Holistic Sexual-Reproductive Healthcare Services and Needs for Queer Individuals: Healthcare Providers' Perspectives

There are ongoing debates and controversies about whether genderqueer individuals have specific sexual-reproductive healthcare services and needs (SRHSNs). This study intended to identify and explore queer-specific SRHSNs among healthcare providers (HCPs) in Gauteng Province, South Africa. This was an exploratory sequential mixed-methods study, and this article focuses on the qualitative findings of that investigation. Thirty-three HCPs were purposively sampled, and semi-structured one-on-one interviews were used to collect data between September and November 2023. The data were analyzed using thematic content analysis (TCA). The results of this study revealed nine main themes: a crucial need for inclusive healthcare facilities; a need for psychological, counseling, and therapeutic support in sexual and reproductive healthcare; access to sexual-reproductive education and integrating support; suggested reproductive health services for queer sexual wellness; improved accessibility and particular queer reproductive healthcare; optimizing services related to human immunodeficiency virus (HIV), pre-exposure prophylaxis (PrEP) access, and sexually transmitted illness (STI) treatment; genderqueer persons' parenthood aspirations and empowerment; the safe availability of intimacy tools; and navigation transitions. A holistic and inclusive healthcare approach that fits psychological support, comprehensive sexual-reproductive education, and specialized services to accommodate the unique needs of queer individuals should be implemented and made easily accessible.

Developing an Inclusive Model of Young Heterosexual and Sexual Minority Women's Sexual Decision-Making

Efforts to improve sexual health outcomes among young cisgender women require in-depth understanding of how women with diverse sexual identities make decisions about their sexual health. We conducted semi-structured interviews with 31 young cisgender women with diverse sexual identities and histories (age range 18-29 (M = 23.32); 81% White; 29% bisexual, 26% heterosexual, 16% lesbian, 13% queer, 10% pansexual, 3% gay, 3% demisexual) about their decision-making surrounding sexual risk reduction. By conducting thematic analysis, we found that, regardless of partner sex or gender, women adapted sexual health strategies based on how much commitment, trust, and communication existed in their relationships. Because heteronormative structural influences limited access to information and safer sex options, women had to rely on trust and communication more with other women and partners with vaginas, compared to men and partners with penises. Women did not consider safer sex strategies with partners with vaginas (e.g. hand washing) risk-reduction techniques; instead, they considered them general hygiene or a way to take care of a partner. We propose that an inclusive model of young women's sexual decision-making should: (a) highlight the influence of relationships; (b) frame prevention in terms of overall health instead of pregnancy and STIs; and (c) acknowledge that structural factors, such as heteronormativity and sex-negativity, constrain women's decisions.

Queering Cisgender LGB+ Women's Sexual Health Scripts

The invisibility of lesbian, gay, and bisexual (LGB+) women in sexual health research is of particular concern when it comes to understanding and supporting their sexual health practices. We conducted a qualitative secondary analysis of sexual health decision-making interviews among 22 LGB+ cisgender women who ranged in age from 20 to 26 (M = 23.1 years, SD = 1.8 years). Participants were mostly bisexual (n = 9), White (n = 13), and all reported at least some college education. Results showed that LGB+ women both reify and push against heteronormativity in their sexual partnerships. By queering definitions of "sex" beyond heterosexual intercourse, leaning into trust as a foundation of new sexual partnerships, and promoting accessible and realistic hygienic strategies for STI prevention, LGB+ women queer, or reimagine, new sexual scripts. These results highlight the need for relationship and sexual health scholars to direct focus toward the promotion of holistic sexual and relationship education and research which reflects LGB+ women's various sexual desires, goals and needs. Understanding LGB+ women's sexual scripts and health outcomes will ensure that this population continues to be validated and supported by clinicians, researchers, and educators.

