The confluence model of sexual aggression identifies hostile masculinity and impersonal sexuality as core risk factors, with their interaction amplified in men high in dominance and low in nurturance; empathy has been proposed as the mechanism underlying this moderation. The present study tested whether empathy accounts for the effects of dominance/nurturance or whether dominance/nurturance contributes unique variance beyond empathy. In an online sample of 300 heterosexual men (age 18–65 years), sexual aggression was assessed with the Sexual Experience Survey, hostile masculinity with the Hostile Sexism Scale of the Ambivalent Sexism Inventory, impersonal sexuality with the Sociosexual Orientation Inventory Revised, dominance/nurturance via the difference score of the Bem Sex-Role Inventory Revised, and empathy with the Interpersonal Reactivity Index. Three latent negative binomial regression models were compared using structural equation modeling. Hostile masculinity and impersonal sexuality consistently predicted higher sexual aggression counts; empathy was a significant negative predictor, whereas the dominance/nurturance difference score was not. No latent interactions reached significance, but complementary response surface analysis confirmed a synergistic hostile masculinity × impersonal sexuality effect. Results indicate that empathy, not dominance/nurturance, attenuates sexual aggression risk within the confluence model. Findings recommend replacing dominance/nurturance with empathy in future confluence model research and prioritizing empathy-enhancing components in prevention programs targeting high-risk men.
Evidence on the proportion and characteristics of sexual and gender minorities (SGM) in Japan is limited. We aimed to provide nationally calibrated, descriptive estimates of sexual orientation and gender identity (SOGI) distributions and related socioeconomic and health indicators. We analyzed a nationwide web survey conducted in Japan in September–October 2022. SOGI was estimated using a two-step measure of assigned sex at birth and current gender identity, plus a romantic/sexual attraction item for sexual orientation. Gender-diverse (GD) respondents were not reclassified by sexual orientation. We produced population estimates from 27,690 eligible respondents using inverse probability weighting calibrated to the 2019 Comprehensive Survey of Living Conditions. Among the Japanese population aged 15 years and over, 8.6
Sexual and gender minority (SGM) individuals face discrimination in health care, compromising both well-being and access to services. Such experiences may foster expectations of mistreatment and mistrust of health care professionals, contributing to delays in care with potentially adverse consequences. This study examined perceived discrimination, mental and physical health, trust in providers, and care-seeking behavior among young adults in Spain, comparing SGM participants with their cisgender heterosexual peers. A cross-sectional online survey was conducted with 217 participants (M = 21.5 and SD = 4.6), of whom 144 identified as cisgender heterosexual and 73 as SGM. Qualitative open-text responses were analyzed using reflexive thematic analysis. Data were collected between January and April 2025. SGM participants reported higher levels of perceived discrimination, greater psychological distress, lower trust in providers, and more delays in seeking care than cisgender heterosexual participants. Although perceived discrimination was associated with psychological distress, trust, and delayed care at the bivariate level, discrimination did not emerge as an independent predictor of health outcomes in multivariate regression models. Qualitative findings illustrated that discrimination (including misgendering, medical paternalism, and moral judgement) was experienced in everyday clinical encounters and linked to identity concealment and erosion of trust. These findings suggest that universal health coverage and legal protections are insufficient to ensure equitable care in the absence of affirming, culturally competent care. Structural reforms, inclusive protocols, and provider training are essential to reduce health disparities affecting SGM populations.
Female sexual difficulties such as pain and dysfunction occur within a complex biopsychosocial ecosystem that evolves across the lifespan. This qualitative study explored how a large sample of Christian women (N = 629) who have experienced sexual difficulties in marriage construct meaning around key dimensions of their sexual functioning, including sexual satisfaction and desire. Reflexive thematic analysis of open-ended survey responses revealed the multifactorial attributions Christian women make when accounting for stability and change in their sexual functioning over time. Findings indicate that for married Christian women experiencing sexual pain and difficulty, attainment of desired sexual health is shaped by sociocultural, biological, psychological, relational, and situational factors that are frequently overlapping and interdependent. Changes in one partner’s health, beliefs, or circumstances may disrupt this biopsychosocial–spiritual ecosystem, thereby enhancing or diminishing women’s sexual functioning. Notably, emotionally and spiritually supportive relationships appeared to mitigate the negative effects of diminished functioning. We conclude with recommendations, such as refined assessment tools and timing of interventions, for researchers and practitioners working with women presenting with sexual pain or difficulty, particularly women affected by the Evangelical Purity Movement.
Sexual function problems are common during the perinatal period, with prevalence estimates ranging from 36 to 88
Sexting is a widespread sexual practice in society that has exponentially increased over the last decade. Research suggests that this practice may be associated with higher rates of both online victimization and sexual violence. Therefore, this meta-analysis examined the relationship between sexting and different types of sexual violence using the databases WoS, Scopus, Dialnet, and PsycINFO. Thirteen studies analyzed the relationship between sexting and sexual violence, while seven examined the relationship between sexting and online victimization. The results showed that the relationship between sexting and sexual violence was stronger in more gender-heterogeneous groups, whereas the relationship with online victimization was higher in younger groups. This research can contribute to a better understanding of the problems associated with sexting, as well as the most vulnerable groups. Future studies should continue exploring these relationships by including additional variables, such as the role of sexual orientation in this association.
