Editor’s Choice Articles

Homosexuality is a sensitive issue in Africa that inspires a great deal of public contention and controversy and attracts much social science research interest. Due to the sensitivity of the issue, conducting empirical research on homosexuality in Africa or within African population groups could be subject to several challenges. This article presents an autoethnographic account of my experiences conducting empirical research on attitudes towards homosexuality among Cameroonians based at home and those living in Switzerland. The paper highlights the key challenges, surprises, and lessons learned experienced in the different stages of the research process, from design to data collection, analysis, and publication of findings. Drawing on these experiences, the article calls attention to some aspects that young researchers embarking on research in sensitive topics should be aware of and should plan for upfront. It proposes practical coping approaches that can support young researchers to navigate the difficult waters of researching homosexuality in challenging settings so they can achieve their research goals within the timeframe and resources available to them. Full article

Comprehensive sexuality education (CSE) is an important framework utilized worldwide to provide students and young people with accurate, affirming, and socially conscious sexuality education. However, there is still a lack of CSE curricula in school contexts that is relevant for students with various disabilities. This article takes the Ontario, Canada, context as an example of where and how CSE can improve to be more inclusive for students with disabilities. This article reviews the current context of CSE in Ontario, Canada, including its controversies, while providing recommendations for meeting the needs of students with various disabilities, including psychological, intellectual, and physical disabilities. This article aims to provide practical recommendations, such as pertinent curricular content and pedagogical recommendations for scholars, researchers, and policymakers for improving CSE for students with disabilities in schooling. Full article

Congenital adrenal hyperplasia (CAH) is a heterogeneous group of autosomal recessive disorders due to defects in adrenal steroid biosynthesis. In about 90% of patients, CAH is caused by pathogenetic variants in CYP21A2 gene, impairing the function of 21-hydroxylase (21-OH) enzyme. CAH can present as classical form (simple virilizing or salt wasting) or as non-classical form (NC-CAH). NC-CAH is due to pathogenetic variants in the CYP21A2 gene that result in 20–70% residual activity of 21-hydroxylase. Early diagnosis may be missed, mainly in childhood, jeopardizing long-term outcome. This paper will review some information on clinical findings, symptoms, diagnostic approaches, and treatments of NC-CAH in childhood, allowing better management and long-term outcome. Full article

The presently ubiquitous idea of how gender is defined remains deeply indebted to modern thought, depending on the concept of sex as its reference point. Originating with practices arising from capitalism, modern thought’s concept of sex was enhanced with the search for the norm regarding standardization, then further refined through the research program of eugenics. Gender, in contrast to sex, has its roots in sexual practice changes from the second half of the twentieth century onward, developed in association with 1980s postmodern thought. The presuppositions of the two concepts differ radically. Understanding the difference between sex and gender matters because gender is now more than a critique of sex—it is an idea that is accepted and understood in popular culture and affects how people interpret their sexuality. This review examines the foundations of modern and postmodern thought, then focuses on sex and gender with respect to their history within these modes of thought. The conclusion, pointing to future research, is that a further reformulation of sexuality will be required for gender, as a postmodern idea, to truly separate itself from the presumptions of sex as a modern concept, permitting individuals to express their sexuality as they choose without negative social and psychological repercussions. Full article

Men often perceive greater sexual willingness underlying women’s behaviors than women themselves intend. This discrepancy can contribute to sexual miscommunication and, sometimes, acts of sexual assault. The current study tested whether actor–observer asymmetry is present in women’s ratings of sexual intent to offer an additional explanation for past findings. We hypothesized that women rating their own behaviors would report less sexual intent compared to women rating another woman’s behaviors. We also hypothesized that these ratings would be influenced by the physical attractiveness of a male target through self-reported sexual arousal as a mediation pathway. Results from a community sample of 164 women (M_age = 42 years) generally supported these hypotheses. Sexual arousal was positively associated with ratings among all participants, but the mediation pathway was significant only for women rating another woman’s behavior. The findings suggested that actor–observer asymmetry is present in ratings of sexual intent. This effect might account for some of the sexual overperception phenomena and explain why third-party observers of women’s sexual behavior (e.g., potential partners, Title IX investigators, jurors) sometimes misinterpret sexual willingness. Full article

