Sexes

17 pages, 388 KB

Open AccessArticle

Freedom Regarding Sexual and Reproductive Health and Rights for Adolescents and Young Adults of Haut-Sassandra, Côte d’Ivoire: A Study of Stakeholder Opinion

by Titilayo Tatiana Agbadje, Marlyse Mbakop Nguebou, Loukou Gilbert Konan, Mariame Koné, Abdoulaye Anne, Jean Ramdé, Souleymane Diabaté and Maman Joyce Dogba

Sexes 2025, 6(4), 61; https://doi.org/10.3390/sexes6040061 - 2 Nov 2025

Abstract

In recent years, the sexual and reproductive health of adolescents and young adults (ages 10–24) in Africa has improved through national and international initiatives. However, major challenges remain in enabling young people to exercise their sexual and reproductive health rights (SRHRs), especially in [...] Read more.

In recent years, the sexual and reproductive health of adolescents and young adults (ages 10–24) in Africa has improved through national and international initiatives. However, major challenges remain in enabling young people to exercise their sexual and reproductive health rights (SRHRs), especially in Côte d’Ivoire. This study aimed to explore the perspectives of stakeholders on the freedom of choice of adolescents and young adults with regard to SRHRs in Haut-Sassandra, Côte d’Ivoire. We conducted this qualitative descriptive study between September and October 2023. Participants were selected using a purposive sampling method. Overall, 137 stakeholders participated in the study: 57 teachers and administrators, 17 community leaders, and 63 parents. Data were collected through interviews and focus groups, using an interview guide. Through a deductive thematic approach, we identified three forms of freedom of choice: conditional, absent, and absolute. The average age of the study participants was 46.1 years. The findings reveal that several factors influence the freedom of choice among adolescents and young adults regarding their SRHRs. These include age, gender, parental involvement, prior education, autonomy, and perceived maturity. Limited freedom was commonly associated with younger age (10–18 years), perceived immaturity, and a lack of autonomy. In contrast, greater freedom was linked to older age (18–24 years) and higher levels of perceived maturity. Stakeholders’ perspectives were shaped by cultural and religious norms, a protective attitude toward youth, and a sense of disengagement from adolescent concerns. This study underscores the importance of interventions aimed at increasing stakeholders’ knowledge and awareness of adolescents’ sexual and reproductive rights. Full article

(This article belongs to the Section Sexual and Reproductive Health, Sexual Medicine, and Psychosocial Remediation)

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27 pages, 778 KB

Open AccessReview

New Horizons in Male Contraception: Clinical, Cultural and Technological Innovation Aspects

by Lucca Moisés Santiago Silva, Ryan Lago Araujo Rieper, Vanessa Castro Felix Lima, Diana Marcela Aragón Novoa, Igor Brasil de Araújo, Izabel Almeida Alves and Aníbal de Freitas Santos Júnior

Sexes 2025, 6(4), 60; https://doi.org/10.3390/sexes6040060 - 28 Oct 2025

Abstract

Background/Objectives: The main contraceptive options for men are condoms, vasectomy and coitus interruptus. Clinical and preclinical trials are being conducted to develop a new male contraceptive (NMC), which can be either hormonal or non-hormonal. A patent landscape and literature review of clinical studies [...] Read more.

Background/Objectives: The main contraceptive options for men are condoms, vasectomy and coitus interruptus. Clinical and preclinical trials are being conducted to develop a new male contraceptive (NMC), which can be either hormonal or non-hormonal. A patent landscape and literature review of clinical studies from the last 10 years were carried out to discuss clinical perspectives and sociocultural aspects related to the use of NMC. Methods: An integrative review of clinical aspects was conducted using eleven clinical trials, and a discussion of sociocultural aspects was conducted using thirteen articles. Results: Studies of non-hormonal contraceptives, particularly vaso-occlusive methods, are in more advanced clinical phases, demonstrating contraceptive potential and reversibility. In addition to clinical trials, efforts to develop NMC include addressing gender disparities and understanding masculinity. Alternative technologies and methods for contraception were identified as key to the development of NMC. Despite clinical and technological advances, there is a need to expand clinical studies on male contraceptives, involving larger samples, long-term follow-ups, and reversibility tests. There is a global social need that both men and women should have a wide variety of contraceptive options. Conclusions: This review emphasizes the importance of exploring new technologies for male contraceptives to expand options while optimizing the satisfaction and safety of these contraceptive options for the population. Full article

(This article belongs to the Section Sexual and Reproductive Health)

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18 pages, 282 KB

Open AccessArticle

Beliefs, Attitudes and Behaviors Related to Sexual Consent in Complex Sexual Scenarios

by Anais Sánchez Arévalo, María Polo, Alba Rincón, Claudia Bravo and Nieves Moyano

Sexes 2025, 6(4), 59; https://doi.org/10.3390/sexes6040059 - 23 Oct 2025

Abstract

Sexual consent, although more extensively studied in recent decades, remains a complex and nuanced concept that is often difficult to define and investigate. This study aimed to analyze the relationships between beliefs, attitudes, and behaviors related to sexual consent, and the ability to [...] Read more.

