The costs and benefits of perceived sexual agency for men and women

Pornography Use and Sexual Objectification of Others

Researchers have demonstrated associations between use of pornography and sexual objectification of women. We examine whether self-reported preference for degrading pornography moderated the relation between use frequency and sexual objectification of others. Participants were 1,342 heterosexual women and men residing in the United States. In women and men, pornography use frequency was associated with the sexual objectification of others, even after controlling for interest in generally explicit content. In men, interest in degrading pornography content significantly predicted sexual objectification of women. Our results suggest greater pornography use is associated with greater sexual objectification of others, across a variety of content categories.

Evaluating a Theory-Based Online Program for Preventing Sexual Aggression: An Experimental-Longitudinal Study With German University Students

This pre-registered study evaluated an intervention designed to reduce sexual aggression perpetration and victimization by changing risky scripts for consensual sexual interactions and corresponding risky sexual behavior, and by improving sexual self-esteem, refusal assertiveness, and initiation assertiveness. In a four-wave longitudinal study covering 23 months, 1181 university students in Germany (762 female) were randomly assigned to an intervention and a no-intervention control group. The intervention group completed six weekly modules addressing the targeted theory-based risk and vulnerability factors of sexual aggression perpetration and victimization. Controlling for baseline levels (T1), the intervention group showed less risky sexual scripts one week post-intervention (T2), which predicted less risky sexual behavior nine months later (T3), which predicted lower odds of sexual aggression perpetration and victimization 12 months later (T4). No direct intervention effects on rates of sexual aggression perpetration and victimization at T3 and T4 were found. No indirect intervention effect on sexual aggression was found via sexual self-esteem and sexual assertiveness. However, sexual self-esteem at T2, which was higher in the intervention group, predicted lower odds of sexual aggression victimization at T3 via higher initiation assertiveness at T3. Implications for reducing sexual aggression and conceptualizing risk and vulnerability factors of sexual aggression are discussed.

Sexual Assertiveness and Its Correlates in Emerging Adults: An Exploratory Study in Cuenca (Ecuador)

Objective: Sexual assertiveness (SA), i.e., the ability to communicate thoughts and desires that may be translated into satisfying sexual activity within an intimate relationship, is important for safe and satisfying sexual behavior. In an attempt to unravel which cultural, relational, and individual variables are related to the development of SA in emerging adults, an exploratory study was conducted in Cuenca, Ecuador. Methods: Five hundred and thirty-eight participants completed scales that measured their levels of SA, endorsement of the sexual double standard, relationship satisfaction, and mental well-being. Results: This study showed a negative effect of the sexual double standard on SA in both men and women and this effect was slightly tempered by the level of education. Women reported higher levels of SA than men. In women, SA was associated with general mental well-being and relationship satisfaction; but not in men. For both women and men, no association was found with relationship status or duration. Conclusions: These findings corroborate evidence highlighting the importance of SA for healthy sexual relationships and emphasize the importance of (sex) education for SA for lower educated women and men. The results are discussed in relation to findings on SA in other contexts.

It's The "Why": Links between (Non)autonomous Sexual Motives, Sexual Assertiveness, and Women's Orgasm in Casual Sex

Existing literature shows conflicting and inconclusive evidence regarding women's sexual experiences in casual sex. Some studies have found negative sexual outcomes (e.g., fewer orgasms), while others have found positive sexual outcomes (e.g., more orgasms, higher sexual satisfaction) when women had casual sex. According to self-determination theory (Deci & Ryan, 1985), people's needs are fulfilled when their choice and behavior are self-motivated and reflect their intrinsic values. We hypothesized that women's autonomous motivation to have casual sex would be associated with higher orgasmic function, whereas nonautonomous motivation would be associated with lower orgasmic function in casual sex. We also hypothesized that sexual assertiveness would mediate the relationship between sexual motives and orgasmic function in casual sex. Participants in this study were women (N = 401) aged 18-59 years who reported having had casual sex in the past 12 months. Participants completed an online survey reporting their motives to have casual sex, sexual assertiveness, and orgasmic function (e.g., orgasm frequency, satisfaction with orgasm) in casual sex. We focused on two motives: (a) pleasure motive and (b) insecurity (i.e., self-esteem boost and pressure) motive. Results showed that greater pleasure (autonomous) motives related to higher sexual assertiveness, which in turn related to higher orgasmic function in casual sex. In contrast, greater insecurity (nonautonomous) motives related to lower sexual assertiveness, which in turn related to lower orgasmic function in casual sex. The findings support self-determination theory, suggesting that autonomous motives are important for women's sexual experience in casual sex.