Sex workers’ humor has received comparatively little attention in the literature to date, and work that does consider this phenomenon focuses on humor in face-to-face contexts. Increasingly, elements of sex workers’ labor and community building take place online. This article examines the emergence of sex work humor in online spaces, considering how this humor provides evidence of resilience within this community. The article uses a critical discourse analysis approach blended with a cultural studies lens to examine 171 discrete texts drawn from sex work communities in Australia and New Zealand. These include social media postings from peer-led organizations and correspondence between sex workers and their clients, which was profiled in news media during the COVID-19 lockdowns. The humor evident within these texts falls into three major categories: humor about clients; humor as a mechanism of discussing stigma and discrimination; and humor as an agent of activism and social change. The findings indicate that humor can be evidence of resilience among sex-working communities, that it is politically productive and effective from a communications perspective, and present the possibility that it may also contribute to resilience. The presence of humor in online sex work spaces of sociality further highlights the importance of these spaces for community building, and draws attention to additional harms created by deplatforming. Full article

The sex industry literature predominantly focuses on the lived experiences of cisgender female sex workers, their customers, and work dynamics. Recently, there has been a shift in the discourse regarding sex work as the sex industry has been openly represented within art, fashion, and film. As such, there has been a growing number of qualitative studies dedicated to investigating cisgender men’s experiences of the sex industry. This article seeks to identify and synthesize these emergent findings to identify possible gaps in the literature, aid in defining new research opportunities, and guide public health policy development. Using qualitative meta-synthesis, 66 original studies were identified and analyzed. Nine meta-themes emerged. Findings demonstrated that male sex workers (MSWs) encounter many of the same experiences that have been previously documented by female sex workers, such as work-related discrimination and the influence of economics on their interest and involvement in the industry. However, MSWs also experience areas of privilege and discrimination unique to their lived experiences. This was particularly salient for men who sold sex in countries where sexual minorities are criminalized or decriminalized but not legalized. These findings highlight the need for responsive sex worker resources tailored to address the unique issues faced by MSWs. Full article

For asylum seekers to be granted asylum, they must convince immigration officials that they have been persecuted or that they fear they will be persecuted if returned to their home country. This article discusses the reluctance of asylum seekers to be forthcoming about sexual assault as a form of persecution and the ways in which traumatic memory can affect narratives of persecution for rape survivors. Many asylum seekers, particularly those who have been sexually assaulted, show symptoms consistent with trauma survivors. Consequently, their narratives of persecution are often shaped by partial and incomplete memory recall. The result is that how asylum seekers who have been sexually assaulted tell their stories of persecution is the antithesis of the expectations of credibility. This article is based on qualitative research in Los Angeles, California, and New York City, New York, in the United States. It includes interviews with asylum seekers, immigration attorneys, immigrant service providers, asylum officers, and immigration judges; observations of immigration court hearings; and content analysis of asylum applications. I use these sources to argue that the harm of rape and its long-lasting effects evidenced by symptoms of traumatic memory impacts how asylum seekers articulate stories of persecution. How these stories are told can have devastating effects for asylum seekers that may jeopardize their ability to gain asylum if immigration officials do not view them as credible applicants. Full article

The importance of sexual pleasure as a factor promoting sexual and public health is increasingly recognized. Nevertheless, hardly any theory-based and empirically tested interventions exist for fostering sexual pleasure. Consequently, we developed an unguided online intervention called PleaSure to promote sexual pleasure in women. In a randomized controlled pilot trial with a mixed-method design, we evaluated the effectiveness of PleaSure by comparing the intervention group to a waitlist control group in pre–post measurements over 4 weeks. With 657 participants (M_age = 31.46, SD_age = 8.78), we evaluated an index of sexual pleasure and five facets: sensual pleasure, pleasure-related mastery, pleasure-related validation, interaction pleasure, and bonding pleasure. The results show that the online intervention primarily strengthened the intrapersonal domain of sexual pleasure by increasing pleasure-related mastery. Neither the other facets nor the index was significantly influenced by the intervention. Although the effects of the quantitative data are small, the qualitative data support overall positive effects on participants’ sexual experience. We discuss the content of the intervention and the methods used. Our pilot study suggests that sexual pleasure can be promoted but that major improvements are needed to the intervention’s content and design to do so effectively. Therefore, future studies are encouraged to further develop and implement such resource-efficient interventions in clinical and non-clinical samples to better understand the importance of sexual pleasure to sexual health. Full article

