Sexes, Volume 6, Issue 2 (June 2025) – 12 articles

Barriers to help-seeking behaviors in transgender populations in non-Western contexts are both understudied and poorly understood. Using a quantitative cross-sectional design, this study examined the psychological help-seeking attitudes of 109 transgender persons from Pakistan in relation to their psychological distress and attitudes toward sexuality. This research further identified which components of distress (stress, anxiety, or depression) were stronger predictors and assessed the role of particular demographic/behavioral factors in help-seeking attitudes. Participants completed three validated assessment tools translated into Urdu: Beliefs about Psychological Services Scale, the Depression, Anxiety, and Stress Scale (DASS-21), and the Sexual Attitude Scale. The results indicated that psychological distress predicted expertness and intent but not stigma tolerance. Post hoc analysis using DASS-21 subscales revealed that stress and anxiety were the stronger predictors of attitudes related to expertness and intent. The Sexual Attitude Scale marginally predicted stigma tolerance directly and also moderated the relationship between psychological distress and help-seeking attitudes for stigma tolerance. Finally, a role for demographic/behavioral factors—possibly serving as a proxy for mental health literacy—was identified for stigma tolerance. These findings reiterate the importance of tailored mental health awareness initiatives within the transgender community in non-Western settings and highlight the need for qualitative research to further understand the dynamics of psychological distress along with other linked factors. Full article

Sex education goes far beyond merely conveying biological facts; it encompasses the psychological, social, and cultural aspects of sexuality. A gender-sensitive approach to sex education for boys* aims to address their specific needs and challenges, critically reflect on hegemonic norms of masculinity, and develop alternative, non-toxic models of masculinity. This article explores the foundations and core elements of such a gender-sensitive sex education for boys*, considering theoretical concepts such as sexual socialization, hegemonic masculinity, and sexual scripts, as well as sexual health and rights for boys*. An intersectional perspective enables a nuanced analysis of the diverse social inequalities that shape boys’* sexual development. This paper argues for four key elements of gender-sensitive sex education for boys*: (1) empowerment and self-determination to strengthen boys* in their formation of sexual identity; (2) the development of alternative masculinities to challenge stereotypical gender constraints; (3) the promotion of gender justice by raising boys’* awareness of their societal responsibility; and (4) fostering critical competencies in dealing with media and social norms. These approaches contribute to establishing a holistic and inclusive form of sex education that acknowledges boys* in their diversity and helps create a more just society. Full article

Stealthing, the nonconsensual removal of a condom during sexual intercourse, is a prevalent yet underreported form of sexual misconduct, particularly among college students. This white paper examines the legal landscape, gaps in responses, and the burden of stealthing on college students. It presents actionable strategies for college campuses to combat stealthing, including updating policies, enforcing a zero-tolerance policy, training staff, providing survivor-centered support services, integrating cultural competency, and ensuring transparent enforcement of processes. These strategies aim to empower college campuses to prevent and reduce stealthing, promote informed consent, and enhance survivor support. Full article

Measures of sexual orientation and family functioning are widely used among sexual minority populations. However, data on whether these measures are culturally syntonic and responsive to the needs of a particular population, such as Hispanic sexual minority youth (HSMY), are lacking. Therefore, this study assessed whether HSMY understand measures of sexual orientation and family functioning as intended. Authors conducted individual interviews with five HSMY to evaluate the face validity of a measure of sexual orientation (i.e., Klein Sexual Orientation Grid) and measures of family functioning (i.e., Parent–Adolescent Communication Scale, Parenting Practices Scale, Parental Monitoring of Peers). Data were analyzed using a general inductive approach. For the sexual orientation measure, five themes were identified related to the: (1) clarity of questions, (2) challenging nature of questions, (3) difficulty of responses, (4) suggestions to improve response options, and (5) need for questions to include gender identity. For family functioning, three themes were identified: (1) relevance of the measures to sexual minority youth, (2) the importance of understanding family history and cultural context, and (3) capturing the context of how sexual minority status and disclosure impact family functioning. HSMY had generally positive feedback regarding these measures; however, they also suggested specific changes associated with wording and specificity of the measures to make them more relevant to HSMY’s unique needs. Full article

