Masturbation and Sexual Health

Abstract

In this study we applied research examining the hypothesized benefits of masturbation in dealing with sexual problems to the urgent health crisis posed by the HIV/AIDS pandemic. This is the first study to test the hypothesized relationship between masturbation and HIV risk as predicted by the Sexual Health Model, a sex-positive approach to sexual health developed in response to the need for a more explicit focus on sexuality and relationships in HIV prevention. This is also the first study to examine the relationship between several masturbation variables (i.e., masturbation guilt, lifetime masturbation, and current masturbation) and HIV-related sexual behaviors and attitudes in a sample of African American women (N =239). Data was collected using face-to-face structured interviews as part of the Women's Initiative for Sexual Health (WISH), a randomized, controlled trial of an HIV prevention intervention based on the Sexual Health Model, targeting low income, adult African American women. Contrary to expectations, results showed that participants who reported masturbating were more likely to report having multiple partners, being in a nonmonogamous relationship and engaging in high-risk sexual behaviors. There was no significant relationship between level of masturbation guilt and HIV risk nor between masturbation and consistent condom use or attitudes toward condoms. This study adds to the growing empirical support for associations between sexual health variables and safer sex and argues for a more explicit focus on sexuality in HIV prevention.     

What Do Men Want?

Abstract

Men play a key role in determining good sexual health outcomes for themselves and their sexual partners. However, many interventions and much of the programmatic focus and effort in reproductive and sexual health care delivery, are focused on women. This paper shows how international goals for development (the Millennium Development Goals), and international agreements on population and development (such as that agreed at the International Conference on Population and Development, Cairo,1994) cannot be met without the full and active involvement of men. We argue that achieving international goals and targets requires more than simply encouraging men to take more responsibility for their actions, it requires a detailed understanding of men's own concerns in the field of sexual health and a commitment to address those concerns to achieve better sexual health for all.

Using examples from south Asia, the paper explores the evidence surrounding the burden of men's sexual ill-health in the Region. We find that while public health programmes are (rightly) focused on controlling HIV (and sexually transmitted infections to some degree), evidence from population-based surveys of men across south Asia shows that men are most concerned with ‘psycho-sexual conditions’ including discharge syndromes, weakness, and erectile dysfunction. There is evidence that some of these conditions may be linked to higher rates of risk-taking and gender-based violence in some men. We further review patterns of care seeking for men reporting these and other sexual health problems.

We conclude that the challenges facing public health professionals are how to ensure that men receive interventions which are appropriate (and affordable and accessible and of high quality) for addressing their own sexual health concerns whilst also meeting wider public health goals of improving population levels of sexual and reproductive health.     

Using Masturbation in Sex Therapy

Abstract

Masturbation may be useful in treating hypoactive sexual desire disorder. To examine this possibility, the current study examined the relationships between masturbation, sexual desire, sexual fantasy, and dyadic sexual activity. The relationships between masturbation and other constructs were also examined: overall sexual dysfunction, relationship satisfaction, life stress, and sexual attitudes. Mediational analyses suggest several causal pathways between masturbatory desire, masturbatory frequency, sexual fantasy, sexual desire, and sexual activity. Developing a model of masturbation may help illustrate its role in sexual functioning and highlight its potential role in sex therapy.     

Patterns of Masturbatory Behaviour

Abstract

In 1966, 1981 and 1996 the Department of Sex Research at Hamburg University, Germany, carried out three surveys into the sexual behavior of university students. Taken as a longitudinal study they provide information on the social history of sexuality over the past three decades for well-educated young adults (20 to 30 years old) in Germany. The samples consist of 8,641 men and women. In this paper data from the studies is analyzed under two aspects:

1. Shifts in masturbatory behavior 1966–1981–1996. Men and especially women begin to masturbate considerably earlier than used to be in the eighties, not to mention in the sixties. As a consequence, most young women nowadays have already experienced masturbation when having their first heterosexual intercoursethus following a pattern of sexual socialization that traditionally was typical for boys. In addition, in 1996, more students of both sexes had masturbated in the year preceding the investigation. The more relevant point is, however, that young adults (according to active incidence during the last 12 months) now masturbate almost irrespective of whether they have intercourse often or rarely, whether they are singles or live in a steady relationship or whether or not they are satisfied with their current relationship. So masturbation peacefully coexists with sex between partners and a loving relationship more often than it did in 1981 and 1966.

