Sexual identity and sexual well-being in female heterosexual university students

Conceptualizing Sexual Wellbeing: A Qualitative Investigation to Inform Development of a Measure (Natsal-SW)

Despite increasing scientific and policy interest in sexual wellbeing, it remains poorly conceptualized. Many studies purporting to measure it instead measure related but distinct concepts, such as sexual satisfaction. This lack of conceptual clarity impedes understanding, measuring, and improving sexual wellbeing. We present qualitative research from multi-stage, mixed-methods work to develop a new measure of sexual wellbeing (Natsal-SW) for the fourth British National Survey of Sexual Attitudes & Lifestyles. Literature review and discussion generated a conceptual framework with seven proposed domains: respect, self-esteem, comfort, self-determination, safety and security, forgiveness, and resilience. Semi-structured interviews with 40 adults aged 18-64 then explored whether and how these domains aligned with participants' own understandings, experiences, and language of sexual wellbeing. Data were analyzed thematically. Participants conceptualized sexual wellbeing as distinct from sexual satisfaction and sexual health and as multidimensional, dynamic, and socially and structurally influenced. All seven proposed domains resonated with accounts of sexual wellbeing as a general construct. The personal salience of different domains and their dimensions varied between individuals (especially by gender and sexual orientation) and fluctuated individually over time. This study clarifies dimensions of domains that participants considered important, providing an empirical basis to inform development of a new measure of sexual wellbeing.

Feasibility and effectiveness of communication tools for addressing intimacy and sexuality in patients with cancer: a systematic review

PURPOSE

Patients diagnosed with cancer might experience changes in intimacy and sexuality due to the illness itself, treatment, or psychological and social factors. Healthcare professionals (HCPs) often feel reluctant to discuss these changes. This study aimed to provide an overview of the feasibility and effectiveness of communication tools that support communication regarding changes in intimacy or sexuality among patients with cancer.

METHODS

This is a systematic review. Databases are PubMed, Embase, CINAHL, PsycInfo, Web of Science and Cochrane Library from inception to June 2023. The Mixed Methods Appraisal Tool was used to assess included studies. Data were summarized in data charting forms.

RESULTS

In total 35 studies were included, published between 2001 and 2023. Most had a quantitative design and moderate methodological quality. In 11 studies, the PLISSIT model (Permission, Limited Information, Specific Suggestions, Intensive Therapy) was used. Tools were integrated in counselling sessions or training programmes for individual patients, couples, groups of patients, or HCPs. All tools were considered feasible by patients or HCPs. Twenty studies reported significant improvement in sexual functioning, quality of life, quality of care or combined outcomes.

CONCLUSION

Tools to support communication about changes in intimacy and sexuality among patients with cancer seem feasible and effective. The most commonly used tool, the PLISSIT model, proved to be feasible for HCPs and to have a positive effect on patients' and partners' sexual functioning and quality of life. Giving attention to changes in intimacy and sexuality seems to be important in itself, regardless of the communication tool or approach used.

Development and Validation of a Brief Measure of Sexual Wellbeing for Population Surveys: The Natsal Sexual Wellbeing Measure (Natsal-SW)

Sexual wellbeing is an important aspect of population health. Addressing and monitoring it as a distinct issue requires valid measures. Our previous conceptual work identified seven domains of sexual wellbeing: security; respect; self-esteem; resilience; forgiveness; self-determination; and comfort. Here, we describe the development and validation of a measure of sexual wellbeing reflecting these domains. Based on the analysis of 40 semi-structured interviews, we operationalized domains into items, and refined them via cognitive interviews, workshops, and expert review. We tested the items via two web-based surveys (n = 590; n = 814). Using data from the first survey, we carried out exploratory factor analysis to assess and eliminate poor performing items. Using data from the second survey, we carried out confirmatory factor analysis to examine model fit and associations between the item reduced measure and external variables hypothesized to correlate with sexual wellbeing (external validity). A sub-sample (n = 113) repeated the second survey after 2 weeks to evaluate test-retest reliability. Confirmatory factor analysis indicated that a "general specific model" had best fit (RMSEA: 0.064; CFI: 0.975, TLI: 0.962), and functioned equivalently across age group, gender, sexual orientation, and relationship status. The final Natsal-SW measure comprised 13 items (from an initial set of 25). It was associated with external variables in the directions hypothesized (all p < .001), including mental wellbeing (0.454), self-esteem (0.564), body image (0.232), depression (-0.384), anxiety (-0.340), sexual satisfaction (0.680) and sexual distress (-0.615), and demonstrated good test-retest reliability (ICC = 0.78). The measure enables sexual wellbeing to be quantified and understood within and across populations.

