Sexes, Volume 6, Issue 1 (March 2025) – 13 articles

Climate action represents the most comprehensive of the 2015 United Nations 17 Sustainable Development Goals (SDGs) in that climate change impacts all other goals. Urban overpopulation is a primary cause, as energy consumption is a significant source of carbon dioxide emissions directing climate change. The population increase origin is attributable to the agricultural/urban developments that became geographically widespread approximately 6000 years ago. Simultaneously, religious belief stressed multiple children, with women obligated to produce them. This female duty created gender inequality and reduced the health and well-being of women, as pregnancy is a noted risk factor for decreased lifetime health. Regardless of the detrimental risk to their health and well-being, the gender inequality, and the adverse effects of birthing multiple children regarding climate action, women today continue to feel obliged to reproduce appropriately. This burden requires change to meet the three sustainable development goals of good health and well-being (SDG 3), gender equality (SDG 5), and climate action (SDG 13). An author-developed mindfulness-based psychoanalytic narrative research method presents a means for promoting such change based on a qualitative narrative analysis of the responses of several participants regarding its success in clarifying the values of these women in overcoming career-related burnout. Full article

Sexual violence among school-aged girls is a global health problem. Research has shown that school-aged girls experience high rates of sexual violence that often go unreported. In Kenya, one in three girls experiences sexual violence before the age of 18. Sexual violence against girls can prevent them from safely attending school and cause health issues that affect school performance. This qualitative study explored community and environmental factors associated with sexual violence against school-aged girls in Kitui County, Kenya. A total of 25 in-depth interviews were conducted with key stakeholders from Kitui South Sub County. The stakeholders were from six sectors, including the police, health, education, community, religious, and criminal justice sectors. The data were analyzed using conventional content analysis to gain an understanding of the stakeholder’s perspectives and knowledge relating to sexual violence against school-aged girls. Stakeholders frequently identified the criminal justice system, culture and traditional beliefs, and threats to well-being as barriers to reporting sexual violence offenses. Girls who experience sexual violence often contend with shame from the community, and the effects of stigma include loss of resources, additional violence, poorer marriage prospects, unplanned pregnancies, school dropouts, or abandonment. Perpetrators often threatened or bribed the families of girls who experienced sexual violence with gifts or monetary incentives to prevent them from reporting the crime to local authorities, while the criminal justice system itself presents numerous challenges for victims. The reporting of sexual violence could be increased by focusing on intervention strategies that challenge attitudes, norms, and behaviors rooted in gender inequality. By addressing the underlying causes of stigma and inequality, we can create a safer environment for school-aged girls to report sexual violence and seek justice. Full article

This paper explores the ways that sex workers in one Canadian city cultivate resilience in their workplaces. In 2017–2019, a period following the enactment of Canada’s revised prostitution law, a cross-section of active sex workers (N = 59) from Victoria, Canada, were interviewed about what they do to keep safe in their sex work jobs, including what they do before or during dates, how their strategies for safety have changed over time, how they draw on their larger networks, and what resources they wish they could access to improve their abilities to remain safe. Using an ecological framework of resilience, our findings show that, despite job precarity, stigma, and criminalisation, participants were actively involved in developing strategies to keep safe at work. Their resilience is a combination of factors unique to each worker’s social location and their access to workplace safety measures, including screening techniques and tools, diverse social networks, and safe working locations. We call for a public health approach to sex work that builds on workers’ strengths and enacts policies that aim to dismantle the structural environments of risk in their occupation. Full article

(1) Background: The climacteric phase is a crucial period in a woman’s life, due to the changes that affect both her physical and psychological well-being. This study aims to explore the psychological risks associated with the climacteric period in Spanish women, evaluating the influence of conformity to female gender norms. (2) Methods: A descriptive correlational study was conducted with 429 women, using surveys to assess psychological risk (GHQ-12) and conformity to gender norms (CFNI-45). The sample was recruited from central Spain, covering women aged 45–64 years. (3) Results: 20% of the women showed signs or suspicion of psychological pathology, with a higher prevalence in younger women. Participants displayed greater conformity to gender norms related to domestic chores, but less conformity to norms of sexual fidelity and thinness. Health perception was identified as significantly influencing psychological risk and conformity to the norm of thinness, acting as a moderator in this relationship. (4) Conclusions: The study indicates that age and conformity to female gender norms influence psychological risk during the climacteric phase. Younger women and those with greater conformity to the norm of thinness exhibited higher psychological vulnerability. This highlights the need for interventions that address these factors in order to promote emotional well-being and a positive perception of health during this stage of life. Full article

