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Sexuality, Health, and Gender

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A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: closed (31 January 2025) | Viewed by 15504

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Dr. María Isabel Ventura-Miranda

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Guest Editor

Department of Nursing, Physiotherapy and Medicine, University of Almería, 04120 Almería, Spain
Interests: community health; carers; compassion; quality of professional life
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. María Dolores Ruiz-Fernández

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Dr. Isabel María Fernández Medina

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Guest Editor

Department of Nursing, Physiotherapy and Medicine, University of Almería, 04007 Almeria, Spain
Interests: neonatology; pediatric; nursing students; quality of life; qualitative research
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Sexual health is a right for all people; it is fundamental to the overall health and well-being of individuals, couples and families, and to the social and economic development of communities and countries. We are witnessing a problem of enormous social impact related to gender (a state originating in culture and society). Therefore, the ability of men and women to achieve sexual health and well-being depends on their access to comprehensive and quality information about sex, their knowledge of the risks they may face, and their vulnerability to the consequences. This vulnerability is affected by the adverse effects of unprotected sexual activity, the ability to access sexual health care, and living in an environment that affirms and promotes sexual health.

Sexual health issues are wide-ranging and include sexual orientation and gender identity, sexual expression, relationships, and pleasure. They also include negative consequences or conditions, such as human immunodeficiency virus (HIV) infections, sexually transmitted infections (STIs), and reproductive tract infections (RTIs) and their adverse outcomes (such as cancer and infertility). We are pleased to invite you to submit to this Special Issue on Sexuality, Gender, and Health.

This Special Issue aims to investigate the sexuality, health, and gender of the population.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following:

Unprotected sexual activity;
The ability to access sexual health care;
Living in an environment that affirms and promotes sexual health;
Sexual orientation and gender identity;
Sexual expression, relationships, and pleasure;
Negative consequences or conditions, such as human immunodeficiency virus (HIV) infections;
Sexually transmitted infections (STIs);
Reproductive tract infections (RTIs) and their adverse outcomes (such as cancer and infertility);
Unwanted pregnancies and miscarriages;
Sexual dysfunction;
Sexual violence and harmful practices (such as female genital mutilation);
Sexual and reproductive health;
Gender-based violence;
LGTBQ+ collective;
Cancer and sexuality.

We look forward to receiving your contributions.

You may choose our Joint Special Issue in International Journal of Environmental Research and Public Health.

Dr. María Isabel Ventura-Miranda
Prof. Dr. María Dolores Ruiz-Fernández
Dr. Isabel María Fernández Medina
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

sexual health
gender
sexual education
identity
Sexual violence
LGTBQ+ Collective
community health

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Published Papers (8 papers)

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Research

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17 pages, 682 KiB

Open AccessArticle

Exploring the Roles of Body Dissatisfaction, Cognitive Distraction, and Age in Sexual Distress Related to Sexual Function and Sexual Satisfaction in Men: An Extended Understanding Using a Moderated Mediation Model

by Ivanilda B. Costa, Pedro J. Rosa and Patrícia M. Pascoal

Healthcare 2025, 13(7), 843; https://doi.org/10.3390/healthcare13070843 - 7 Apr 2025

Viewed by 944

Abstract

Background/Objectives: Self-objectification theory posits that objectification of people’s bodies, as a synonym for self-worth, translates into body surveillance and dissatisfaction, which has a negative impact on both social and emotional adjustment. According to empirical data based on cognitive models, body dissatisfaction translates into cognitive distraction during sexual activity, affecting sexual response. However, the association of body dissatisfaction with other sexual outcomes, such as satisfaction and distress, in heterosexual men is understudied in comparison to women. Methods: This observational, cross-sectional, and correlational study used a convenience sample of 597 heterosexual males with a mean age of 35.52 (SD = 8.78) obtained through a web survey. Results: Results suggested that cognitive distraction mediated the association between body dissatisfaction, sexual distress, and satisfaction. A moderating effect of age was found, detecting a decrease in the mediated effect of cognitive distraction as men aged, reinforcing the idea of age as a protective factor. Conclusions: Our study further supports cognitive models that are useful to understand sexual outcomes and not merely sexual function and reinforce the existence of heterosexual men’s body dissatisfaction and its detrimental effects, suggesting that health practitioners should assess this phenomenon in a context related to sexual health. Full article

(This article belongs to the Special Issue Sexuality, Health, and Gender)

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14 pages, 270 KiB

Open AccessArticle

Mental Health and Drug Use Patterns Among Men Who Have Sex with Men (MSM) Engaging in Chemsex in the UK

by Lukasz Lagojda, Deberson Ferreira de Jesus, Daniel Kinnair and Marc Chrysanthou