"It was with my consent since he was providing me with money": a mixed methods study of adolescent perspectives on peacekeeper-perpetrated sexual exploitation and abuse in the Democratic Republic of Congo

Background

The United Nations Organization Stabilization Mission in the Democratic Republic of Congo (MONUSCO) has been marred by widespread allegations of sexual exploitation and abuse (SEA) of women and girls by UN peacekeepers. There is minimal research conducted on the perceptions of communities most affected by the SEA themselves, and even less about those below the age of 18.

Methods

Using mixed-methods data, we examined the perceptions of adolescents aged 13–17 on how the lives of women and girls have been affected by the presence of UN peacekeepers within the DRC. SenseMaker, a mixed-methods narrative capture tool, was used to survey participants around six United Nations bases across eastern DRC. Each participant shared a story about the experiences of Congolese women and girls in relation to MONUSCO personnel and interpreted their own stories by answering a series of questions. Patterns of adolescent perspectives (aged 13–17) were analyzed in comparison to all other age groups and emerging qualitative themes were mapped onto quantitative variables.

Results

Quantitative data showed that adolescents were more likely, in comparison to all other age groups, to perceive interactions between peacekeepers and women/girls as being initiated by the woman/girl, that the MONUSCO personnel was perceived to be able to offer protection, and that the interactions between local women/girls and peacekeepers were sexual in nature. Three qualitative themes emerged: poverty bringing peacekeepers and women/girls together, material/financial gain through transactional sex and sex work, and support-seeking actions of affected women/girls.

Conclusions

Our mixed methods data illustrate the problematic finding that adolescents facing poverty may perceive SEA as protective through the monetary and material support gained. These findings contribute to the growing body of literature on peacekeeping economies and have implications for the prevention of, and response to, peacekeeper-perpetrated SEA.

Understanding Sexual Agency. Implications for Sexual Health Programming

Debates on human agency, especially female and sexual agency, have permeated the social scientific literature and health educational practice for multiple decades now. This article provides a review of recent agency debates illustrating how criticisms of traditional conceptions of (sexual) agency have led to a notable diversification of the concept. A comprehensive, inclusive description of sexual agency is proposed, focusing on the navigation of goals and desires in the wider structural context, and acknowledging the many forms sexual agency may take. We argue there is no simple relation between sexual agency and sexual health. Next, we describe the implications of such an understanding of sexual agency for Comprehensive Sexuality Education (CSE) and for sexual health and rights (SHR) programming more generally. We put forward validation of agentic variety, gender transformative approaches, meaningful youth participation, and multicomponent strategies as essential in building young peoples’ sexual agency and their role as agents of wider societal change. We also show that these essential conditions, wherever they have been studied, are far from being realized. With this review and connected recommendations, we hope to set the stage for ongoing, well-focused research and development in the area.

Differentiating contributions of self-objectification and self-sexualization to young women's sexual agency

Findings consistently illustrate the negative association between women's sexual objectification and their sexual functioning. At the same time, some scholars argue that sexualized self-presentation may be a way to embrace one's sexuality and may signify empowerment. To date, no studies have explicitly explored the potential differential contributions of self-objectification and self-sexualization to multiple aspects of women's sexual agency. Towards this end, we surveyed 556 undergraduate women to examine how body surveillance, self-objectification, and self-sexualization differentially predict women's sexual assertiveness, sexual satisfaction, feelings of entitlement to sexual pleasure, condom use self-efficacy, and sexual esteem. Path analysis demonstrated consistent negative links between body surveillance, one behavioral manifestation of self-objectification, and sexual agency outcomes, but revealed both negative and positive links between measures of sexualization and sexual agency. This complex set of associations highlights the value of studying self-objectification and self-sexualization both in tandem and separately, so that researchers can develop a better understanding of the implications of each for women's sexual agency.