Do Sex Toys Make Me Satisfied? The Use of Sex Toys in Denmark, Norway, Sweden, Finland, France, and the UK

Sex toys are easily accessible in many countries in the Western world. Yet, cross-country studies on sex toy ownership and use and their association with relationship, sexual, and life satisfaction are rare. Using a cross-country convenience sample of 11,944 respondents from six European countries (Denmark, Sweden, Norway, Finland, France, UK), we investigated the rate and factors linked to sex toy ownership and use and their associations with sexual, relationship, and life satisfaction. Data were collected in May and June 2022 through respondent panels by Cint, a market research software platform. Participants received an e-mail invitation for the study and completed an online self-report survey. We found that more than half of respondents owned or had owned a sex toy, with the most common sex toys owned being dildos and vibrators, followed by handcuffs, penis rings, and anal sex toys. Across countries, the majority of sex toy owners reporting using these either alone or with a steady partner (55-65%) and a minority with casual partners (10-15%). Controlling for socio-demographics, parental status, sexual orientation, number of sex partners, and relationship status and length, we found that sex toy ownership and use were significantly associated with higher sexual and life satisfaction, while higher relationship satisfaction was only significantly associated with currently owning a sex toy (but not number of sex toys) and frequency of use with a partner (but not alone). Across results, we generally found little cross-country variation.

How do new mothers describe their postpartum sexual quality of life? a qualitative study

BACKGROUND

Sexuality plays a critical role in a woman's postpartum quality of life and also has a strong impact on the quality of her relationship. Given the sparse body of published literature on the subject, we aimed to explore how new mothers explain their postpartum sexual quality of life.

METHOD

A qualitative study was carried out in Iran and Switzerland from December 2018 to March 2019. Focus groups and semi-structured in-depth interviews (IDIs) were conducted with mothers in the first four months after parturition. Mothers who were older than 18 years, were married or in a stable relationship, and experienced a low-risk vaginal birth or cesarean section participated in the study. We used Graneheim and Lundman's approach for analyzing the data. Multiple data collection methods, maximum variation sampling, and peer checks were applied to enhance the rigor of the data.

RESULTS

We achieved data saturation after two focus group discussions (FGDs), 15 IDIs in Iran, and 13 IDIs in Switzerland. We extracted three themes for postpartum sexual quality of life: (a) sexual worldview, (b) interpersonal relationship, and (c) postpartum sex storm. The participants described sexual worldview as "sexual beliefs", "sexual perceptions", and "sexual behaviors". The interpersonal relationship consists of "changes in postpartum interpersonal relationships" and "supportive role of the husbands/partners". The last one, postpartum sex storm, has three categories including "direct changes in sexual life", "indirect changes in sexual life", and "resumption of sexual intercourse". Differences between the two cultures were identified in some subcategories such as "sexual interests", "comparable to the first intercourse in life", "negative sexual behaviors of husbands/partners", "positive sexual behavior of mothers", "helping with child care and housework", and "emotional support".

CONCLUSION

New mothers explained postpartum sexual quality of life as a three-theme phenomenon. Although most results were similar in both cultures, there were some differences. Our study's results suggest that sexual quality of life is a topic that encompasses international as well as cultural aspects.

The sextech industry and innovative devices for treating sexual dysfunction

Since the digital revolution, there has been a notable increase in the use and popularity of sex toys and innovative sexual devices, which can be attributed to advancements in technology. The sex toys industry strives to improve sexual experience, pleasure and sexual health, and to address sexual dysfunction through devices and technology. With the growth of this industry, new products that are considered "smart sexual devices" have gradually entered the market. Smart sexual devices feature wireless connectivity to a smartphone application that allows the user to control the device's features and provide personal or sexual data about their sexual experiences. Other smart devices have sensors and are able to collect physical data during usage. With the aid of this data, individuals may be able to understand their sexual behavior and arousal better, resulting in improved sexual experience or the overcoming of sexual dysfunction. The present article aims to explore the potential applications of technology-based devices, and smart sexual devices, in the treatment of male sexual dysfunctions, including premature ejaculation (PE), and delayed ejaculation (DE), as well as female sexual dysfunction (FSD), such as sexual arousal disorder and female orgasmic disorder. Furthermore, we examine the advantages and disadvantages of these devices. Given the limited literature available on this subject and the absence of controlled studies, we conduct a narrative review of the existing scientific research on technological and smart sexual devices.

Sexual life of Spanish women during the lockdown by COVID-19: Differences according to sexual orientation?

