ORIGINAL RESEARCH—PSYCHOLOGY: Age of First Sexual Intercourse and Acculturation: Effects on Adult Sexual Responding

Unveiling silenced narratives: a scoping review on sexual function challenges in migrant and refugee women

INTRODUCTION

Of the approximately 281 million international migrants and 35.3 million refugees around the world, almost half are women. These individuals experience significant stress due to language barriers, financial difficulties, poor living and working conditions, and discrimination. Consequently, concerns related to sexuality may receive lower priority despite their significant impact on overall well-being.

OBJECTIVES

This scoping review aims to review the sexual function of migrant and refugee women and identify any knowledge gaps in the field.

METHODS

We conducted a scoping review following the PRISMA-ScR guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews). We searched online databases-Medline, Embase, Emcare, PsycINFO, CINAHL, Scopus, Web of Science, and Cochrane-and gray literature, with no restrictions on year of publication, language, or study design. Utilizing Covidence software, 2 authors screened and extracted data from studies based on predetermined eligibility criteria. A thematic analysis was executed, and findings were reported descriptively.

RESULTS

Initially, we identified 5615 studies; after screening titles, abstracts, and full texts, we ultimately included 12 studies. The review identified a limited body of research with various unvalidated tools. Moreover, these studies yielded heterogeneous results: migrant women reported less sexual knowledge, experience, and liberal attitudes, resulting in lower rates of desire and arousal as compared with nonmigrants. Some studies showed lower sexual function in migrants, while others found no significant differences between migrants and nonmigrants. The assimilation into Western cultures may influence migrants' sexual attitudes and behaviors. Factors such as education and gender role ideology can also significantly affect sexual function among migrant populations.

CONCLUSION

This review underscores the limitations in previous sexual function research, emphasizing the need for a more inclusive approach. It also offers valuable insights for codesigning programs to address sexual dysfunction among migrant and refugee women, improving their well-being. Future research should prioritize neglected populations and create culturally sensitive interventions to reduce sexual health disparities in migrants.

Exploring the Orgasm Gap Across Racial/Ethnic Groups: A Descriptive Analysis

Orgasm gaps between heterosexual men and women, and for women across sexual orientations, are well-established in research. However, no large-scale assessments of orgasm frequency by race/ethnicity exist. Here, we analyzed 10 years of cross-sectional Singles in America survey data between 2011 and 2021 to investigate the orgasm gap at the intersection of gender and racial/ethnic identity (i.e. White, Black, Hispanic/Latino, and Asian) for heterosexual participants (N = 27,347). White and Hispanic/Latino men reported greater orgasm frequency than Black and Asian men. Hispanic/Latino women reported the greatest orgasm frequency, and Asian women reported the lowest, with White and Black women's frequencies in between. The orgasm gap between men and women was largest for White (d = 0.89) and Asian (d = 0.86) groups, although Asian participants reported a lower orgasm frequency than White participants overall. The orgasm gap was smaller for Hispanic/Latino participants (d = 0.66), because Hispanic/Latino women reported a greater orgasm frequency than other racial/ethnic groups of women. The orgasm gap was smaller for Black participants (d = 0.61), because Black men reported a lower orgasm frequency than some other racial/ethnic groups of men. This descriptive study serves as an important starting point for future research on orgasm experiences across racial/ethnic groups.

Assessment of knowledge, attitude, and practice of sexual health among students in a Chinese medical college: a cross-sectional study

Background

Sexual health is an essential part of overall well-being, and medical students' sexual education, level of sexual knowledge, and attitudes toward sexual health will affect their sexual behavior.

Aim

To explore the correlation among medical decision tendency, sex education level, and sexual health KAP (knowledge, attitudes, and practices).

Methods

We conducted a cross-sectional survey in March 2019. Data were collected via online surveys with a self-developed questionnaire covering sexual KAP and sexual education. We used Spearman correlation to assess the effect of sexual education on KAP after scoring the related questions.

Outcomes

Outcomes included descriptive analysis and correlation of medical and nursing students' KAP and education regarding sexual health.

Results

Medical and nursing students hold a high level of sexual knowledge (74.8%) and a positive attitude toward premarital sex (87.5%) and homosexuality (94.5%). By conducting the correlation analysis, we observed that medical and nursing students' tendency to support friends' homosexuality was positively correlated with the view that medical intervention for transgender or gay/lesbian people is unnecessary (P < .01). A positive correlation was also found between medical and nursing students who want more diverse sexual education and who would tend to provide patients with more humanistic care regarding their sexual needs (P < .01).