A new sexual wellbeing paradigm grounded in capability approach concepts of human flourishing and social justice

Over the last twenty years, there has been a growing interest in measuring sexual wellbeing, including by a WHO/UNFPA working group in 2007, which sought clarity on key dimensions and asked for indicators of these to be devised. However, there remains a lack of conceptual clarity surrounding the concept of sexual wellbeing, which may create variation in what is being assessed and to what we are referring. This paper proposes one way in which to achieve conceptual clarity might be through the utilisation of a Capability Approach, thereby posing a new set of normative questions about what sexual wellbeing is. The central argument in this paper is for researchers, theorists and practitioners to focus more fully on a person's freedom to achieve sexual wellbeing within a particular social and cultural context. We suggest the kinds of data that might need to be captured to operationalise and measure such an understanding. By offering new critical insights, we hope to drive forward empirical and methodological development in the evaluation of sexual wellbeing.

The Sexual Self as a Function of Relationship Status in an Emerging Adult Sample

A sample of emerging adult university students completed a survey with the goal of investigating components of "the sexual self" and how these constructs were influenced by romantic relationship status. Three general aspects of the sexual self were considered: sexual self-concept, comfort with sexuality, and past sexual behavior. Sexual self-concept was defined as composed of constructs such as sexual self-schema, self-efficacy, consciousness, optimism, problem self-blame, power/other control, and motivation to avoid risky sex. Sexual comfort, conceptualized as a personality disposition of erotophobia-erotophilia, was assessed using three instruments. This included the Sexual Opinion Survey, the original individual difference measure of erotophobia-erotophilia. Past sexual behavior was assessed with the Derogatis Sexual Functioning Inventory. Findings suggested that individuals in a relationship had more positive sexual self-concepts and were more erotophilic and comfortable with sexuality generally. These differences were modest, based on effect size statistics. Past sexual experience also differed, contingent on relationship status. Some sexual self-concept scales were predictive of sexual satisfaction, while comfort with sexuality was predictive of relational satisfaction. Romantic relationships may have important implications for sexual selfhood, but this is a tentative suggestion, as this was a correlational study and the relationships are likely bidirectional.

Anxiety Sensitivity in the Sexual Context: Links between Sexual Anxiety Sensitivity and Sexual Well-Being

Anxiety sensitivity, the fear of physiological arousal sensations, has been linked to lower sexual frequency, poorer sexual function, and greater sexual anxiety. The current study assessed whether anxiety sensitivity specific to the sexual context, termed sexual anxiety sensitivity, was linked to a wide range of indicators of sexual well-being over and above associations accounted for by general anxiety sensitivity. As a first step, we developed the Sexual Anxiety Sensitivity Inventory (SASI). Participants were 484 adults aged 19 to 60 years old who completed an on-line survey. To develop the SASI, we constructed parallel items to those on the Anxiety Sensitivity Scale-3 (ASI-3; Taylor et al., 2007). The SASI demonstrated the same three-factor structure as the ASI-3 and showed high internal consistency providing evidence for its reliability. As predicted, sexual anxiety sensitivity was significantly associated with all ten of the markers of the behavioral, cognitive-affective, and functional domains of sexual well-being assessed and six of these associations remained significant after controlling for general anxiety sensitivity. The results provide evidence that sexual anxiety sensitivity is an important construct for understanding individuals' sexual well-being and provide initial evidence that the specificity of the SASI has value as a reliable and valid measure for assessing sex-related anxiety sensitivity. Implications for clinicians and researchers are discussed.