The COVID-19 pandemic may have exacerbated the sexual health differences that already existed among women based on their sexual orientation. Therefore, a total of 971 Spanish women aged 18-60 years (84 % heterosexual and 16 % with a minority sexual orientation) answered an ad hoc online questionnaire about sexual behavior during April 2020. Compared to heterosexual women, sexual minority women showed a greater increase in sexual frequency, masturbated more, had more sex with a housemate, and engaged in more online sexual activities during lockdown. The emotional impact of the pandemic, having privacy, and age showed a relationship with the quality of sexual life, but not sexual orientation. Based on these results, women's sexual lives are not as closely related to their sexual orientation as they are to other variables. Therefore, it seems more necessary to address issues affecting women in general during lockdown than to focus on their specific sexual orientation.

Sexual Enrichment Aids: A Mixed Methods Study Evaluating Use, Hygiene, and Risk Perception among Women

Sexual Enrichment Aids (SEAs), or "sex toys" like dildos or vibrators, are used to enrich sexual experiences, either alone or with sexual partners. Although SEA use has become increasingly prevalent in recent decades, there remain significant gaps in knowledge regarding sexual behaviors and hygiene surrounding their use. In this study, we use mixed methods approaches (cross-sectional survey of n = 800 women and qualitative semi-structured interviews of n = 24 women) to better understand sexual behavior, potential risks, and hygiene practices of women who self-identify as having sex with men, with women, or with women and men when using SEAs. We identified SEA use is common, with 79.9% of women using an SEA. Among these women, 31.8% of women indicated that they share SEAs with sexual partners. Further, condom use is rare while sharing SEAs, with only 14% of women utilizing condoms regularly. The majority (81.8%) of women wash their SEAs, primarily with soap and water. Yet, there is no consensus among women interviewed regarding the perceived risk associated with SEA use. Together, our findings support the need for increased evidence-based education for women to increase safety and hygiene of SEA use.

Medical Counseling on Sexual Enrichment Aids: Women's Preferences and Medical Practitioner Expertise

OBJECTIVE

To investigate women's preferences and experiences regarding health counseling of safe sexual enrichment aid use and hygiene and current counseling behaviors of medical practitioners on this topic.

METHODS

This study used mixed methodology, leveraging quantitative data from a cross-sectional survey of 800 women and semi-structured qualitative interview data from 24 women across sexual practice groups. Additionally, we conducted a cross-sectional survey of 192 medical practitioners to understand current counseling behaviors and attitudes.

RESULTS

The majority of women (96.2%, 607/631) had never been counseled by a practitioner on safe sexual enrichment aid use and hygiene but would feel comfortable receiving counseling on the subject under certain circumstances. Overwhelmingly, women indicated the need for a nonjudgmental practitioner. Many cited the importance of having a female practitioner and preferred one within obstetrics and gynecology. Among medical practitioners, counseling on this topic was infrequent; 27.0% (52/192) stated that they counsel patients on safe sexual enrichment aid use and hygiene when discussing safe sex, and 21.4% (41/192) reported that this topic is included when counseling women after a sexually transmitted infection diagnosis. Only 7.4% (14/188) and 6.4% (12/188) had received training on this topic or were aware of any professional guidelines or recommendations, respectively.

CONCLUSION

Evidence-based guidelines should be developed that practitioners can use to counsel patients, ensuring that women are able to engage in sexual enrichment aid use safely.

Clinical use and implications of sexual devices and sexually explicit media

Given that sexual pleasure is a core component of sexual health, devices that are designed to enhance and diversify sexual pleasure are particularly useful in clinical practice. Despite their growing popularity and widespread use in various biopsychosocial circumstances, many taboos still seem to exist, as indicated by the paucity of scientific literature on the prevalence, application and effectiveness of sexual devices for therapeutic use. However, sex toys and sexual devices are commonly used and have a variety of indications to expand individual and partnered sexuality and to treat sexual difficulties. Different devices are associated with specific advantages and potential risks, opportunities, barriers and ethical challenges when used in a clinical context. Increased knowledge about the aim and functional possibilities of sexual devices might help health-care professionals overcome potential embarrassment, preconceptions and other barriers, learn which patients might benefit from which products, consider their use in treatment programmes, educate about correct use and safety issues, and facilitate open communication about sexual pleasure with their patients.