Healthcare 2025, 13(7), 719; https://doi.org/10.3390/healthcare13070719 - 24 Mar 2025

Cited by 1 | Viewed by 791

Abstract

Background: Chemsex is a subtype of sexualized drug use which is increasingly more prevalent amongst gay, bisexual, and other men who have sex with men (MSM). This use of psychoactive substances in sexual contexts poses an emerging public health concern, since it has been associated with an array of health risks, including mental health risks. Objective: As Chemsex appears to be increasing in the UK, this study aimed to explore Chemsex patterns and mental health amongst Chemsex users in the UK. Methods: Chemsex/drug use patterns and the prevalence of coexisting depression and anxiety, based on the Hospital Anxiety and Depression Scale (HADS), were assessed in an MSM sample via an anonymous online survey between December 2023 and February 2024. Results: A total of 141 UK adults participated in the survey (age range: 26–41 years). High overall use of the three common Chemsex-related substances was reported, including γ-hydroxybutyrate/γ-butyrolactone (GHB/GBL) (77.3%), synthetic cathinones (64.5%), and methamphetamine (47.5%). Injecting (“slamming”) was less prevalent (17.0%), although this practice was the most common amongst weekly Chemsex users (54.2%). Based on provided HADS responses, a high incidence of anxiety (49.9%) was reported among the study population, with the highest (abnormal) anxiety scores observed among weekly Chemsex users (44.4%). The incidence of depression was lower overall (27.0%), whilst the highest (abnormal) scores were also observed in weekly Chemsex users (61.5%). Conclusions: As relevant UK data remain limited, this study offers novel insight into Chemsex patterns and mental health challenges among MSM in the UK, suggesting unmet needs for targeted interventions on mental health issues among this population. Further large-scale and prospective studies are necessary to explore the nuanced interplay between the frequency of Chemsex use and its impact on mental health. Full article

(This article belongs to the Special Issue Sexuality, Health, and Gender)

15 pages, 833 KiB

Open AccessArticle

Influence of Gender Role on Resilience and Positive Affect in Female Nursing Students: A Cross-Sectional Study

by L. Iván Mayor-Silva, Guillermo Moreno, Alfonso Meneses-Monroy, Patricia Martín-Casas, Marta M. Hernández-Martín, Antonio G. Moreno-Pimentel and Leyre Rodríguez-Leal

Healthcare 2025, 13(3), 336; https://doi.org/10.3390/healthcare13030336 - 6 Feb 2025

Viewed by 1448

Abstract

Introduction: Women experience more social barriers, gender stereotypes, biases, and discrimination than men, which can increase their vulnerability to mental health problems. Therefore, it is essential to adopt a gender perspective in research on nursing students, examining the impact of these factors on their well-being and psychological resources like resilience. This study aims to analyze the relationship between gender roles in resilience and positive or negative affect among female nursing students. Methods: A cross-sectional study was conducted with first- and fourth-year female nursing students at a public university in Madrid, Spain. Sociodemographic variables, positive and negative affect (PANAS scale), resilience (CD-RISC scale), and gender roles (BRSI inventory) were analyzed. ANOVA, correlation analysis, and linear regression models were used to study the relationships between variables. Results: The study included 338 students with a mean age of 21.43 years, of which 80.2% had a high level of resilience, with a positive affect score of 31.96 (SD: 7.34) and a negative affect score of 22.99 (SD: 7.35). Overall, 48.5% had undifferentiated roles, 23.7% feminine roles, 14.2% androgynous roles, and 13.6% masculine roles. Female students with masculine and androgynous roles showed higher resilience levels (93.48% and 97.92%) compared to those with feminine and undifferentiated roles (81.25% and 70.73%) (p < 0.001). Female students with androgynous and masculine roles showed higher positive affect levels compared to those with feminine and undifferentiated roles (p < 0.001), with no differences in negative affect. These results were observed in both first- and fourth-year students. A high correlation was found between masculine roles and positive affect and resilience in both first- and fourth-year students. Conclusions: Gender roles influence positive affect and resilience in females. Among female nursing students, androgynous and masculine roles are associated with higher levels of resilience and positive affect compared to feminine and undifferentiated roles. Differences in psychological well-being may be related to socially constructed gender roles rather than biological sex, with masculine roles enhancing resilience and feminine roles correlating with greater vulnerability. Full article

(This article belongs to the Special Issue Sexuality, Health, and Gender)

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19 pages, 2793 KiB

Open AccessArticle

Differential Effects of Pandemic-Related Stressors on Mental Health by Age and Sex

by Joshua B. Borja and Scott B. Patten

Healthcare 2025, 13(3), 224; https://doi.org/10.3390/healthcare13030224 - 23 Jan 2025

