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Sex Education and Sexual Knowledge, Attitudes, and Behavior Among Florida College Students: Exploring the Impact of Curriculum Theme -
Sexual Cognitive Schemas Mediate the Relationship Between Personality and Sexual Function -
New Directions for Sexual Consent in a Digitized World: A Narrative Review -
A Reversed Orgasm Gap? Gender Differences in Orgasm Frequency During Heterosexual Partner Sex -
Sexual Objectification, Health and Well-Being in Spanish Women
Journal Description
Sexes
Sexes
is an international, peer-reviewed, open access journal on the interdisciplinary study of sexuality, with broad coverage of issues related to sexual health and behavior, published quarterly online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within ESCI (Web of Science), EBSCO, and other databases.
- Journal Rank: JCR - Q2 (Social Sciences, Interdisciplinary)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 43.1 days after submission; acceptance to publication is undertaken in 6.1 days (median values for papers published in this journal in the second half of 2025).
- Recognition of Reviewers: APC discount vouchers, optional signed peer review, and reviewer names published annually in the journal.
- MDPI’s Journal Cluster of Social Studies: Challenges-Journal of Planetary Health, Disabilities, Genealogy, Laws, Sexes, Social Sciences and Societies.
Impact Factor:
1.3 (2025);
5-Year Impact Factor:
1.5 (2025)
Latest Articles
Disentangling from Intimate Partner Violence: A Qualitative Study of Survivors’ Experiences
Sexes 2026, 7(3), 33; https://doi.org/10.3390/sexes7030033 - 25 Jun 2026
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Background and Objectives: Intimate partner violence (IPV) is a major public health concern, with nearly one in three women experiencing rape, physical assault, stalking, emotional manipulation, or a combination of these behaviors in their lifetime. As an often neglected cause of injury
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Background and Objectives: Intimate partner violence (IPV) is a major public health concern, with nearly one in three women experiencing rape, physical assault, stalking, emotional manipulation, or a combination of these behaviors in their lifetime. As an often neglected cause of injury worldwide, IPV is underreported and not well recognized by healthcare professionals. Employment has been identified as a key factor in women’s successful disentanglement from IPV. The purpose of this qualitative study was to explore the factors that influenced women who had experienced IPV, established a career path, and successfully disentangled from IPV. Materials and Methods: Women who experienced IPV were recruited from a local university. Results: Ten female participants completed open-ended interviews (mean age = 47, SD = 10.25). Five main themes emerged as the most important in disentangling from their abusive situation: tipping point, grit, religion, children, and education/career. The main theme or step in the process that led to disentanglement was the tipping point. Once the tipping point had been reached, participants moved toward disentanglement. Conclusions: Disentanglement from IPV was enhanced for women who reached a tipping point of abuse.
Full article
Open AccessArticle
Quantifying Homonegativity Among Refugees in Germany: First Evidence and Implications for LGBTQI Refugees’ Safety
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Gerhard Hapfelmeier, Daniel El-Wahsch, Stephan Bender and Marco Walg
Sexes 2026, 7(3), 32; https://doi.org/10.3390/sexes7030032 - 23 Jun 2026
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Refugees identifying as lesbian, gay, bisexual, transgender, queer, and intersexual (LGBTQI) may experience discrimination not only prior to and during flight but also within the host country, including stigmatisation by other refugees. Such experiences can severely affect mental health, making LGBTQI refugees a
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Refugees identifying as lesbian, gay, bisexual, transgender, queer, and intersexual (LGBTQI) may experience discrimination not only prior to and during flight but also within the host country, including stigmatisation by other refugees. Such experiences can severely affect mental health, making LGBTQI refugees a particularly vulnerable group. To date, however, quantitative data on homonegativity within refugee populations remain scarce. In this cross-sectional survey, 70 adult refugees in Germany reported interpreter preferences across three everyday settings. Homonegativity was operationalised as the consistent rejection of an LGBTQI-identifying interpreter across all settings. Sixteen participants (22.9%) showed consistent rejection. This proportion exceeds estimates of negative attitudes towards homosexuals reported for the German general population. Consistent rejection was associated with higher religiosity and was more common among participants who identified as Muslim, with higher rates among refugees from Syria compared with those from Afghanistan. No significant associations were found for age, gender, or length of stay. While the majority of participants did not reject LGBTQI-identifying interpreters, a substantial minority did so consistently. These findings underscore the importance of considering subgroup-specific preferences in interpreter assignment practices and indicate potential risks of discrimination against LGBTQI refugees within shared accommodation settings.