In some areas of sex research, we note room for methodological improvement of research practices. In particular, in the field of hypersexuality research, where societal norms have been influential, methodological improvement might advance goals of objectivity in research. We propose that hypersexuality research should: firstly, take into account relevant subpopulations; secondly, use Item Response Theory (IRT) to construct item banks for measurement instruments; and, thirdly, measure sexual desire and related important constructs where and how they play out—in daily life, changing from moment to moment. We show that comparing relevant subpopulations can lead to depathologizing normative, but highly frequent, sexual behavior. Using IRT can lead to more precise measurement instruments by assessment of characteristics of individual items. Measuring sexual desire as an inherently fluctuating process in everyday life, and as part of emotion regulation processes, can direct research towards relevant associations other research methods might miss. Bringing into practice our three proposals for improvement can procure a number of advantages. We illustrate these advantages mainly for the field of hypersexuality research, but our suggestions might also be beneficial for sex research in general. Full article

Developments in the study of sexuality in the lives of disabled people have been relatively slow, as the spectre of a medicalised model continues to dominate most debates and invalidate any form of sexual identity. The social model of disability has enabled the amplification of voices that have been previously silenced; however, progress has stalled. Within autism studies, however, the rise of neurodiversity studies coupled with intersectionality, has presented an opportunity to explore sexualities in terms of difference rather than deficiency, therefore bypassing deficit models which have dominated any study of non-heterosexual lives. Such deficit models have focussed upon discovering what it is about autism that leads autistic people to think they are non-heterosexual, often resulting in a lack of support for young LGBT+ people as sexuality is dismissed as a result of autism. Reflecting upon findings from my own ongoing work alongside emerging social research, this article explores important developments and potential future directions. This will highlight the progress made and the barriers remaining. Using a sociological approach and a framework inspired by Plummer, which focusses upon the importance of sexual stories, the article will show that much needs to be done. The diversity of goals and multiplicity of stories means that disabled and autistic sexuality stories have not been accepted into the public consciousness. Full article

Research on sexual diversity in physical education (PE) focuses primarily on students and rarely on teachers. Against this background, this study takes a look at teachers and explores the question of how lesbian, gay, and bisexual (LGB) teachers experience PE. Our study was conceived as a systematic literature review of qualitative studies published between 1990 and 2022. The processual study selection was carried out according to PRISMA. A total of nine studies were identified that met our inclusion criteria. We analyzed and compared the findings of these studies. On an overarching level, our analysis shows that the identified studies predominantly focus on the challenges and problems associated with the sexuality of LGB teachers. Furthermore, our analysis shows that the PE teachers interviewed in the studies perceive and anticipate school as a homophobic context. From the teachers’ perspective, PE is a special subject that they experience as particularly risky due to their sexuality. Against the backdrop of these experiences, many PE teachers use protective strategies, which mainly consist of hiding their own sexuality and ignoring the perceived homophobia. In the end, research implications are discussed, highlighting the need for ongoing research on LGB PE teachers. Full article

