Online relationship seeking is common among adolescent sexual minority men (ASMM), yet research has primarily compared sexual health between ASMM who seek partners online with those who do not, overlooking heterogeneity in dating motivations. We examined associations between motivations for online relationship seeking (dates only vs. both dates/sex) and HIV-related behaviors and assessed racial/ethnic differences in these associations. Data from three timepoints were drawn from a 12-month HIV prevention intervention with ASMM in the U.S. Logistic regressions examined associations between motivations for online relationship seeking and HIV/STI testing, condomless sex without using pre-exposure prophylaxis (PrEP), and PrEP interest. The sample included 266 ASMM aged 13-18 years (Md = 17; 59% ASMM of color). Overall, 38% reported seeking dates only online, whereas 62% sought both dates/sex; the former group was significantly younger, p = .04. ASMM who sought both dates/sex online were more likely to test for HIV (p = .04) and STI (p = .01) than those seeking dates only. Hispanic ASMM were more likely than non-Hispanic peers to engage in condomless sex when not using PrEP (p = .001) and were less likely to test for HIV (p = .02). These findings highlight the need for tailored relationship and sexual health programs, particularly for Hispanic and younger ASMM who more often seek dates only.
The purpose of this study was to explore how harmonious, obsessive, and inhibited sexual passion may change over five years of marriage, and to also evaluate whether sexual relatedness, sexual competence, and sexual autonomy-core constructs of self-determination theory (SDT)-at the beginning of marriage may be important predictors of sexual passion across time. With a nationally representative sample of 2106 mixed-sex recently married couples, we analyzed the intercepts and slopes of the three types of sexual passion over five years. The results indicated that the three types of sexual passion all had relatively stable means across time with small but significant positive slopes. Also, of the three SDT predictors of sexual passion, higher levels of sexual autonomy early in marriage were related to lower initial levels of inhibited sexual passion and higher levels of harmonious sexual passion over time. Curiously, sexual relatedness, though associated with lower levels of sexual inhibition across time, was associated with decreasing levels of sexual harmony.
The role of mentalizing - the ability to understand one's own and other's mental states - for sexuality is insufficiently understood. Thus, this study examined the longitudinal associations between sexual mentalizing and sexual function, activity, satisfaction, as well as general mentalizing in a cross-lagged panel design. German-speaking adults (N = 2650 [n = 1191 women] at T1; N = 1769 [n = 799 women] at T2) completed online measures on general and sexual mentalizing ability, sexual function, interpersonal and autoerotic sexual activity, and sexual satisfaction twice, four months apart. Cross-lagged effects were analyzed in gender-stratified path models. Largely reciprocal associations emerged: Sexual mentalizing predicted sexual function and interpersonal sexual activity in both genders, with significant reversed effects indicating reciprocal influences. Sexual mentalizing did not predict sexual satisfaction, while the reversed effect was significant in both genders. Among women, sexual mentalizing and autoerotic sexual activity were reciprocally associated, suggesting greater introspective involvement in women's autoerotic activity. General mentalizing predicted sexual mentalizing only in men, while sexual mentalizing predicted general mentalizing in both genders, suggesting gender-specific developmental pathways. Findings highlight mentalizing as an important psychological ability shaping sexual function and behavior over time and signal the potential of mentalization-based approaches for improving sexual health.
Although sex work in academia has been studied in the context of undergraduate student involvement, to date, no study has empirically examined the experiences of graduate students and academic faculty members involved in adult industry/sex work. Considering the potential negative impacts on the reputation and professional futures of those in academia who occupy professionalized spaces, it is important to understand how these individuals may be impacted in their careers. In this study, we distributed an online survey to graduate students and professional academics who had engaged in adult industry/sex work at some point, either currently or in the past. We thematically analyzed qualitative responses from 29 participants who reported on how their adult industry/sex work impacted their academic experiences. Five main overarching themes were identified, including impacts on their academic trajectory, attitudes toward academia, finances, and attitudes toward others, as well as no impact on their academic experience. No one theme dominated the responses, suggesting that the effects of adult industry/sex work on academic life are not universal, but instead may be shaped by intersecting identities and experiences.
