Are the Predictors of Sexual Violence the Same as Those of Nonsexual Violence? A Gender Analysis

IntroductionViolence manifests itself in such multifarious ways as sexual, physical, and psychological abuse. What has hitherto eluded the medical community, however, is whether sexual and nonsexual abuse share the same predictors.AimDrawing upon a representative sample of married men and women in the Iranian capital, Tehran, we aimed to determine: (i) the overlap between sexual abuse and physical and psychological violence, and (ii) the predictors that sexual violence victimization share with physical and psychological violence victimization.Main Outcome MeasuresVictimization through any type of sexual coercion by the husband in the context of the current marital relationship, as determined via the conflict tactic scales-revised (CTS-2).MethodsIn a cross-sectional survey in Tehran in 2007, 460 married Iranian men and women were selected via a multicluster sampling method from four different randomized regions. Independent variables comprised sociodemographic characteristics, subscores of psychological, and personality characteristics known to be allied with intimate abuse (personal and relationship profile), and dichotomus data on victimization history through all types of violence by the spouse including psychological aggression, physical assault, and sexual coercion (CTS-2).ResultsIn both genders, the experience of physical or psychological violence increased the likelihood of sexual violence victimization. In both genders, higher conflict was a predictor of sexual and psychological violence victimization. In addition, the common predictors of sexual and physical violence victimization were low self-control and high violent socialization in the men and women, respectively.ConclusionsSexual violence victimization shares some factors with the victimization of nonsexual types of marital abuse, but this seems to be partially gender dependent. Mohammadkhani P, Forouzan AS, Khooshabi KS, Assari S, and Moghani Lankarani M. Are the predictors of sexual violence the same as those of nonsexual violence? A gender analysis. J Sex Med 2009;6:2215–2223.     

The importance of sexual self-disclosure to sexual satisfaction and functioning in committed relationships

IntroductionPast research indicates that sexual self‐disclosure, or the degree to which an individual is open with his or her partner about sexual preferences, is a key aspect of sexual satisfaction and that partner's lack of knowledge about one's sexual preferences is associated with persistent sexual dysfunction.AimsTo replicate and extend past research by examining (i) how one's own levels of sexual self‐disclosure are related to one's own sexual health (after controlling for partner's levels of sexual self‐disclosure); (ii) how one's partner's levels of sexual self‐disclosure are associated with one's own sexual health (after controlling for one's own levels of sexual self‐disclosure); and (iii) whether gender moderates the associations between sexual self‐disclosure and sexual health.Main Outcome MeasuresScores from the Golombok Rust Inventory of Sexual Satisfaction and the Sexual Communication Satisfaction Scale.MethodsA cross‐sectional dyadic study using a convenience sample of 91 heterosexual couples in long‐term committed relationships. Data were analyzed using the Actor–Partner Interdependence Model.ResultsOne's own level of sexual self‐disclosure is positively associated with one's own sexual satisfaction, β = ?0.24, t(172.85) = ?3.50, P < 0.001. Furthermore, partner's level of sexual self‐disclosure is associated with men's sexual satisfaction but not with women's sexual satisfaction, β = ?0.45, t(86.81) = ?4.06, P < 0.001 and β = 0.02, t(87.00) = 0.20, ns, respectively. The association between own self‐disclosure and sexual problems is stronger for women as compared with men, β = ?0.72, t(87.00) = ?6.31, P < 0.001 and β = ?0.24, t(86.27) = ?3.04, P < 0.01, respectively.ConclusionsOur results demonstrate that sexual self‐disclosure is significantly associated with sexual satisfaction and functioning for both men and women, albeit in different ways. Our findings underscore the importance of sexual self‐disclosure and highlight the importance of the interpersonal level of analysis in understanding human sexuality. Rehman US, Rellini AH, and Fallis E. The importance of sexual self‐disclosure to sexual satisfaction and functioning in committed relationships. J Sex Med 2011;8:3108–3115.     