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Open AccessArticle
Examining Sex Differences Across the Lifespan on the Mobile Half-Version of the Connors Continuous Performance Test
by
Spenser Barry, Jordan Price, Chris Beasley and Len Lecci
Sexes 2026, 7(2), 31; https://doi.org/10.3390/sexes7020031 - 20 Jun 2026
Abstract
Concussions exert a massive cost on our economic and healthcare systems. Many of the most commonly employed neurocognitive measures in concussion assessment have been shown to be psychometrically problematic. Additionally, norms are established from largely male populations. The present study investigates the use
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Concussions exert a massive cost on our economic and healthcare systems. Many of the most commonly employed neurocognitive measures in concussion assessment have been shown to be psychometrically problematic. Additionally, norms are established from largely male populations. The present study investigates the use of a validated and reliable measure of concussion sequelae, the mobile half-version of the Connors Continuous Performance Test 3rd Edition (CCPT-3), on a representative population to study the influence of sex and age on normative values collected at baseline. Baseline data were analyzed from 71,976 participants across a wide range of academic and athletic contexts, as well as healthcare settings. Multiple regressions examined the influence of sex as a function of age in different developmental groups: children, adolescents, young adults, adults, and older adults. Sex effects emerged during childhood, peaked during adolescence, and decreased in adulthood. Females showed better accuracy (fewer commission and omission errors), whereas males had faster response speeds (hit-rate RT). Effect sizes were generally in the small to very small range (sex effect sizes ranged from Cohen’s d = 0.02 to 0.39). The findings highlight the importance of accounting for sex and age in cognitive test performance and underscore the impact of correcting for even small effects when working with large samples.
Full article
(This article belongs to the Section Biological and Psychosocial Basis Underlying Sexual Response and Differences)
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Open AccessArticle
Drug Use, Mental Health, and Gender Identity Among Mexican University Students
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Xóchitl De San Jorge-Cárdenas, María del Carmen Gogeascoechea-Trejo, Patricia Pavón-León, María Cristina Ortiz-León, Monserrat Armenta-Reséndiz and Betzaida Salas-García
Sexes 2026, 7(2), 30; https://doi.org/10.3390/sexes7020030 - 20 Jun 2026
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Drug use, mental health, and gender identity are complex phenomena influenced by multiple social, psychological, and cultural factors. Previous research indicates that the university stage represents a period of vulnerability for mental health, especially among students whose gender identity differs from the traditional
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Drug use, mental health, and gender identity are complex phenomena influenced by multiple social, psychological, and cultural factors. Previous research indicates that the university stage represents a period of vulnerability for mental health, especially among students whose gender identity differs from the traditional categories of man or woman. This study aimed to examine the association between gender identity, drug use, and symptoms of anxiety and depression among students at a public university in Mexico. A cross-sectional correlational study was conducted through a public invitation survey among undergraduate students enrolled in a public university in Mexico. Data were collected using the Drug Use Questionnaire for University Students administered through the LimeSurvey platform. Variables included sociodemographic characteristics, gender identity (man, woman, and other identity), drug use, and symptoms of anxiety and depression. The results indicate that students who identified with another gender identity showed a higher likelihood of using the substances analyzed compared with those who identified as women, particularly prescription drugs and marijuana. Additionally, they presented higher odds of reporting anxiety and depressive symptoms compared with those who identified as men. These findings highlight the need for targeted prevention and support strategies to improve mental health among students with diverse gender identities.
