Parents play a central role in supporting children experiencing gender dysphoria and in navigating decisions regarding social and medical transition. Despite this, parental perspectives remain underrepresented within the academic literature. This systematic review synthesized research examining how parents understand and interpret experiences of gender dysphoria during childhood and adolescence. Searches were conducted across multiple databases. Twenty-eight studies met the inclusion criteria. The literature consisted predominantly of qualitative studies and showed variation in recruitment methods and sampling strategies. Several themes emerged. Parents frequently described shock, confusion, grief, and uncertainty, followed by processes of meaning-making and adaptation. Social stigma and concerns regarding children's future were commonly reported. Many studies described trajectories toward acceptance and advocacy, although the literature relied heavily on highly self-selected samples, with supportive mothers overrepresented and dissenting or ambivalent perspectives underrepresented. Most studies were informed by gender-affirmative frameworks, and few examined parental experiences longitudinally or across differing explanatory frameworks. The findings suggest that parental experiences are complex and insufficiently represented within current research. Greater methodological and viewpoint diversity is needed to inform family-inclusive approaches to the care of children and adolescents experiencing gender dysphoria.
This study aimed to assess the effect of life skills-based group counseling on sexual intimacy among women of reproductive age. In this randomized controlled trial, 118 women (all scoring below 60 on the intimacy questionnaire) were allocated to intervention and control groups via block randomization. The intervention group attended eight life skills-based counseling sessions. Sexual intimacy data were collected at baseline, immediately after, and one-month post-intervention. Data were analyzed using chi-square, independent t-test, and repeated measures ANOVA with SPSS-24. Immediately after the intervention and at the one-month follow-up, mean sexual intimacy scores were significantly higher in the intervention group compared to the control group (p < 0.001). Repeated-measures ANOVA showed a significant main effect of time and a significant time × group interaction (p < 0.001), indicating that patterns of change in sexual intimacy scores over time differed between groups. Furthermore, the overall between-group difference remained significant (p = 0.001). The results suggest that life skills-based group counseling is associated with improved sexual intimacy among women of reproductive age who report low baseline sexual intimacy.
This study focuses on infidelity psychology in married couples. The measure of infidelity was relative to attachment styles, marital satisfaction, commitment to relationships, and infidelity attitudes. Standardized instruments, including the Investment Model Scale, Attitudes Toward Infidelity Scale, Adult Attachment Scale, and Infidelity Scale, were used to collect data. The findings indicated that attitudes toward infidelity and anxious and avoidant attachment strategies were positively related to infidelity. In contrast, infidelity was negatively correlated with greater marital bliss and devotion. The mediation analysis revealed the mediating role of anxious and avoidant attachment styles between psychological variables and infidelity. These findings highlight the roles of personality inclination and emotional insecurity in infidelity. This study highlights the need to address attachment issues to reduce the risk of infidelity. Further, the implications for future studies and treatment modalities are discussed.Infidelity; anxious attachment; avoidant attachment; marital satisfaction; relationship commitment; family systems, emotional insecurity.
Sexual dysfunction during SSRI/SNRI treatment is common, but persistent sexual dysfunction after discontinuation remains clinically contested and poorly quantified. This structured narrative review and evidence-informed framework-development exercise integrates published and regulatory evidence available to 14 May 2026 on clinical assessment, sexual-domain documentation, differential diagnosis, counseling, risk minimization, and pharmacovigilance reporting. Persistent symptoms may represent a plausible and potentially severe adverse drug reaction when temporality, persistence, phenotype specificity, and assessment of stronger alternative explanations support that interpretation. Genital sensory change, orgasmic or ejaculatory anhedonia, and a clearly documented change from baseline are high-value clinical features, but no single symptom is pathognomonic. Current evidence does not justify precise prevalence claims, mechanistic certainty, or curative-treatment recommendations. Because monitoring cannot guarantee prevention and abrupt discontinuation may cause withdrawal or psychiatric relapse, risk communication should be proportionate and individualized. Immediate priorities are shared decision-making, direct follow-up questioning, structured differential diagnosis, support for distress and relationship impact, and higher-quality adverse-event reports.
Studies examining the association between intimate partner violence (IPV) and dyadic sexual desire are scarce, although it has been suggested that IPV may hinder sexual desire. In addition, the quality of communication between partners can also contribute to sexual desire. As it remains unknown whether communication quality moderates the IPV-sexual desire link, the present study examined the associations between both partners' IPV perpetration and dyadic sexual desire, and whether both partners' communication behaviors moderate these associations. A sample of 178 couples (18-29 years old) from the general population completed self-report questionnaires on IPV and sexual desire, and positive and negative communication behaviors were coded from a video-recorded date-planning discussion. Results revealed a positive association between a perpetrator's sexual IPV (i.e., verbal insistence to engage in sex) and their own dyadic sexual desire, as well as a negative association with the partner's dyadic sexual desire. Results also showed a complex pattern of interactions between sexual IPV and communication behaviors in relation to dyadic sexual desire, with some patterns consistent with protective processes and others consistent with more negative relational dynamics. Findings encourage further examination of how IPV relates to dyadic sexual desire and the role of communication behaviors in these associations.