Viewed by 1144

Abstract

Objective: There have been consistent concerns about a greater impact of COVID-19 on the mental health of younger people and females. We aimed to explore the potential synergistic effect of various pandemic-related stressors with age and sex on the mental health of the general Canadian household population during the COVID-19 pandemic. Methods: Using cross-sectional data from the Statistics Canada 2022 Mental Health and Access to Care Survey (MHACS), frequencies for major depressive episode (MDE), generalized anxiety disorder (GAD), general psychological distress, and various pandemic-related and demographic factors were estimated. Odds ratios were estimated using binary logistic regression models. These estimates used a replicate bootstrapping procedure recommended by Statistics Canada. Finally, Relative Excess Risk due to Interaction (RERI) models were used for each outcome to evaluate the interactions of each pandemic-related stressor with age and sex on an additive scale. Results: Past-12-month MDE and GAD, psychological distress, and the various COVID-19 stressors were more prevalent in young people and females. Overall, the stressors were confirmed to be associated with these outcomes. There were greater-than-additive interactions between age and difficulty accessing healthcare, loneliness, physical health problems, household relationship challenges, and work stress; and between sex and severe illness of a loved one, loneliness, work stress, LGBTQ2+ status, marital status, difficulty accessing healthcare, physical health problems, job/income loss, and financial difficulties. Generally, evidence of synergy was found between age and pandemic-related stressors and sex and pandemic-related stressors. Conclusions: Greater-than-additive interactions of pandemic-related stressors with age and sex may indicate synergistic vulnerabilities within females and young people. Future pandemics, via corresponding stressors, may be associated with increased mental health vulnerability in females, youth, and especially young females. Full article

(This article belongs to the Special Issue Sexuality, Health, and Gender)

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17 pages, 447 KiB

Open AccessArticle

Exploring the Intersection of Mental and Reproductive Health Among Women Living with HIV in Spain: A Qualitative Secondary Data Analysis

by Ariadna Huertas-Zurriaga, David Giménez-Díez and Juan M. Leyva-Moral

Healthcare 2025, 13(2), 168; https://doi.org/10.3390/healthcare13020168 - 16 Jan 2025

Viewed by 1028

Abstract

Background/Objectives: Globally, girls and women make up over half of those living with Human Immunodeficiency Virus (HIV), facing unique reproductive and mental health challenges. An HIV diagnosis impacts motherhood desires and increases trauma, stigma, and depression risks. Addressing these overlapping vulnerabilities with tailored, comprehensive healthcare is essential. This study aims to qualitatively explore the complex interplay between mental health and reproductive decision making among women living with HIV (WLWH). Methods: A secondary data analysis approach was employed, utilizing qualitative data from a wider study. Theoretical sampling was used to recruit a sample of WLWH attending the HIV clinic at a public hospital in Badalona (Barcelona, Spain). Interviews took place in a private and quiet space between May 2019 and January 2020. To perform secondary data analysis, Braun and Clarke’s thematic analysis was used. Results: Twenty-six women living with HIV were interviewed, with an average age of 39.3 years. The participants had diverse nationalities and faced economic challenges. Following data analysis, four main themes were identified: Emotional Fragmentation and Reproductive Self-Perception after the HIV Diagnosis; Coping Strategies in Reproductive Decision Making; Impacting Emotional Resilience and Motherhood Decisions; and Emotions, Mental Health, and Desire for Motherhood. The themes revealed the profound emotional impact of HIV on their identity, mental health, and reproductive decision making, affecting motherhood aspirations. Conclusions: Women living with HIV face psychological challenges in reproductive decision making, including anxiety and stigma. The study highlights their resilience and emphasizes incorporating hope-based strategies into HIV care, advocating for integrated and mental health-focused approaches to improve support and outcomes. Full article

(This article belongs to the Special Issue Sexuality, Health, and Gender)

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14 pages, 289 KiB

Open AccessArticle

Burnout in Assisted Reproduction Professionals: The Influence of Stressors in the Workplace

by Raquel Urteaga and Amelia Díaz

Healthcare 2024, 12(21), 2136; https://doi.org/10.3390/healthcare12212136 - 26 Oct 2024