2. Masturbation in steady relationships, 1996. A detailed analysis of masturbation frequencies during the last four weeks also shows small differences between students who live in a sexually satisfying relationship and those without relationship. Only a minority feels the need to justify masturbation on the grounds that they lack sex with their partner. Three-quarters expressly state that masturbation is a form of sex in its own right and, therefore, does not interfere with partner sex. Furthermore, there is a tendency that students living in steady relationships experience masturbation slightly more positively than those living alone.     

Masturbation in a Generational Perspective

Abstract

Each generation has adopted views on masturbation via transforming cultural definitions of sexuality and normality. This article presents how masturbation habits have changed during the last decades in different generations and how these habits are linked to the partnership status. The analysis is based on three national follow-up sex surveys in Finland (in 1971, in 1992, and in 1999), and sex surveys in Sweden (in 1996), in Estonia (in 2000), and in St. Petersburg, Russia (in 1996).

Across these countries, each new generation had been more active in masturbation than the previous one. However, in Estonia masturbation had increased in each generation about 20 years later and in St. Petersburg about 30 years later than in Finland and Sweden. The increase in masturbation was almost unrelated to the relationship status and to the years spent in the relationship. The masturbation habits that each generation had internalized in adolescence seemed to remain unchanged through the course of their lives. The implications of these findings are that masturbation did not decrease with age and that masturbation was not a compensation for a missing sex partner but an independent way to gain sexual pleasure. The results indicate that masturbation is linked to the perceptions within a given culture of its nature and consequences during the teenage years of participants.     

Reparative Therapy for Gays and Lesbians

Abstract

In recent years there has been much public controversy about “conversion or reparative therapies” designed to change homosexuals into heterosexuals. Various national mental health associations have taken a stand against these therapies. Social service professionals who work with gay and lesbian clients need to develop beliefs about the mutability of sexual orientation that reflect sound research findings.     

Putting the “S” Back into Sexual and Reproductive Health

ABSTRACT

Sexuality is the most fundamental aspect of our lives and yet it has long been the silent partner in sexual and reproductive health (SRH). Growing awareness of the rights-based approach to health, the commitment of governments and international bodies to promote sexual health and well-being, and the failure of many of the interventions to combat the HIV/AIDS epidemic are helping the reproductive health community put the “S” back into SRH even as the Millennium Development Goals fail to address SRH directly. The disconnect is due to the fragmented, non-holistic approach to reproductive health, short-sightedness in neglecting violations like gender-based violence, a lack of training for students and health care professionals in sexuality, a dearth of indicators and sexuality research and discrimination against vulnerable groups like youth and sexually diverse populations. Recommendations include reaching consensus about the nexus between sexuality and reproductive health and strengthening the commitment to gender equity, empowerment, sexuality and sexual rights among policymakers. Ensuring that explicit and positive references to sexuality are universal, especially in comprehensive sexuality education, youth-focused programs and the integration of HIV and other SRH programs, and strengthening the ability of program managers and service providers to work on sexual health issues are key to successful integration and program sustainability. Strengthening understanding, acceptance and competence in serving sexually diverse populations and improving the research and evaluation specific to sexuality are longer processes, but equally important in the paradigm shift to non-stigmatizing, gender-equitable, rights-based, pleasurable sexual health services.     