University Students’ Sexual Identity Development as a Determinant of Sexual Self-Hood

Sexual identity development was explored as a predictor of sexual self-concept and erotophobia–erotophilia using a student sample. Sexual identity development was operationalized using Worthington et al.’s Measure of Sexual Identity Development, which is theoretically based on Marcia’s identity model. Based on Worthington et al.’s scale, there are four sexual identity development domains: commitment to one’s sexual identity, exploration of one’s sexual identity, sexual orientation uncertainty, and synthesis/integration of one’s sexual identity. Several of Snell’s Sexual Self-Concept scales (e.g., sexual depression, sexual self-efficacy) and Tromovitch’s Comfort with Sexuality scales (e.g., comfort talking about sexuality, comfort with the sexual activities of others) were used to define sexual self-concept and erotophobia–erotophilia, respectively. A sample of students enrolled in an introductory psychology course at a Canadian university completed these instruments. Results suggest that sexual identity development was strongly predictive of sexual self-concept scales, multivariately. Sexual identity development was also predictive of comfort with sexuality. Sexual self-concept and erotophobia–erotophilia were also related to each other. These relationships supported the idea that a positive sexual identity development process contributes to a favorable view of the sexual self. However, the study was cross-sectional and correlational, so conclusions about directionality are preliminary and causality cannot be inferred.

"Making Peace" with Bodies and Sexual Selves: Changes during COVID-19 among Adults in the United States

The COVID-19 pandemic has negatively impacted the physical and mental health of many and has necessitated widespread societal shifts, including changes to work and family activities. These changes have impacted individuals’ identity, including their sexual self-image and body image, yet research on perceptions of these changes is missing. This study reports on quantitative and qualitative data from an electronic survey with adults in the United States (N = 326) to examine these perceptions. Body appreciation did not significantly differ between demographic groups. Themes emerging from the qualitative results included changes in general self-image (becoming more restricted or disempowered), changes in sexual self-image (deepening, becoming more sexy/sexual, or less sexy/sexual), and changes in body image (positive, negative, and neutral). Our findings point to positive, negative, and neutral effects on sexual self-image and body image, implying that nuanced approaches are needed to understand how identity has transformed as a result of the COVID-19 pandemic.

What is sexual wellbeing and why does it matter for public health?

Sexual health has provided a guiding framework for addressing sexuality in public health for several decades. Although the WHO definition of sexual health is revolutionary in acknowledging positive sexuality, public health approaches remain focused on risk and adverse outcomes. The long-standing conflation of sexual health and sexual wellbeing has affected our ability to address everyday sexual issues. This Viewpoint provides a way forward to resolve this impasse. We propose sexual wellbeing as a distinct and revolutionary concept that can be operationalised as a seven-domain model. We situate sexual wellbeing alongside sexual health, sexual justice, and sexual pleasure as one of four pillars of public health enquiry. We argue that sexual wellbeing is imperative to public health as a marker of health equity, a meaningful population indicator of wellbeing, a means to capture population trends distinct from sexual health, and an opportunity to refocus the ethics, form, and practices of public health.

Effect of the Lockdown Due to COVID-19 on Sexuality: The Mediating Role of Sexual Practices and Arousal in the Relationship Between Gender and Sexual Self-Esteem

The scientific evidence suggests that COVID-19 is affecting much more than the physical health of individuals, particularly in places where a lockdown has been established to slow down the spread of the virus. An area that may be particularly affected is human sexuality. This study explored the impact of the situation generated by COVID-19 on the sexuality of 201 adults living in Spain. We collected data cross-sectionally through an online survey during the month of April 2020. Results showed a reduction of sexual self-esteem and a decrease in the number of interpersonal sexual relations, although the frequency of masturbation and the consumption of pornography did not vary compared to previous levels. A regression analysis showed that masturbation, the ability to maintain sexual arousal and interpersonal sex were mediating variables in the relationship between gender - specifically being male - and having higher sexual self-esteem during the lockdown. This study provides new insight on the relevance of certain sexual behaviors in a pandemic situation with considerable social restrictions and on the effect of this situation on sexual self-esteem and arousal. It brings some clarity on the relationship between sexual self-esteem and gender, about which there is currently no consensus in the scientific literature.

Correction to: Emotional intimacy and sexual well-being in aging European couples: a cross-cultural mediation analysis

[This corrects the article DOI: 10.1007/s10433-019-00509-x.].