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Open AccessArticle
Psychological Distress and Well-Being in Relation to Sexual Minority Status Among Malaysian Undergraduates: Findings from a Multi-Institutional Survey
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Muhamad Nur Fariduddin, Ching Sin Siau, Norhayati Ibrahim, Bee Suan Wee, Chee Seong Low, Choy Qing Cham, Kai Shuen Pheh, Jocelyn Ker Sin Lee, Latha Ravindran, Meng Chuan Ho, Mimi Fitriana, Pei Boon Ooi, Ponnusamy Subramaniam, Roy Rillera Marzo, Sharifah Munirah Syed Elias, Suzanna Awang Bono, Lei Hum Wee, Hui Zhu Thew, Rosediani Muhamad and Caryn Mei Hsien Chan
Sexes 2026, 7(2), 29; https://doi.org/10.3390/sexes7020029 - 18 Jun 2026
Abstract
Psychological distress is increasing among university students, especially sexual minority individuals in Malaysia, who face stigma and challenges within a sociocultural and dual legal system. This study examined the relationship between sexual minority status and both negative (psychological strain, distress, suicidality) and positive
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Psychological distress is increasing among university students, especially sexual minority individuals in Malaysia, who face stigma and challenges within a sociocultural and dual legal system. This study examined the relationship between sexual minority status and both negative (psychological strain, distress, suicidality) and positive (self-esteem, purpose in life, social support, religiosity) mental health indicators among Malaysian undergraduates. A cross-sectional, multi-institutional survey was conducted utilizing an existing dataset, yielding a final analytical sample of 2244 participants (1870 heterosexual and 374 sexual minority students). Data were analyzed using Welch’s ANOVA and multiple logistic regression, controlling for demographic variables. Heterosexual students reported significantly lower depressive symptoms, anxiety, stress, and suicidality compared to gay, bisexual, and participants with other sexual orientation. In the fully adjusted model, sexual minority identity remained significantly associated with higher deprivation strain (aOR: 1.043), depression (aOR: 1.025), and suicidality (aOR: 1.117). Conversely, identifying as a sexual minority was linked to lower religious commitment (aOR: 0.961) and lower perceived family support (aOR: 0.943). Self-esteem and purpose in life lost statistical significance in the fully adjusted model. Sexual minority undergraduates in Malaysia face heightened psychological distress and suicidality, underscoring the need for comprehensive campus mental health interventions.
Full article
Open AccessReview
The Multifaceted Role of Olfaction in Human Sexuality: A Narrative Review
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Marco Leuzzi, Giuseppe Seminara, Maria Carmela Zagari, Sabrina Bossio and Antonio Aversa
Sexes 2026, 7(2), 28; https://doi.org/10.3390/sexes7020028 - 12 Jun 2026
Abstract
Olfaction plays a fundamental yet often underappreciated role in human sexual behavior, attraction, and relationship dynamics. Beyond the debated existence of human pheromones, emerging evidence supports a broader framework of chemosensory communication influencing emotional, cognitive, and behavioral aspects of sexuality. This review synthesizes
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Olfaction plays a fundamental yet often underappreciated role in human sexual behavior, attraction, and relationship dynamics. Beyond the debated existence of human pheromones, emerging evidence supports a broader framework of chemosensory communication influencing emotional, cognitive, and behavioral aspects of sexuality. This review synthesizes recent literature examining the relationship between olfactory function and human sexual experience in a clinical context. We provide an overview of how olfactory capacities can impact on 3 types of close mating-related aspects: (1) chemosignals and socio-sexual effects, (2) olfactory function and sexual behavior, and (3) olfactory dysfunction and sexual outcomes. Accumulating evidence suggests that olfactory function is associated with sexual satisfaction, partner bonding, and relationship stability. Conversely, olfactory dysfunction, whether congenital or acquired, appears to negatively affect sexual motivation, intimacy, and emotional aspects of sexual experience. Current findings indicate that olfactory processing may represent a clinically relevant, yet often overlooked, component of sexual health. Integrating olfactory assessment into clinical andrological practice may provide additional insight in cases of unexplained sexual dysfunction.
Full article
(This article belongs to the Special Issue 2nd Edition: Exclusive Papers Collection of the Editorial Board of Sexes)
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Open AccessArticle
Disability, Gender, and Inequities in Perceived Quality of Sexuality Education: A Cross-Sectional Population Study
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Elena S. Rotarou, Andrea Yupanqui-Concha and Dikaios Sakellariou
Sexes 2026, 7(2), 27; https://doi.org/10.3390/sexes7020027 - 2 Jun 2026
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Sexuality education is a key component of sexual and reproductive rights; however, important inequities persist across populations, particularly among people with disabilities. This study examines perceived quality of sexuality education in Chile, with a primary focus on disability-related inequities and a specific analytic
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Sexuality education is a key component of sexual and reproductive rights; however, important inequities persist across populations, particularly among people with disabilities. This study examines perceived quality of sexuality education in Chile, with a primary focus on disability-related inequities and a specific analytic emphasis on women with disabilities. We analysed data from the 2022–2023 National Survey on Health, Sexuality, and Gender (n = 17,679). The outcome was self-reported perceived quality of sexuality education. Survey-weighted descriptive analyses and ordinal logistic regressions were conducted. One model included the full sample, and a second focused on women with disabilities (n = 2324). Predicted probabilities were estimated for key interactions. Nearly half of participants reported poor sexuality education (47.2%). Predicted probabilities indicated consistently lower probabilities of reporting good sexuality education among people with disabilities across gender groups and most age groups. Among women with disabilities, higher education (secondary: odds ratio (OR) = 2.53, 95% Confidence Interval (CI): 1.84–3.49; tertiary: OR = 1.74, 95% CI: 1.12–2.72), foreign nationality (OR = 2.87, 95% CI: 1.27–6.50), and good self-rated health (OR = 1.74, 95% CI: 1.14–2.66) were associated with higher perceived quality, indicating heterogeneity within this population. These findings highlight consistent disability-related inequities in the perceived quality of sexuality education and underscore the need for inclusive, accessible, and gender-sensitive approaches grounded in human rights.