Background: Pedophilia is a deviant sexual interest subject to more public stigma and punitive attitudes than others. Pedophilia has received a disproportionate amount of scholarly attention in comparison to other deviant sexual interests. To address this, the present study offers a comparison of the public stigma and punitive attitudes associated with pedophilia, fetishism, and hypersexuality. Methods: Recruited in Australia, one-hundred and twelve individuals participated in an anonymous online survey. Stigmatising and punitive attitudes toward pedophilia, fetishism, and hypersexuality were assessed via sub-scales of perceived dangerousness, deviance, intentionality, and punitive attitudes. Results: Participants held harsher punitive attitudes toward people with pedophilia and thought them to be more deviant and dangerous than people with fetishism and hypersexuality. Participants perceived hypersexuality to be more dangerous and deviant than fetishism. No consistent combination of perceived dangerousness, deviance, and intentionality predicted punitive attitudes toward all conditions. Rather, combinations of punitive attitude predictors were unique across conditions. Conclusions: This research articulates the unparalleled public stigma and punitive attitudes faced by people with pedophilia, compared to people with fetishism and hypersexuality. Findings which suggest that public stigma is stronger for hypersexuality than it is for fetishism are relatively novel, as are the observed predictors of punitive attitudes toward each condition. Knowledge produced by this study contributes to an improved conceptualisation of how the public views individuals who experience deviant sexual interests. Full article

Debates on human rights in recent years have brought to the fore stark fault lines between African countries, where societal intolerance towards homosexuality is prevalent, and Western countries, which hold more tolerant views towards homosexuality. As contention rages around African identity and homosexuality, one interesting question calls for attention: how do the attitudes of Africans towards homosexuality evolve—or not—when they migrate from their home context to a more open society where homosexuality is widely accepted? This study draws on Herek’s ‘attitudes toward lesbians and gay men scale’ (ATLG) to investigate homophobia among Cameroonians at home compared to Cameroonian migrants in Switzerland and uses in-depth interviews to understand the reasons for any change in or persistence of attitudes. Survey data shows that Cameroonian migrants in Switzerland portray significantly less homophobia compared to Cameroonians living at home. Qualitative analysis identified four factors that contributed to change in attitudes among Cameroonian migrants: (i) experiencing racial prejudice and xenophobia prompted self-reflection about their own prejudices towards others; (ii) witnessing, first-hand, the huge infrastructure and development gap between their host and home country exposed anti-homosexuality politics back home as a needless distraction from actual development priorities; (iii) greater opportunities to meet and interact with gay people in the host country challenged long-held home-grown stereotypes about homosexuality; and (iv) non-discrimination standards and codes of conduct in the workplace in the host country encouraged conformity and shifts towards greater tolerance. Full article

Globally, over a third of women have experienced physical or sexual violence in their lifetime. In Russia, human trafficking, sexual exploitation, and physical abuse of women are amongst the world’s highest. Applying cognitive dissonance theory and sexual script theory, this study explores whether women (n = 654) trading sex in Russia appraise their experiences of entering the commercial sex trade as voluntary or forced. Contributing client factors were also analyzed, including beatings (66%), rape (66%), and humiliation (86%) by clients. Multiple logistic regression assessed whether women who reported voluntarily entering the commercial sex trade were more likely to experience physical abuse but less likely to experience rape (AOR:1.37); were more likely to perceive men using them as decent/caring (AOR = 2.54); were more likely to sell sadistic/masochistic services (AOR: 2.31); and less likely to stop selling sex (AOR: 5.84). Implications of this study reveal the importance of intervention strategies that account for a woman’s unawareness of her own exploitation and mistreatment as well as the psychological barriers that prevent her from seeking help. The necessity of recognizing women selling sex as sufferers of coercion and abuse is also emphasized. Full article

Research has linked childhood sexual trauma (CST) with adverse adult outcomes (AAOs) that span physical, psychological, and social domains of functioning. Differences in conceptualizing and measuring CST, however, have inhibited the examination of trauma-related variables hypothesized to impact adult outcomes. We used National Sexual Health Survey (NSHS; 1995–1996) data to examine trauma chronicity (i.e., duration) and AAOs (domains: physical and mental health, close relationships, and achievement). The NSHS (N = 6537, 18–70 years) assessed duration using perpetrator-specific CST reports. Adjusting for background characteristics, we examined CST duration in relation to AAOs and CST-related help-seeking. Approximately 8% of participants reported CST. Chronic (vs. single-exposure) CST survivors were at substantially higher risk of experiencing AAOs [i.e., mean AAOs and specific AAOs (e.g., physical and emotional health problems, divorce/separation, and poverty)]. CST had direct effects on sexual dysfunction and satisfaction, and on relationship stressors which may impact sexual relationship quality. Although 62% of CST survivors did not seek help, those with more chronic CST histories reported a higher prevalence of trauma-related help-seeking. Our work underscores the importance of examining CST chronicity in relation to long-term developmental outcomes. Chronicity assessment may be an important screening tool in the therapeutic context and in broader community screening efforts. Full article