Sexual consent, although more extensively studied in recent decades, remains a complex and nuanced concept that is often difficult to define and investigate. This study aimed to analyze the relationships between beliefs, attitudes, and behaviors related to sexual consent, and the ability to interpret complex sexual scenarios with varying characteristics. A voluntary sample of 738 individuals over 18 years of age was recruited, mainly through social networks. Data analysis was conducted using descriptive statistics and mean comparison tests. Participants with higher scores for continuous consent, communicative sexuality, and positive attitudes toward consent, as well as lower scores for subtle coercion and (lack of) perceived control, showed more accurate interpretations of sexual assault situations. These findings may contribute to the development and implementation of programs aimed at reducing the use of coercive and violent strategies in sexual relationships. Full article

(This article belongs to the Section Sexual Behavior and Attitudes)

18 pages, 632 KB

Open AccessArticle

Promoting Sexual and Reproductive Health in Young People: A Systematic Review of Reviews

by Sonia Barriuso-Ortega

Sexes 2025, 6(4), 58; https://doi.org/10.3390/sexes6040058 - 17 Oct 2025

Abstract

Background: Sexual and reproductive health promotion is a political and social process that involves not only individual actions but also strategies to change social, environmental and economic factors. It is necessary to know the characteristics of effective interventions in order to design new [...] Read more.

Background: Sexual and reproductive health promotion is a political and social process that involves not only individual actions but also strategies to change social, environmental and economic factors. It is necessary to know the characteristics of effective interventions in order to design new evidence-based programmes. However, programmes need to follow a holistic approach, hence the importance of Comprehensive Sexuality Education. Methods: An extensive bibliographic search was carried out. Twenty systematic reviews between 2015 and 2025 were selected following PRISMA 2020. Results: This review shows that interventions to promote SRH are effective and have significant results in increasing SRH knowledge, attitudes and skills, the competencies of professionals and improving access to SRH services. It has been possible to extract that it is necessary to promote SRH with the inclusion of young people, the adaptation of interventions according to the needs of each person, the coordination between different areas, the application of the intersectional and gender perspective, the application of a rights-based approach, the use of comprehensive and inclusive education models, the training of professionals and the carrying out of evaluations to disseminate the results. Furthermore, there are shortcomings in the evidence, such as the lack of an intersectional perspective, the lack of inclusion of certain groups and the lack of rigorous evaluations following quality standards. Conclusion: Programmes based on Comprehensive Sexuality Education are effective and have certain common characteristics. Full article

(This article belongs to the Section Sexual and Reproductive Health, Sexual Medicine, and Psychosocial Remediation)

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15 pages, 851 KB

Open AccessArticle

Psychological and Physical Correlates After Gender-Affirming Mastectomy: Insights from a Case Report and Review of the Literature

by Giuseppe Seminara, Marco Alessi, Maria Carmela Zagari, Francesca Greco, Antonino Raffa, Marco Leuzzi, Ettore D’Aleo, Lorenzo Campedelli, Mara Lastretti, Emanuela A. Greco, Cristina Segura-Garcia, Antonio Aversa and Cristiano Monarca

Sexes 2025, 6(4), 57; https://doi.org/10.3390/sexes6040057 - 16 Oct 2025

Abstract

Gender dysphoria stems from incongruence between gender identity and assigned sex, often causing significant distress related to breast anatomy in transmasculine individuals. Gender-affirming hormone therapy typically precedes mastectomy, which is a fundamental intervention in transgender healthcare. Surgical challenges arise in patients with large [...] Read more.