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Open AccessArticle
Sexual Touching While Sleeping: Occurrence, Context, Responses, and Perceptions of Sexual Assault Among Undergraduates
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Michelle Drouin and Tara Cornelius
Sexes 2026, 7(2), 26; https://doi.org/10.3390/sexes7020026 - 26 May 2026
Abstract
Sexual consent is central to cases of sexual assault and rape. Logically, sleeping persons cannot consent; yet there has been scant research examining the experience of sexual touching while sleeping. The current research is the first known to specifically examine sexual touching with
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Sexual consent is central to cases of sexual assault and rape. Logically, sleeping persons cannot consent; yet there has been scant research examining the experience of sexual touching while sleeping. The current research is the first known to specifically examine sexual touching with a sleeping partner, with a goal of understanding the contextual features surrounding, responses to, and perceptions of the legality and acceptability of these behaviors. Undergraduate participants from two universities (N = 724) completed several measures assessing their experience of sexual touching while sleeping, the context, sexual precedence, responses, and their perceptions of such touching. A significant proportion reported waking up to someone touching them sexually (n = 233; 32.2%), including genital touching and penetration, and about one in ten (n = 71; 9.8%) reported completely sleeping through a sexual act. Participants had been touched sexually while sleeping by a range of individuals from spouses to strangers, but it was more common among established sexual partners. Perceptions of legality and acceptability of sexual touching while sleeping were influenced by relationship context and sexual precedence. Meanwhile, immediate, longer-term, and affective responses to specific sexual touching while sleeping incidents varied by both relationship type and sexual precedence. This research provides important avenues for education and prevention efforts, particularly in light of the discordance between perceptions of legality and acceptability and current conceptualizations of consent and legal statutes.
Full article
(This article belongs to the Section Sexual Behavior and Attitudes)
Open AccessArticle
Sexual Objectification, Health and Well-Being in Spanish Women
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M. Pilar Matud, Lorena Medina, Carmen Rodríguez-Wangüemert and Ignacio Ibáñez
Sexes 2026, 7(2), 25; https://doi.org/10.3390/sexes7020025 - 18 May 2026
Abstract
Sexual objectification is the treatment of a person as a body or a collection of body parts that are valued primarily for their sexual appeal. The main purpose of this study was to determine the relevance of sexual objectification to women’s health and
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Sexual objectification is the treatment of a person as a body or a collection of body parts that are valued primarily for their sexual appeal. The main purpose of this study was to determine the relevance of sexual objectification to women’s health and well-being across the life cycle, from middle adolescence to old age. Additionally, the relevance of age and education to sexual objectification and its association with traditional gender role attitudes was examined. This study was cross-sectional and the sample consisted of 6112 Spanish women between the ages of 16 and 85, who were assessed using seven questionnaires and scales. The results show that lower age and lower number of children were associated with greater importance of sexual and physical attractiveness and with a more sexualized image, although there were no differences between adolescent and emerging adult women. Greater importance placed on sexual and physical attractiveness, as well as total sexual objectification, was associated with greater mental distress, lower psychological well-being, lower life satisfaction, and lower self-esteem at every life stage. Greater importance placed on sexual and physical attractiveness was associated with more traditional gender role attitudes among all age groups, except for older women. We conclude that sexual objectification is a threat to women’s mental health and well-being.
Full article
(This article belongs to the Special Issue 2nd Edition: Exclusive Papers Collection of the Editorial Board of Sexes)
Open AccessPerspective
Time to Dump the Sex/Gender Dichotomy for Science and Society
by
Anagha Joshi
Sexes 2026, 7(2), 24; https://doi.org/10.3390/sexes7020024 - 12 May 2026
Abstract
Women have been historically underrepresented in every step of scientific enquiry and, therefore, the knowledge of female bodies is lacking. Now the tide is turning to bring focus on the role of sex and gender in human health and disease. The increasing demands
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Women have been historically underrepresented in every step of scientific enquiry and, therefore, the knowledge of female bodies is lacking. Now the tide is turning to bring focus on the role of sex and gender in human health and disease. The increasing demands by publishers, funders, and policymakers to pay attention to both sex and gender are commendable. Nevertheless, the premise of the definitions of sex, framed as biological attributes of an individual, contrasting with gender, which is defined through the sociocultural roles, identities, and power structures, carries all pitfalls of the nature–nurture divide, undermining that they are deeply intertwined and interact continuously across the lifespan, shaping physiology and behavior. Current scientific studies rarely disentangle the two for etiological purposes, for their respective contributions to health outcomes. Despite this, there is a push to use both terms appropriately in research and society. This invariably results in the oversimplification of complex processes of sex/gender intertwining, leading to incomplete or misleading causal inferences. Here, I make a case for retiring the sex/gender etiological split in the scientific and public discourse and embracing sex/gender intertwining, rather than minimizing it. This will then enable researchers to focus on how they interact with other variables to produce phenotypes, bringing scientific clarity.