The Impact of Sociosexualization and Sexual Identity Development on the Sexual Well-Being of Youth Formerly in the Foster Care System

PURPOSE

Youth in the child welfare system experience disproportionate rates of negative sexual health outcomes as well as increased engagement in risky sexual behaviors. This study explored the impact of sociosexualization and sexual identity development on the sexual well-being of youth formerly in the foster care system.

METHODS

Two hundred and nineteen youth formerly in the foster care system completed an Internet-based survey, including measures of the level of sexuality-related topics discussion, relationship quality with the individual with whom the topics were discussed, adverse childhood experiences, severity of sexual abuse history, sexual identity development, and sexual well-being. Hierarchical regressions examined the impact of youths' sociosexualization experiences and four domains of sexual identity development on their sexual well-being.

RESULTS

Sexual Identity Commitment was the strongest positive predictor of youths' sexual well-being (β = .428) followed by Sexual Identity Synthesis/Integration (β = .350) and Sexual Identity Exploration (β = .169). Sexual Orientation Identity Uncertainty negatively impacted sexual well-being (β = -.235), as did adverse childhood experiences (β range = -.150 to -.178) and sexual abuse severity (β range = -.208 to -.322). Sexuality-related discussions with foster parents negatively impacted youths' sexual well-being, whereas discussions with peers were a positive predictor.

CONCLUSION

Enhancing youths' sexual identity development and reducing the impact of traumatic experience are critical to improving sexual well-being. The influence of sexuality-related discussions on sexual well-being requires further analysis as impacts varied widely. Public policies should provide guidance to professionals on what services should be provided to enhance youths' sexual development.

Emotional intimacy and sexual well-being in aging European couples: a cross-cultural mediation analysis

Sexual health research tends to focus on problematic aspects of sexuality. This also applies to research on sexuality in older men and women, where attention has been primarily on the negative impact of aging. To contribute to the emerging interest in positive (successful) sexual aging, we aimed to: (1) further validate a recently developed 5-dimensional measure of sexual well-being (Štulhofer et al. in J Happiness Stud, 2018. 10.1007/s10902-018-0049-1) and (2) explore the structure of associations among emotional intimacy, frequency of sexual intercourse, and sexual well-being in older European couples. Using data from a 2016 community-based survey of 218 Norwegian, 207 Danish, 135 Belgian, and 117 Portuguese couples aged 60-75 years, we applied actor-partner interdependence structural modeling approach to confirm the validity of the sexual well-being measure in couples and explore a path analytic model in which the frequency of sexual intercourse was hypothesized to mediate the association between emotional intimacy and sexual well-being. Although we observed consistent and significant actor effects, with emotional intimacy and frequency of sexual intercourse predicting both male and female partners' sexual well-being across countries, the proposed mediation was observed only in Norwegian and Portuguese men and Norwegian and Belgian women. Partner effects were gender-specific; male partner's emotional intimacy was related to his female partner's reported frequency of sex and sexual well-being but not the other way around. Apart from being one of the few cross-cultural assessments of successful sexual aging, this study's findings support the use of a new sexual well-being measure in research on older adults' sexuality.

Youth Sexual Development: A Primer for Social Workers

Sexuality and sexual expression are core aspects of most clients' lives, yet most schools of social work fail to cover sexual development, leaving social workers uninformed about this essential area of human development. This is particularly the case when the sexual development of youths is concerned, as youth sexuality is often considered too controversial to explore. Considering a positive approach to youth sexuality that seeks to enhance youths' sexual development and promote their achievement of full sexual and reproductive rights, this article seeks to provide social workers with a resource they can use to enhance their understanding of youth sexual development and its applicability to social work practice. The two main theoretical orientations used to understand sexual identity development are covered as well as the research support for each. Following the explanation of theory is a discussion of how the two theoretical orientations can be integrated to form a more expansive base for the understanding of sexual identity development. A final section provides guidance on how an advanced understanding of youthful sexual identity development can enhance social work practice at the micro, mezzo, and macro levels.

A Rapid Review of Sexual Wellbeing Definitions and Measures: Should We Now Include Sexual Wellbeing Freedom?