Mental health disparities among sexual and gender minority (SGM) populations remain a clinical concern. Existing mental health models have advanced understanding, but often overlook sexual health as a key outcome. We propose that integrating minority and intraminority stress within an evolutionary framework (highlighting processes, e.g., shame, arrested flight, insecure striving) may offer a unifying perspective. We suggest stigma triggers threat-defense systems that shape sexual behavior around survival-oriented social motives (e.g., avoiding rejection), rather than intimacy, pleasure, and care. This commentary highlights the need for clinicians to assess sexual and relational functioning with an evolutionarily-informed framework when working with SGM patients.
Couples often recognize the patterns that keep them stuck long before they become capable of interrupting them. Love-Centered Therapy (LCT) is a clinically derived process model that synthesizes attachment theory, somatic psychology, interpersonal neurobiology, and decolonial scholarship. LCT organizes intervention through three interconnected constructs: learned templates for intimate relationships (the First Story), the repetitive unsatisfying interactions those templates produce (the First Story Cycle), and the emotions generated by that ongoing interaction (the Relational Field). Intervention focuses on helping partners approach their learned responses with curiosity rather than judgment, take responsibility for their own activation, and return to relational contact from a more regulated state.
Criteria used by healthcare practitioners (HCPs) to set goals and assess when treatment was successful, met its goals, and/or should be ended has not been studied for men seeking treatment of premature ejaculation (PE). This study describes HCPs' priorities regarding treatment goals, assessment of success, and decisions to end treatment for men with PE, and examined whether HCP characteristics influenced these decisions. Overall, 240 medical and mental health professionals completed an online or in-person survey on treatment objectives and termination criteria in PE care. Results indicated that, according to HCP reports, patients' primary treatment goal was increased ejaculation latency, whereas HCPs themselves most strongly prioritized reducing distress and improving coping. For ejaculation latency, 44.7% of HCPs defined success according to the client's preferred level. Beyond latency, reduced stress and improved coping received the highest success rating, and 76.9% of HCPs reported moderate-to-high success in treating men with PE. Treatment termination was most often linked to increased sexual satisfaction and reduced distress. Professional training, identity, and PE treatment experience influenced goals, success assessment, and termination decisions. PE treatment requires explicit shared decision-making to align clinicians' biopsychosocial priorities with patients' symptom-specific expectations.
Digital interventions for female sexual pain disorders, including genito-pelvic pain/penetration disorder (GPPPD)/vaginismus and vulvodynia/vestibulodynia, may help address persistent barriers to specialist care. In this systematic review with evidence mapping and limited quantitative synthesis, we synthesized evidence on clinical efficacy and engagement across digital formats, including guided internet-based programs, app-based interventions, and digital therapeutics. Fifty-one studies were included in the qualitative synthesis, and three contributed to a limited quantitative synthesis. The most directly relevant trials suggested improvements in penetration-related outcomes, sexual function, pain-related outcomes, or both, while guided formats showed stronger engagement. Overall, digital care appears promising, but the literature remains methodologically heterogeneous, and the strongest direct evidence is concentrated in a relatively small subset of diagnosis-specific trials.
The reclassification of vaginismus under genito-pelvic pain/penetration -disorder (GPPPD) in the DSM-5 has reshaped the conceptual framework of female sexual pain disorders, introducing both integration and terminological heterogeneity. This study provides a comprehensive bibliometric and thematic analysis of the vaginismus/GPPPD literature, mapping conceptual, clinical, and disciplinary shifts over time. A bibliometric analysis was conducted using the Web of Science Core Collection (1994-2026). After screening and deduplication, 655 articles and reviews were analyzed using Python-based tools for descriptive bibliometrics, network analysis (coauthorship, co-citation, keyword cooccurrence), and text mining (TF-IDF and nonnegative matrix factorization). Publication output was descriptively higher after the DSM-5 transition: 220 records were identified for the pre-DSM-5 period (1994-2012), whereas 435 records were identified from 2013 onward, with the mean annual publication count increasing from 11.58 to 31.07 publications per year. The literature evolved from a predominantly psychosexual framework toward pain-focused, multidisciplinary, and biopsychosocial models incorporating pelvic floor dysfunction, women's health, and sociocultural context. Despite diagnostic changes, the term vaginismus remained highly prevalent. Psychosocial assessment persisted as a central domain, while multidisciplinary and rehabilitation-oriented approaches gained prominence. Overall, the field reflects conceptual expansion rather than replacement, underscoring the need for greater terminological clarity and interdisciplinary collaboration.