This systematic review evaluates the psychometric properties of instruments used to measure minority stress in lesbian, gay, bisexual, and queer (LGBQ) populations. A systematic search identified measurement instruments for dimensions of minority stress in adult LGBQ populations. The instruments were evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology. Eight out of 105 instruments qualified for appraisal. The Lesbian, Gay, and Bisexual Identity Scale (LGBIS) and its German adaptation, LGBIS-DE, demonstrated the strongest psychometric properties and are recommended for use. However, the review indicated notable variation in how minority stress was conceptualized and operationalized across instruments. Additionally, content validity, as defined by COSMIN, has not been sufficiently explored, compromising the robustness of many instruments. This review highlights the need for greater standardization in the definition of minority stress constructs and a greater focus on content validity in future research. While the LGBIS and LGBIS-DE demonstrated strong psychometric properties, data were not available for all psychometric categories, particularly for reliability and responsiveness. Further research is needed to further validate the instruments included. PROSPERO Registration Number: CRD42021257995.
Building on the Compensatory-Dissociative Online Gaming model (Giardina et al., 2024a), the current study proposes a compensatory–dissociative continuum of online pornography consumption. Using a person-centered approach, we identified distinct young adult profiles based on compensatory and dissociative patterns. We first examined differences in psychopathological symptoms, impulsivity, loneliness, emotion regulation, basic psychological needs, and early childhood trauma. We then explored how early childhood trauma moderates the links between compensatory and dissociative patterns profiles, problematic pornography use characterized by loss of control, distress, and impairment, and overall online pornography consumption. A total of 608 young adults (436 men [73
The global wave of pandemic-induced uncertainty sparked a rise in online criminal activities, with sextortion emerging as a leading form of exploitation. It involved perpetrators coercing victims into providing sexual images or favors under the threat of exposing compromising material. As daily routines were disrupted and digital reliance increased, cybercriminals seized new opportunities to target vulnerable individuals, thereby amplifying sextortion risks worldwide. This research explored the asymmetric association between pandemic uncertainty and sextortion across 10 key nations (Brazil, Canada, Germany, India, Mexico, Nigeria, the Philippines, Russia, South Africa, and the USA). An innovative pandemic uncertainty index was employed, integrating data from multiple outbreaks, namely COVID-19, MERS, SARS, and Ebola. Prior studies had relied on panel data methods and often disregarded the diverse economic structures across countries. However, by utilizing the Quantile-on-Quantile tool, this study revealed nuanced relationships between the variables, capturing global trends while uncovering the distinctive dynamics of each country. The findings indicated that pandemic-induced uncertainty was associated with increased sextortion rates across different quantiles in the selected economies, highlighting varied patterns across nations. The findings underlined the urgency for policymakers to craft tailored, context-specific strategies to combat sextortion, especially as the digital landscape had become increasingly shaped by pandemic-related fears. To protect vulnerable populations, targeted interventions are needed to address the unique challenges and nuanced trends observed across countries.
Although sexual orientation change efforts are generally understood to be ineffective and health-undermining, this understanding is based almost entirely on retrospective, cross-sectional data. We present prospective, longitudinal data from a sample of 315 sexual minority current/former members of the Church of Jesus Christ of Latter-day Saints to examine the efficacy and impact of self-initiated sexual orientation change efforts (SISOCE). We found that 74.6
Although qualitative research on dyspareunia has increased in recent years, most studies have focused on women’s individual experiences or on specific difficulties within the couple, leaving underexplored how partners jointly construct the meanings of sexuality when pain becomes part of the relationship. Against this backdrop, this study explored how couples make sense of sexuality and how their interactional processes shape the relational patterns through which they navigate intimacy in the presence of pain. Drawing on episodic interviews with nine Italian heterosexual couples (M age = 34 years) affected by dyspareunia associated with vulvodynia and/or endometriosis, we conducted a reflexive thematic analysis through which four themes were co-constructed: “Between Body and Emotion: The Shifting Landscape of Sexuality”; “He Holds Back, She Consents: Silent Sacrifices”; “Together Alone: When Coping Is Delegated”; and “From Pain to Partnership: Reimagining Sexuality Together.” Across narratives, couples described greater connection and intimacy when they were able to co-construct meanings and activate communicative spaces grounded in acknowledgment, mutual support, and negotiation. These findings underscore the importance of couple-centered clinical interventions that focus on interactive processes and promote reciprocity and a shared redefinition of sexuality. Adopting a relational and dialogical lens, the study highlights sexuality not as an individual function disrupted by pain, but as an evolving co-created process through which partners continually remake intimacy together.