An increasing number of studies refer to sexual wellbeing and/or seek to measure it, and the term appears across various policy documents, including sexual health frameworks in the UK. We conducted a rapid review to determine how sexual wellbeing has been defined, qualitatively explored and quantitatively measured. Eligible studies selected for inclusion from OVID Medline, PsychInfo, PubMed, Embase, CINAHL were: in English language, published after 2007, were peer-reviewed full articles, focused on sexual wellbeing (or proxies for, e.g. satisfaction, function), and quantitatively or qualitatively assessed sexual wellbeing. We included studies with participants aged 16-65. Given study heterogeneity, our synthesis and findings are reported using a narrative approach. We identified 162 papers, of which 10 offered a definition of sexual wellbeing. Drawing upon a socio-ecological model, we categorised the 59 dimensions we identified from studies under three main domains: cognitive-affect (31 dimensions); inter-personal (22 dimensions); and socio-cultural (6 dimensions). Only 11 papers were categorised under the socio-cultural domain, commonly focusing on gender inequalities or stigma. We discuss the importance of conceptualising sexual wellbeing as individually experienced but socially and structurally influenced, including assessing sexual wellbeing freedom: a person's freedom to achieve sexual wellbeing, or their real opportunities and liberties.

Emotional intimacy and sexual well-being in aging European couples: a cross-cultural mediation analysis

Sexual health research tends to focus on problematic aspects of sexuality. This also applies to research on sexuality in older men and women, where attention has been primarily on the negative impact of aging. To contribute to the emerging interest in positive (successful) sexual aging, we aimed to: (1) further validate a recently developed 5-dimensional measure of sexual well-being (Štulhofer et al. in J Happiness Stud, 2018. 10.1007/s10902-018-0049-1) and (2) explore the structure of associations among emotional intimacy, frequency of sexual intercourse, and sexual well-being in older European couples. Using data from a 2016 community-based survey of 218 Norwegian, 207 Danish, 135 Belgian, and 117 Portuguese couples aged 60-75 years, we applied actor-partner interdependence structural modeling approach to confirm the validity of the sexual well-being measure in couples and explore a path analytic model in which the frequency of sexual intercourse was hypothesized to mediate the association between emotional intimacy and sexual well-being. Although we observed consistent and significant actor effects, with emotional intimacy and frequency of sexual intercourse predicting both male and female partners' sexual well-being across countries, the proposed mediation was observed only in Norwegian and Portuguese men and Norwegian and Belgian women. Partner effects were gender-specific; male partner's emotional intimacy was related to his female partner's reported frequency of sex and sexual well-being but not the other way around. Apart from being one of the few cross-cultural assessments of successful sexual aging, this study's findings support the use of a new sexual well-being measure in research on older adults' sexuality.

Implications of no recent sexual activity, casual sex, or exclusive sex for college women's sexual well-being depend on sexual attitudes

OBJECTIVE

We examine how sexual activity relates to sexual well-being within the context of sexual attitudes, sexual agency, and sexual desire.

PARTICIPANTS/METHODS

We surveyed 471 college women in 2012-2014 who had ever had sex.

RESULTS

Sexual agency and sexual desire consistently predicted well-being, regardless of recent sexual activity. There was a significant interaction between recent sexual activity (none, casual, or exclusive relationship) and sexual attitudes. Exclusive sex was associated with higher than average sexual well-being, especially for women with permissive attitudes. Women who had casual sex and held permissive to average attitudes had the next highest levels of well-being, but those with non-permissive attitudes fell substantially below the overall mean. Women who had no recent sex were consistently below the mean, especially for women with more permissive attitudes.

CONCLUSIONS

A disconnect between sexual attitudes and recent sexual activity may lower women's sexual well-being.