This study explores the complexities of women’s self-representation on social media, examining its potential detrimental effects and consequences. This study examines image exposure through the lens of Machine Learning, within the framework of Instagram’s visual culture. By examining digital content and its impact on users, this study aims to shed light on the detrimental effects of objectification and harmful stereotypes on individuals and society. In this study, we explore women’s self-representation through the portrayal of their bodies. Leveraging Google Vision API, we investigate the feasibility of automating the identification of imagery among women users located in Mexico. Our findings reveal that Google Vision API is a useful tool for detecting racy and adult content. We identify a quantitative evidence between clothing and body parts in these images, suggesting that women often share photos in revealing attire. Contrasting conventional survey and manual labeling methods, our results highlight the potential use of machine learning techniques to analyze this sort of imagery. The analysis reveals that over 90% of the examined images contain some degree of nudity or provocative poses. These findings provide valuable insights into the self-representation of women on social media, highlighting prevailing visual trends and their potential sociocultural implications. Full article

Our study addresses prostitution as a phenomenon linked to the feminization of poverty, the exploitation of women, and gender inequality, highlighting the role of male demand in its perpetuation. Spain is positioned as one of the main destinations for prostitution, with a high incidence of men paying for sex, normalizing this practice. Male motivations, classified in categories such as loneliness, risk attraction, domination, and validation of masculinity, reinforce objectification and violence against women. The aim of this study is to explore the different motivational typologies of prostitution consumption perceived by the Spanish population, as well as the perceived differences between men and women with respect to these typologies. With a sample of 198 young Spaniards (57.1% female, M = 22.5 years), we used the Motives for Prostitution Consumption Scale (MCP). Factor analyses identified two main factors: experimentation and attraction to the forbidden and sexual needs, satisfaction, and companionship, consistent with previous typologies in the literature. Results revealed that women perceive control and dominance as predominant motivations, while men emphasize sexual and affective needs. The MPC demonstrated satisfactory internal consistency indices (α ≥ 0.70) and the ability to discriminate between groups with different perceptions of the motivations of women and men. Limitations include a predominantly young university sample and the need for further validation with more diverse populations. The study reinforces the importance of analyzing male motivations for prostitution use in order to design educational strategies to promote gender equality and reduce prostitution. Full article

The notion of resilience has been widely invoked as that essential resource by which sex workers may endure, cope, or thrive despite encountering adversities and stressors. A useful definition within the resilience discourse around sex work is the ability to connect, reconnect, and resist disconnection in response to hardships, adversities, and trauma. In this article, we will examine the history of ‘resilience’ and show how it has been ubiquitously applied to sex workers in some Pacific Island settings. The resounding message of resilience discourse is that sex workers must learn to cope, accommodate, and adapt themselves to conditions that oppress them, and in fact, presuppose a continued acceptance of a degraded place in the world. Rather than resistance as a political action aimed at changing the social, institutional, and economic structures that have placed sex workers there, resilience shifts the onus onto the individual sex worker or her community support to learn to adapt to those conditions. Resilience strategies may be pragmatic but, in the end, to present these as any kind of solution to sex worker struggles becomes little more than victim blaming. Full article

Background: Adolescence is a critical life period marked by significant vulnerability to risky sexual behaviours. Comprehensive sex education offers better sexual and reproductive health to adolescents. Aim: We aimed to analyse the effectiveness of sex education interventions on reducing risk behaviours among adolescents. Methods: A systematic peer review was conducted. The databases consulted were PubMed, Scopus, Web of Science, and CINAHL. The inclusion criteria were as follows: randomized clinical trials published between 2013 and 2023 and methodological quality ≥ 5 points as per the Van Tulder scale. Results: A total of 255 studies were identified, with 25 finally selected. Of them, sixteen dealt with non-condom use, one was about early sexarche, and eight combined several risk behaviours. There was predominance of in-person teaching at schools with lectures and varied activities. The sample was predominantly comprised by girls aged between 14 and 16 years old. Certain variability regarding content, technique, number of sessions, duration, locus, and teaching modality and staff was observed in the com-prehensive sex education interventions. Almost all the interventions were effective in reducing risky sexual behaviours; however, two studies failed to achieve a reduction in risky sexual behaviours. Full article