Syphilis remains a major public health concern globally, with rising incidence contributing to preventable complications, including congenital syphilis. As such, the Western Sydney Local Health District implemented a direct syphilis referral pathway between the public health unit and sexual health services. This study aimed to explore healthcare professionals’ experiences of this direct referral pathway and its perceived impact on clinical outcomes and care coordination. A qualitative study was conducted as part of a quality improvement initiative. Semi-structured interviews were undertaken with clinicians from public health and sexual health services involved in the referral pathway. Interviews were audio recorded, transcribed verbatim, and analyzed using inductive and deductive thematic analysis. Fourteen clinicians participated, including medical practitioners and registered nurses. Two overarching themes were identified: (1) proactive case follow-up as a safeguard against preventable consequences of syphilis and (2) infrastructure and interprofessional relationships as enablers of sustained coordination. Participants reported that the pathway enabled proactive engagement of high-risk populations (i.e., pregnant women), resulting in faster treatment and reduced loss to follow-up. Improved interprofessional communication, clearer roles, and access to digital tools (e.g., shared referral forms and electronic medical records) enhanced coordination. Persistent challenges included stigma, unstable housing, and difficulties engaging some patients despite repeated outreach. Clinicians perceived the direct syphilis referral pathway as improving timeliness, coordination, and equity of care for high-risk patients. Strengthened collaboration between public health and sexual health services supported integrated management, although ongoing social and structural barriers highlight the need for complementary supportive interventions.
Exposure to Internet pornography (IP) in childhood and early adolescence is common, representing an important focus for researchers interested in the impact of sexually explicit media consumption on psychosocial development and well-being. Recent research has documented connections between early IP use and elevated risk for young women’s sexual victimization in adulthood, but possible mechanisms of this association remain largely unexplored. Grounded in sexual script theory, the current study aimed to investigate the role of pornography sex scripting (i.e., self-reported repetition of sexual behavior depicted in IP) in the relationship between individuals’ self-reported early exposure to IP and later sexual victimization. Using data from a cross-sectional survey of emerging adult women (N = 677), the current study (1) replicated previously identified associations between women’s early IP exposure during childhood and sexual victimization in adulthood; and (2) found that women’s self-reported engagement in pornography sex scripting partially mediated this association. Results and implications for further research and sexual violence prevention efforts are discussed within the context of the current study’s strengths and limitations.
Public attitudes toward sexual and gender minority (SGM) populations have important implications for health outcomes and human rights. This study examined how China’s 2017 censorship policy restricting media portrayals of SGM populations was associated with attitudes towards same-sex behavior using data from the Chinese General Social Survey (2010–2021, N = 66,057). Using interrupted time series analysis, we found that the policy was associated with a significant shorter-term decrease in positive attitudes (OR = 0.73, 95
Sexually transmitted infections (STIs) are most prevalent among emerging adults (ages 18–29) in the USA. Heightened risk of STIs is partly due to increased self-exploration and experimentation during this developmental period, compounded by sexual health misinformation that spreads through peer interactions and online media. Despite a well-documented impact of (false) beliefs on behavior, very little is known about sexual myths among emerging adults in the USA and the structure of these myths. In the current study, we introduce the Sexual Health Myth-Conceptions Scale (SHMCS) with two primary goals: (1) to identify common sexual health myth-conceptions (i.e., a fusion of myths and misconceptions) among US emerging adults and (2) to evaluate the scale’s psychometric properties. A sample of 1,162 US-based emerging adults were recruited through Prolific, an online crowdsourcing platform, and completed the 34-item SHMCS. Item-level characteristics, exploratory factor analysis, exploratory structural equation modeling, and bifactor analysis were used to establish factorial validity. Item response theory (IRT) was used to examine item and scale performance. Results of factor analyses reinforce three persistent factors, including multi-topic or general, pornography use, and STIs/pregnancy. Results of a 2-PL IRT model reinforce good discrimination and moderate item difficulty across the spectrum of myth-conceptions. Although the SHMCS would benefit from further psychometric refinement, it shows promise as a tool for assessing general and domain-specific sexual health myth-conceptions and for advancing understanding their roles in sexual health among emerging adults.
Viewing times (VTs) are established indirect measures of sexual interests. They are based on the effect that stimuli of sexually attractive target groups are scrutinized longer than stimuli of non-attractive groups in sexual attractiveness rating tasks. When assessing sexual interest in children and adults, decision latencies for target sexual maturity categories are typically compared by subtracting average latencies for children from average latencies of adults. In this study, several ways of improving the scoring algorithm were explored (e.g., using standardized differences, excluding the longest VTs of each category from the scoring, or conducting a profile analysis based on peaks in certain target categories). Scoring algorithms were compared in terms of reliability, convergent validity, and the influence of confounding variables in a secondary analysis of a German male community sample (N = 8554). Additionally, the influence of the scoring on the number of participants who would be classified as exhibiting (increased levels of) sexual interest in children was investigated. The VT task’s validity proved to be quite robust to changes in scoring, but the reliability and classification proportions differed substantially between scores. The best performing score was the mean difference of adult and child target groups with the exclusion of the longest VT in each target category. The results imply that the scoring approach should be chosen based on the research or diagnostic goal of using the VT task (e.g., whether one prioritizes sensitivity or specificity). The study underlines the influence of measurement and scoring approach on prevalence estimates of (increased) sexual interest in children.