Gender dysphoria stems from incongruence between gender identity and assigned sex, often causing significant distress related to breast anatomy in transmasculine individuals. Gender-affirming hormone therapy typically precedes mastectomy, which is a fundamental intervention in transgender healthcare. Surgical challenges arise in patients with large breasts on lean frames, requiring customized techniques to achieve a natural, proportional, androgynous chest. This case report describes a 23-year-old transmasculine patient with macromastia and a tall, lean build who underwent gender-affirming mastectomy with free nipple grafts and muscular sculpture aimed at an androgynous esthetic. Pre- and postoperative evaluations showed marked improvements in body image, physical strength performance, and emotional well-being. Psychological assessments revealed significant reductions in body uneasiness and gender dysphoria, while human figure drawings demonstrated increasing bodily integration and identity congruence. A general improvement in physical performance over time was reported, particularly in upper body strength, with minor fluctuations potentially related to the surgical intervention and recovery phase. The narrative literature review supports these outcomes, highlighting satisfaction rates above 90%, minimal regret, and consistent gains in psychosocial functioning and sexual and mental health, including reduced anxiety and depression. This evidence reinforces that gender-affirming mastectomy is medically necessary, particularly when tailored to individual anatomical and esthetic needs, affirming identity and alleviating distress. Full article

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22 pages, 544 KB

Open AccessArticle

Determinants of HIV Testing Among Men Who Have Sex with Men in Ghana: Insights from the Ghana Men’s Study II

by Kofi Atakorah-Yeboah Junior, Edith Phalane, Thomas Agyarko-Poku, Kyeremeh Atuahene, Yegnanew Alem Shiferaw and Refilwe Nancy Phaswana-Mafuya

Sexes 2025, 6(4), 56; https://doi.org/10.3390/sexes6040056 - 15 Oct 2025

Abstract

Despite notable progress in HIV prevention and treatment, men who have sex with men (MSM) continue to bear a disproportionate burden of HIV, particularly in sub-Saharan Africa, where systemic barriers restrict access to HIV testing. This study draws on data from the 2017 [...] Read more.

Despite notable progress in HIV prevention and treatment, men who have sex with men (MSM) continue to bear a disproportionate burden of HIV, particularly in sub-Saharan Africa, where systemic barriers restrict access to HIV testing. This study draws on data from the 2017 Ghana Men’s Study II (GMS II), to examine the socio-demographic, behavioural, and structural factors influencing HIV testing among MSM. The Ghana Men’s Study II dataset, involving 4095 MSM, was de-identified and analysed using STATA (software version 17). Before the analysis, missing information for categorical variables were treated using the mode imputation technique. Chi-square test was done to describe relevant characteristics of the study population, such as socio-demographic/socio-economic variables and behavioural practices. Multivariable logistic regression analysis was performed for variables with p < 0.05 to determine significant predictors of HIV testing among MSM. All the statistical analyses were performed at a 95% confidence interval, with significant differences at p < 0.05. In multivariable logistic regression analysis, age 25–34 (AOR: 1.43; 95% CI: 1.18–1.74, p < 0.001), having a senior high school education (AOR: 1.69; 95% CI: 1.02–2.80, p = 0.040), tertiary education (AOR: 2.03; 95% CI: 1.17–3.55, p = 0.012), being a light drinker of alcohol (AOR: 1.28; 95% CI: 1.04–1.58, p = 0.020), and having a comprehensive knowledge of HIV (AOR: 1.50; 95% CI: 1.26–1.78, p < 0.001) had higher odds for HIV testing. Other factors such as being a Muslim (AOR: 0.69; 95% CI: 0.54–0.90, p = 0.005) and sold sex to other males (AOR: 0.67; 95% CI: 0.50–0.90, p = 0.007) were also positively associated with HIV testing among Ghanaian MSM. The findings revealed a number of socio-demographic and behavioural factors associated with HIV testing among the MSM population in Ghana. Full article

(This article belongs to the Section Sexually Transmitted Infections/Diseases)

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17 pages, 788 KB

Open AccessArticle

Stakeholder Perceptions of Direct Conferencing as an Approach to Repairing Harm in Campus Sexual Misconduct Cases

by Tyler N. Livingston

Sexes 2025, 6(4), 55; https://doi.org/10.3390/sexes6040055 - 14 Oct 2025

Abstract

The present research assessed university student stakeholders’ perceptions of positive outcomes (i.e., appropriateness and benefits of conferencing) and negative outcomes (i.e., endangerment and revictimization of the complainant) associated with restorative justice-based direct conferencing in sexual misconduct cases. Stakeholders received random assignment to a [...] Read more.

