"You Feel Like Normal Sex is not Enough Anymore": Women's Experiences of Coercive and Unwanted Anal Sex with Men

"What Is Normal?": A Qualitative Exploration of Health Practitioners' Reports of Treating Patients Presenting with Unpleasant Sexual Experiences

Sexual health, including sexual pleasure, is fundamental to holistic health and well-being, and is considered an area of priority health in Australia. Despite the importance of sexual functioning, women experience significant gaps in sexual well-being compared to men and often do not seek medical care or treatment. Health practitioners are central to the identification and treatment of sexual dysfunction, including fostering sexual well-being for patients. Despite this, minimal research has explored health practitioners' experiences in treating reports of unpleasant sex. This study aimed to explore health practitioners' experiences, responses, and confidence in treating patients presenting for unpleasant sexual experiences. An online, mixed-methods survey was completed by 96 participants. Thematic analysis identified 11 core themes. These themes included five patient centred themes (health risks, diverse sex acts, painful vaginal intercourse, relationship breakdown and violence, unwanted sex) and six health practitioner centred themes (communication and counselling, what is normal, ongoing care and follow up, emotional response, limited practical training, and highly prevalent). Participants described a complex sexual health landscape, with social contexts impacting women's sexual experiences and engagement in treatment. Additionally, health practitioners reported the need for a biopsychosocial approach to understanding and responding to unpleasant sexual experiences for patients, while simultaneously reporting limited education in this area. Findings reflect the need for health practitioners to be cognisant of matters related to sexual function, consent, coercion, client engagement, and treatment pathways, identifying a need for greater education and holistic approaches to sexual healthcare across medical settings.

The Multiple Roles of Emotion in Interpretation and Memory of Sexual Consent

In this paper, we explore the role of emotion in the interpretation and memory of sexual encounters. We consider situations likely to generate negative emotions during sex, and the mechanisms through which the experience of negative emotions can lead to false memories of coercion and mislabeling of an encounter as sexual assault. Specifically, we consider the role of emotion in directing attention during a sexual encounter and the effects of emotion as context for interpretation at the time of the encounter, and for retrieval and interpretation when the encounter is later recalled and reported. Our intent is to provide a greater understanding of the processes of interpretation and memory through which false claims of sexual assault might arise, if and when they do arise.

Gender Differences in Sexual Violence Victimization Experiences and Validity of Victimization Reports: A Think-Aloud Study

This study compared the qualitative nature of women and men's sexual violence (SV) victimization, the types of experiences captured and missed on the Sexual Experiences Survey-Short Form Victimization (SES-SFV) across genders, and common interpretations of the SES-SFV items. Fifty-four university students (31 women, 21 cis men, 2 trans men) who had recent unwanted (but not necessarily nonconsensual) sexual experiences thought out loud while privately completing the SES-SFV. They also typed descriptions of experiences reported on SES-SFV items or similar experiences when nothing was reported on an item. Results indicated that women's victimization was more frequent and severe than cis men's, except when men were victimized by men. Although verbal coercion was common across genders, event descriptions indicated that women's verbal coercion experiences were more often harsh and part of a partner's ongoing SV or coercive control. The findings suggest that quantitative measurement can mask important gender differences in victimization and (based on analysis of false positives and negatives) may underestimate rape and attempted rape experiences, especially women's. Findings suggested that responding to the SES-SFV was not traumatic or distressing. However, participants sometimes expressed confusion about the items and interpreted them in unintended ways.

Sexual Behaviors as a Mediator Between Pornography Use and Heterosexual Relationship Outcomes

This study seeks to build on previous research about how pornography use is associated with relationship outcomes. Using the 3AM model (Wright, 2011) as a theoretical guide, sexual behaviors were tested as a possible mediator of the association between pornography use and relationship well-being. Using a national data set of individuals in heterosexual relationships (n = 2519), associations between different types of pornography use (alone use vs. joint use), sexual behaviors, and relationship outcomes were analyzed. Results showed that pornography use with a partner is a distinct activity when compared to pornography use alone. Additionally, significant indirect relationships between pornography use and relationship outcomes were found through sexual behaviors. Both vaginal sex and oral sex had positive effects, while anal sex had a unique, negative effect (use of sex toys was not significantly related). Future research should continue to examine the context of pornography use and how it is related to behaviors and outcomes in relationships.

"He'd Tell Me I was Frigid and Ugly and Force me to Have Sex with Him Anyway": Women's Experiences of Co-Occurring Sexual Violence and Psychological Abuse in Heterosexual Relationships

Intimate partner sexual violence (IPSV) is a common yet hidden form of violence. It is primarily perpetrated against women by their male partners and is associated with a range of serious mental and physical health outcomes. Despite these harms, it is chronically under-researched. In particular, the overlaps between IPSV and psychological abuse in relationships are poorly understood. Extant literature has focused primarily on the relationship between IPSV and physical violence, neglecting the fact that IPSV often involves verbal or emotional coercion, threats or blackmail rather than the use of 'force'. In this paper, we draw on reflexive thematic analysis of qualitative interviews with n = 38 victim/survivors of IPSV to explore how they understood the relationship between sexual and psychological abuse in their heterosexual relationships. Four themes were developed from this analysis: 1. I felt like I couldn't say Nno'; 2. I felt degraded and worthless; 3. Letting me know who's boss; and 4. Making me feel crazy. These themes broadly correspond to four distinct patterns or interactions between IPSV and psychological abuse. Our findings strongly suggest that the relationship between sexual and psychological abuse in relationships is far more complex than previous research would indicate. Psychological abuse is not simply a tool to obtain sex and sexual violence is not only used as a mechanism of psychological control. Instead, the two forms of abuse interact in ways that can be unidirectional, bi-directional or simultaneous to develop and maintain an environment of fear and control and erode women's self-worth.