Understanding the factors influencing the age of sexual initiation among adolescents is crucial for addressing risky behaviours and supporting healthy development. This study aimed to identify determinants of sexual initiation age among Polish adolescents, focusing on gender differences and 15 factors related to lifestyle, family, school, and social environment. The analysis involved 3296 Polish adolescents aged 15–17 who participated in the international Health Behaviour in School-aged Children (HBSC) survey in 2018. The Cox proportional hazard model (aligned with censored data) revealed that frequent use of psychoactive substances is the main predictor of the age of sexual initiation (HR = 5.20; 95% CI: 3.66–7.38), with even moderate use having an impact (HR = 2.81; 95% CI: 2.04–3.86). Gender was not found to significantly influence the age of initiation, but the determinants did vary by gender. For boys, high physical activity and intensive socialising with peers are important factors influencing the age of sexual initiation. For girls, a positive self-assessment of appearance is more strongly associated with earlier initiation, while good academic performance and family support have a delaying effect. Effective intervention programs should consider these diverse determinants since they significantly shape adolescents’ decisions about sexual activity and their ensuing psychological experiences. Full article

Consent is a foundational component of BDSM (Bondage/Discipline, Dominance/Submission, Sadism/Masochism). It distinguishes non-normative, consensual practices from instances of abuse and exploitation. Its centrality within BDSM, however, underscores the complexity of consent as a constitutive mechanism that facilitates varied intersubjective engagements, from continuous negotiation and aftercare to the use of safe words. The ontological basis of consent within BDSM relies on a model of subjective autonomy wherein individuals actively shape their desires and boundaries within a consensual framework. This paper argues that a significant motivation for many BDSM practitioners lies in the desire to subvert autonomy by engaging in acts that challenge traditional consent boundaries. However, reliance on a purely liberal interpretation of consent often marginalizes such subversive expressions, thereby pushing certain BDSM practices and individuals toward pathological or criminal categorization. Here, I propose an ethical framework grounded in a liberal consent model, which is open to the inclusion of these marginalized practices, thus, fostering a more inclusive understanding of BDSM subjectivity. Full article

Background: Syphilis has recently reemerged as a significant public health concern, with rising incidence rates globally. Malignant syphilis is a rare and severe variant of secondary syphilis, often associated with immunocompromised states, particularly HIV infection. Methods: Here, we reported a rare case of malignant syphilis in a young man with well-controlled HIV. Case: A 35-year-old man with well-controlled HIV presented with disseminated ulcerated nodules and plaques, accompanied by fever, asthenia, and mild itching. Histopathology of the scapular ulcer revealed a granulomatous infiltrate. Cutaneous leishmaniasis, atypical mycobacteriosis, and T-cell lymphomas were excluded. Serological testing and polymerase chain reaction confirmed a diagnosis of malignant syphilis. Full article

Female sex workers (FSWs) in South Africa have a high HIV prevalence. To reduce the rate of new infections, pre-exposure prophylaxis (PrEP) was introduced to FSWs; however, studies show that FSWs’ uptake and adherence to PrEP has been inconsistent. This study explored existing evidence related to strategies used to encourage PrEP uptake and adherence. Utilizing the scoping review framework, seven peer-reviewed articles were analyzed thematically. The themes were (1) PrEP promotion and distribution, (2) PrEP counselling and using educational resources, and (3) using instant messaging and rewards programs. The suggestions from the literature include a generalized PrEP promotion and distribution approach not aimed towards high-risk groups to avoid stigma. PrEP pick-up points should include sex work-friendly healthcare facilities as well as community-based venues. PrEP counselling should be conducted prior to PrEP administration to prepare users on how to deal with side effects. Information, education, and communication materials should be colorful and consist of catchy phrases targeted to the whole population. Instant messaging has been found to be effective in encouraging adherence. FSWs should be instrumental in informing intervention best practices. Future interventions aimed at FSWs should focus on holistic wellness that incorporates the psychosocial aspects of HIV prevention. Full article

Staff attitudes towards the sexuality of adults with mild intellectual and developmental disabilities may influence how the sexuality of service users is dealt with. The present study aimed to examine these attitudes in a Spanish context. A total of 102 staff members from service facilities for adults with intellectual and developmental disabilities, including direct-care and professional staff, responded to an online version of the Attitudes Towards the Sexuality of Individuals with Intellectual Disabilities Scale. In general, the participants demonstrated an understanding that adults with intellectual and developmental disabilities have sexuality. They reported favourable attitudes towards some self- and other-oriented sexual behaviours and sex education. Intermediate scores and variability on some items revealed concerns about these adults’ ability to control their sexual urges, perceptions of sexual abuse, pornography use, and contraception. Some differences appeared in relation to socio-demographic variables, experience and job position. Although generally favourable, differences in dispositional attitudes, such as talking about sexuality, were related to years of experience in the field. Professional staff reported greater acceptance of some sexual behaviours compared to direct-care staff. These findings are relevant to understanding variability in staff perceptions. The need for support to respond to service users’ sexuality, especially among direct-care professionals, is discussed. Full article