Full article
(This article belongs to the Special Issue 2nd Edition: Exclusive Papers Collection of the Editorial Board of Sexes)
Open AccessArticle
The Gendered Role of Resilience in First Responders in South Africa
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Anita Padmanabhanunni and Tyrone B. Pretorius
Sexes 2026, 7(2), 23; https://doi.org/10.3390/sexes7020023 - 1 May 2026
Abstract
First responders are routinely exposed to potentially traumatic events and occupational stress, placing them at heightened risk for mental health difficulties. Despite the prominence of psychological resilience in first responder research, insufficient attention has been given to gender differences in how resilience functions
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First responders are routinely exposed to potentially traumatic events and occupational stress, placing them at heightened risk for mental health difficulties. Despite the prominence of psychological resilience in first responder research, insufficient attention has been given to gender differences in how resilience functions within male-dominated occupations. The present study investigated gender differences in the relationships between perceived stress, resilience, and mental health outcomes among South African first responders (n = 429). Participants completed the Perceived Stress Scale-10, the Connor–Davidson Resilience Scale-10, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, and the Posttraumatic Stress Disorder (PTSD) Checklist for DSM-5. Correlational and mediation analyses were conducted. There were no significant gender differences in overall levels of resilience. Perceived stress was associated with depression, anxiety, and PTSD for both genders. Resilience showed significant direct protective effects for men across all mental health outcomes, whereas for women it was significantly associated only with depression and PTSD but not anxiety. Mediation analyses revealed that resilience mediated the relationship between perceived stress and mental health outcomes for men only. These findings suggest that resilience operates through gender-specific pathways. It underscores the importance of conceptualizing resilience as a contextually shaped process rather than solely an individual capacity in first responder populations.
Full article
(This article belongs to the Section Gender Studies)
Open AccessReview
Endocrine Noise: Sex-Specific Disruption of Hypothalamic–Pituitary–Adrenal (HPA) Axis by Endocrine-Disrupting Chemicals
by
Viktoria Xega, Martina Hong Yang and Jun-Li Liu
Sexes 2026, 7(2), 22; https://doi.org/10.3390/sexes7020022 - 23 Apr 2026
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Environmental chemicals are rarely considered stressors in the way that psychological or physical stressors are. Yet many endocrine-disrupting chemicals (EDCs) interact with the body’s core stress response system. This review examines how EDCs alter hypothalamic–pituitary–adrenal (HPA) regulation and how biological sex influences those
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Environmental chemicals are rarely considered stressors in the way that psychological or physical stressors are. Yet many endocrine-disrupting chemicals (EDCs) interact with the body’s core stress response system. This review examines how EDCs alter hypothalamic–pituitary–adrenal (HPA) regulation and how biological sex influences those responses. Drawing on human epidemiological data and experimental models, we describe how EDC exposure affects cortisol dynamics, feedback sensitivity, and adrenal signaling, with a particular focus on sex-dependent outcomes. We propose the concept of endocrine noise to describe how low-dose, often mixed EDC exposures introduce persistent interference into hormone signaling without necessarily causing overt endocrine deficiency or excess. In this framework, EDCs act as chronic, low-grade stressors that reset the timing, feedback precision, and rhythmic organization of the HPA axis rather than as isolated reproductive toxicants. We argue that EDCs should be understood as chronic, context-dependent stress modifiers that reshape sex-specific “risk architectures” for affective, metabolic, and immune disorders. Recognizing sex-specific HPA architecture and endocrine noise has immediate implications for study design and regulation, including the need for sex-stratified analyses, circadian-sensitive sampling of cortisol, and risk assessments that consider how the same exposure can push female and male stress systems in divergent directions.