Numerous systematic reviews and meta-analyses have evaluated interventions for sexual function and sexual health in women with cancer, yet they report inconsistent effect sizes for the same intervention families, and the extent to which they draw on overlapping primary studies has not been quantified. We aimed to synthesize and appraise this review-level evidence under a single framework, evaluating methodological quality (AMSTAR 2), certainty of evidence (GRADE), and between-review overlap (corrected covered area, CCA). Following the PRIOR and PRISMA 2020 guidelines, three databases (1,700 records) plus hand-searching were screened. Eighteen systematic reviews/meta-analyses met eligibility. Each was appraised with AMSTAR 2; certainty was derived for pooling reviews using a GRADE-informed approach; overlap was quantified with CCA and pairwise Jaccard coefficients. Pooled sexual function effects were consistently positive (SMD 0.63-0.98), though partly obscured by scale heterogeneity (raw FSFI mean differences vs. standardized effects) and very high statistical heterogeneity (I2 = 79-95%). Methodological quality was low or critically low in 89% (16/18) of reviews. Overall CCA was slight (3.57%) but concentrated within clusters (11.6-37.5%); a single RCT recurred across six reviews, indicating an illusion of independent evidence. Although these interventions show a beneficial direction, certainty is low; effect-magnitude claims should be cautious, and future syntheses should report overlap and apply GRADE.
Vulvar lichen sclerosus (VLS) is a chronic, inflammatory skin condition that can lead to vulvar itch and pain as well as challenges in sexual relationships. Yet, little research explores how couples coping with VLS navigate sexual challenges. Informed by sexual script theory and the concept of sexual script flexibility (i.e., adapting a typical sexual routine in response to a sexual problem), we aimed to examine the sexual challenges faced by couples coping with VLS and the strategies they used to cope and maintain satisfying sexual lives. A sample of 98 couples (196 individuals) independently completed two open-ended survey questions about VLS-related sexual challenges and coping strategies, which were analyzed using a reflexive thematic and abductive approach. Couples were found to cope with sexual challenges in three main ways, by 1) using sexual aids, but with varied experiences (3 subthemes), 2) focusing on the partner, for better or worse (2 subthemes), and 3) redefining the sexual relationship as a couple (4 subthemes). Within each of the three themes and nine subthemes, we discuss how couple members' coping strategies align with sexual script flexibility or not, and couples' nuanced reactions to implementing flexible strategies in their sexual lives.
We aimed to explore the associations between perfectionism, sexual distress, and sexual pleasure, using worry and cognitive distraction as serial mediators. Grounded in dimensional and transdiagnostic frameworks of emotional problems, as well as cognitive models of perfectionism and sexual function, we tested a theoretically driven mediation model in a large online community sample (N = 902; Mage = 32.89, SD = 11.21). Controlling for gender identity and sexual orientation, results showed that perfectionistic evaluative concerns were indirectly associated with greater sexual distress through sequential pathways involving worry and cognitive distraction related to body appearance and performance. Smaller indirect effects were also observed for sexual pleasure. Overall, findings highlight the role of maladaptive cognitive processes in linking perfectionism to sexual outcomes, supporting transdiagnostic accounts of sexual distress and pleasure, and underscoring the relevance of targeting transdiagnostic cognitive mechanisms in future clinical interventions.
The Pornography Consumption Inventory (PCI) assesses motivations for pornography consumption and has been validated in various cultural contexts. In the Spanish validation, its 13 items are distributed into three factors: Emotional avoidance, Sexual curiosity, and Excitement seeking and sexual pleasure. Given the differences in the use and effects of pornography, it is relevant to ensure that the PCI measures pornography consumption equivalently across different groups. The general objective of this study is to further examine its psychometric properties in the Spanish population by analyzing its measurement invariance across gender, age, relationship status, and sexual orientation. The sample consisted of 1,366 cisgender Spanish adults. Results indicated that the three-factor model showed an overall acceptable, although not optimal, fit across subgroups. Also, the results showed acceptable strict measurement invariance of the PCI across groups and revealed differences in its dimensions by gender, age, and sexual orientation. Furthermore, in general, its dimensions were positively associated with propensity for sexual excitation, solitary sexual desire, dimensions of the subjective orgasm experience, and frequency of pornography consumption. Overall, findings support the use of the PCI for group comparisons, although results should be interpreted with caution.
This mixed-methods study examined the associations between spousal support and menopausal symptoms, sexual distress, and mental well-being among postmenopausal women. The study included 441 postmenopausal women. Data were collected using the Personal Information Form, Menopausal Spousal Support Questionnaire (MSSQ), Menopause Symptom Assessment Scale (MSAS), Female Sexual Distress Scale-Revised (FSDS-R), Warwick-Edinburgh Mental Well-Being Scale (WEMWBS), and a semistructured interview form. Quantitative data were analyzed using descriptive statistics and hierarchical multiple regression, and qualitative data were analyzed using thematic analysis. The mean age of participants was 55.49 ± 6.34 years, and the mean menopause age was 48.12 ± 3.78 years. The mean MSSQ score was 68.82 ± 30.28, the MSAS score was 26.42 ± 5.64, the FSDS-R score was 28.98 ± 9.65, and the WEMWBS score was 37.46 ± 7.17. Spousal support was negatively associated with menopausal symptoms and sexual distress and positively associated with mental well-being. Qualitative findings showed that many women perceived inadequate support from their husbands and relied on personal coping strategies to manage symptoms. These findings highlight the importance of developing couple-based educational and counseling interventions to strengthen spousal support during postmenopause.