Sexual Pleasure and Wellbeing

ABSTRACT

Pleasure may be the key to the successful working of the reproductive systems of humans. However, for all the enjoyment sexual relationships can provide, there are countervailing forces of guilt and disappointment at work on the individual psyche. Religious and social norms enforce limits on sexual expressiveness. These controls are defended as means to protect individuals and their partners from unhappiness due to infidelity. The contrasting balance of potential pleasure on the one hand and deeply felt self-controls on the other gives rise to many problems of sexual health. Couples with discordant expectations about sexual pleasures can find their relationships crumbling. Deeply planted understandings about inappropriate behavior can cause individuals to feel shame or fear when faced with choices about their sexuality and particularly their desires. People unable to achieve desired pleasures due to physical handicaps experience a loss of wellbeing that can be extremely distressing. Simultaneously society struggles to control the individual expression of harmful sexual behavior such as child molestation while protecting the rights of individuals to enjoy personal satisfaction. The recognition and promotion of sexual pleasure as an integral part of wellbeing is one of the most challenging elements on the sexual health agenda. Progress in this area will require extraordinary efforts by professional groups and political leaders to forge a forthright understanding of the meaning of pleasure in people's lives, and the priority of promoting healthy sexuality as a part of a global health agenda.     

Sexual Health in the Netherlands: Main Results of a Population Survey Among Dutch Adults

ABSTRACT

In 2006, the Rutgers Nisso Groep conducted an extensive population survey to assess the epidemiology of sexual health in the Netherlands. The sample consists of a random selection of the adult population living in the Netherlands (N= 4147) who were approached through internet panels. The study assesses the prevalence of a broad range of sexual health issues, including sexual and relational satisfaction, experience of sexuality, sexual identity, paraphilia, excessive desire, sexual dysfunctions, contraception, abortion, infertility, testing for sexually transmitted infections and HIV, condom use, and sexual violence. The data show, among other findings, that a small half of the adult Dutch population was basically without sexual health-related problems or stress during the year preceding the study. The other half experienced problems to a varying extent in one or more areas. Overall, 24% of the women and 19% of the men have experienced a need for professional sexual health care during the previous year. For women and men alike, relational problems are the most common complaint. About half of those in need of one or another form of sexual health care actually received it. Young people and people with an ethnic minority background show an elevated need for sexual health care.     

Child Sexual Abuse and Women's Sexual Health: The Contribution of CSA Severity and Exposure to Multiple Forms of Childhood Victimization

Research studies have provided increasing evidence for the potential adverse impact of child sexual abuse on women's sexual health. The present study examined the association between child sexual abuse and sexual health while controlling for various forms of childhood victimization. Self-report questionnaires were administered to 889 young women from the province of Quebec. Results suggest that child sexual abuse survivors were more likely to report having experienced other forms of childhood victimization than were women without child sexual abuse. Women with a history of both child sexual abuse and multiple forms of victimization were at greater risk of experiencing more adverse outcomes, including risky sexual behaviors, sexual problems, and negative sexual self-concept. Regression analyses revealed that child sexual abuse was significantly related to indicators of sexual health outcomes even when controlling for the effect of single forms of victimization. Clinically, interventions optimizing sexual health may be particularly helpful for a subgroup of child sexual abuse survivors.     

Examining the efficacy of an mHealth media literacy education program for sexual health promotion in older adolescents attending community college

Objective: To determine the feasibility of a mobile health (mHealth), media literacy education program, Media Aware, for improving sexual health outcomes in older adolescent community college students. Participants: 184 community college students (ages 18–19) participated in the study from April–December 2015. Methods: Eight community college campuses were randomly assigned to either the intervention or a wait-list control group. Student participants from each campus completed web-based pretest and posttest questionnaires. Intervention group students received Media Aware in between questionnaires. Results: Several intervention effects of the Media Aware program were significant, including reducing older adolescents' self-reported risky sexual behaviors; positively affecting knowledge, attitudes, normative beliefs, and intentions related to sexual health; and increasing media skepticism. Some gender differences in the findings were revealed. Conclusions: The results from this study suggest that Media Aware is a promising means of delivering comprehensive sexual health education to older adolescents attending community college.     