Discounting theory provides a framework for understanding how behaviors, such as condom-protected sex, can lose their value. Eligible participants [N = 498; M = 44.3 years of age; White (72.3%); heterosexual (81.9%)], recruited from Prolific, completed an online survey where they indicated their willingness to engage in penile-vaginal and penile-anal intercourse with a hypothetical partner, as well as their willingness to give oral sex to and receive oral sex from that person. To determine if the discounting of skin barriers (i.e. condoms and dental dams) varied across these sexual acts, participants then indicated the likelihood they would use a skin barrier based on 1) the sexual act they were randomly assigned to, 2) how long they had to wait for a skin barrier (i.e. delay discounting), and 3) the likelihood of contracting an STI (i.e. probability discounting). For each sexual act, the likelihood of using a skin barrier decreased as the delay to a skin barrier increased, or the probability of contracting an STI decreased. These effects were most pronounced when either giving or receiving oral sex compared to when engaging in penile-vaginal or penile-anal intercourse. Additionally, except for penile-anal intercourse, men and women were equally willing to engage in the specified sexual acts. However, greater discounting of a skin barrier by men was primarily restricted to penile-vaginal intercourse and receiving oral sex. These results have important implications for understanding how the likelihood of using a skin barrier is impacted by the type of sexual activity being engaged in.
Sexual practices commonly known as "rough sex" have become prevalent among adolescents and people in the first few decades of adulthood. Some (e.g. sexual "choking" and smothering) pose serious health risks. The increased prevalence of rough sex has presented new challenges to sexuality educators who now often field questions from young people about these sexual practices - sometimes to the shock and upset of parents and community members. Clinicians, too, have observed more marks and bruises on their patients, which have often been attributed to rough sex. Young people report having first learned, as adolescents, about rough sex from pornography, social media, and mainstream media, urging conversations about media and policy. How might social, behavioral, and public health research inform education, intervention, and policy related to these sexual practices? In this article, we first describe the conceptual challenges of defining "rough sex" and "consensual rough sex" and then use data from multiple countries to describe the prevalence and demographic correlates of rough sex generally as well as for specific practices that fall under this umbrella term. Then, we review research on the health consequences of certain rough sex practices, how people report having learned about rough sex, their reasons for engaging in it, their lived experiences with rough sex, and the relationship between rough sex and partner violence. Finally, we discuss implications for health and safety, sexuality education, clinical care, violence prevention, and policy; identify limitations of the existing research on rough sex; and suggest priorities for subsequent research and interventions.
Technology offers new opportunities for adolescents to engage in sexual activity and experimentation. Most research has examined online and offline behaviors in isolation, rather than considering how these experiences co-occur in diverse ways for youth and associate with sexual well-being. This study identified subclasses of adolescents based on their frequency of engagement in consensual online and offline sexual behaviors over the past three months and examined associations with sociodemographic and socioemotional characteristics, as well as positive sexuality outcomes, namely sexual well-being and respectful attitudes toward partners. Participants were 1,177 Quebec adolescents (Mage = 16.00) who completed self-report questionnaires. Gender-stratified models included 998 cisgender girls and boys who reported having engaged in at least one sexual behavior in their lifetime. Latent class analysis revealed four subclasses for boys (Pornography-focused; Low sexual engagement; Moderate digital and physical engagement; Moderate digital and high physical engagement; and three subclasses for girls (Low sexual engagement; Moderate digital and physical engagement; Moderate digital and high physical engagement). Age, sexual identity, and socioemotional characteristics were examined as predictors of class membership, while sexual well-being and respectful attitudes toward partners were compared across classes. Results highlight the importance of examining diverse in-person and digital sexual behaviors jointly to understand patterns of sexual engagement and well-being among adolescents.
Recovery is a central concept in the fields of mental health and addiction, yet its definition remains a subject of debate. Compulsive Sexual Behavior Disorder (CSBD), classified in the ICD-11 as an impulse control disorder, is a relatively prevalent mental health concern. This scoping review mapped and summarized the state of art of the concept of recovery in CSBD, including study characteristics, terminology and measures used, main recovery approach (deficit-based versus strengths-based, or mixed), and the key aims of these studies. Embase, Medline, PsycInfo, and the Web of Science were searched and reviewed using PRISMA-ScR guidelines. Empirical and case studies published in English peer-reviewed journals related to recovery or any bio-psychosocial change were included. Sixty-five articles were included. Most studies were conducted in Western countries among white, heterosexual men. Most studies did not use the term recovery, and only one defined it implicitly. Alternative terms included symptom reduction and positive improvement. More than 50% of the studies were classified under mixed recovery approach. The studies' main aim was treatment evaluation, whereas theoretical and conceptual approaches were scarce. The absence of a clear definition of recovery, combined with the evolving understanding of CSBD, has led to varied and inconsistent terminology. While some studies adopt a mixed recovery approach, most focus narrowly on heterosexual white men and individual treatment, often excluding socio-cultural elements and contexts. Future research should clarify the concept of recovery, incorporate broader social and environmental dimensions, and include more diverse populations.