Access to adequate and appropriate service provision has a direct positive impact on health and wellbeing. Experiences of inaccessible, discriminatory, and culturally unsafe services and/or service providers are considered a root cause for the health inequalities that exist among Indigenous queer youth. Experiences of discrimination and cultural inappropriateness are commonplace, with Indigenous queer youth noting issues related to access to services and treatment, stereotyping, and a lack of quality in the care provided, which discourage Indigenous people from accessing care. This paper examines the perspectives of Indigenous LGBTIQ+ youth and health service providers to identify what challenges, obstacles and opportunities are currently being faced and what could be implemented to improve the health and wellbeing outcomes for Indigenous LGBTIQ+ youth in the future. Full article

Low fertility has persisted in Japan for decades. Sexless marriages may indirectly contribute to low fertility. Inactive sexual lives within intimate and committed relationships may be linked to sexual activity outside such relationships, called “casual sex”. This study aimed to explore the correlates of casual sex and sexlessness. A web-based questionnaire survey was conducted among married and single men (n = 4000) aged 20–54 years in Japan. Sexlessness were reported by 56% of men, whereas 11% had had casual sex and 31% had had non-casual sex (with spouse, fiancé, or girlfriends/boyfriends) in the last month. Among married men, higher income and long working hours were positively associated with casual sex. Regarding never-married men: those with lower educational status and without full-time jobs were more likely to report casual sex, those in rural areas were more likely to be sexless than those in urban and suburban areas, and those with depression were more likely to be sexless than those without depression. Matching app use was strongly associated with casual sex among married and never-married men, suggesting that such tools may facilitate sexual activity outside committed and intimate relationships. Sexual behavior is closely linked to one’s social and economic environment and health status. Full article

The aim of this study was to investigate the association between masturbation frequency and sexual dysfunction among men and women, focusing on individuals with and without regular sexual partners, and to determine whether sexual compatibility (e.g., similar sexual desire levels and a match between desired behaviors and behaviors one’s partner is willing to engage in) in the relationship affects masturbation frequency. Here, 12,271 Finnish men and women completed an online survey about masturbation frequency, sexual function, and sexual compatibility with their partner for those who were in a relationship. The results indicated that masturbation frequency was positively associated with overall sexual function for women. This was moderated by relationship status, meaning that more frequent masturbation was associated with better orgasmic function and sexual satisfaction in single women, whereas the opposite was true for women who were in a relationship. For men, more frequent masturbation was associated with better erectile function for single men, and better ejaculatory latency but worse orgasmic function, intercourse satisfaction, and more symptoms of delayed ejaculation for men who were in a relationship. Lower sexual compatibility and sexual dysfunctions in the partner were associated with more frequent masturbation in both sexes. The associations between masturbation frequency and sexual function vary for single and partnered individuals, and are, for the latter group, further affected by sexual compatibility. Full article

The role of masturbation frequency and pornography use on sexual response during partnered sex has been controversial, the result of mixed and inconsistent findings. However, studies investigating this relationship have often suffered from methodological shortcomings. We investigated the role of masturbation frequency and pornography use on both the occurrence and severity of delayed/inhibited ejaculation (DE), an increasingly common sexual problem among men. We did so in a large (nonclinical) multinational sample of cisgender men (N = 2332; mean age = 40.3, SE = 0.31) within a multivariate context that relied on multiple (and, when possible, standardized) assessments of sexual dysfunctions while controlling for possible confounding variables. Results indicated a weak, inconsistent, and sometimes absent association between the frequency of pornography use and DE symptomology and/or severity. In contrast, both poorer erectile functioning and anxiety/depression represented consistent and strong predictors of DE and, to a lesser extent, DE severity. Other factors, including relationship satisfaction, sexual interest, and masturbation frequency, were significantly though moderately to weakly associated with DE. In conclusion, associations (or sometimes lack thereof) between masturbation frequency, pornography use, and delayed ejaculation are more clearly understood when analyzed in a multivariate context that controls for possible confounding effects. Full article