Factors Associated With Condom Use Among Sexually Active US Adults,National Survey of Family Growth, 2006–2010 and 2011–2013

BackgroundCondom-less sex can increase the risk of acquiring or transmitting HIV.AimTo characterize the prevalence of condom use at the most recent sex act and identify factors associated with use of a condom at the most recent sex act in adults in the United States.MethodsData from the cross-sectional National Survey of Family Growth from cycles 2006 through 2010 and 2011 through 2013 were analyzed for sexually active men and women 18 to 44 years old who reported having sex (vaginal, anal, or oral) with an opposite-sex partner in the past 12 months. HIV-related sexual risk behaviors (SRBs) in the past 12 months included sex with at least four opposite-sex partners; exchanging sex for money or drugs; sex with an injection drug user; sex with an HIV-positive person; sex with a man who previously had sex with a man (women only); sex with a man (men only); or sex with a partner who had sex with other partners.OutcomesThe outcome for this analysis was condom use at the most recent anal or vaginal sex act.ResultsOverall prevalence of condom use was 24.8%; only 33.8% of adults with at least one SRB reported the use of a condom. Only 46.4% of unmarried or single men (vs 14.7% married or cohabitating men) and 32.3% unmarried or single women (vs 14.1% married or cohabitating women) with SRBs reported using a condom at the most recent sexual encounter and were less likely to use a condom at the most recent sexual encounter compared with those who did not report SRBs. We did not find a significant relation between using a condom and SRBs in married or cohabitating men and women.Strengths and LimitationsOur analysis adds to the literature on how condom use varies by marital status. We measured the use of condoms at the most recent sexual act, which might not reflect an individual's previous behavior of condom use. Nonetheless, condom use at the most recent sexual act has been documented in previous studies as a valid proxy of condom use over time.ConclusionContinued efforts are needed to promote condom use in heterosexual adults in the United States, particularly those at high risk for HIV, namely individuals engaging in anal sexual acts and with multiple sex partners.Nasrullah M, Oraka E, Chavez PR, et al. Factors Associated With Condom Use Among Sexually Active US Adults, National Survey of Family Growth, 2006–2010 and 2011–2013. J Sex Med 2017;14:541–550.     

Anxious and avoidant attachment, vibrator use, anal sex, and impaired vaginal orgasm

IntroductionDisturbances in intimate relationships are among the risk factors for female sexual dysfunction. Insecure styles of anxious attachment (preoccupations about abandonment) and avoidant attachment (avoidance of closeness in relationships) are robustly associated with sexual problems, relationship difficulties, and several indices of poorer physical and mental health. Similar indices of poorer sexual, relationship, and health functioning are associated with impairment of orgasm triggered by penile‐vaginal stimulation (vaginal orgasm), but unrelated or related to greater frequency of other sexual behaviors. However, research examining the differential association of sexual activities with insecure attachment styles has been lacking.AimsThe aim of this study was to test the hypotheses that insecure attachment styles are associated with lesser vaginal orgasm consistency, and are unrelated or directly related to greater frequency of other sexual behaviors.MethodSeventy coitally experienced women recruited at a Scottish university completed the Revised Experience in Close Relationships scale, and reported their frequency of various sexual behaviors (and corresponding orgasms) in a recent representative month.Main Outcome MeasuresThe main outcome measures for this study are multivariate correlations of various sexual activities with insecure attachment styles, age, and social desirability response bias.ResultsAnxious attachment was associated with lesser vaginal orgasm consistency, but with higher frequency of vibrator and anal sex orgasms. Avoidant attachment was associated with higher frequency of vibrator orgasms. Neither anxious nor avoidant attachment was associated with lifetime number of penile‐vaginal intercourse partners.ConclusionsThe results provide evidence that inability to attain a vaginal orgasm is associated with anxious attachment, among other indices of poorer mental health and relatedness. Vaginal orgasm might be the relevant sexual activity for the maintenance of a secure attachment style with a sexual partner and/or more insecurely attached women might have difficulties in attaining vaginal orgasms and be more inclined to sexual activities characterized by more emotional and physical detachment, as part of a characterological discomfort with intimacy. Costa RM and Brody S. Anxious and avoidant attachment, vibrator use, anal sex, and impaired vaginal orgasm. J Sex Med 2011;8:2493–2500.     