Understanding how men who have sex with men (MSM) identify with sexual role labels such as Top, Bottom, or Versatile offers descriptive insights into how sexuality, identity, and self-presentation intersect on dating platforms. Drawing on cross-sectional data from 141,156 active users of the global gay dating app Surge, this study describes age-based and regional differences in sexual role identification. We model user-reported role preferences using Poisson regression with interaction terms for age and continent, accounting for non-linear age effects and regional heterogeneity. Younger MSM were more likely to identify as Bottom or Versatile, while older users more often identified as Top. Across continents, Versatile was the most common identification in Europe and Oceania, whereas Bottom was most common in the Americas and Africa. These descriptive patterns are consistent with sexual role labels being context-dependent and may reflect age-related and cultural variation in how roles are communicated and perceived within MSM communities. The study highlights how platform-based data may help illuminate patterns of intimacy and self-presentation among MSM worldwide.
This study examined how a rape victim's involvement in sex work shapes perceptions of sexual victimization in Israel, where the purchase of sexual services is prohibited while their sale is legal. Participants were 455 undergraduate students who read a vignette describing the rape of a young female student, depicted either as a sex worker or with no mention of sex work. Overall, perpetrator blame was high, victim blaming was low, and support for severe punishment of the perpetrator was strong across conditions. However, identifying the victim as a sex worker was associated with higher victim blame and shared blame, greater negative emotional responses, and greater support for lenient punishment of the perpetrator, particularly among male participants. Regression analyses indicated that negative emotional responses toward the victim were consistently associated with moral judgments of blame and perpetrator punishment, independent of the victim's sex work status and participants' sex. The findings demonstrate that stigma operates through both cognitive and affective pathways, producing conditional recognition of victimhood and moral exclusion of sex working victims. The results underscore the social and legal implications of stigmatization for victims of sexual violence and highlight the need for interventions that address emotional as well as cognitive dimensions of rape myth acceptance.
The Process-Based Consent Scale (PBCS) was developed to reflect contemporary consent attitudes and practices, with three subscales (Ongoing Consent, Subtle Coercion, and Communicative Sexuality) emerging through exploratory and confirmatory factor analysis. However, its measurement invariance across key sociocultural groups has not been evaluated, limiting confidence in group-based comparisons. This study confirmed the PBCS's bi-factor structure, evaluated its measurement invariance across gender (men vs. women/gender-diverse) and sexual orientation (LGB+ vs. non-LGB+), and assessed its concurrent validity with sexually aggressive behaviors in a Canadian sample (N = 1,046). Multi-group confirmatory factor analysis supported full configural, metric, and scalar invariance across gender and sexual orientation. LGB+ participants showed more prosocial responses across all three subscales, and women/gender-diverse participants endorsed significantly less Subtle Coercion than men. Higher endorsement of Subtle Coercion and lesser endorsement of Ongoing Consent were associated with sexually aggressive behaviors across groups, supporting the instrument's concurrent validity. Findings indicate that the PBCS is a robust and invariant measure of Ongoing Consent, Subtle Coercion, and Communicative Sexuality across gender and sexual orientation.