Willingness to Engage in Consensual Nonmonogamy Among Emerging Adults: A Structural Equation Analysis of Sexual Identity, Casual Sex Attitudes, and Gender

Research on consensual nonmonogamy (CNM) has increased over the past decade. However, willingness to engage in CNM is an understudied phenomenon within this body of literature. Little research has examined the correlates of this aspect of CNM or focused on individuals in the developmental period of emerging adulthood. This study used multigroup structural equation modeling (SEM) to test a conceptual model of emerging adults' (ages 18 to 29; N = 890) willingness to engage in CNM. Results indicated that emerging adult experimentation/possibilities, sexual identity exploration, and permissive attitudes toward casual sex were all related to willingness to engage in CNM. Results also showed that the pathway from emerging adult experimentation/possibilities to willingness to engage in CNM was differentially mediated across gender. Specifically, for women there was an indirect (and positive) pathway from experimentation/possibilities to willingness to engage in CNM through sexual identity exploration. For men there was an indirect (and positive) pathway from experimentation/possibilities to willingness to engage in CNM through permissive attitudes toward casual sex. Implications for future studies on CNM among emerging adults are discussed.

The construct of sexual openness for females in steady intimate relationships

The analysis of open-minded attitudes towards sexuality in general requires a construct based on attitudinal dimensions. Although several existing studies involve sexual attitudes, they differ substantially and standardized conceptual work is missing. Thus, the authors introduce the latent variable sexual openness to develop a construct based on self-oriented attitudes towards different sexual topics. Available survey data of female German students in a steady relationship allowed providing a first empirical test for the applicability of this construct. Five subdimensions are acknowledged central for sexual openness: sexual practices, masturbation, bisexuality, permissiveness, and pornography consumption. Confirmatory factor analysis and correlations confirmed the idea of an underlying mechanism with an impact on all five variables. Though further validation of the construct of sexual openness is required, the findings strongly support the notion of an overarching latent attitude variable, which influences the individual relation to everything sexual. The results were compared to other studies and potential approaches for future analyses were proposed.

Sexual well-being of older men and women

Most older adults experience sexual desire and engage in sexual activity, however, our knowledge about the sexual well-being (SWB) of older adults is still scarce. The present study aimed to examine the SWB of older adults as well as differences in their SWB based on gender and relationship status. The final sample consisted of 297 adults (149 men and 148 women) who ranged in age from 65 to 75 years; 63% (n=188) were currently in a romantic relationship. Participants were recruited using the crowdsourcing platform Amazon's M-Turk. Participants completed a background questionnaire, as well as measures of sexual behaviours (frequency of genital and non-genital activity and masturbation alone), sexual affect and cognitions (sexual esteem, attitudes, and satisfaction), sexual motivation (sexual interest), and sexual functioning. Our participants reported overall positive SWB; specifically, positive sexual self-esteem and attitudes toward sex as well as high sexual satisfaction and interest. Furthermore, participants who were in a relationship engaged in frequent genital and non-genital sexual activity. About two-thirds of the participants in a current relationship had experienced at least one sexual difficulty in the last three months, but only one-quarter were distressed about it. Although some gender and relationship status differences emerged, in general both the men and women and participants who were and were not in a relationship reported positive SWB. These results are discussed in terms of the ways in which they extend our knowledge on the SWB of older adults and challenge popular myths about sexuality in later life.

Predictors of the Sexual Well-being of Individuals Diagnosed with Herpes and Human Papillomavirus

Research suggests that having a sexually transmitted infection (STI) such as genital herpes and human papillomavirus (HPV) can negatively affect sexual well-being. However, there is little research examining factors associated with poorer sexual well-being among individuals with a STI. This study investigated the extent to which stigma experiences, individual characteristics, and STI characteristics were associated with multiple aspects of sexual well-being among individuals diagnosed with herpes and/or HPV. Participants were an average of 36 years old (SD = 11.58) and included 188 individuals with herpes and/or HPV who completed measures of sexual activity, sexual problems, and sexual cognitive-affective factors. The results showed that experiences of stigmatization were the most important predictors of sexual well-being. Participants who perceived were stigmatized by others as well as those who internalized negative social attitudes to a greater extent reported poorer sexual well-being across all dimensions, over and above individual and STI characteristics. The implications of these findings for sexual health professionals are discussed.