Posts, Likes, Shares, and DMs: A Qualitative Exploration of How Social Media Is Related to Sexual Agency in Young People

It is well documented that social interactions have a crucial impact on all aspects of personal development for adolescents, however few studies have documented how social interactions affect a young person's sense of sexual agency. The aim of the current qualitative study was to examine young people's perceptions of their own sexual agency in relation to their social media attitudes and behaviors. Participants (n = 31) were recruited from a nonprofit organization and asked to complete a one-hour in-depth interview and a demographic survey. Using an inductive method, involving constant comparison, we identified four overarching themes: (a) Participants utilize different social media platforms for distinct purposes and are cognizant of each audience; (b) Based on past experiences, participants have negotiated and created their own rules of engagement for online behavior; (c) Participants have different expectations about how others should act online versus how they act in relation to flirty or sexual messages; (d) Participants were concerned about the authenticity of online identities and are aware of vulnerability in online interactions. Our results highlight the need for sexual health researchers to observe social network etiquette closely through the lens of autonomy and agency.

Latin American Women´s Beliefs, Views and Ideas About Sexual Assertiveness: A Focus Group Study in Cuenca (Ecuador)

In an attempt to extend our understanding of how social contexts co-create female sexuality in Latin America, the aim of the current study was to explore the beliefs, views, and ideas about sexual assertiveness in Latino emerging adult women. Seventeen women between 22 and 30 years old living in Cuenca, Ecuador, participated in focus groups. A constructivist grounded theory approach was used to analyze the data. Findings suggest that the overall views about sexual assertiveness in emerging adult women can be grouped into five categories: (1) gender role schemata; (2) concerns about the partner's thoughts and reactions; (3) gendered attitudes towards the use of specific methods of contraception; (4) talking about sexual histories as a challenging task; and (5) replication of family patterns. The findings of this study are discussed within existing literature that highlights the influence of gender role schemata on sexual assertiveness. Finally, a plea for more culturally sensitive research is formulated as well as some educational - the need to reinforce sex education programs - and clinical - highlighting the ability to be sexually assertive from the start of a relationship - implications are mentioned.

Following Their Lead? Connecting Mainstream Media Use to Black Women's Gender Beliefs and Sexual Agency

Although media exposure has emerged as a significant predictor of consumers' sexual decision making, less is known about the mechanisms involved and about the dynamics of these relations for adults, in general, and for African American adults, in particular. To address these gaps, we used structural equation modeling (SEM) to test whether heterosexual Black women's endorsement of traditional gender and sexual roles mediates connections between their consumption of four mainstream media (music videos, reality TV programming, movies, and women's magazines) and three dimensions of their sexual well-being (sexual assertiveness, sexual inhibition, and sexual deception). We surveyed 594 heterosexual Black women aged 17 to 55 who were undergraduate and graduate students at two universities (one historically Black university and one predominantly White institution). Results confirmed expectations, such that greater media consumption was associated with greater support of traditional gender and sexual roles; in turn, endorsing these roles predicted lower levels of sexual assertiveness, greater sexual inhibition, and more frequent use of sexual dishonesty to retain a partner. We discuss implications of these findings for psychology and sexuality research and also for Black women's sexual relationships.

"No One Can Make that Choice for You": Exploring Power in the Sexual Narratives of Black Collegians

Power is enacted to oppress others, pursue wellness, or resist oppression. For Black people, societal and relational oppression influences racialized and gendered expressions of power within sexual encounters. The current study analyzed power dynamics within Black university students' first and most recent sexual encounters. Using narrative inquiry within a critical paradigm, five narrative strategies were identified within participants' interviews: 1) Offering a Peek into Powerlessness, 2) Detailing Disempowerment, 3) Privileging Stereotypical Power, 4) Reclaiming Power, and 5) Emphasizing Empowered Sex. Racialized, gendered sexual socialization among Black students is discussed. Counseling considerations to increase sexual wellness for Black people are explored.