Sexualized drug use (SDU) is an emerging and understudied phenomenon among trans and/or non-binary populations (TNBP). This study aimed to analyze the prevalence of SDU, gender differences in the use of 14 different substances, motivations for engaging in SDU and factors associated with emotion regulation-related SDU among TNBP who reported this practice. We conducted a cross-sectional online survey with a convenience sample of 1772 participants over 15 years of age, recruited through social media accounts of LGBTIQ+ organizations and influencers and 39 gender identity units in Spain. SDU was defined as intentional use of substances during sexual experiences within the past year. Motivations for SDU were assessed. Factors associated with emotion regulation - driven SDU were analyzed using Poisson regression with robust variance. The gender distribution was 35.3% trans men, 22.6% trans women, and 42.1% non-binary individuals. Overall, 10.5% of participants reported SDU and 1.4% reported chemsex. Cannabis (7.5%), poppers (4.8%) and ecstasy (3.2%) were the most frequently used substances. Among SDU participants, nearly two-thirds identified pleasure as their primary motivation, while the rest cited emotion regulation. Emotion regulation-driven SDU was associated with trans men and non-binary identities, migrant background, lower socioeconomic status, having experienced anxiety in the past year, and having ever suffered physical violence. Emotion regulation-related SDU was linked to structural vulnerabilities. These findings highlight the need for public health policies that consider the specific characteristics of TNBP communities, including their motivations for SDU and the role of systemic violence and discrimination in shaping substance use practices.
As sexual minorities, individuals on the asexual spectrum (a-spec) may be at risk of being stigmatized and dehumanized. We examined whether participants endorsed lack of sexual attraction, romantic attraction, and experiences of affection as defining features of a-spec identities (Study 1a, N = 486), and tested whether departures from allonormativity (i.e., experience of sexual attraction; Study 1b, n = 292) and amatonormativity (i.e., desire to establish a romantic relationship, Study 2, N = 232) drove stigmatization. Participants primarily endorsed lack of sexual attraction as defining a-spec identities (Study 1a), but heterosexual (vs. sexually diverse) participants also endorsed lack of romantic attraction and experiences of affection. Heterosexual (vs. LGBTQ+) participants also attributed fewer positive and more negative emotions to a-spec targets (vs. allosexual), regardless of their sexual activity (Study 1b). Lastly, heterosexual (vs. LGBTQ+) participants attributed fewer positive emotions to both a-spec targets, perceived them as less sociable, and perceived aromantic a-spec targets as more immature (vs. allosexual amatonormative targets; Study 2). Overall, a-spec identities are perceived as less legitimate and emotionally rich, under norms privileging sexual and romantic conformity. This stigmatization appears to be nuanced, emerging primarily when a-spec individuals are described as departing from normative models of romantic relationships.
Plurisexuality, an umbrella term describing attraction to more than one gender (e.g., bisexuality, pansexuality), has become increasingly visible in Anglo-Western societies. Yet dominant heterosexual-homosexual binaries remain entrenched, contributing to the erasure, stigmatization, and delegitimisation of plurisexual identities. Gendered sexual norms further shape these dynamics, positioning plurisexual women at the intersection of sexualization and invisibility. Despite comprising a substantial proportion of queer communities, plurisexual women's experiences remain underexplored in qualitative research. This study drew on in-depth interviews with a community-based sample of plurisexual women (N = 20) living in Aotearoa New Zealand. Informed by social constructionist epistemology, a critical approach to sexuality studies, intersectional theory, and critical feminist psychological methodology, we conducted a reflexive thematic analysis to examine how participants discussed their sexual identities and daily experiences, negotiating marginalization within the bicultural context of Aotearoa New Zealand. Findings revealed a governing discursive landscape in which plurisexuality, particularly bisexuality, is constructed as socially unacceptable, shaping what participants felt able to say, do, and claim. Within this landscape, plurisexual identities were experienced as both sites of political possibility and sources of alienation, requiring ongoing cognitive, emotional, and relational work. These findings highlight the distinctive social positioning of plurisexual women and underscore the need for sexuality research that moves beyond mononormative and gender-binary frameworks to better reflect lived experience.
Globally, men who have sex with men (MSM) face significant sexual stigma and are at disproportionate risk of HIV and STIs. This cross-sectional study examined differences in HIV/STI-associated psychosocial characteristics and sexual behaviors among men who have sex with both men and women (MSMW) and men who have sex with men exclusively (MSME) in Kenya. MSM were categorized as either MSMW or MSME based on the reported sex of recent sexual partners. Depressive symptoms, alcohol use, and substance use were evaluated using the Patient Health Questionnaire 9 (PHQ-9), Alcohol Use Disorders Identification Test (AUDIT), and Drug Abuse Screening Test (DAST), respectively. Overall, 730 cisgender MSM were included in this analysis (405 MSMW and 325 MSME). MSMW reported twice as many partners as MSME in the last three months, while MSME were more likely to report engaging in receptive anal sex. MSMW were more likely to report hazardous alcohol and substance use. However, MSMW scored lower than MSME on the MSM Sexual Stigma Scale. These findings emphasize the need for socially aware, stigma-informed approaches that recognize how MSM may experience and manage sexual stigma differently, shaping their mental health, substance use, and sexual risk behaviors.