Clinical Translation

Medical and nursing students who want more diverse sexual education and who had higher scores in the sexual knowledge test tend to provide their patients with more humanistic care regarding sexual needs.

Strengths and Limitations

The research shows the current situation of medical and nursing students' sexual education experience and preference and sexual knowledge, attitudes, and behavior. Heat maps were used to more intuitively describe the correlation between medical students' characteristics and their sexual knowledge, attitudes, and behaviors and sex education. The results may not be generalizable across China, as the participants were from 1 medical school.

Conclusion

It is essential to provide sexual education for medical and nursing students to ensure a more humanistic approach to patient care regarding sexual needs; therefore, we recommend that medical schools invest in sexual education for medical and nursing students throughout their education.

Sexual function among women with vaginismus: a biopsychosocial approach

BACKGROUND

Vaginismus is known as a type of sexual pain disorder. Regarding the multifactorial nature of vaginismus, the biopsychosocial model is one of the best models to describe this sexual disorder.

AIM

The present research was conducted to study the determinants of sexual function in women with and without vaginismus based on the biopsychosocial model.

METHODS

This case-control study was conducted in Iran on 420 women with and without primary vaginismus who met the inclusion criteria. All eligible people were included in the research once their eligibility was verified and their informed permission was acquired; convenience and purposive sampling techniques were used continually. Data collection tools included the demographic and obstetric information form and multiple published scales and questionnaires. Structural equation modeling with LISREL 9.2 software (Scientific Software International) was used to evaluate the determinants of the sexual function of vaginismus.

OUTCOMES

Participants rated their determinants of sexual function based on the biopsychosocial model.

RESULTS

The mean ages of the case and control groups were 27.67 and 28.44 years, respectively. The direct, indirect, and total effects of the dimensions of sexual health on sexual function and the diagnostic score of vaginismus of the women with vaginismus were significant (P < .001). Furthermore, based on the results, the diagnostic score of vaginismus in women with vaginismus was significantly affected by the direct, indirect, and cumulative impacts of vaginal penetration cognition and fear of sex (P = .016, P = .005). Women with and without vaginismus were able to accept the models' excellent fit.

CLINICAL IMPLICATIONS

This study helps inform health planners and policy makers about the sexual function of women with vaginismus, the factors related to this disorder, and the multidimensional nature of this sexual problem.

STRENGTHS AND LIMITATIONS

This study attempted to offer a more comprehensive and complete view of present knowledge via surveying different aspects of sexual health and by means of valid and reliable tools and path analysis. The study's merits include the use of the biopsychosocial model to evaluate sexual function in women with vaginismus, the use of a variety of questionnaires to compare women with and without vaginismus, and the size of the sample. The research was limited by the fact that electronic sampling was conducted because of the COVID-19 epidemic.

CONCLUSION

Based on the findings of the present study for the group of women with vaginismus, the direct, indirect, and overall effects of the majority of dimensions of sexual health were significantly correlated with sexual function and vaginismus.

Unconsummated marriage among Chinese couples: a retrospective study

Background

Unconsummated marriage (UCM) is a significant problem among couples who are unable to achieve successful sexual intercourse and penovaginal penetration, and the etiology and clinical characteristics of UCM in Chinese couples remain unknown.

Aim

In a retrospective analysis of patients with UCM, we investigated clinical characteristics and treatment outcomes among Chinese couples with UCM.

Methods

During the period from January 2019 to May 2021, we examined 127 consecutive couples with unconsummated marriage. The couples were evaluated separately by andrologists and gynecologists, and combined treatments were conducted by therapists.

Outcomes

We calculated the distribution of etiologies of UCM in Chinese couples.

Results

Among the couples whose data were evaluated, 93 couples visited the andrologist first and 34 couples visited the gynecologist first. The most common complaints associated with sexual dysfunction were erectile dysfunction (ED) in male patients and vaginismus and dyspareunia in female patients. Unconsummated marriage among Chinese couples was caused primarily by female factors (55.8%). With couple-oriented treatment conducted by sexual therapists, the success rate was 67.7%.

Clinical Translation

If a couple is diagnosed with UCM, both the husband and wife should be treated individually receive guidance from a sex therapist toward successful sexual intercourse.

Strengths and Limitations

This is to our knowledge the first report regarding the etiology of UCM in Chinese couples. Here we report our routine diagnostic and therapeutic workups. However, we were not able to perform hormonal and imaging studies of the female partners. Moreover, patients presenting with UCM who visited our department without a partner were not included in the statistics.