Young adults diagnosed with severe mental illness (SMI), intellectual disability (ID), and autism spectrum disorder (ASD) often experience significant barriers in accessing sexual health education, contributing to poor sexual and relational well-being. The Educational Intervention and Training Program on Sexuality and Affectivity (eITPoSA) was developed to address this gap through a structured psycho-educational approach tailored to their cognitive and emotional needs. A pilot study was conducted with 12 participants diagnosed with SMI, ID, and ASD, who attended the training sessions covering topics such as body knowledge, genital sexuality, privacy, and hygiene. Pre- and post-intervention assessments were carried out using structured monitoring grids, with data analyzed through descriptive statistics, paired-samples t-tests, and Cohen’s d to evaluate effect sizes. Results demonstrated statistically significant improvements across all domains, particularly in body knowledge (31.43% to 86.65%), genital sexuality (15% to 90%), and hygiene (47.27% to 96.36%). These findings suggest that the eITPoSA program effectively enhances sexual and relational competencies in young adults diagnosed with SMI, ID, and ASD. Future research should focus on expanding the sample size and exploring long-term retention of educational outcomes to further validate the program’s efficacy. Full article

The sharing of explicit sexual images through virtual platforms has grown exponentially in recent generations, causing various issues such as low self-esteem, sextortion, and cyberbullying, among others. Therefore, it is imperative to have a deeper understanding of this issue. This research aims to construct an instrument that allows for the identification of the motivations that lead to the practice of sexting in young university students. The research had two phases: conducting an Exploratory Factor Analysis, which included 320 university students (48.2% female and 51.8% male) aged between 18 and 30 (M = 20.4; SD = 2.62). In the second phase, 1056 university students (55.9% female and 44.1% male) within the same age range as the first phase participated (M = 22.38; SD = 2.64), for whom a Confirmatory Factor Analysis (CFA) was conducted. The final version of the scale consisted of a unidimensional model comprising eight items that assess internal and external motivations leading to the practice of sexting, with an adequate fit index (CFI = 0.991, TLI = 0.988, and RMSEA = 0.068). Additionally, an omega coefficient of 0.93 was found, indicating adequate reliability. It was concluded that the Sexting Motivation Scale (EMS by its initials in Spanish) demonstrates good reliability and construct validity, making it suitable for measuring motivation for sexting. Full article

Among the models of romantic relationships, consensual non-monogamy (CNM) is one in which several affective and/or sexual relationships are allowed simultaneously. This type of relationship, still considered non-normative, has experienced a considerable increase in recent years. However, research is still limited, and studies on the subject in Spain are scarce. To better understand the differences and similarities between monogamous and CNM relationships, this study investigated both relational models, divided by sex, for four factors concerning romantic relationships: relationship satisfaction, sexual desire, jealousy, and conflict resolution styles. In a sample of 210 persons, the results showed that CNM females reported significantly higher levels of consensus and dyadic sexual desire than monogamous females. Jealousy levels were similar in both types of relationships. People in CNM relationships displayed greater conflict resolution skills through negotiation and compromise, whereas monogamous females reported using the non-constructive style of conflict engagement more than CNM females and monogamous males. CNM males indicated a greater use of withdrawal compared to CNM females. Overall, females showed more passionate jealousy than males. This investigation highlights the importance of studying romantic relationships and their different models. Full article

Recent legal reforms incorporating the concept of sexual consent into the Penal Code, alongside high-profile scandals involving male idol groups and comedians, have heightened societal attention to sexual crimes in Japan. Although studies have extensively examined this topic, findings have been predominantly from Western or English-speaking countries, which raises questions regarding their applicability to other cultural contexts. To address this gap, this study examined whether the results of prior research could be generalized to Japan. This study examined six hypotheses derived from previous studies. Using a vignette-based online survey (N = 748), participants read a hypothetical sexual assault case and answered questions on sentencing, negative social reactions, and victim/perpetrator blaming. An analysis revealed that only one hypothesis was supported: respondents recommended longer sentences for perpetrators when the victim was male rather than female. Additionally, women were more likely to exhibit egocentric reactions, such as expressing more anger toward the perpetrators than the victims, than men. No other hypothesized gender-based differences, which included victim-blaming or harsher sentencing by male observers, were supported. These findings highlight the risks of generalizing research findings across cultural contexts and emphasize the importance of conducting culturally specific studies. Full article