Condom use resistance (CUR) involves use of coercive and non-coercive tactics to persuade a sexual partner who wants to use a condom to forgo use. Given that limited research has explored use of CUR tactics among men who have sex with men (MSM), the present study sought to estimate the prevalence and correlates of CUR among MSM. Participants (N = 261 MSM reporting recent heavy alcohol use and condomless anal sex) completed measures assessing CUR tactics and correlates (i.e., sexual frequency and risk, sexual sensation seeking, compulsive sexual behavior, alcohol use) as well as measures especially relevant to MSM (i.e., internalized homonegativity, concerns about HIV and sexually transmitted infection [STI] risk, sexual position preference). Results indicated a majority of participants reported any lifetime use of non-coercive (76.8%) and coercive (54.3%) CUR tactics. Frequency of CUR tactic use was significantly associated with increased sexual sensation seeking, compulsive sexual behavior, casual sex frequency, condomless anal sex frequency, and decreased STI concern, but showed limited association with internalized homonegativity, HIV concern, sexual position preference, and alcohol use. Results suggest that prevalence and correlates of CUR among MSM may be similar to men who have sex with women, but this comparison should be made cautiously given the unique dynamics of male-male sexual encounters (e.g., topping vs. bottoming).
Around the world, the lives of transgender and non-binary individuals have become ever more prominent in public discourse, as have the rights and lives of sex workers. To date, an extensive number of scoping reviews exist documenting the lives and issues faced by both vulnerable populations. However, few scoping studies exist at these intersections. This scoping review takes its starting point by looking at the intersections of these two populations - transgender and nonbinary sex workers. The review demonstrates that there is an overrepresentation of transfeminine sex workers in the literature, with far less research existing on transmasculine sex workers, and even less on non-binary sex workers falling under the trans umbrella. There is abundant research from public health scholars, which has helped advance knowledge, shaping policy and direct services and clinical support for trans women sex workers, especially regarding HIV prevention and harm reduction. The ongoing public health focus in studies has left wide gaps in the literature, eclipsing the much scarcer yet vital work in gender and labor studies. In this article, I synthesize these findings from studies in public health, labor studies, and gender studies and explore dominant, developing, and emerging themes across these three primary fields. In charting new developments in the latest studies, I pinpoint new directions for future lines of inquiry in research studies focused on transgender and non-binary sex workers of various identities.
Intimate partner and sexual violence (IPV/SV) remain pervasive global public health issues. Prevention efforts typically occur at the primary level (promoting consent and healthy relationships), secondary level (encouraging bystander intervention and screening), or tertiary level (supporting survivors through reporting and access to resources). The rapid emergence of artificial intelligence (AI) chatbots, including large language models (LLMs) such as ChatGPT, presents new opportunities to expand access to information and potentially strengthen prevention efforts across these levels. However, little is known about how these tools are currently being used or evaluated within IPV/SV prevention. This scoping review synthesized 40 peer-reviewed articles, preprints, and conference papers published between 2017 and 2025 that examined AI chatbots in IPV/SV contexts. Twenty-six studies described the development of domain-specific chatbots designed to support survivors by documenting incidents of violence, facilitating or streamlining reporting to authorities, and connecting users with services such as counseling. In addition, general-purpose LLMS (e.g., ChatGPT, Gemini) appeared to consistently produced evidence-based and accurate responses to questions related to IPV/SV. Findings suggest that AI chatbots may have a meaningful role in IPV/SV prevention; however, most existing applications focus on tertiary prevention after harm has occurred. This emphasis mirrors broader policy and service landscapes that prioritize crisis response over primary prevention. To realize the potential of AI in this field, future researchers should explore how chatbots and LLMs can be incorporated into primary and secondary prevention, particularly in strengthening education, promoting healthy relationships, and supporting early intervention.