Conclusions

Unconsummated marriage among Chinese couples may be caused byfactors affecting both the husband and wife or the husband and wife individually; however, factors affecting women are the predominant causes of UCM. Lack of knowledge about sex-related issues, as well as cultural beliefs, play an important role. A preliminary evaluation by an andrologist and a gynecologist, followed by couple treatment conducted by the sex therapist, is highly `recommended to treat UCM effectively.

Evidence of a Bidirectional Association Between Daily Sexual and Relationship Satisfaction That Is Moderated by Daily Stress

Prior research provides mixed evidence regarding the direction of the association between sexual and marital satisfaction. Whereas some studies suggest a bidirectional association, other studies fail to document one direction or the other. The current investigation used a 12-day diary study of 287 married individuals to clarify the nature of this association. Results from time-lagged mixed modeling revealed a significant positive bidirectional association. Both higher global sexual satisfaction one day and satisfaction with sex that occurred that day predicted higher marital satisfaction the next day; likewise, higher marital satisfaction one day significantly predicted higher global sexual satisfaction the next day and higher satisfaction with sex that occurred the next day. Both associations remained significant after controlling for participant's gender/sex, neuroticism, attachment insecurity, self-esteem, stress, perceived childhood unpredictability and harshness, age of first intercourse, construal level, age, and length of marriage. We also explored whether these covariates moderated either direction of the association. Daily stress was the most reliable moderator, with three of the four interactions tested remaining significant after Bonferroni corrections. The bidirectional association between global sexual and marital satisfaction and the positive association between satisfaction with sex that occurred that day and marital satisfaction the next day were significantly stronger when individuals experienced high versus low stress. Although the exploratory nature of all moderation analyses suggests they should be replicated before drawing strong conclusions, these findings highlight the importance of sexual satisfaction to marital satisfaction and vice versa and point to the power of stress in strengthening these associations.

A Learning Experience? Enjoyment at Sexual Debut and the Gender Gap in Sexual Desire among Emerging Adults

Gender differences in experience of first intercourse are among the largest in sexuality research, with women recalling less pleasure and satisfaction than men. This "enjoyment gap" has not been considered in explanations of gender differences in sexual desire. Yet, reinforcement and incentive learning feature prominently in recent models of women's sexual desire, and nonhuman animal models demonstrate their impact at sexual debut. We examined whether women's lower sexual desire is explained by their gender or by gendered experience of enjoyment at sexual debut. Emerging adults (N = 838) provided retrospective accounts of physical (orgasm) and affective (satisfaction) enjoyment at (hetero)sexual debut. We replicated gender differences across behavioral, general, and multidimensional measures of trait sexual desire; however, they were contingent on experience and measurement method. When its cognitive multidimensional properties were appreciated, women's sexual desire varied with experience of orgasm at sexual debut and diverged from men's only when orgasm did not occur. Such effects were not observed for satisfaction, nor for men. Nor did effects of a control event - masturbatory debut - extend beyond solitary sexual desire. Findings underscore the importance of orgasm equality, and suggest its absence at sexual debut may play an unacknowledged role in differentiating sexual desire.

Perceptions and Experiences of Pakistani-Descent Female Adolescents Living in Canada, on Developing Sexuality and Self-Identity