Viewed by 1139

Abstract

Background/Objectives: Most of the research in assisted reproduction has focused on the stressful situation experienced by women or couples looking for a desired pregnancy; however, the stress experienced by assisted reproduction professional teams is seldom studied. The present study aims to evaluate burnout and its relationship with workplace stressors among assisted reproduction professionals. Methods: A cross-sectional design was used to conduct an online self-assessment national survey, sent to all members of the Spanish Association for Fertility. The questionnaire contained sociodemographic and occupational questions about stressors in the workplace and the Maslach Burnout Inventory (MBI-HSS) to assess the three subscales of burnout: emotional exhaustion, depersonalization and personal accomplishment. Results: The percentages showing high emotional exhaustion and depersonalization in the whole sample were 41.8% and 43.2%, respectively. Additionally, low personal accomplishment was displayed in 42.6% of the respondents. Embryologists stand out for presenting the highest percentages of burnout (emotional exhaustion = 72.1%; depersonalization = 48.1%; low personal accomplishment = 48.1%), whilst psychologists showed the lowest percentages in high emotional exhaustion (32.3%) and depersonalization (24%), and gynecologists in low personal accomplishment (28.5%). Working under pressure was the stressor most experienced by the sample (76.6%) and the one that better predicted the three subscales of burnout. Conclusions: This study highlights the close relationship between high levels of burnout and workplace stressors and shows the need to reduce workplace stressors to improve the well-being of professionals working in assisted reproduction, and, consequently, that of the patients they look after. Full article

(This article belongs to the Special Issue Sexuality, Health, and Gender)

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9 pages, 232 KiB

Open AccessOpinion

The Effects of Gender-Affirming Hormone Therapy on Quality of Life: The Importance of Research on Youth

by Monika Mazur and Paweł Larionow

Healthcare 2024, 12(13), 1336; https://doi.org/10.3390/healthcare12131336 - 4 Jul 2024

Cited by 1 | Viewed by 4323

Abstract

Gender-affirming hormone therapy (GAHT) plays a significant role in the medical care of transgender individuals, helping to align their physical characteristics with their gender identity. While numerous studies have investigated the impact of GAHT on adults, research focusing on its effects on the quality of life (QoL) of transgender youth is limited. In this opinion paper, we aim to address selected challenges associated with gender-affirming medical care, such as (1) the necessity for evidence-based youth gender-affirming medical care, (2) the urge to explore different approaches to gender-affirming medical care diversely in transgender youth research, and (3) understanding the challenges of the detransition process (which refers to stopping or reversing gender-affirming medical or surgical treatments), as well as suggest possible solutions for meaningful progress. Notably, the available evidence underlines a positive impact of GAHT on various aspects of QoL of transgender youth, such as mental health and social functioning, by alleviating gender dysphoria, improving body satisfaction, and facilitating appearance congruence (the degree to which an individual’s physical appearance represents their gender identity). However, challenges related to methodological limitations, as well as ethical considerations, and several sociocultural factors highlight the need for further research to better understand the long-term effects of GAHT on the QoL of transgender youth. Ethical considerations, such as ensuring informed consent and weighing potential benefits against risks, are pivotal in guiding healthcare decisions. Additionally, navigating these ethical responsibilities amid sociocultural contexts is crucial for providing inclusive and respectful care to transgender youth. Addressing these research gaps is, therefore, crucial to developing successful healthcare programmes, raising awareness, and promoting the holistic well-being of transgender youth through comprehensive and affirming care. Full article

(This article belongs to the Special Issue Sexuality, Health, and Gender)

13 pages, 471 KiB

Open AccessStudy Protocol

Biopsychosocial Predictors of Postpartum Depression: Protocol for Systematic Review and Meta-Analysis

by Marwa Alhaj Ahmad, Shamsa Al Awar, Gehan Sayed Sallam, Meera Alkaabi, Darya Smetanina, Yauhen Statsenko and Kornelia Zaręba

Healthcare 2024, 12(6), 650; https://doi.org/10.3390/healthcare12060650 - 14 Mar 2024

Viewed by 3675

Abstract

During the postpartum period, psychological disorders may emerge. Aims and objectives: With the current study, we aim to explore the biological determinants that act on women during labor and incur the risk for postpartum depression (PPD). To reach the aim, we will perform the following tasks: (i) identify biological peripartum risk factors and calculate pooled prevalence of PPD for each of them; (ii) explore the strength of the relationship between peripartum risk factors and PPD; (iii) rank the predictors by their prevalence and magnitude of association with PPD. The knowledge obtained will support the development and implementation of early diagnostic and preventive strategies. Methods and analysis: We will systematically go through peer-reviewed publications available in the PubMed search engine and online databases: Scopus, Web of Science, EMBASE. The scope of the review will include articles published any time in English, Arabic, or Polish. We will deduplicate literature sources with the Covidence software, evaluate heterogeneity between the study results, and critically assess credibility of selected articles with the Joanna Briggs Institute’s bias evaluation tool. The information to extract is the incidence rate, prevalence, and odds ratio between each risk factor and PPD. A comprehensive analysis of the extracted data will allow us to achieve the objectives. The study findings will contribute to risk stratification and more effective management of PPD in women. Full article

(This article belongs to the Special Issue Sexuality, Health, and Gender)

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