He is a Stud, She is a Slut! A Meta-Analysis on the Continued Existence of Sexual Double Standards

(Hetero)sexual double standards (SDS) entail that different sexual behaviors are appropriate for men and women. This meta-analysis (k = 99; N = 123,343) tested predictions of evolutionary and biosocial theories regarding the existence of SDS in social cognitions. Databases were searched for studies examining attitudes or stereotypes regarding the sexual behaviors of men versus women. Studies assessing differences in evaluations, or expectations, of men’s and women’s sexual behavior yielded evidence for traditional SDS (d = 0.25). For men, frequent sexual activity was more expected, and evaluated more positively, than for women. Studies using Likert-type-scale questionnaires did not yield evidence of SDS (combined M = −0.09). Effects were moderated by level of gender equality in the country in which the study was conducted, SDS-operationalization (attitudes vs. stereotypes), questionnaire type, and sexual behavior type. Results are consistent with a hybrid model incorporating both evolutionary and sociocultural factors contributing to SDS.

Women's Sexual Satisfaction, Communication, and Reasons for (No Longer) Faking Orgasm: Findings from a U.S. Probability Sample

We aimed to assess, among a U.S. probability sample of adult women: (1) the prevalence of, and reasons given for, faking and no longer faking orgasm, (2) women's histories of sexual non-communication and reasons for non-communication, (3) associations between sexual non-communication and sexual satisfaction and faking orgasm, (4) associations between specific sexual communication and recent sexual satisfaction, and (5) associations between specific sexual communication and faking orgasm. Respondents were 1008 adult women ages 18-94 from the GfK KnowledgePanel (a nationally representative probability sample of non-institutionalized and English-speaking adults), who completed a confidential Internet-based survey. Although 58.8% of female respondents reported having ever faked/pretended orgasm, 67.3% of those who had ever faked orgasm no longer did. Women who continued to fake orgasms were more likely to indicate embarrassment talking about sex with their partner in explicit ways and were less likely to agree that they and their partner are able to talk specifically about what makes sex more pleasurable for them. More than half (55.4%) of women reported they had wanted to communicate with a partner regarding sex but decided not to; the most common reasons were not wanting to hurt a partner's feelings (42.4%), not feeling comfortable going into detail (40.2%), and embarrassment (37.7%). Greater self-reported sexual satisfaction was associated with more comfortable sexual communication. Study findings and implications for professionals are discussed in the context of adult sexual development and learning. This includes growing more comfortable talking with a partner about sexual preferences and sexual pleasure.

"Fulfilling His Needs, Not Mine": Reasons for Not Talking About Painful Sex and Associations with Lack of Pleasure in a Nationally Representative Sample of Women in the United States

INTRODUCTION

Although much research has examined correlates of pain during sex, far less research has examined why women have sex despite having pain and why they avoid telling their partner.

AIM

The purpose of our study was to examine women's reports of painful sex, including location of pain, whether they told their partner, factors associated with not disclosing their pain, and their reasons for not disclosing.

METHODS

We used data from the 2018 National Survey of Sexual Health and Behavior, a probability-based online survey of 2,007 individuals ages 14 to 49 years. We limited our sample to adult women who reported a sexual experience that was painful in the past year (n = 382; 23.2%). The primary outcome in quantitative analyses was whether women told their partner they experienced pain during sex. Associations with social identities and sexual health were explored via logistic regression. Those who did not tell their partner about painful sex were asked why; their accounts were coded and analyzed qualitatively.

MAIN OUTCOME MEASURE

Women were asked, "To what extent was this sexual experience physically painful for you?" Those who reported any pain were asked, "Did you tell your partner that you were in pain during sex?" and, if applicable, "Why didn't you tell your partner that you were in pain during sex?"

RESULTS

Of those reporting pain during sex, most said it was "a little painful" (81.6%) and occurred at the vaginal entrance (31.5%), inside the vagina (34.4%), or at or around the cervix (17.4%). Overall, 51.0% (n = 193/382) told their partner about their pain. Adjusting for age and wantedness, women who reported little or no event-level sexual pleasure had nearly 3-fold greater odds of not telling a partner about painful sex (adjusted odds ratio = 3.24; 95% CI, 1.43-7.37). Normalizing painful sex, considering pain to be inconsequential, prioritizing the partner's enjoyment, and gendered interactional pressures were the predominant themes in women's narratives.