Immigrant adolescents make up a substantial proportion of newcomers to Canada. Most newcomer youth from South Asia aged 15 to 24 are from racialized “visible minority” backgrounds. The sexual health needs of female immigrant adolescents in Canada have been largely unmet and have increased in magnitude over the last few years. For immigrant female adolescents, the silence around issues of sexuality needs can affect their physical, emotional, sexual health, and overall well-being as well as their ability to reach their full potential. Evidence suggests that immigrant adolescents lack sexual and reproductive health knowledge and use fewer sexual health-related services and sex education resources than non-immigrant youth. In Pakistani immigrant adolescents, this difference appears to be associated with socio-cultural and religious practices. The purpose of this study was to qualitatively explore the experience of developing sexuality and its relationship to well-being in middle- to late-female adolescents of Pakistani-descent, living in a large urban area in Canada. The study aimed to establish space for dialogue and to bridge the perceived cultural divide on issues of sexuality using the postmodern feminist lens, which often arises between individuals from different cultural backgrounds. Using the interpretive descriptive methodology, a purposive sample of 21 female adolescents who were of first- or second-generation Pakistan-descent was obtained. Participants included female adolescents aged from 14 to 19 years. Data were collected using a semi-structured interview guide and a timeline. A total of 21 first interviews and seven follow up interviews were conducted. The narratives and timelines presented in this study tell the story of female Pakistani adolescents, their narratives, and the timelines reflect the complexities of the sexuality of female adolescents and how they perceive and attribute meanings to their experiences. The study found that living in a bicultural world can cause significant stress and anxiety among female adolescents, especially when making personal life decisions related to sexuality. Moreover, silence around all aspects of female sexuality negatively affects the capacity for desire and pleasure. In addition, the intersection of gender and patriarchy have created layers of power and oppression in adolescent lives that tightly control their sexuality. The participants’ stories reveal the complex interaction of factors that influence the behavior of female adolescents related to sexuality and sexual health. These findings establish the need for cultural awareness while viewing each girl’s experience in relation to the intersectionality of social spheres such as race, ethnicity, culture, and religion. Finally, this study provides implications to policymakers to revise the existing policies and create youth-friendly policies for immigrant youth to draw attention to the hidden voices of female adolescents and increase the awareness of ways to address issues arising in evolving sexuality.

Determination of Sexual Attitude, Sexual Self-Consciousness, and Sociocultural Status in Women With and Without Lifelong Vaginismus: A Case-Control Study

Vaginismus is a sexual dysfunction occurring in females presented as a contraction of the muscles around the vagina as a reflex, causing the failure of vaginal penetration. Although many psychological, social, and cultural factors that may cause vaginismus have been suggested, its underlying mechanisms are not clear. The aim of this study was to determine the sexual attitude, sexual self-awareness, and sociocultural status of women with and without lifelong vaginismus. This is a case-control study. A total of 148 women were included in the study: 74 women with a lifelong vaginismus diagnosis and 74 women without a history of vaginismus/painful sexual activity controls. Data were collected using a structured questionnaire, the Sexual Self-Consciousness Scale, and the Hendrick Brief Sexual Attitudes Scale. Sexual shyness (OR = 0.854), sexual self-focus (OR = 0.888) and birth control (OR = 1.279), communion (OR = 1.198), and instrumentality (OR = 1.330; the sub-dimensions of the Sexual Attitude Scale) were associated with (χ² = 96.130, p < .001) vaginismus at the rate of 63%. Those who did not receive sexual information; those who obtained information about sexuality from the social media; those who had negative thoughts about sexuality due to religious reasons; those who found the genitals and sexuality as disgusting; and those having more feelings of fear and pain are more likely to have vaginismus. Some socio-cultural factors may negatively affect women and cause vaginismus. Women with vaginismus had low sexual self-consciousness and negative attitudes toward sexuality. It may be incomplete to consider vaginismus only as a vaginal entry problem. Therefore, in the treatment of vaginismus, women's sexual attitude, sexual self-awareness, and sociocultural factors should be evaluated in a holistic manner.

Sexual Debut Among Heterosexual Men of African and Caribbean Descent: Are the Youth Initiating Sex Earlier than the Older Generation?

Although age at first sex is considered a measure of sexual risk and vulnerability for HIV infection, there is a dearth of literature on age at sexual debut in the Canadian context. This study examined time variations to first sex among heterosexual African, Caribbean, and Black (ACB) men in four Ontarian cities. A population-based retrospective survey (n = 879) on timing to first sexual intercourse was conducted between 2018 and 2019 among self-identified heterosexual ACB men 16 years or older and residing in London, Ottawa, Toronto or Windsor. We used the lognormal survival analysis technique to examine variations in time to first sexual intercourse among age cohorts and between cities. The findings showed a generational shift in the pattern of sexual initiation, with younger heterosexual ACB men initiating sexual intercourse earlier compared with those currently older than 50 years. We observed those between 16 and 19 years, 20 and 29 years, and 30 and 39 years of age to have significantly higher risk ratios of TR = 0.852, TR = 0.869, and TR = 0.855, respectively. At city level, the results show marked spatial variations, with youth in cities of Toronto, Ottawa, and London at the highest risk of early sexual debut relative to those in Windsor. Early initiation of first sexual intercourse among heterosexual ACB youth was observed with those in the larger cities being at a relatively higher risk. There is the need for programs aimed at delaying sexual debut among youth in general. It is, however, important to recognize the relative risk of those in the larger cities.