Intimate partner violence and its association with women's reproductive health in Pakistan

ObjectiveTo determine the prevalence of intimate partner violence in Pakistan and its association with reproductive health outcomes.MethodsA cross-sectional survey was conducted in 8 hospitals in Lahore and Sialkot between October 2008 and January 2009. Information from randomly selected ever-married women of reproductive age was collected via a structured interview. Psychologic, physical, and sexual violence was categorized as “no” or “severe” violence. Associations between reproductive health outcomes and violence were assessed by multivariate logistic regression.ResultsAmong 373 women interviewed, 75.9% reported severe psychologic, 34.6% reported severe sexual, and 31.9% reported severe physical violence at least once in marital life. Women who experienced severe physical violence were more likely to have their husband's noncooperation in using contraceptives (adjusted odds ratio [AOR], 3.31; 95% confidence interval [CI], 1.93–5.68), poor prenatal care (AOR, 2.11; 95% CI, 1.23–3.69), unplanned pregnancies (AOR, 2.29; 95% CI, 1.39–3.76), and poor self-reported reproductive health (AOR, 2.95; 95% CI, 1.71–4.91) as compared with non-abused women. Similar associations existed for other types of violence.ConclusionThe results highlight the magnitude of violence and its association with reproductive health of women. Urgent action is needed to mitigate the violence and its consequential damage to health.     

Genital and Subjective Sexual Response in Women After Restorative Proctocolectomy with Ileal Pouch Anal Anastomosis—A Prospective Clinical Trial

IntroductionSexual dysfunction after ileo pouch anal anastomosis (IPAA) is common. The most systematic physical reaction to sexual stimulation is an increase in vaginal vasocongestion. Genital response can be assessed by vaginal pulse amplitude (VPA) using vaginal photoplethysmography.AimTo assess whether restorative proctocolectomy with IPAA is associated with autonomic pelvic nerve damage and changes in subjective indices of sexual function in women.MethodsFemale patients undergoing IPAA between April 2004 and January 2006 were included. During sexual stimulation (visual and vibrotactile) changes in vaginal vasocongestion were measured by vaginal photoplethysmography. Concurrently, quality of life (SF-36) and sexual functioning (FSFI, FSDS) were assessed using validated questionnaires.Main Outcome MeasuresPrimary endpoint was difference in VPA pre- and postoperatively. Secondary endpoints were differences in feelings of sexual arousal and estimated lubrication pre- and postoperatively and difference in psychological and sexual functioning pre-and postoperatively.ResultsEleven patients were included. For eight patients (median age 37 [22–49 years]) pre- and postoperative data were collected. VPA analysis showed a significant reduction in vaginal vasocongestion during sexual stimulation postoperatively, P = 0.012. Subjective sexual arousal and estimated lubrication during the experiment, reported psychological and sexual functioning pre- and postoperative were not different.ConclusionsVaginal vasocongestion after IPAA was significantly reduced in this small study; indicating that IPAA in women might possibly be associated with autonomic pelvic nerve damage or partial devascularization of the vagina. Subjectively reported sexual arousal, estimated lubrication, psychological and sexual functioning were not diminished. Future research should focus on the possible advantage of a full close rectal dissection in these patients. Vlug MS, Laan ET, van Lunsen RHW, van Koperen PJ, Polle SW, and Bemelman WA. Genital and subjective sexual response in women after restorative proctocolectomy with ileal pouch anal anastomosis—A prospective clinical trial.     

Aspects of Sexual Self-Schema in Premenopausal Women with Dyspareunia: Associations with Pain,Sexual Function,and Sexual Distress

IntroductionAlthough it is known that women with dyspareunia suffer from impaired psychological and sexual functioning, the study of the various dimensions of sexual self-schema and their associations with these outcomes has been neglected.AimTo examine whether self-image cognitions about vaginal penetration, body image, and feelings and beliefs about one's own genitals contribute to the variance in pain, sexual functioning, and sexual distress.MethodsPremenopausal women (n = 231; M age = 24.85, SD = 5.55) with self-reported dyspareunia completed an online survey focusing on self-image cognitions about vaginal penetration, body image, female genital self-image, pain during intercourse, sexual functioning, sexual distress, anxiety, and catastrophizing.Main Outcome Measures(i) Pain intensity during intercourse, (ii) the Female Sexual Function Index without the Pain subscale, and (iii) the Female Sexual Distress Scale.ResultsControlling for anxiety and catastrophizing, negative self-image cognitions about vaginal penetration, negative body image, and negative genital self-image together accounted for a portion of the variance in increased pain intensity, sexual dysfunction, and sexual distress. However, only self-image cognitions about vaginal penetration (β = 0.25, P = 0.005) contributed uniquely to the variance in pain intensity, whereas self-image cognitions about vaginal penetration (β = ?0.18, P = 0.048) and genital self-image (β = 0.21, P = 0.008) contributed independently to the variance in sexual functioning. Finally, self-image cognitions about vaginal penetration (β = 0.28, P < 0.001), body image (β = 0.24, P < 0.001) and genital self-image (β = ?0.14, P = 0.006) each contributed independently to the variance in sexual distress.ConclusionsFindings suggest that self-image cognitions about vaginal penetration and feelings and beliefs about one's own body and genitals are associated with pain and sexuality outcomes in women with dyspareunia. Pazmany E, Bergeron S, Van Oudenhove L, Verhaeghe J, and Enzlin P. Aspects of sexual self-schema in premenopausal women with dyspareunia: Associations with pain, sexual function, and sexual distress. J Sex Med 2013;10:2255–2264.     