The present research assessed university student stakeholders’ perceptions of positive outcomes (i.e., appropriateness and benefits of conferencing) and negative outcomes (i.e., endangerment and revictimization of the complainant) associated with restorative justice-based direct conferencing in sexual misconduct cases. Stakeholders received random assignment to a 2 (allegation severity: more vs. less) × 2 (evidence strength: lower vs. higher) between-participant experimental design. More severe allegations and higher evidence strength were associated with lower ratings of appropriateness; allegation severity and evidence strength interacted to affect ratings of benefits; and more severe allegations, but not stronger evidence, were associated with higher ratings of endangerment and revictimization. Belief in the alleged perpetrator’s guilt explained the relationship between evidence strength and ratings of appropriateness, and desire to punish the alleged perpetrator explained the relationship between allegation severity and ratings of appropriateness. Researchers and Title IX coordinators should evaluate and respond to stakeholder sentiment toward direct conferencing. Full article

(This article belongs to the Section Sexual Behavior and Attitudes)

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16 pages, 237 KB

Open AccessReview

Norms of Masculinities and Gender Socialization Among Young Boys in South Africa: Implications for Gender-Based Violence, Policies, and Interventions

by Judith I. Ani and Lucky Norah Katende-Kyenda

Sexes 2025, 6(4), 54; https://doi.org/10.3390/sexes6040054 - 2 Oct 2025

Abstract

Masculinity norms and gender socialization play a critical role in shaping boys’ attitudes, behaviours, and interactions within society. In South Africa, historical legacies of colonialism and apartheid, coupled with deeply ingrained cultural and societal expectations, have contributed to rigid masculinity norms that emphasize [...] Read more.

Masculinity norms and gender socialization play a critical role in shaping boys’ attitudes, behaviours, and interactions within society. In South Africa, historical legacies of colonialism and apartheid, coupled with deeply ingrained cultural and societal expectations, have contributed to rigid masculinity norms that emphasize dominance, emotional restraint, and aggression. These constructs not only influence boys’ development but also have significant implications for gender-based violence (GBV). This paper explores how norms of masculinity and processes of gender socialization among boys in South Africa shape attitudes and behaviours that contribute to gender-based violence (GBV). The central aim is to offer a critical theoretical synthesis and contextual analysis that informs the development of gender-equitable policies and interventions. Drawing on theoretical frameworks such as hegemonic masculinities, intersectionality, and social learning theory, this study examines how historical, cultural, and socio-economic factors shape gender socialization and influence boys’ developmental trajectories. Through an intersectional lens, this paper underscores the urgent need to challenge harmful masculinity norms and promote alternative models that encourage emotional expression, empathy, and equitable gender relations. Finally, it provides recommendations on how these harmful norms can be disrupted through educational, community, media, and policy-level reforms to foster healthier masculinity norms and reduce GBV in South Africa. Full article

28 pages, 551 KB

Open AccessArticle

Gender Identity Health Within a Sample of Transmasculine Youth

by B. J. Rye and Aliyah S. d’Gama Rose

Sexes 2025, 6(4), 53; https://doi.org/10.3390/sexes6040053 - 26 Sep 2025

Abstract

Personal identity is a multidimensional, universal, and ever-developing construct that forms primarily during youth. One domain of identity—gender—manifests quite clearly in terms of developmental course and psychosocial components in the lives of transgender individuals. Members of this population often initiate various social and [...] Read more.

Personal identity is a multidimensional, universal, and ever-developing construct that forms primarily during youth. One domain of identity—gender—manifests quite clearly in terms of developmental course and psychosocial components in the lives of transgender individuals. Members of this population often initiate various social and medical transitions to rework their gendered characteristics to align more authentically with their internal selves. Consequently, healthcare and social service professionals express growing interest in facilitating and fostering the psychological health of transgender youth. Rather than focus on adversity (e.g., depression, suicidality, mental illness), the current study addresses this concern by describing positive components of the gender identity of 120 transmasculine youth participants. To this end, we operationalized gender identity health through three overarching constructs: developmental process, psychological functioning, and the positive outcomes of being a transgender person. Further, we investigate how these components interrelate, plus compare responses by age and gender identity cohorts. For age, we compared adolescent responses to the identity measures to those of transgender emerging adults (n = 166; 20–29 years) and adults (n = 53; 30–39 years). For gender, we partitioned the adolescent participants into binary (n = 91) versus non-binary (n = 29) identities. The descriptive results demonstrated that identity is reasonably developed, functional, and positive in this adolescent sample. Moreover, the three hypothetical components of transgender identity demonstrated modest overlap with each other. The youth did not differ in identity development, functionality, or positivity compared to older cohorts. Binary transmen scored slightly higher on gender authenticity and commitment than their non-binary transmasculine counterparts, but the two gender groups were the same on the other identity components. We discuss some practical implications of these findings as focus areas for healthcare providers and support systems to continue to foster healthy identity development. Full article