Previous research has shown that women may use self-enhancement strategies to compete with one other. Lumbar curvature in women is considered to enhance a woman′s attractiveness, potentially due to its role in bipedal fetal load and sexual receptiveness. The current study investigated the role of lumbar curvature on women’s perceptions of sexual receptiveness as well as its role in women’s intrasexual competitiveness. Study 1 (N = 138) tested and confirmed that women’s intrasexual competition influences their perception of sexual receptivity of women as a function of lordosis posture depicted in a standing posture. Study 2 (N = 69) replicated these results and extended them to other postures, namely, the quadruped and supine positions. Study 3 (N = 106), using a two-alternative forced-choice task, revealed that other women perceive relatively larger arched-back postures as more threatening to their relationship and frequently as being more attractive. Collectively, this work suggests that women consider a lordotic posture in other women as a signal of sexual receptivity and perceive it as a threat to their relationship. This research provides robust support for the sexually receptivity hypothesis of lumbar curvature, questioning the alternative morphological vertebral wedging hypothesis. Full article

With approximately two-thirds of the United States adult population classified as overweight or obese, obesity remains a critical public health concern. Obesity not only contributes to several health complications including type 2 diabetes mellitus and cardiovascular disease, but the condition is also associated with sexual dysfunction in both women and men. Despite evidence linking obesity and its concomitant pathophysiology to sexual problems, the potential roles of psychosocial factors such as body image are understudied. This narrative review evaluates the research linkages between obesity and sexual dysfunction, with particular attention to the potential effects of body image dissatisfaction. A literature search of biomedical and psychological databases was used to identify research pertaining to obesity, sexual function, and/or body image constructs. The pathophysiological effects of obesity on sexual function are well-documented in mechanistic studies and animal trials, often with corroboration in human clinical samples. However, very few studies examine obesity, body image, and sexual function in tandem. Body image dissatisfaction appears to independently impinge upon the sexual response cycle and mental health outcomes, irrespective of body weight. While obesity is often associated with negative body image appraisal, it is unclear whether these constructs exert additive, synergistic, or antagonistic effects on sexual responsivity. Additionally, overweight/obese individuals who exhibit higher levels of body image satisfaction or self-confidence appear to be protected from the deleterious effects of obesity on sexual satisfaction, at least to some extent. Greater reliance upon conceptual/theoretical models from the body image literature may better clarify the relationships between these constructs. Full article

In the present study, we explore the proposed cyclic models for problematic hypersexuality (PH) that involve shame, self-esteem, and sexual desire. These cyclic models are characterized by temporal associations but have not been investigated previously with intensive longitudinal designs. In this study, we collected up to 70 measurements per participant within a period of seven consecutive days, which allowed us to investigate associations between fluctuations of shame, self-esteem, and sexual desire. Participants were divided in four subgroups: (1) women (n = 87); (2) men (n = 46) from a general population convenience sample; (3) men watching porn >2 times per week, showing non-problematic hypersexuality (NH; n = 10); and (4) men watching porn >2 times per week, experiencing PH (n = 11). Multilevel analyses, including cross-level interactions, were used to investigate between-group differences in intraindividual processes. Results showed that prior increases in shame forecasted higher current sexual desire for men with PH, but not for the other groups, suggesting that men with PH use sexual desire to downregulate dysphoric feelings of shame. Differences between groups in associations between self-esteem and sexual desire were also found. Based on our results, we propose the Split Pleasure/Shame model, which represents emotion dysregulation in PH, and juxtapose this with the pleasurable experience of sex by non-PH groups. Further intensive longitudinal research is necessary to test this model and, more generally, to investigate the fluctuating nature of sexual desire. Full article