Examining Links between Sexual Risk Behaviors and Dating Violence Involvement as a Function of Sexual Orientation

Study ObjectiveTo examine the association between dating violence perpetration and victimization and sexually risky behaviors among sexual minority and heterosexual adolescent girls.DesignAdolescent girls reported on sexual orientation, sexual behaviors, and risk-taking, and their use of, and experience with, dating violence in the past year. Data were analyzed using multinomial regression adjusted for race, poverty, living in a single parent household, and gender of current partner to examine (1) whether sexual minority status was associated with sexual risk behaviors after sociodemographic correlates of sexual risk were controlled; and (2) whether dating violence context accounted for elevated risk.SettingUrban, population-based sample of girls interviewed in the home.Participants1,647 adolescent girls (38% European American, 57% African American, and 5% other) aged 17 years. Over one-third of the sample lived in poverty.InterventionsNone.Main Outcome MeasureSexual risk-taking.ResultsSexual minority status differentiated girls engaging in high sexual risk-taking from those reporting none, after controlling for sociodemographic and relationship characteristics. Dating violence perpetration and victimization made unique additional contributions to this model and did not account for the elevated risk conferred by sexual minority status.ConclusionsSexual minority girls (SMGs) were more likely than heterosexual girls to report high sexual risk-taking and teen dating violence victimization. As with heterosexual girls, sexual risk-taking among SMGs was compounded by dating violence, which was not explained by partner gender. Adolescent girls' risky sexual behavior may be reduced by interventions for teen dating violence regardless of sexual minority status.     

Pain Experienced During Vaginal and Anal Intercourse with Other‐Sex Partners: Findings from a Nationally Representative Probability Study in the United States

IntroductionRecent U.S. nationally representative data indicate that about 30% of women and 5% of men reported pain occurring during their most recent sexual event; however, little is known about the severity, duration, or context of such pain, or its prevalence during vaginal vs. anal intercourse.AimsTo document the prevalence and characteristics of pain during vaginal and anal intercourse among U.S. women and men (ages 18+) at their most recent other‐sex sexual event, including the self‐reported severity, duration, and location of their pain; how participants addressed their pain; and partner communication related to the pain.MethodsData from a subsample of 1,738 women and men in the 2012 National Survey of Sexual Health Behavior, a nationally representative probability survey of Americans ages 18+ collected via the Internet, were analyzed.Main Outcome MeasuresParticipants responded to items about their background characteristics; whether they had vaginal or anal intercourse during their most recent sexual experience; the severity, duration, and location of any pain experienced during said sexual event; and whether they responded to or communicated about the pain.ResultsAbout 30% of women and 7% of men reported pain during vaginal intercourse events, and most of the reports of pain were mild and of short duration. About 72% of women and 15% of men reported pain during anal intercourse events, with more of these events including moderate or severe pain (for the women) and of mixed duration. Large proportions of Americans do not tell their partner when sex hurts.ConclusionPain is a relatively common, and often not discussed, aspect of both vaginal and anal intercourse events occurring between women and men. Individual and clinical implications are discussed. Herbenick D, Schick V, Sanders SA, Reece M, and Fortenberry JD. Pain experienced during vaginal and anal intercourse with other‐sex partners: Findings from a nationally representative probability study in the United States. J Sex Med 2015;12:1040–1051.     