Sexual Function in Postmenopausal Women and Serum Androgens: A Review Article

Abstract

Objectives: This study aimed to narratively summarize the effects of serum androgens on sexual function of postmenopausal women and the impact of administration of various types of androgens in improving the sexual function of these women. Methods: After searching for articles indexed in various databases, a total of 59 studies were selected. Results: There appears to be a great deal of controversy regarding the relationship between androgens and sexual function and the beneficiary effect of androgens therapy. Conclusions: Androgens may affect sexual function; however, androgen therapy, as an option for improving sexual function in menopause, needs further research.     

Mental health and substance use of sexual minority college athletes

ABSTRACT

Objective: Assess the mental health and substance use of sexual minority collegiate student-athletes in the United States, as compared with heterosexual college students and heterosexual student-athletes. Participants: Undergraduate students (N = 196,872) who completed the American College Health Association's National College Health Assessment (Fall 2008–Fall 2012 administrations). Methods: Written cross-sectional survey. Results: Sexual minority student-athletes had a higher risk of experiencing mental health difficulties than their heterosexual athlete peers. There were no significant differences in mental health between sexual minority male athletes and nonathletes. Sexual minority female athletes appeared to fare better than nonathlete peers. Substance use was greater among sexual minority students (athlete and nonathlete) and was mediated by mental health. Conclusions: Participation in athletics does not appear to be associated with an elevated risk of negative mental health outcomes for sexual minority participants; however, there are disparities in mental health outcomes by sexual orientation regardless of athletics participation.     

Addressing Sexually Transmitted Infections (STIs), including HIV/AIDS,in the Context of Sexual Health

ABSTRACT

Sexually transmitted infections (STIs) have occupied a central place in public health agendas for at least the past 500 years, but have been the subject of opinions, decrees and “moral positions” for much longer. Societies have long tried to control the sexual behaviors of their populations, not only for reasons of social control, but also with the objective of controlling the spread of disease—HIV is the latest example of how societies respond to infections spread through the most private of individual behaviors. The article outlines the burden of disease associated with sexually transmitted infections including HIV, and explores their impact on efforts to achieve the Millennium Development Goals (MDGs). A large number of options for prevention and care of the sexually transmitted infections and HIV are currently available in both resource-rich and resource-constrained settings. In this article I move beyond the narrow focus of biomedical interventions concentrated on the individual and explore the evidence for public health measures aimed at controlling these infections. Using a public health framework I outline the various measures that can be implemented for STI/HIV control, and in addition to exploring the evidence for their public health effectiveness, I also look at how each of these interventions can be delivered within a paradigm of sexual health more generally. Finally, the article proposes recommendations for which effective strategies should be incorporated into a broader framework for promoting sexual health.     

Behavioral health correlates of exposure to community violence among African-American adolescents in Chicago

AimsThough public health researchers are more aware of behavioral health concerns among African American youth, few studies have explored how exposure to community violence may be related to adverse youth concerns. This study examines the relationship between exposure to community violence and mental health problems, substance use, school engagement, juvenile justice involvement, and STI risk behaviors.MethodsA total of 638 African American adolescents living in predominantly low-income, urban communities participated in the study by completing self-report measures on exposure to community violence, mental health, school engagement proxies, substance use, delinquency markers and sexual risk behaviors.ResultsAdolescents who reported higher rates of exposure to community violence were significantly more likely to report poorer mental health, delinquent behaviors, a history of juvenile justice involvement, lower school bonding and student-teacher connectedness. These youth were also significantly more likely to use alcohol, cigarettes, and illicit substances, and engage in sexual risk behaviors.ConclusionsFindings suggest that there is a critical need for culturally relevant prevention and intervention efforts for African American adolescents who are frequently exposed to community violence.     