I Want Your Sex: The Role of Sexual Exploration in Fostering Positive Sexual Self-Concepts for Heterosexual and Sexual Minority Women

Openness and self-exploration have been associated with myriad benefits. Within the realm of sexuality, sexual exploration may be 1 facet of openness and self-exploration that yields benefits. Prior literature suggests that such exploration may have benefits for sexual orientation minority persons, though limited research has investigated the benefits of sexual exploration for heterosexuals. The present study used data from 346 adult women (185 exclusively heterosexual, 161 not exclusively heterosexual) to investigate the role of sexual exploration as a mediator between sexual orientation status and positivity toward sex. Results of a structural equation modeling analysis supported mediation of the relationship between sexual orientation and sexual positivity via sexual exploration. Implications for future research and clinical interventions are presented.

Good, Giving, and Game

In two dyadic studies (a short-term longitudinal study and a daily experience study), we demonstrate that people high in sexual communal strength (i.e., those motivated to meet a romantic partner’s sexual needs) have partners who are more satisfied with and committed to their relationships. In Study 1, people higher in sexual communal strength had partners who felt more satisfied and committed to the relationship both at that time and 3 weeks later. In Study 2, the partners of people high in sexual communal strength perceived their partners as more responsive to their needs during sex, and this was one reason why they reported feeling more satisfied and committed in the relationship. Implications for theories of communal motivation and approaches to sexuality in romantic relationships are discussed.

Sexual health behaviors and sexual orientation in a U.S. national sample of college students

Many studies have examined differences in sexual behavior based on sexual orientation with results often indicating that those with same-sex partners engage in higher risk sexual behavior than people with opposite sex partners. However, few of these studies were large, national sample studies that also include those identifying as unsure. To address that gap, this study examined the relationship of sexual orientation and sexual health outcomes in a national sample of U.S. college students. The Fall 2009 American College Health Association-National College Health Assessment was used to examine sexual health related responses from heterosexual, gay, lesbian, bisexual, and unsure students (N = 25,553). Responses related to sexual behavior, safer sex behaviors, prevention and screening behaviors, and diagnosis of sexual health related conditions were examined. The findings indicated that sexual orientation was significantly associated with engaging in sexual behavior in the last 30 days. Sexual orientation was also significantly associated with the number of sexual partners in the previous 12 months, with unsure men having significantly more partners than gay, bisexual and heterosexual men and heterosexual men having significantly less partners than gay, bisexual and unsure men. Bisexual women had significantly more partners than females reporting other sexual orientations. Results examining the associations between sexual orientation and safer sex, prevention behaviors, and screening behaviors were mixed. Implications for practice, including specific programmatic ideas, were discussed.

Young women's adolescent experiences of oral sex: relation of age of initiation to sexual motivation, sexual coercion, and psychological functioning

Research examining oral sex during adolescence tends to investigate only potential negative consequences without considering its place in sexual development or distinctions between cunnilingus and fellatio. Using retrospective reports from 418 undergraduate women, we examined the relations among young women's ages of initiation of both cunnilingus and fellatio and sexual motives, experiences of sexual coercion, and indicators of psychological functioning. Age at cunnilingus initiation was unrelated to sexual coercion or psychological functioning; however it was related to engaging in sex for personal stimulation and gratification (personal drive motive) and to feel agentic, assertive, and skillful (power motive). Age at fellatio initiation was related to feelings of inferiority compared to others and a devaluing of the self (interpersonal sensitivity). Findings challenge the unilateral assumption that all adolescent sexual activity is negative and indicate the need for future research distinguishing between cunnilingus and fellatio.

Young women's experiences and perceptions of cunnilingus during adolescence

Recent studies indicate that cunnilingus may be as prevalent as fellatio among American adolescents. Despite this approximate equivalence in rates, there is an imbalance in the amount and type of attention paid to fellatio and cunnilingus. Furthermore, there has been little empirical examination of young women's experiences and perceptions of cunnilingus during adolescence. Two studies in response to this gap in knowledge were conducted. In Study 1, regression analyses indicated that a young woman's sexual assertiveness was linked to having more lifetime cunnilingus partners, as well as more cunnilingus experiences in the past three months. Study 2 explored young women's perceptions of cunnilingus and their speculations about their male partners' perceptions thereof. Linear mixed modeling revealed that participants had highly favorable impressions of cunnilingus, which they believed their male partners shared. These findings are considered in terms of positive adolescent sexual development and cultural norms regarding female sexuality.