CLINICAL IMPLICATIONS

Providers should ask about painful sex, if the woman continues intercourse despite pain, and how she feels about this as a means of assessing any sexual and social pressures.

STRENGTHS & LIMITATIONS

Strengths include the use of social theory in nationally representative survey research to examine how contextual factors influence sexual health, but experiences were largely limited to heterosexual interactions.

CONCLUSION

Many women do not discuss painful sex with their partners, lack of pleasure is significantly more likely among this group, and gender norms and cultural scripts are critical to understanding why. Carter A, Ford JV, Luetke M, et al. "Fulfilling His Needs, Not Mine": Reasons for Not Talking About Painful Sex and Associations with Lack of Pleasure in a Nationally Representative Sample of Women in the United States. J Sex Med 2019; 16:1953-1965.

Perceptions of Sexual Script Deviation in Women and Men

Traditional sexual scripts are characterized by a gendered power inequality (male dominance vs. female submission) (Sanchez, Fetterolf, & Rudman, 2012). Although gender differences in a variety of sexual behaviors have been decreasing, research into sexual scripts provides some support for the existence of traditional sexual scripts adherence. Study 1a and 1b focused on men's evaluations of sexual script deviation in women (i.e., sexually assertive behavior) and the possible disapproval of these behaviors (backlash effects). Participants (381 and 382 self-identified heterosexual men) were presented with a randomly assigned vignette describing a hypothetical sexual scenario in which a woman behaved either sexually assertive or sexually timid. Both studies indicated that men to some extent expressed disapproval of sexually assertive women. With the aim to assess if backlash effects were due to women's sexual script deviation or if there was an overall negative evaluation of sexually assertive behavior irrespective of the target's gender, in Study 2 we focused on the perception of sexually assertive behavior in both women and men (N = 268). Although we found that gender role conformity was held for women, but not for men, the results suggest that the negative evaluation of sexual assertiveness was not due to script deviation, but that there is an overall conservative attitude toward sexually assertive behavior. Our study provides some insight into the motives of traditional sexual script adherence particularly for women.

Traditional Sex and Gender Stereotypes in the Relationships of Non-Disclosing Behaviorally Bisexual Men

Traditional stereotypes about sex and gender present men as assertive, aggressive, sexually adventurous, and emotionally restrained, and women as docile, passive, sexually modest, and emotionally sensitive. Past research has shown that such stereotypes impose constraints on heterosexual relationships that decrease sexual satisfaction for men and women. This study examined the impact of traditional sex and gender stereotypes on a sample of 203 behaviorally bisexual men who were in a heterosexual relationship with a woman to whom they did not disclose their same-sex behaviors. Participants' descriptions of their partners reified several traditional stereotypes regarding men's and women's sexual dispositions (e.g., men are more sexually adventurous than women), role during sex (e.g., men should be dominant and women submissive), relationship desires (i.e., women prefer long-term intimate relationships and men prefer unattached sexual gratification), and emotional involvement (e.g., women are emotionally sensitive and men emotionally detached). These stereotypes shaped participants' sexual relations with women and men, which were widely conceived as acts of domination-submission. Perceiving women as more skilled for emotional intimacy and affection, most participants would only develop intimate relationships with them; however, some participants also perceived women as too emotionally sensitive and described men as better companions. Many participants were dissatisfied with these gender norms although they conformed to them, further supporting that traditional sex and gender stereotypes impose constraints on relationships that can limit authentic sexual expression and intimate satisfaction.

Examining the unique contribution of body appreciation to heterosexual women's sexual agency

Although numerous studies demonstrate links between negative body image and sexual well-being, recent research has emphasized studying the positive aspects of these constructs. The current study built upon this prior research by examining the association between body appreciation and sexual agency among a US community sample of 355 heterosexual women aged 18-40. This study also examined whether body appreciation is uniquely associated with sexual agency above and beyond levels of self-objectification. Regression analyses demonstrated that women who reported greater body appreciation also reported greater condom use self-efficacy, sexual satisfaction, sexual assertiveness, and feelings of entitlement to sexual pleasure, and lower levels of body self-consciousness during intimacy. These findings remained consistent even when self-objectification was entered into the model as a covariate. Results highlight the importance of studying how body appreciation may promote women's sexual agency.