Association of lubricant use with women's sexual pleasure, sexual satisfaction, and genital symptoms: a prospective daily diary study

IntroductionAlthough lubricant use is commonly recommended to women for solo and partnered sexual activities, little is known about women's use of lubricant or their relationship to sexual pleasure and satisfaction.AimThe aim of this study was to assess: (i) how adult women used lubricant during partnered and solo sexual activities; (ii) relations between women's reports of sexual pleasure and satisfaction and their use of a lubricant during a particular sexual event; and (iii) to what extent lubricant use was associated with subsequent genital symptoms.MethodsA total of 2,453 women completed a 5‐week internet‐based, double‐blind prospective daily diary study in which they were assigned to use one of six water‐ or silicone‐based lubricants.Main Outcome MeasuresBaseline data included demographics, contraceptive use, and sexual behavior during the 4 weeks prior to study enrollment. Daily diary data included reports of penile–vaginal sex, penile–anal sex, solo sex, lubricant use, lubricant application, ratings of sexual pleasure and satisfaction, and genital symptoms.ResultsWater‐based lubricants were associated with fewer genital symptoms compared with silicone‐based lubricants. In addition, the use of a water‐based or silicone‐based lubricant was associated with higher ratings of sexual pleasure and satisfaction for solo sex and penile–vaginal sex. Water‐based lubricant use was associated with higher ratings of sexual pleasure and satisfaction for penile–anal sex as compared with no lubricant use.ConclusionThe water‐ and silicone‐based lubricants used in this study were associated with significantly higher reports of sexual pleasure and satisfaction and rarely associated with genital symptoms. Herbenick D, Reece M, Hensel D, Sanders S, Jozkowski K, and Fortenberry JD. Association of lubricant use with women's sexual pleasure, sexual satisfaction, and genital symptoms: A prospective daily diary study. J Sex Med 2011;8:202–212.     

Acceptance of Vulvovaginal Pain in Women with Provoked Vestibulodynia and Their Partners: Associations with Pain,Psychological, and Sexual Adjustment

IntroductionProvoked vestibulodynia (PVD) is a common vulvovaginal pain condition associated with negative psychological and sexual consequences for affected women and their sexual partners. Greater pain acceptance has been found to be associated with better functional and psychological outcomes in individuals with chronic pain, and acceptance-based strategies are being increasingly incorporated into treatment protocols. The present study is a novel investigation of pain acceptance in PVD couples.AimThe aim was to examine the associations between acceptance of vulvovaginal pain and women's pain during intercourse, as well as the psychological and sexual adjustment of both women with PVD and their partners.MethodsSixty-one couples (M_age for women = 27.95 years, SD = 5.87; M_age for men = 30.48 years, SD = 6.70) in which the woman was diagnosed with PVD completed the Chronic Pain Acceptance Questionnaire, in reference to women's vulvovaginal pain. Women also rated their pain during intercourse, and couples completed measures of anxiety, depression, sexual function, and sexual satisfaction.Main Outcome MeasuresDependent measures were (i) women's self-reported pain during intercourse on a numerical rating scale; (ii) State-Trait Anxiety Inventory trait subscale; (iii) Beck Depression Inventory-II; (iv) Derogatis Interview for Sexual Functioning; and (v) Global Measure of Sexual Satisfaction Scale.ResultsWomen's greater pain acceptance was associated with their lower self-reported pain during intercourse, controlling for partner's pain acceptance. Greater pain acceptance among women was associated with their own lower anxiety and depression, greater sexual functioning, as well as their own and their partner's greater sexual satisfaction, controlling for the partner's pain acceptance. Additionally, greater pain acceptance among male partners was associated with their own lower depression.ConclusionsFindings suggest that psychological interventions for PVD should target increasing couples' vulvovaginal pain acceptance in order to improve women's pain and the sexual and psychological functioning of both members of the couple. Boerner KE and Rosen NO. Acceptance of vulvovaginal pain in women with provoked vestibulodynia and their partners: Associations with pain, psychological, and sexual adjustment. J Sex Med 2015;12:1450–1462.     

Sexting and Young Adolescents: Associations with Sexual Abuse and Intimate Partner Violence