Relationships between women's emotional reaction to first coital experience and subsequent sexual risk-taking behaviour

Objectives: The study aimed to consider the affective reactions of young French women to their experience of first sexual intercourse and examine the relationship with subsequent risky sexual behaviours, using cluster profiles.Methods: A descriptive cross-sectional study was conducted among women in France (n = 391) (mean age 22.36 years, standard deviation 3.08). Participants completed a questionnaire with self-reported measures of emotional responses to first sexual intercourse and risky sexual behaviours.Results: Cluster analyses revealed four emotional reaction profiles: Pleasure, Guilty-pleasure, Negative-emotional and Anxiety-unpleasant. The Pleasure group reported overall and higher satisfaction and positive emotions towards first sexual intercourse; this group reported lower condom use. The Guilty-pleasure group felt pleasure tinged with guilt and reported fewer same-sex partners. The Negative-emotional profile group tended to feel major negative emotions related to initial coital experience, reporting lower or no pleasure. The Anxiety-unpleasant group reported little pleasure and major anxiety associated with first sexual intercourse. The latter two groups, respectively, reported a higher number of male sexual partners and higher alcohol consumption prior to sexual intercourse compared with the two pleasure groups.Conclusion: These results suggest that women's emotional reactions to first sexual intercourse may be associated with subsequent healthy versus risky sexual behaviours in young adulthood.

Are you fluent in sexual emoji?😉: Exploring the use of emoji in romantic and sexual contexts

This research presents an exploratory study of how individuals use emoji, specifically in sexually suggestive contexts. Emoji are small images that depict emotions, concepts, or items that are used in computer-mediated communication in order to add context, emotion, and personality to messages. The dataset consists of 693 participants recruited via online social networks and forums. Results indicate that the use of emoji play a significant role in the sending and receiving of sexually suggestive messages; of individuals who have sent these messages, 51% report that the use of emoji led to the sexually suggestive behaviour and 54% report that emoji appear in their messages sometimes, often, or always. The three most common object emoji last sent and received in a sexually suggestive message are the tongue (👅), the eggplant (🍆), and the sweat droplets (💦), while the three most common face emoji last sent and received in this context are the smirking face (😏), the winking face (😉), and the blowing a kiss face (😘). Additionally, this study demonstrates that extraversion and number of casual sexual partners is significantly related to the use of sexually suggestive emoji, as both extraversion and numbers of casual sexual partners account for 5.9% of the shared variance in the use of sexual emoji. This research provides empirical information that may be used to guide future research into the use of emoji in computer-mediated communication.

Influence Factors of Sexual Activity for Internal Migrants in China

Background

Sexual frequency is associated with the quality of life. China’s internal migrants that are sexually active are more likely to participate in sexual behavior. However, less work has been undertaken to assess the sexual frequency and its predictors in migrants.

Aim

This study seeks to explore which factors were related to sexual frequency in migrants and how the association varies with different levels of sexual frequency.

Methods

A total of 10,834 men and 4,928 women aged 20–49 years from 5 cities in China were enrolled by multi-stage sampling during August 2013–August 2015.

Outcomes

Sexual frequency among migrants was determined by asking: How many times have you had sexual intercourse with a man/woman in the past 30 days?

Results

In this study, sexual frequency with an average age of 38.28 years was 5.06 (95% CI 5.01–5.11) time per month. Negative binomial showed that male gender, younger age, earlier age of sexual debut, masturbation, more knowledge of sexual and reproductive health, longer time together with a spouse, and higher school education and incomes were predictors of increased sexual frequency in migrants. Communicating with sexual partners frequently had the largest effect on sexual frequency compared with occasional communicating (β = 0.2419, incidence rate ratio = 1.27, 95% CI 1.23–1.31). In the quantile regression, months of cohabitation (β = 0.0999, 95% CI 0.08–0.12), frequent sexual communication (β = 0.4534, 95% CI 0.39–0.52), and masturbation (β = 0.2168, 95% CI 0.14–0.30) were positively related to lower levels of sexual frequency. Interestingly, migrants who had low and high sexual frequency would be affected in opposite directions by the knowledge of sexual and reproductive health.

Clinical Translation

Clinicians can more understand the relationship between sexual frequency and its factors that can as the symptom basis of sexually-related diseases.

Conclusions

The present findings indicate that specific demographic, socioeconomic, and epidemiological characteristics influenced sexual frequency among migrants. Sexual communication as the largest effect predictor to sexual frequency should be paid more attention to, to improve sexual activity of migrants.