Supporting the Sexual Rights of Women Living With HIV: A Critical Analysis of Sexual Satisfaction and Pleasure Across Five Relationship Types

In the context of human immunodeficiency virus (HIV), a focus on protecting others has overridden concern about women's own sexual well-being. Drawing on feminist theories, we measured sexual satisfaction and pleasure across five relationship types among women living with HIV in Canada. Of the 1,230 women surveyed, 38.1% were completely or very satisfied with their sexual lives, while 31.0% and 30.9% were reasonably or not very/not at all satisfied, respectively. Among those reporting recent sexual experiences (n = 675), 41.3% always felt pleasure, with the rest reporting usually/sometimes (38.7%) or seldom/not at all (20.0%). Sex did not equate with satisfaction or pleasure, as some women were completely satisfied without sex, while others were having sex without reporting pleasure. After adjusting for confounding factors, such as education, violence, depression, sex work, antiretroviral therapy, and provider discussions about transmission risk, women in long-term/happy relationships (characterized by higher levels of love, greater physical and emotional intimacy, more equitable relationship power, and mainly HIV-negative partners) had increased odds of sexual satisfaction and pleasure relative to women in all other relational contexts. Those in relationships without sex also reported higher satisfaction ratings than women in some sexual relationships. Findings put focus on women's rights, which are critical to overall well-being.

Exploring Definitions and Prevalence of Verbal Sexual Coercion and Its Relationship to Consent to Unwanted Sex: Implications for Affirmative Consent Standards on College Campuses

Campus sexual assault is a pervasive issue impacting the well-being, quality of life, and education of all students. There have been many recent efforts to prevent and address campus sexual assault, most notably the adoption of affirmative consent standards. (1) Efforts to address sexual assault on college campuses through an affirmative consent standard could be undermined by traditional gender norms, sexual scripts, and the power dynamics inherent in heterosexual relations, which lead to situations in which many women provide consent to unwanted sex. (2) Studies indicate that college women are likely to experience verbal sexual coercion, yet research has failed to come to a consensus on how to define, operationalize, and study verbal sexual coercion. (3) Research on sexual consent is also lacking, in particular as it relates to consent to unwanted sex as a result of the presence of verbal sexual coercion. (4) This article discusses how multiple forms of unwanted sex can be conceptually examined. (5) Policy implications and areas for future research are discussed.

[Trajectories of women living with HIV/AIDS in Brazil. Progress and permanence of the response to the epidemic]

This article analyzes the trajectories of 85 women living with HIV/AIDS in six Brazilian cities: Belém, São Paulo, Ribeirão Preto, Goiânia, Recife and Pelotas, to understand some specific aspects of their experiences before and after diagnosis. It is based on in-depth interviews conducted in 2009 addressing women diagnosed with HIV between 1 and 20 years previously. The results show a profile characterized by limited access to school, health services and labor and a marked presence of violence. The reasons for applying HIV tests vary over time and there is an increase in prenatal testing, although no modifications in the context of the infection are apparent. For some women, the diagnosis determines changes in lifestyle. However, for the majority, social and labor experiences and the decisions about love, sexuality and reproduction seem to respond to their immediate demands and opportunities. The management of the diagnosis and the support received influence living with HIV/AIDS. These results show the need for actions for prevention and testing not restricted to pregnant women, even in the context of a concentrated epidemic. Studies adopting a biographical perspective can contribute to prevent or improve living with HIV/AIDS appropriate to the different moments of the womens' trajectories.