(This article belongs to the Section Sexual Diversity: Orientation, Gender, Identity, and Attraction)

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14 pages, 480 KB

Open AccessReview

Sex and Relationship Education for Individuals with Disabilities: A Review of the Literature Through an Ecological Systems Lens

by Gustav Oppermann, Caroline Van Zant, Isabel Coughlan, Sophie Howarth, Nicole Sparapani and Kathryn Pedgrift

Sexes 2025, 6(3), 52; https://doi.org/10.3390/sexes6030052 - 17 Sep 2025

Abstract

Despite advances toward disability inclusion, high-quality sex and relationship education (SRE) is often inaccessible for disabled communities. Confounding this issue, each individual’s experience of SRE is shaped by aspects within their environment, such as societal contexts, cultural factors, policy frameworks at the national [...] Read more.

Despite advances toward disability inclusion, high-quality sex and relationship education (SRE) is often inaccessible for disabled communities. Confounding this issue, each individual’s experience of SRE is shaped by aspects within their environment, such as societal contexts, cultural factors, policy frameworks at the national and local levels, and the attitudes of parents and educators. This informal review of the literature synthesizes historical and contemporary literature—focusing primarily on individuals with intellectual disabilities and autism—to explore the multifaceted barriers and opportunities for effective SRE. We have situated the literature within Bronfenbrenner’s ecological systems theory to illuminate how interactions among and within the environment shape individual experiences with SRE. The literature outlines several barriers to successful SRE programs for the disabled community, including pervasive misconceptions about the sexual and relational needs of disabled individuals, inadequate training for educators, and limited empirical evidence underpinning best practices. Our paper underscores the need for comprehensive, evidence-based curricula that align with the desires of the disabled community, are accessible to people with disabilities and their communities, and employ a variety of instructional methods to support learning across the life course, beginning in adolescence. We conclude by outlining future directions for research and practical solutions for curriculum development, emphasizing the importance of addressing these multi-layered challenges to enhance SRE for disabled people and their communities. Approaching and conceptualizing the literature within a systems framework and through our shared perspectives and experiences is noteworthy, as our review provides a descriptive and unique lens to understanding SRE influences on people with disabilities nationally and internationally. Full article

(This article belongs to the Special Issue Addressing Health Disparities in Sexual and Gender Minority Populations: A Call for Inclusive and Trauma Informed Care Approaches)

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16 pages, 273 KB

Open AccessArticle

Examining the Most Insidious Stressor: Systemic Protective Factors and Mental Health Outcomes for Latina/e/x Sexually Expansive Women

by Dumayi Gutierrez

Sexes 2025, 6(3), 51; https://doi.org/10.3390/sexes6030051 - 10 Sep 2025

Abstract

Background: Sexually expansive (sexual identities beyond traditional monosexual categories) Latina/e/x women navigate intersecting systems of oppression shaped by cultural expectations, gender norms, and heterosexism. Despite their resilience, they remain underrepresented in minority stress research. This study examines how individual (sexual and ethnic identity [...] Read more.

Background: Sexually expansive (sexual identities beyond traditional monosexual categories) Latina/e/x women navigate intersecting systems of oppression shaped by cultural expectations, gender norms, and heterosexism. Despite their resilience, they remain underrepresented in minority stress research. This study examines how individual (sexual and ethnic identity centrality), relational (social support from family, partners, and friends), and communal (community connectedness) protective factors relate to internalized heterosexism and improved or diminished mental health factors (life satisfaction and psychological distress). Methods: Grounded in an intersectional ecological systems and minority stress framework, this study uses secondary data from the Generations Study, a national longitudinal investigation of sexually expansive adults in the U.S. from 2016 to 2019. A subsample of sexually expansive Latina/e/x women (n = 120) was analyzed using one-way ANOVA, multiple regression, and moderation analyses. Results: Sexual and ethnic identity centrality was independently associated with lower internalized heterosexism. Family, friend, and significant other social support were significantly associated with improved and diminished mental health factors, as was community connectedness with sexual identity centrality. ANOVAs and moderation results were non-significant. Conclusions: These findings highlight the protective impact of identity affirmation and social support on mental health, offering valuable insights for clinicians, researchers, and community leaders supporting a strong yet underrepresented group. Full article