Due to constantly evolving technology, a new challenge has entered the relationship landscape: the inclusion of robots as emotional and intimate partners. This article raises the question of the degree to which companionship and intimacy may be fulfilled by robots. Three hundred and fourteen undergraduates, the majority of whom were first- or second-year college students, responded to an online survey on robot acceptance. Factor analysis identified two constructs, which the authors labeled as simulated companionship (e.g., robots as companions/helpful assistants) and simulated intimacy (e.g., robots as intimate partners–emotional and sexual). Data analysis revealed a difference between companionship and intimacy regarding student robot acceptance for home use. Overall, there was greater acceptance of robots as companions than as intimate partners. Group differences for simulated companionship were found for gender, sexual values, commitment to religion, and sexual orientation. While robots may enhance various elements of human life, the data revealed the limits of outsourcing emotional intimacy, companionship, and sex to machines. Full article

Bondage/discipline, Dominance/submission, Sadism/Masochism (BDSM) is a multifaceted spectrum of consensual sexual practices, that has long intrigued the psychological community for its implications on mental health and personality. While previous research has shed light on its psychopathological aspects, less is known about the distinct psychosexual dimensions that characterize individuals who assume dominant or submissive roles within these dynamics. Our research aims to identify differences in personality traits between dominant and submissive individuals and explore the relationship between BDSM roles and mental health outcomes. While previous studies have explored personality traits in BDSM practitioners, research specifically examining the associations between BDSM roles and multiple psychological constructs remains limited. To address this, we employed Bayesian methods with non-informative priors, including ANOVA and linear regression, to evaluate the associations between self-identified BDSM roles and psychological constructs with the specific intent to build informative priors for future research. A sample of 99 BDSM practitioners from online forums participated, providing responses across several psychometric instruments. The study utilized comprehensive psychometric evaluations, including the Big Five Inventory for personality assessment, the Hypersexual Behavior Inventory for hypersexuality, the Brief Sensation Seeking Scale for sensation seeking, the Patient Health Questionnaire for depression, and the General Anxiety Disorder scale for anxiety. Bayesian regression analysis revealed that dominant practitioners exhibit lower hypersexuality and agreeableness, while submissive practitioners show higher levels of agreeableness, depression, hypersexuality, and sensation seeking. These findings highlight distinct psychosexual profiles associated with BDSM roles and provide several implications for mental health professionals working with BDSM practitioners, emphasizing the need to assess and address underlying psychological factors. Future research should further explore these psychosexual dynamics to develop targeted interventions for enhancing psychological well-being and relationship satisfaction within the BDSM community. Full article

Foreign bodies in urological patients are commonly found in the lower urinary tract, especially in the bladder and urethra. Items such as pens, pencils, wires, and cables are often inserted for erotic stimulation, typically associated with alcohol intoxication or psychiatric disorders. The aim of this study is to present the adverse events of non-conventional sexual manipulation and the harmful effects of using atypical objects for masturbation purposes. The study presents a series of case reports describing patients with self-inflicted foreign bodies in the lower urinary tract, collected over 20 years at a single medical center. Most patients were admitted to the hospital with lower urinary tract symptoms (LUTSs) and signs of infection, such as abdominal pain and fever. Only 6 out of 12 patients revealed their intention regarding foreign body insertion. Additionally, 9 out of 12 patients did not attend the follow-up visit. Self-inflicted foreign bodies in the lower urinary tract vary in type and motive. Patients may be reluctant to disclose these circumstances, complicating diagnosis and treatment, which can lead to serious health risks and a reduced quality of life. Full article

Sexual and gender minority (SGM) communities experience an increased risk for sexual victimization. Because these rates are reported in aggregate, little is known about the unique experiences of sexual violence among individuals with differences of sex development/intersex variations (DSD/I). The purpose of this study is to describe the experiences of sexual victimization in adolescents and young adults (AYAs) with DSD/I as part of a larger qualitative study exploring experiences of minority stress, stigma, and resilience. Participants were recruited through multidisciplinary care clinics and DSD/I support groups in the United States and the Netherlands. Data on sexual experiences and sexual health were analyzed thematically, with a specific focus on reports of sexual victimization. Of the 20 participants, 25% reported experiences of sexual violence. Experiences were reported across gender identities and DSD/I diagnoses. Participants described experiences as (a) resulting from DSD/I, (b) exacerbated by DSD/I, or (c) healthcare practices experienced as sexual violence. Medicalization, early loss of (bodily) autonomy, and cisgender heteronormative reproductive societal norms were reported as possible factors associated with sexual victimization experiences. The sexual victimization of individuals with DSD/I appears prevalent and associated with specific risk factors and, therefore, deserves clinical and scientific attention. Full article