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Open AccessArticle
Sexual Cognitive Schemas Mediate the Relationship Between Personality and Sexual Function
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Zsuzsanna Kövi, Veronika Mészáros, Zsuzsanna Mirnics, Nahathai Wongpakaran, Tinakon Wongpakaran and Krisztina Hevesi
Sexes 2026, 7(2), 21; https://doi.org/10.3390/sexes7020021 - 22 Apr 2026
Abstract
Sexual cognitive schemas are central cognitive representations of sexual aspects of self that shape the interpretation of sexual experiences and may contribute to individual differences in sexual functioning. The present study aimed to validate the Questionnaire of Cognitive Schema Activation in Sexual Context
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Sexual cognitive schemas are central cognitive representations of sexual aspects of self that shape the interpretation of sexual experiences and may contribute to individual differences in sexual functioning. The present study aimed to validate the Questionnaire of Cognitive Schema Activation in Sexual Context (QCSASC) in a Hungarian sample and to examine whether sexual cognitive schemas mediate the relationship between personality traits and sexual functioning. A total of 256 university students (202 females) completed the QCSASC and the Zuckerman–Kuhlman–Aluja Personality Questionnaire. Moreover, the Female Sexual Function Index was administered. The factor structure was examined using exploratory and confirmatory factor analyses, and associations among personality, schemas, and sexual function were tested using correlational, regression, and mediation analyses. Results supported a five-factor structure of the Hungarian QCSASC, identifying Helplessness, Incompetence, Rejection, Unattractiveness, and Unlovability schemas, all showing good internal consistency. Sexual cognitive schemas were positively related to Neuroticism and negatively to Extraversion. Female sexual function was related to the Incompetence schema. Personality traits showed no direct link with female sexual functioning; however, through the sexual cognitive schema, there was a significant indirect link between personality (Extraversion, Neuroticism) and female sexual functioning. These findings suggest that sexual cognitive schemas can represent a pathway between personality traits and sexual functioning.
Full article
(This article belongs to the Special Issue 2nd Edition: Exclusive Papers Collection of the Editorial Board of Sexes)
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Open AccessArticle
Development and Psychometric Validation of the Attitudes Toward Contraceptive Use Scale (ACUS) in University Students
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María Fernández-Martínez, Sebastián Sanz-Martos, Cristina Fernández-Martínez, Ganna Ovsyeyenko and Carmen Álvarez-Nieto
Sexes 2026, 7(2), 20; https://doi.org/10.3390/sexes7020020 - 14 Apr 2026
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Adolescence and youth are key stages for acquiring responsible sexual behaviour. Previous research has focused on measuring knowledge; however, in order to achieve the goal of developing safe sexual behaviour, it is necessary to complement this with measures of attitudes, for which there
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Adolescence and youth are key stages for acquiring responsible sexual behaviour. Previous research has focused on measuring knowledge; however, in order to achieve the goal of developing safe sexual behaviour, it is necessary to complement this with measures of attitudes, for which there is currently a lack of valid and reliable measurement tools specifically focused on attitudes toward contraceptive use. The objective of this research is to develop and psychometrically validate the Attitudes Toward Contraceptive Use Scale (ACUS) in university students. A cross-sectional correlational validation study was designed using Item Response Theory. The sample consisted of 411 nursing students aged between 18 and 25 years. The final version of the scale, comprising 12 items, was evaluated using the Rasch Rating Scale Model (Andrich model), and its reliability was assessed in terms of internal consistency and temporal stability. The Rasch model showed an excellent overall fit, high item reliability (0.989), adequate person reliability (0.81), and good temporal stability (ICC = 0.796). The ACUS is a valid and reliable instrument for assessing attitudes toward contraception among university students. It can be used to identify less favourable attitudinal profiles toward contraceptive use and subsequently guide educational interventions.
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Open AccessReview
New Directions for Sexual Consent in a Digitized World: A Narrative Review
by
Rebecca Fisico, Margaret C. McKinnon and Heather Moulden
Sexes 2026, 7(2), 19; https://doi.org/10.3390/sexes7020019 - 31 Mar 2026
Abstract
Sexual interactions are complex human exchanges that are further complicated in the digital domain. This is because the introduction of technology to sexual interactions has prompted change in not only sexual activity but also communication pertaining to consent. Challenges have emerged in defining,
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Sexual interactions are complex human exchanges that are further complicated in the digital domain. This is because the introduction of technology to sexual interactions has prompted change in not only sexual activity but also communication pertaining to consent. Challenges have emerged in defining, interpreting, and communicating sexual consent within a digital context. Accordingly, it is critical to understand how sexual consent is understood and communicated within digital contexts. Herein, the literature concerning digital sexual consent was reviewed and critically analyzed. This narrative review describes digital sexual consent practices, as well as critically analyzes the literature pertaining to sexual consent to identify similarities and differences between in-person and digital consent practices. It is suggested that digital sexual consent should be viewed as a subset of sexual consent rather than a separate sexual consent practice. Future directions pertaining to research and application are discussed.