Zhang J, Wu J, Li Y, et al. Influence factors of sexual activity for internal migrants in China. J Sex Med 2018;6:97–107.

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.

Sexual Functioning in Young Women and Men: Role of Attachment Orientation

Prior research has documented various ways in which adult attachment styles are characteristic of differential behavioral and cognitive patterns within romantic relationships and sexuality. However, few studies have examined the direct influence of anxious or avoidant attachment orientation on sexual function. The aim of the present study was to assess the impact of insecure attachment on sexual function. Undergraduate students completed questionnaires measuring attachment style and sexual functioning. Among women, attachment avoidance tended to be associated with impairments in all aspects of sexual function, whereas anxious attachment tended to be associated with declines in arousal, satisfaction, and ability to achieve orgasm. A different trend was seen in men: Anxious attachment tended to be associated with multiple facets of sexual dysfunction, while avoidant attachment did not correlate with any sexual function deficits and was associated with superior physiological competence. These results suggest that both anxious and avoidant attachment styles are important yet differential predictors of sexual function in men and women.

Casual sexual relationships: Identifying definitions for one night stands, booty calls, fuck buddies, and friends with benefits

Operational definitions of casual sexual relationships (CSRs; i.e., Friends with Benefits, Booty Call) have not been validated in previous research. In this exploratory study of terminology used to describe various CSRs, participants were provided with definitions for One Night Stand, Booty Call, Fuck Buddy, and Friends with Benefits relationships and asked to identify the corresponding label for each definition. Overall, a majority (i.e., ≥81%) of men (n=341) and women (n=544) accurately identified the corresponding labels. Specifically, a higher proportion of participants with sexual intercourse experience identified the corresponding definition labels, whereas there was no difference in the proportion of those with or without previous casual sex experience. Furthermore, a higher proportion of female participants identified the corresponding labels, possibly reflecting a greater capacity to identify subtle relationship cues conveyed within the definitions. Given the prevalence of CSRs in the current cultural context, it is vital for researchers to ensure that the terminology they use accurately reflects their participants' understanding of the concepts under investigation.

Age, quality, and context of first sex: associations with sexual difficulties

INTRODUCTION

Research consistently indicates an association between a younger age at first sex and poorer sexual health outcomes. However, research addressing associations between age at first sex and sexual difficulties has produced mixed findings. Moreover, little is known about links between the context and quality of first sex and subsequent sexual difficulties.

AIMS

The aims of this study are to examine whether (i) age and (ii) context and quality at first sex are associated with sexual difficulties; (iii) examine whether age at first sex and context and quality variables are independently associated (after mutual adjustment) with sexual difficulties; and (iv) examine whether age at first sex has an indirect effect on sexual difficulties through an effect on context or quality.

METHODS

Data from 388 questionnaires were gathered from students aged 17-21 living in accommodation halls and by postal invitation to adults aged 25-35.

MAIN OUTCOME MEASURES

The main outcome measure was the Golombok-Rust Inventory of Sexual Satisfaction (GRISS), which assesses sexual difficulties via an overall score and seven subscales.

RESULTS

Appraising first sex as emotionally negative was associated with the majority of sexual difficulties. A less stable relationship at first sex was associated with sexual communication problems and dissatisfaction. Greater enjoyment and using substances were associated with a lower likelihood of anorgasmia for women. Age at first sex was directly associated with reduced sexual frequency only. A younger age at first sex was associated with a greater likelihood of negative appraisal and lower likelihood of a stable relationship and thereby indirectly associated with several sexual difficulties.

CONCLUSIONS

Experiencing first sex as emotionally negative was consistently associated with later sexual difficulties. When attending to sexual difficulties, understanding the quality and context of first sex may be more useful than knowing the age at first sex. This research is limited by the retrospective nature of the reports of first sex.

Sexual function of women practicing sex in nonconventional settings

The quality of sexual intercourse in the context of conjugal visits by women to their jailed partners is unknown. This study aimed to assess the quality of the sex lives and psychological conditions of women attending conjugal visits with their jailed inmate partners. This controlled study involved 124 women between the ages of 18 to 40 years who engaged in sexual relations with their inmate partners (conjugal visit group) or with their partners at home (control group). Sexual function was assessed using a semi-structured questionnaire and the Female Sexual Function Index, and psychological parameters were evaluated using the Hospital Anxiety and Depression scale. The total Female Sexual Function Index scores was similar in the 2 groups. The percentage of women reporting good quality of the relationship was significantly higher in the conjugal visit group. Also, the Hospital Anxiety and Depression scale scores were higher in the conjugal visit group. Depression was a risk factor for sexual dysfunction and had a negative effect on scores in the desire, excitement, lubrication, and sexual satisfaction domains, whereas anxiety was associated with lower sexual desire scores. A regular + poor quality of the relationship and being religious were factors associated with sexual dysfunction. Sexual practices in jail were not a risk for sexual dysfunction in this sample.