(This article belongs to the Special Issue Addressing Health Disparities in Sexual and Gender Minority Populations: A Call for Inclusive and Trauma Informed Care Approaches)

12 pages, 443 KB

Open AccessReview

Healthcare Access for Transgender Women in Malaysia: A Narrative Review of Barriers and Enabling Factors

by Lahari A. Telang, Aoife G. Cotter and Abdul Rashid

Sexes 2025, 6(3), 50; https://doi.org/10.3390/sexes6030050 - 5 Sep 2025

Abstract

Malaysia is an upper-middle-income country and one of the few in Asia that has achieved Universal Health Coverage (UHC). Despite this, healthcare in Malaysia is less accessible to marginalized groups, such as transgender women, because a legal framework denies them gender-appropriate identification. Healthcare [...] Read more.

Malaysia is an upper-middle-income country and one of the few in Asia that has achieved Universal Health Coverage (UHC). Despite this, healthcare in Malaysia is less accessible to marginalized groups, such as transgender women, because a legal framework denies them gender-appropriate identification. Healthcare settings often fall short in addressing transgender-specific health needs. Transgender women face compounded stigma and discrimination, along with unique social and interpersonal challenges that greatly increase their risk of poor overall health. This narrative review explores the barriers to accessing and using primary, sexual, oral, and mental healthcare for transgender women in Malaysia. The discussion covers enabling factors like training healthcare workers, prioritizing transgender health needs, working with community-led organizations, implementing health policy reforms, and utilizing technology-based health interventions. Full article

(This article belongs to the Section Sexual and Reproductive Health, Sexual Medicine, and Psychosocial Remediation)

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18 pages, 277 KB

Open AccessArticle

Differences Between Users and Non-Users of Dating Apps in Adulthood: Psychological and Social Implications

by Adriana Jiménez-Muro, Pedro J. Ramos-Villagrasa and Ángel Castro

Sexes 2025, 6(3), 49; https://doi.org/10.3390/sexes6030049 - 3 Sep 2025

Abstract

Since the popularization of dating apps, the scientific literature developed in the last decade still has various limitations that concern both the populations studied and the variables evaluated. Therefore, this study aimed to analyze the use of dating apps among adults (25–50 years) [...] Read more.

Since the popularization of dating apps, the scientific literature developed in the last decade still has various limitations that concern both the populations studied and the variables evaluated. Therefore, this study aimed to analyze the use of dating apps among adults (25–50 years) and the relationship between the use of these apps and mental, physical and sexual health and substance use. A total of 1004 adults of both sexes (M = 36.61, SD = 7.16; 50.7% women, 49.3% men) participated in the study, filling out a battery of online questionnaires. A 40% prevalence of dating apps use was found. Men, non-heterosexuals, and single people showed higher use of these apps. No relationship was found between the use of dating apps and mental health (self-esteem, anxiety, depression). On the other hand, a direct association was found between being a dating app user and the consumption of substances (tobacco, alcohol, marijuana, cocaine, mental health medication), concern about physical appearance, and the practice of physical exercise. In addition, app users showed better sexual functioning than non-users. The main finding of the study is that there are no differences in mental health (self-esteem, anxiety, depression) between adult users and non-users of dating apps. The results obtained have significant implications both a psychological and social viewpoint. Therefore, they must be considered when implementing prevention and promotion programs for sexual health. Full article

19 pages, 618 KB

Open AccessArticle

After the Act: After-Sex Behaviors and Their Correlates in Straight Chinese Couples

by Sijia Huang, Julie Yang and Pekka Santtila

Sexes 2025, 6(3), 48; https://doi.org/10.3390/sexes6030048 - 31 Aug 2025

Abstract

We examined after-sex behaviors and their associations with relationship satisfaction, sexual satisfaction, intimacy, and sexual dysfunction in heterosexual Chinese couples. Forty-two couples participated in a randomized controlled trial of an online Sensate Focus intervention. They completed survey questions before and after the intervention, [...] Read more.