Recovering Process from Child Sexual Abuse During Adulthood from an Integrative Approach to Solution-Focused Therapy: A Case Study

ABSTRACT

In recent times, strengths-based recovery approaches that focus on the present and build strategies that look toward the future have become popular. However, some cases require the consideration of experiences from previous stages of the clients’ development. This single-case study explores the psychotherapeutic process of a middle-aged woman who presented with a history of child sexual abuse (incest) and a long-term adult diagnosis of depression that was treated in public health services. This psychotherapy involved an integrative approach to solution-focused therapy; specifically, the approach proposed by Yvonne Dolan to work with adult survivors of sexual abuse, in conjunction with techniques and strategies from the transtheoretical model. Measures incorporating therapeutic working alliance and outcomes were administered over sessions. Results showed positive outcomes from this therapeutic intervention, which remained at 3-month and 12-month follow-ups. Implications for practitioners’ specialist practice in health services are discussed, given the complexity of comorbid mental health conditions with a history of child sexual abuse.     

Sexual Health for the Millennium: An Introduction

ABSTRACT

This special issue of the International Journal of Sexual Health is devoted to the issues of the United Nations Millennium Development Goals and the effort by the World Association for Sexual Health to argue that the promotion of sexual health is an essential strategy for attaining those goals. Recently, the World Association for Sexual Health has published Sexual Health for the Millennium: A Declaration and Technical Document (2008). This special issue of the IJSH contains the background papers which served as a foundation for the development of the declaration and technical document. These articles argue that sexuality is a fundamental aspect of being human, that human development must be premised on the promotion of sexual health and is a basic human right for all citizens. Public policies designed to promote human development must make the promotion of sexual health an essential strategy. This special issue is designed to stimulate more interest in the Sexual Health for the Millennium: A Declaration and Technical Document, encourage further analysis and research which will support the statements in the declaration, provoke more advocacy for sexual health, and, most importantly, to stimulate sound and effective public policies to create a sexually healthier world.     

What College Students Do Not Know: Where Are the Gaps in Sexual Health Knowledge?

Abstract

Objective: This study aimed to understand the gaps in college students’ knowledge regarding sexual health information. Participants: A sample of 242 participants enrolled in an introductory college course participated in this study in the Fall 2009 semester. Methods: Students participated in 1 of 2 brief interventions and wrote a response paper about their experience. The papers were analyzed using conventional content analysis for information that was new to participants by looking for key words that suggested learning took place. Results: The findings indicated that the majority of participants learned new information. Most learning occurred regarding sexually transmitted infections (ie, types, symptoms, prevalence, treatment, testing) and correct condom use. There were also demographic differences regarding reported new information. Conclusions: Findings can be used to develop future sex education programs for college students by providing college educators with an understanding of where students lack knowledge of sexual health.     

Crisis or Creation? A Systematic Examination of False Memory Syndrome

SUMMARY

In 1992, the False Memory Syndrome Foundation (FMSF), an advocacy organization for people claiming to be falsely accused of sexual abuse, announced the discovery of a new syndrome involving iatrogenically created false memories of childhood sexual abuse. This article critically examines the assumptions underlying “False Memory Syndrome” to determine whether there is sufficient empirical evidence to support it as a valid diagnostic construct. Epidemiological evidence is also examined to determine whether there is data to support its advocates' claim of a public health crisis or epidemic. A review of the relevant literature demonstrates that the existence of such a syndrome lacks general acceptance in the mental health field, and that the construct is based on a series of faulty assumptions, many of which have been scientifically disproven. There is a similar lack of empirical validation for claims of a “false memory” epidemic. It is concluded that in the absence of any substantive scientific support, “False Memory Syndrome” is best characterized as a pseudoscientific syndrome that was developed to defend against claims of child abuse.