences (more mother – daughter than mother –son) were found in the extent of sexual communication based on adolescents’ reports, but no gender differences were found based on mothers’ reports, or on observations of conversations. Aspects of laboratory interactions, however, did distinguish mother– daughter and mother – son dyads, and related to self‐report measures. Girls’ reported sexuality communication frequency related to behavior in the laboratory setting. During mother – son conversations, one person usually took on the role of questioner, whereas the other did not. In contrast, there was evidence for mutuality of positive emotions for mother – daughter dyads, but not for mother – son dyads.     

Correlates of Sexual Behavior in Young Children

SUMMARY

Sexual behavior in children ages 2–12 is related to a variety of environmental, child-specific, and reporter-related variables. This paper reviews correlational research that has examined the relationship of sexual behavior to the variables of sexual abuse, domestic violence, physical abuse, family sexuality, age and gender of the child, child behavior problems, and reporter characteristics. Sexual behavior is directly related to environmental variables that cause dysregulated behavior in children. It is also associated with child behavior problems and varies with age and gender. There are a number of reporter-specific variables, including education level, abuse history, and openness to sexuality, that are also related to the level of reported sexual behavior. The article concludes with a reminder that correlation does not mean causation.     

Beyond hookup culture: Current trends in the study of college student sex and where to next

A prominent body of sexuality research on college‐enrolled students in the twenty‐first century focuses on “hookup” culture, marked by the prevalence of sexual encounters between students with no expectation for a relationship to develop. This article will review and respond to current themes in the literature on hookup culture on college campuses. I argue that this literature privileges the White, middle‐class heterosexual experience, although less is known about how students who cannot or choose not to participate in this culture experience sexual relationships on college campuses. I place studies of hookup culture in conversation with those attentive to the effects of race, class, gender, and sexuality on access to, and experience of, hookup culture. I conclude with suggestions for future research, to include a renewed interest in sexual relationships forged outside of hookup cultures.     

A Case Study Using Photovoice to Explore Racial and Social Identity Among Young Black Men: Implications for Social Work Research and Practice

This article describes an exploratory qualitative case study using a research method novel to social work known as Photovoice. This case study of the Photovoice process assesses its value as a community-based participatory research (CBPR) method with marginalized communities within social work research. Photovoice was used to engage young Black men as researchers into their own lived experience. Through a photographic and group participatory project, participants discussed how intersections of race, gender, and sexuality affect their lives and health. While this methodology has proliferated within public health literature, little research exists within social work. Photovoice represents a research well-aligned with core social work values of empowerment and social justice. This method offers our profession a participatory, action-oriented tool to inform practice and policy and does so in the voices of communities who often go unheard.     

Parent–Adolescent Sexual Communication and Its Association With Adolescent Sexual Behaviors: A Nationally Representative Analysis in the Netherlands

Sexual communication is a principal means of transmitting sexual values, beliefs, expectations, and knowledge from parents to children. Although this area has received considerable research attention, more studies with representative samples are needed to assure that findings are reflective of populations of interest. A nationally representative sample of parent–adolescent dyads (N = 2,965; mean adolescent age = 13.8 years) in the Netherlands was employed to examine the frequency of parent–adolescent sexual communication and its association with adolescent sexual behaviors (defined as sexual initiation, condom use, and contraceptive pill use). Nine communication topics in the areas of anatomy, relationships and rights, and protection and contraception were examined. In all, 75%of parents reported having discussed at least one topic multiple times with their adolescents. Romantic relationships were discussed most frequently. Hierarchical logistic regression analyses indicated that parent–adolescent sexual communication on protection and contraception was positively associated with adolescent sexual initiation and contraceptive pill use but not condom use. This may reflect that adolescents, when they become sexually active, are more likely to discuss sexuality with their parents. Findings are interpreted within the context of Dutch culture, which is generally accepting of adolescent sexuality and characterized by open sexual communication.     

Toward a Dialectical Model of Family Gender Discourse: Body,Identity, and Sexuality

The goal of this article is to propose a dialectical model representing gender discourse in families. A brief review of literature in sociology, psychology, and gender studies focuses on three dialectical issues: nature versus culture, similarity versus difference, and stability versus fluidity. Deconstructing gender theories from a postmodern feminist perspective, the authors discuss agency and context in families' gender discourse. Narrative excerpts from interviews with an adolescent daughter and her mother illustrate three emergent themes in the social construction of gender: body, identity, and sexuality. The article concludes with recommendations for family researchers.     

Lesbian Health

ABSTRACT

Health care research suggests that lesbians may face unique physical and mental health risks, yet few studies make use of gender and sexuality theories to explain lesbian health. In this study, a social constructionist view of sexuality is used to examine the impact of lesbian identity on well-being. Drawing from nineteen intensive interviews with women who self-identify as lesbians, the results show that individuals' sexual identities change over time and are affected by their social environments. The data also demonstrate that sexual identity and social context have implications for well-being. Specifically, hostile environments, which are characterized by animosity toward gay men, lesbians, and others who do not conform to heteronormative gender expectations, are associated with distress over lesbian identity and with physical and mental health problems. By contrast, supportive environments, which many women report finding through feminism, facilitate the construction of a positive lesbian identity and enhance well-being.