Full article
(This article belongs to the Section Sexual Behavior and Attitudes)
Open AccessArticle
Self-Reported Aspects of Vulvodynia Assessed Through the Administration of an Online Questionnaire
by
Cristina Rizzo, Antonella Verrone, Sofia Galeazzi, Lidia Morgante and Giuseppe Morgante
Sexes 2026, 7(2), 18; https://doi.org/10.3390/sexes7020018 - 30 Mar 2026
Abstract
Vulvodynia is a chronic gynecological condition characterized by unexplained vulvar pain, which may significantly impact every aspect of women’s quality of life, encompassing physical, psychological, and social well-being. Due to its heterogeneous clinical presentation and associated comorbidities, vulvodynia is often misdiagnosed and/or not
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Vulvodynia is a chronic gynecological condition characterized by unexplained vulvar pain, which may significantly impact every aspect of women’s quality of life, encompassing physical, psychological, and social well-being. Due to its heterogeneous clinical presentation and associated comorbidities, vulvodynia is often misdiagnosed and/or not adequately treated. This descriptive observational study was conducted using an anonymous questionnaire, which was distributed through social media channels and included 29 questions (25 multiple-choice and four open-ended questions) and aimed to investigate participants’ most frequent symptoms, comorbidities, impact on quality of life, and treatment efficacy and costs. Analyzing a total of 221 answers, we found that burning (85%) and abrasion/irritation sensation (73%) are the most common symptoms, and they are most frequently localized in the vestibular area, while irritable bowel syndrome (35%) is the most common comorbidity. A significant negative effect on individual functioning was confirmed, also due to a noticeable diagnostic delay (4.5 years on average) and treatments’ prohibitive costs potentially impairing participants’ compliance. Our study provides valuable insights into self-reported aspects of women affected by vulvodynia, raising healthcare professionals’ awareness of this issue. Better knowledge of peculiar aspects of vulvodynia may help improve its diagnosis and promote a more personalized and efficient therapeutic approach.
Full article
(This article belongs to the Special Issue 2nd Edition: Exclusive Papers Collection of the Editorial Board of Sexes)
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Open AccessArticle
Let’s Write About It: Rethinking Sexual Consent Through Therapeutic Writing with Women in Chile
by
Anita Tobar-Henríquez, Bárbara Berger-Correa, Sofía Monsalves and Ernesto Guerra
Sexes 2026, 7(2), 17; https://doi.org/10.3390/sexes7020017 - 26 Mar 2026
Abstract
As high rates of sexual violence worldwide have increasingly been met with educational initiatives promoting sexual consent as a core preventive strategy, it becomes crucial to understand how consent is actually conceptualized in specific sociocultural contexts. This study examines how a group of
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As high rates of sexual violence worldwide have increasingly been met with educational initiatives promoting sexual consent as a core preventive strategy, it becomes crucial to understand how consent is actually conceptualized in specific sociocultural contexts. This study examines how a group of adult women in Chile conceptualize sexual consent and how their understandings align with, expand or diverge from the definition promoted by the World Association for Sexual Health (WAS), a widely adopted international framework. Using a therapeutic writing methodology designed to support emotional safety and reflective depth, 34 women completed a collective writing workshop. For this paper, the main writing exercise was analyzed through thematic analysis. Results show three overarching themes: sexual consent as a self-directed and desire-aligned experience; the intricacies of giving in to sexual encounters as shaped by social expectations, emotional pressures, and relational considerations; and the tensions when differentiating consent from giving in, a distinction experienced as meaningful yet fluid and learned over time. Together, these findings reveal that our participants’ conceptualizations of sexual consent extend beyond normative international models, highlighting the need for attuned consent frameworks and educational approaches designed to prevent sexual violence.
Full article
(This article belongs to the Section Sexual Behavior and Attitudes)
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Open AccessArticle
Blurred Lines: Exploring Bisexual Identity in the Face of Invalidation in a Spanish-Speaking Sample
by
Alejandro Kepp Termini and Marta Evelia Aparicio-García
Sexes 2026, 7(2), 16; https://doi.org/10.3390/sexes7020016 - 26 Mar 2026
Abstract
(1) Background: This article explores the qualitative dimensions of bisexual identity through the lived experiences of bisexual individuals. (2) Methods: Drawing on an online questionnaire completed by 226 participants from a Spanish-speaking sample, the study uses a grounded theory-based analysis of participant narratives.