We examined after-sex behaviors and their associations with relationship satisfaction, sexual satisfaction, intimacy, and sexual dysfunction in heterosexual Chinese couples. Forty-two couples participated in a randomized controlled trial of an online Sensate Focus intervention. They completed survey questions before and after the intervention, reporting on after-sex behaviors, relationship satisfaction, sexual satisfaction, intimacy levels, and sexual dysfunction. The findings revealed that negative after-sex behaviors were associated with decreased relationship satisfaction and sexual satisfaction, particularly for women. Negative after-sex behaviors were also correlated with lower levels of intimacy for both genders studied. Additionally, women who engaged in positive after-sex behaviors reported significantly higher levels of sexual functioning across arousal, desire, and overall satisfaction. Lastly, the Sensate Focus intervention did not influence after-sex behaviors. The findings underscore the therapeutic potential of emphasizing after-sex behaviors in improving sexual functioning and intimacy. Notably, gender differences were observed, with women reporting stronger correlations to these behaviors than men. Full article

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16 pages, 1814 KB

Open AccessArticle

Pre-Implementation Evaluation of a Community-Based Surveillance System for Migrants’ Sexual Health in Chile

by Constanza Adrian Parra, Valeria Stuardo Ávila, Kenny Low Andrade, Cristian Lisboa Donoso, Débora Solís, Danilo Gómez, Evelyn Cortés, Cecilia Bustos Ibarra, Paola Contreras Hernández, Jaime Barrientos Delgado and Mercedes Carrasco-Portiño

Sexes 2025, 6(3), 47; https://doi.org/10.3390/sexes6030047 - 20 Aug 2025

Abstract

The increasing migration phenomenon and its impact on sexual health highlight the urgency of improving access to preventive services and developing responsive surveillance mechanisms. This study aims to describe the context and define the implementation circuits of a Community-Based Surveillance System (CBSS) focused [...] Read more.

The increasing migration phenomenon and its impact on sexual health highlight the urgency of improving access to preventive services and developing responsive surveillance mechanisms. This study aims to describe the context and define the implementation circuits of a Community-Based Surveillance System (CBSS) focused on social epidemiological aspects related to sexual health in Chile’s migrant population. A two-phase qualitative design was employed: Phase 1 involved formative research, and Phase 2 focused on the design of CBSS implementation circuits. The formative phase led to the selection and characterization of three community-based organizations (CBOs)—two in Santiago and one in Antofagasta—and two primary healthcare centers (PHCs). Findings revealed heterogeneity in institutional capacities, limited coordination between CBOs and the health system, and a high level of willingness to participate. PHCs showed comparable profiles. Based on this, differentiated operational circuits were co-designed and adapted with stakeholders, and formalized through site-specific implementation manuals. This pre-implementation evaluation helped identify critical contextual barriers and generate tailored strategies for CBSS deployment. The active involvement of local actors is essential to ensuring the contextual relevance, institutional acceptability, and future sustainability of the proposed model. These insights offer transferable learning for the design of health interventions in underserved and structurally constrained settings. Full article

(This article belongs to the Section Sexual and Reproductive Health, Sexual Medicine, and Psychosocial Remediation)

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7 pages, 172 KB

Open AccessEditorial

Understanding Resilience Among People in Sex Work

by Cecilia Benoit and Andrea Mellor

Sexes 2025, 6(3), 46; https://doi.org/10.3390/sexes6030046 - 20 Aug 2025

Abstract

The concept of resilience, the capacity to withstand or overcome major stress or hardship despite difficult circumstances [...] Full article

(This article belongs to the Special Issue Understanding Resilience among People in Sex Work)

32 pages, 1227 KB

Open AccessSystematic Review

Treatment of Irregular Uterine Bleeding Caused by Progestin-Only Contraceptives: A Systematic Review

by Alejandra Ceballos-Morales, Celeste Villalobos-Lermanda, Alexis González-Burboa, Agustín Ciapponi and Ariel Bardach

Sexes 2025, 6(3), 45; https://doi.org/10.3390/sexes6030045 - 19 Aug 2025

Abstract

Progestins have shown to be highly effective, adequately safe contraceptives and a real alternative in the cases with contraindications to estrogen use. This review assesses the effectiveness of treatments for managing uterine bleeding due to the use of progestin-only contraceptives. A systematic review [...] Read more.