Women's techniques for making vaginal penetration more pleasurable: Results from a nationally representative study of adult women in the United States

The study purpose was to assess, in a U.S. probability sample of women, the specific ways women have discovered to make vaginal penetration more pleasurable. Through qualitative pilot research with women that informed the development of the survey instrument used in this study, we identified four previously unnamed, but distinct, techniques women use to make vaginal penetration more pleasurable: Angling, Rocking, Shallowing and Pairing. This study defines each technique and describes its prevalence among U.S. adult women. Weighted frequencies were drawn from the Second OMGYES Pleasure Report—a cross-sectional, online, national probability survey of 3017 American women’s (age 18–93) sexual experiences and discoveries. Participants were recruited via the Ipsos KnowledgePanel®. Data suggest that 87.5% of women make vaginal penetration more pleasurable using ‘Angling’: rotating, raising, or lowering the pelvis/hips during penetration to adjust where inside the vagina the toy or penis rubs and what it feels like. Approximately 76% of women make vaginal penetration more pleasurable using ‘Rocking’: the base of a penis or sex toy rubbing against the clitoris constantly during penetration, by staying all the way inside the vagina rather than thrusting in and out. About 84% of women make vaginal penetration more pleasurable using ‘Shallowing’: penetrative touch just inside of the entrance of the vagina—not on the outside, but also not deep inside—with a fingertip, sex toy, penis tip, tongue, or lips. Finally, 69.7% of women orgasm more often or make vaginal penetration more pleasurable using ‘Pairing’: when a woman herself (Solo Pairing) or her partner (Partner Pairing) reaches down to stimulate her clitoris with a finger or sex toy at the same time as her vagina is being penetrated. These data provide techniques that are at women’s disposal to make penetration more pleasurable—which can enable women to better identify their own preferences, communicate about them and advocate for their sexual pleasure.

Design, Use, and Effects of Sex Dolls and Sex Robots: Scoping Review

BACKGROUND

Although sex toys representing human body parts are widely accepted and normalized, human-like full-body sex dolls and sex robots have elicited highly controversial debates.

OBJECTIVE

This systematic scoping review of the academic literature on sex dolls and sex robots, the first of its kind, aimed to examine the extent and type of existing academic knowledge and to identify research gaps against this backdrop.

METHODS

A comprehensive multidisciplinary, multidatabase search strategy was used. All steps of literature search and selection, data charting, and synthesis followed the leading methodological guideline, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. A total of 29 (17 peer reviewed) and 98 publications (32 peer reviewed) for sex dolls and sex robots, respectively, from 1993 to 2019 were included.

RESULTS

According to the topics and methodologies, the sex doll and sex robot publications were divided into 5 and 6 groups, respectively. The majority of publications were theoretical papers. Thus far, no observational or experimental research exists that uses actual sex dolls or sex robots as stimulus material.

CONCLUSIONS

There is a need to improve the theoretical elaboration and the scope and depth of empirical research examining the sexual uses of human-like full-body material artifacts, particularly concerning not only risks but also opportunities for sexual and social well-being.

Sexual health practices of 16 to 19 year olds in New Zealand: an exploratory study

INTRODUCTION New Zealand sexual health surveillance data suggest that young people aged 15-19 years are at considerable risk of contracting sexually transmitted infections. Although there is an established body of international research around sexual behaviours and sexual health practices among teenagers, there is a dearth of local research focusing on this age group. AIM The aim of this study was to explore the sexual repertoires and sexual health practices among teenagers in New Zealand with a view to better understanding levels of risk in this age group. METHODS This study comprised a cross-sectional online survey designed to ask questions about sexual behaviours. A convenience sample of young people (n=52) aged 16-19 years living in New Zealand completed the survey. RESULTS Most participants (71.2%) were sexually active, reporting engagement in a range of sexual practices. The most commonly reported sexual behaviours were penis-in-vagina sex (86.5%) and oral sex with a person-with-a-penis (81.1%). Infrequent and inconsistent use of barrier protection across all types of sexual behaviour was also reported. DISCUSSION The findings of this study highlight the importance of ensuring that young people have access to sexual health education that routinely includes health information and advice addressing the full range of sexual practices, regardless of the identity classifications they may use, or that may be attributed to them.