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(1) Background: This article explores the qualitative dimensions of bisexual identity through the lived experiences of bisexual individuals. (2) Methods: Drawing on an online questionnaire completed by 226 participants from a Spanish-speaking sample, the study uses a grounded theory-based analysis of participant narratives. (3) Results: The analysis identifies key components of bisexual identity, such as self-recognition, fluidity, and community belonging, as well as recurrent experiences of invalidation, promiscuity stereotypes, and intracommunity discrimination. The findings highlight the processes by which participants navigate and define their bisexuality, emphasizing the interaction between personal introspection, contact with audiovisual media, societal perceptions, and external validation in identity formation. (4) Conclusions: These results provide a nuanced exploration of how bisexual identities are constructed amid persistent challenges of invalidation, erasure, and limited community recognition.
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(This article belongs to the Section Sexual Diversity: Orientation, Gender, Identity, and Attraction)
Open AccessArticle
A Reversed Orgasm Gap? Gender Differences in Orgasm Frequency During Heterosexual Partner Sex
by
Piet Van Tuijl
Sexes 2026, 7(1), 15; https://doi.org/10.3390/sexes7010015 - 17 Mar 2026
Abstract
Large-scale surveys consistently show there is an orgasm gap in heterosexual partner sex of 20% to 36%—with more women not experiencing orgasm during heterosexual partner sex than men. In two Dutch/Flemish general population convenience samples (N = 1028; 756 women (73.5%), 271 men
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Large-scale surveys consistently show there is an orgasm gap in heterosexual partner sex of 20% to 36%—with more women not experiencing orgasm during heterosexual partner sex than men. In two Dutch/Flemish general population convenience samples (N = 1028; 756 women (73.5%), 271 men (26.4%), 1 non-binary (0.1%); Mage = 34.8 years; SDage = 12.7 years) of exclusively and almost exclusively heterosexual respondents, 140 women (20.4%) and 3 men (1.2%) who had sex in the last six months did not regularly experience orgasm during partner sex—representing an orgasm gap of 19.2% (p < 0.001). Women who did regularly experience orgasm during partner sex did more often than men experience orgasm more than once (24.2% of women versus 11.2% of men, a 13% difference; p < 0.001). MANOVA followed by post hoc ANOVAs were used to investigate group differences. Women who did not experience orgasm showed higher levels of sexual distress and sexual inhibition, and lower levels of sexual satisfaction and self-esteem than women who did experience orgasm. Also, higher levels of depressive symptoms and social anxiety were reported by the women not experiencing orgasm during partner sex. The strongest predictor of the number of orgasms during one sex session was the number of orgasms the partner presumably experienced. The current study confirmed the existence of a heterosexual gap, whilst results of this large-scale study also suggest a “reversed” orgasm gap: more women than men experience orgasm more than once during a heterosexual partner sex session.
Full article
(This article belongs to the Section Sexual and Reproductive Health, Sexual Medicine, and Psychosocial Remediation)
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Open AccessArticle
Swiping for Support: The Role of Social Networking Applications in Sexual Health Outreach Among Queer and Trans Communities
by
Taylor Smith, Adam Davies, Justin Brass and Shoshanah Jacobs
Sexes 2026, 7(1), 14; https://doi.org/10.3390/sexes7010014 - 12 Mar 2026
Abstract
This study integrates recent literature with qualitative data from sexual-health outreach workers in the Greater Toronto Area to examine how outreach is delivered to gay, bisexual, transgender, and queer (GBTQ+) men who have sex with men (MSM) in virtual social settings, including social
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This study integrates recent literature with qualitative data from sexual-health outreach workers in the Greater Toronto Area to examine how outreach is delivered to gay, bisexual, transgender, and queer (GBTQ+) men who have sex with men (MSM) in virtual social settings, including social networking applications. Using a symbolic-interactionist framework and reflexive thematic analysis, the study identifies persistent challenges that shape GBTQ+ and MSM users’ engagement with sexual-health services, such as stigma, privacy concerns, and platform-level constraints. Findings highlight mismatches between current outreach practices and community needs in app-based environments and point to opportunities to strengthen the relevance, accessibility, and trustworthiness of digital sexual-health initiatives. The analysis offers practical recommendations for improving service design and delivery in online queer spaces and outlines priorities for future research focused on outreach effectiveness, equity, and user safety.
Full article
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