Progestins have shown to be highly effective, adequately safe contraceptives and a real alternative in the cases with contraindications to estrogen use. This review assesses the effectiveness of treatments for managing uterine bleeding due to the use of progestin-only contraceptives. A systematic review of databases such as Embase, LILACS, CINAHL, and PubMed, with a result of 701 studies published in English between 2005 and 2022, was carried out. 21 randomized clinical trials were analyzed. There were effective non-hormonal alternatives for managing progestin-related bleeding. While several treatments show promise, results must be replicated by studies with longer follow-up periods. Differences came from the five new studies and their good methodological quality—specifically, blinding and assessment of population losses. Benefits were the stop of uterine bleeding and a shortened duration of these episodes, with studies generally reporting satisfaction among their patients. There were few adverse effects seen, with the most common being headaches and nausea, which should be addressed by future studies. These results are expected to be of use for health professionals and midwives working on contraceptive management. Full article

(This article belongs to the Section Women's Health and Gynecology)

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21 pages, 348 KB

Open AccessArticle

The Divergent Associations of LGBTQ+ Belongingness with Illicit Drug Use and Alcohol Consumption Among Adults in Kentucky

by Keith J. Watts, Shawndaya S. Thrasher, Laneshia R. Conner, Kathryn Showalter, DeKeitra Griffin, Sydney P. Howard, Elaine M. Maccio and Justin X. Moore

Sexes 2025, 6(3), 44; https://doi.org/10.3390/sexes6030044 - 9 Aug 2025

Abstract

LGBTQ+ individuals face substance use disparities linked to minority stress. While community belongingness may buffer stress, its role is complex. This study examined divergent associations between belongingness within the LGBTQ+ community and lifetime illicit drug use versus past-year alcohol frequency among LGBTQ+ adults [...] Read more.

LGBTQ+ individuals face substance use disparities linked to minority stress. While community belongingness may buffer stress, its role is complex. This study examined divergent associations between belongingness within the LGBTQ+ community and lifetime illicit drug use versus past-year alcohol frequency among LGBTQ+ adults in Kentucky (n = 2953), a region with notably high rates of substance use. Methods: Cross-sectional online survey data were analyzed. We measured LGBTQ+ belongingness, lifetime use of cocaine/crack/heroin/methamphetamine, and past-year alcohol frequency. Logistic and linear regressions controlled for age, education, gender identity, and income. Results: Greater belongingness predicted significantly higher odds of lifetime illicit drug use (OR = 1.24) but lower past-year alcohol consumption frequency (B = −0.094). Transgender and gender expansive identity predicted significantly higher illicit drug use odds and higher alcohol frequency. Conclusions: In this Kentucky sample, LGBTQ+ belongingness showed divergent substance use associations: it was protective against frequent alcohol use but, unexpectedly, was associated with higher odds of lifetime illicit drug use. Findings highlight belongingness’s complex, context-dependent nature and the need for nuanced research and interventions considering substance type and specific vulnerabilities, particularly for TGE individuals. Full article

14 pages, 463 KB

Open AccessArticle

Stripping Humanity: A Multiple Mediation Analysis of Bias Toward Asexual Parents

by Silvia Di Battista

Sexes 2025, 6(3), 43; https://doi.org/10.3390/sexes6030043 - 7 Aug 2025

Abstract

Some studies have shown that the identities of asexual individuals can be devalued and invalidated through processes of dehumanization. However, research examining dehumanization and attitudes toward asexual parents remains scarce. Drawing on the dual model of dehumanization, this experimental study aimed to investigate [...] Read more.

Some studies have shown that the identities of asexual individuals can be devalued and invalidated through processes of dehumanization. However, research examining dehumanization and attitudes toward asexual parents remains scarce. Drawing on the dual model of dehumanization, this experimental study aimed to investigate the denial of traits associated with human nature (HN; denial of basic human emotions) and human uniqueness (HU; denial of a rational mind), as well as perceptions of parenting competence and warmth attributed to different maternal targets. It was hypothesized that asexual mothers would be judged more negatively on the HN dimension, but not on the HU dimension, compared to allosexual mothers. Furthermore, it was hypothesized that perceived behavior toward children, assessed in terms of warmth, would be associated with the denial of HN (but not HU) for asexual mothers. The study involved 298 participants (M_age = 35.97, SD = 15.04), who read one of three scenarios that were identical except for the sexual orientation of the mother: (1) heterosexual allosexual mother; (2) lesbian allosexual mother; and (3) asexual mother. Participants were then asked to evaluate the target with dehumanization measures and perceived parenting behaviors. Results showed that the asexual mother was perceived more negatively than all other targets across all variables. Moreover, parallel mediation analyses revealed that the perception of a lack of warmth in the asexual mother (compared to the other targets) was mediated by the denial of HN, but not HU. In contrast, both HN and HU were found to mediate judgments of parental competence. These findings provide initial evidence of stigma faced by asexual parents, highlighting the need for further research into the attitudes directed toward them. Full article

(This article belongs to the Section Sexual Diversity: Orientation, Gender, Identity, and Attraction)

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