Cognitive aspects of sexual functioning: differences between East Asian-Canadian and Euro-Canadian women

The purpose of this study was to investigate the sexual beliefs of female undergraduates, as well as the thoughts they experience during sexual experiences. The study aimed to determine potential differences in these variables between East Asian-Canadians and Euro-Canadians, as well as the influence of acculturation on these variables. In addition, the relationships between sexual beliefs, automatic thoughts, and specific aspects of sexual functioning were examined. Euro-Canadian (n = 77) and East Asian-Canadian (n = 123) undergraduate women completed the Sexual Dysfunctional Beliefs Questionnaire, the Sexual Modes Questionnaire, the Female Sexual Function Index, and the Vancouver Index of Acculturation. East Asian women endorsed almost all sexual beliefs assessed in this study more than did Euro-Canadian women, and endorsement of these beliefs was associated with acculturation. In addition, East Asian-Canadian and Euro-Canadian women differed in the frequency of experiencing negative automatic thoughts. Results also revealed associations between difficulties in sexual functioning, and both sexual beliefs and automatic thoughts. Together, these results provide preliminary support for the hypothesis that differences in cognitive aspects of sexuality may underlie the differences in sexual functioning previously observed between these two groups.

Development of the virginity beliefs scale

Past research on first sexual intercourse experiences and virginity has largely focused on using demographics such as age at first intercourse as predictors of future sexual behaviors and beliefs. Carpenter ( 2002 , 2005 ) suggested a model of three virginity metaphors that describe how individuals perceive their virginity: gift, stigma, and process. Using Carpenter's framework as a starting point, scale items were developed based on the conceptual understanding of the three metaphors. In Study 1 (N = 223, mean age = 19.9, SD = 2.4), 50 items were factor analyzed, yielding 22 items found to be strong indicators of the three metaphors; ten items for gift, eight for stigma, and four for process. The three subscales were validated using measures of gender-role beliefs and affective reactions to first intercourse. In Study 2 (N = 359, mean age = 19.7, SD = 2.4), confirmatory factor analysis was used to confirm the 22-item factor breakdown. The resulting Virginity Beliefs Scale is discussed in terms of how it applies to Carpenter's original framework and its future research potential.

Looking back: the experience of first sexual intercourse and current sexual adjustment in young heterosexual adults

A young person's first consensual sexual intercourse experience is often a remarkable and memorable experience. However, little systematic information exists regarding contextual factors of first intercourse, the affective salience of the experience, possible effects on sexual attitudes and beliefs, and subsequent sexual development and adjustment. This retrospective study aimed to examine these in a sample of 475 young adults. Overall, young men and women experienced intercourse for the first time around age 17, were in a committed relationship, and reported positive affective responses. Affective reactions to the first sexual intercourse experience, sexual self-efficacy, sexual aversion, and age at first intercourse affected individuals' current sexual adjustment; however, only sexual self-efficacy mediated between first intercourse and current sexual adjustment in young men and women. Older age at first intercourse was associated with less sexual self-efficacy and lower current sexual adjustment for women. This study provides initial data to suggest that the first sexual intercourse experience significantly impacts current sexual adjustment by affecting beliefs about sexual self-efficacy.

The role of sex guilt in the relationship between culture and women's sexual desire

A large body of literature demonstrates that East Asian women report lower sexual desire than Caucasian women. Although most studies have explained these differences by referring to general culture-linked differences in sexual conservatism, none have examined the potential role of specific constructs such as sex guilt. The goals of the current study were to examine the supposition that sexual conservatism mediates the relationship between culture and sexual desire, and to explore the potential mediating role of sex guilt in the link between culture and sexual desire. Caucasian (n = 105) and East Asian (n = 137) female university students completed questionnaires online. Caucasian women reported significantly higher levels of sexual desire, significantly lower levels of sexual conservatism, and significantly less sex guilt. In the entire sample, sexual conservatism and sex guilt separately mediated the relationship between ethnicity and sexual desire such that women with more sex guilt and those who were more sexually conservative reported lower sexual desire. Among the East Asian women, sex guilt, but not sexual conservatism, mediated the relationship between mainstream acculturation (degree of westernization) and sexual desire such that women with more sex guilt reported lower sexual desire. These findings suggest that sex guilt may be one mechanism by which ethnic groups differ in sexual desire.