Girl Power or Powerless Girl? Television, Sexual Scripts, and Sexual Agency in Sexually Active Young Women

Both traditional gender roles and traditional heterosexual scripts outline sexual roles for women that center on sexual passivity, prioritizing others’ needs, and self-silencing. Acceptance of these roles is associated with diminished sexual agency. Because mainstream media are a prominent source of traditional gender portrayals, we hypothesized that media use would be associated with diminished sexual agency for women, as a consequence of the traditional sexual roles conveyed. We modeled the relations among television (TV) use, acceptance of gendered sexual scripts, and sexual agency (sexual assertiveness, condom use self-efficacy, and sexual shame) in 415 sexually active undergraduate women. As expected, both TV exposure and perceived realism of TV content were associated with greater endorsement of gendered sexual scripts, which in turn were associated with lower sexual agency. Endorsement of gendered sexual scripts fully mediated the relation between TV use and sexual agency. Results suggest that endorsement of traditional gender roles and sexual scripts may be an important predictor of college women’s sexual agency. Interventions targeting women’s sexual health should focus on encouraging media literacy and dismantling gender stereotypic heterosexual scripts. Online slides for instructors who want to use this article for teaching are available on PWQ's website at http://journals.sagepub.com/page/pwq/suppl/index .

When Sex and Power Collide: An Argument for Critical Sexuality Studies

Attentive to the collision of sex and power, we add momentum to the ongoing development of the subfield of critical sexuality studies. We argue that this body of work is defined by its critical orientation toward the study of sexuality, along with a clear allegiance to critical modalities of thought, particularly feminist thought. Critical sexuality studies takes its cues from several other critical moments in related fields, including critical psychology, critical race theory, critical public health, and critical youth studies. Across these varied critical stances is a shared investment in examining how power and privilege operate, understanding the role of historical and epistemological violence in research, and generating new models and paradigms to guide empirical and theoretical research. With this guiding framework, we propose three central characteristics of critical sexuality studies: (a) conceptual analysis, with particular attention to how we define key terms and conceptually organize our research (e.g., attraction, sexually active, consent, agency, embodiment, sexual subjectivity); (b) attention to the material qualities of abject bodies, particularly bodies that are ignored, overlooked, or pushed out of bounds (e.g., viscous bodies, fat bodies, bodies in pain); and (c) heteronormativity and heterosexual privilege, particularly how assumptions about heterosexuality and heteronormativity circulate in sexuality research. Through these three critical practices, we argue that critical sexuality studies showcases how sex and power collide and recognizes (and tries to subvert) the various power imbalances that are deployed and replicated in sex research.

Male and Female Sexual Dysfunction in a Rapidly Changing Cultural Environment: Addressing Gender Equality versus Equivalence in the Bedroom

INTRODUCTION

The socio-sexual climate in Western cultures is changing at an astounding rate. Never before have societal expectations about gender roles shifted so radically, transforming our understanding of what it means to be a sexual man or woman today. We have observed that confusion regarding masculine and feminine roles within long-term committed relationships can represent challenges for the treatment of sexual dysfunction. Despite the relevance to sexual medicine, sexual medicine specialists have largely avoided this controversial topic.

AIM

To review the current literature relating to heterosexual gender roles and sexual intimacy, to offer perspective and context on this issue, and to propose an approach to the man, woman, or couple based in evolutionary theory that we have found useful in our extensive clinical experiences.

METHODS

We reviewed the English-language peer-reviewed literature, primarily from 2000 through 2015, that addressed the impact of heterosexual gender role expression on sexual intimacy in long-term committed relationships.

MAIN OUTCOME MEASURES

Main outcomes include a review of the applicable literature and an assessment of the literature's relevance for patients and practitioners of sexual medicine. An alternative context for understanding heterosexual gender expression grounded in evolutionary theory is provided, as is a new treatment perspective based on our work as a sex therapist and an urologist.

RESULTS

The impact of gender expression on sexual experience might be impossible to ascertain fully because it is difficult to quantify in research, independently and especially in combination. Furthermore, existing research is fraught with challenges and inadequacies.

CONCLUSION

Although we acknowledge and affirm the critical importance of gender equality, modern conceptualizations of gender in the literature ignore pertinent evolutionary adaptations and might be minimally applicable to sexual medicine patients. More research is needed. We propose that equality of genders does not necessarily mean similarity of genders, at least in sexual medicine.