Sexual arousal in East Asian and Euro-Canadian women: a psychophysiological study

INTRODUCTION

Studies of ethnic differences in self-report measures of sexuality have shown East Asian women to be more sexually conservative and less sexually experienced than Caucasian women. There is also strong evidence supporting the notion of ethnic group differences in general measures of nonsexual psychophysiological arousal; however, there have been no previous studies exploring ethnicity and physiological sexual arousal.

AIM

The objective of this study was to explore group differences in self-reported and physiological sexual arousal in Euro-Canadian and East Asian women living in Canada; we also aimed to explore the association between level of acculturation (both mainstream and heritage) and sexual arousal in East Asian women only.

METHODS

Seventy-five women (N=38 Euro-Canadian, N=37 East Asian) completed a battery of questionnaires and underwent psychophysiological sexual arousal testing using the vaginal photoplethysmograph. They also completed a self-report measure of subjective arousal before and after erotic stimulus exposure.

MAIN OUTCOME MEASURES

All women completed the Female Sexual Function Index, Vancouver Index of Acculturation, and Sexual Beliefs and Information Questionnaire. Change in genital sexual arousal (vaginal pulse amplitude; VPA), and change in subjective sexual arousal were measured during exposure to erotic stimuli.

RESULTS

The groups did not differ in the percent increase in VPA induced by erotic stimuli, nor was there a correlation between VPA and subjective sexual arousal. Among East Asian women alone, neither heritage nor mainstream acculturation was correlated with change in VPA.

CONCLUSIONS

East Asian and Euro-Canadian women who show similar ratings of sexual behaviors and self-reported sexual arousal do not differ in physiological or subjective arousal induced by erotic stimuli in the laboratory.

Do East Asian and Euro-Canadian women differ in sexual psychophysiology research participation?

Evidence from studies of ethnic differences in sexual conservativeness and Papanicolaou (Pap) testing behaviors suggests that there may be culture-linked differences in rates of participation in physically invasive sexuality studies, resulting in volunteer bias. The effects of ethnicity and acculturation on participation in female psychophysiological sexual arousal research were investigated in a sample of Euro-Canadian (n = 50) and East Asian (n = 58) women. Participants completed a battery of questionnaires and were given either course credits or $10 for their participation. Participants were then informed about the opportunity to participate in a second phase of the study, which involved psychophysiological sexual arousal testing and which was completely optional. Contrary to expectations, the results showed that the East Asian women were more likely to participate in Phase 2 than the Euro-Canadian women. Among the East Asian women, greater heritage acculturation and lower mainstream acculturation predicted a lower likelihood of Phase 2 participation. The findings suggest the need to be wary of overgeneralizing female psychophysiological sexual arousal research results and may have implications for improving Pap testing behaviors in East Asian women.

Ethnic, gender, and acculturation influences on sexual behaviors

Much research has been conducted on ethnic differences in sexuality, but few studies have systematically assessed the importance of acculturation in sexual behavior. The present study assessed general differences in normative sexual practices in healthy Euro-American, Asian, and Hispanic populations, using measures of acculturation to analyze the relative effects of heritage and mainstream cultures within each group. A total of 1,419 undergraduates (67% Euro-American, 17% Hispanic, 16% Asian; 33% men, 67% women) completed questionnaires which assessed sexual experience and causal sexual behaviors. In concordance with previous studies, Asians reported more conservative levels of sexual experience and frequency of sexual behaviors, fewer lifetime partners, and later ages of sexual debut than Euro-American or Hispanic counterparts. Hispanic reported sexual experiences similar to that of Euro-Americans. There was a significant interaction between mainstream and heritage acculturation in predicting number of lifetime sexual partners in Asian women such that the relationship between heritage acculturation and casual sexual behavior was stronger at lower levels of mainstream acculturation. On the other hand, in Hispanic men, higher levels of mainstream acculturation predicted more casual sexual behavior (one-time sexual encounters and number of lifetime sexual partners) when heritage acculturation was low but less casual sexual behavior when heritage acculturation was high. These results suggest that, for sexual behavior, Hispanic men follow an "ethnogenesis" model of acculturation while Asian women follow an "assimilation" model of acculturation.