Study ObjectiveTo explore whether sexting by young adolescent girls and boys is associated with adverse life experiences including exploitative or violent sexual relationships.Design and SettingCross-sectional, anonymous survey of a convenience sample of minor adolescents younger than age 18 years recruited while waiting for care in clinics affiliated with a children's hospital in a low-resource, high-poverty, urban community.ParticipantsFive hundred fifty-five adolescents aged 14-17 years, 63% girls and 37% boys.Main Outcome MeasuresWe measured sexting by asking, “Have you ever sent a sexually suggestive or naked picture of yourself to another person through text or e-mail?” The survey also measured risk behaviors, sexual abuse, intimate partner violence (IPV), and arrest and included a validated depression scale.ResultsMean age was 15.6 ± 1.1 years; 59% were Hispanic, 28% were black; 44% of girls and 46% of boys ever had sex; 24% of girls and 20% of boys ever sent a sext. More girls than boys reported sexual abuse (16% vs 3%; P < .01), IPV victimization (15% vs 7%; P < .01), and depression (33% vs 17%; P < .01). More boys than girls reported arrest (15% vs 7%; P < .01). Independent associations with sexting for girls were: ever had sex (odds ratio [OR], 4.59; 95% confidence interval [CI], 2.29-9.19; P < .001); sexual abuse (OR, 3.81; 95% CI, 1.80-8.05; P < .001); IPV victim (OR, 2.72; 95% CI, 1.11-6.62; P < .05), and for boys: ever had sex (OR, 4.26; 95% CI, 1.47-12.32; P < .01); sexual abuse (OR, 38.48; 95% CI, 1.48-999.46; P < .05); IPV perpetration (OR, 16.73; 95% CI, 1.64-170.75; 95% CI, P < .05), as well as cannabis use, older age, other race, and arrest.ConclusionFor young adolescents, sexting is independently associated with exploitative and abusive sexual relationships including sexual abuse and IPV with similarities and differences in predictors of sexting for girls and boys.     

The Inventory of Anal Sex Knowledge (iASK): A New Measure of Sexual Health Knowledge Among Adolescent Sexual Minority Males

IntroductionKnowledge about sexual health is a key determinant of sexual behavior among adolescent sexual minority males (ASMM). No measures exist to assess anal sex knowledge, even though anal sex is the primary route by which ASMM acquire sexually transmitted infections (STIs), including a disproportionate burden of human immunodeficiency virus (HIV).AimWe developed a new measure as a first step toward assessing the prevalence and correlates of anal sex knowledge and potential effects of interventions to improve knowledge.MethodsTwo coders independently outlined domains of knowledge within 2 sex education videos designed to address anal sex knowledge among ASMM. An initial set of 56 items, some duplicative, encompassed all domains. A larger team, including a psychometrician, then iteratively revised and reduced the set of items, and assessed construct validity via cognitive testing among ASMM (N = 4, aged 16–17 years old, 75% identifying as racial/ethnic minorities). For the final set of 10 items, factor structure and convergent and divergent validity were assessed using baseline responses to an online survey within a randomized controlled pilot trial among 154 ASMM. Open-ended questions assessed their comprehension and the acceptability of items.OutcomesWe examined correlates that we anticipated would be theoretically related (ie, the HIV Knowledge Questionnaire [HIV-KQ-18] and the STD-Knowledge Questionnaire [STD-KQ]) and theoretically distinct (ie, the Patient Health Questionnaire [PHQ-2], Generalized Anxiety Disorder scale [GAD-2], and employment status).ResultsThe one-factor model explained 42% of the items’ common variance and demonstrated acceptable internal reliability (Cronbach's alpha = 0.72). The measure withstood tests of convergent and divergent validity when compared to current measures (HIV knowledge, r = 0.35 and STI knowledge, r = 0.24, both P < .05; internalizing mental health symptoms, r = -0.07 and employment status, r = 0.13, both P > .05). Few respondents found words unfamiliar or uncomfortable.Clinical ImplicationsA method for assessing anal sex knowledge may offer opportunities to intervene to lessen harmful sequelae of a lack of knowledge.Strength & LimitationsWe developed a brief, psychometrically valid measure of anal sex knowledge. The measure may neither generalize to all anal health knowledge nor to more sexually experienced, older SMM.ConclusionThe resulting 10-item, single-factor measure, the Inventory of Anal Sex Knowledge (iASK), is psychometrically sound and addresses the lack of anal sex knowledge measures among ASMM. The iASK can function to assess the prevalence and sequelae of anal sex knowledge among ASMM as well as the impact of interventions targeting anal sex knowledge.Kutner BA, Perry N, Stout C, et al. The Inventory of Anal Sex Knowledge (iASK): A New Measure of Sexual Health Knowledge Among Adolescent Sexual Minority Males. J Sex Med 2022;19:521–528.     

Demographic and psychosocial features of participants in bondage and discipline, "sadomasochism" or dominance and submission (BDSM): data from a national survey

IntroductionPeople with sexual interests in bondage and discipline, “sadomasochism” or dominance and submission (BDSM) have been seen by many professionals as damaged or dangerous.AimTo examine sexual behavior correlates of involvement in BDSM and test the hypothesis that BDSM is practiced by people with a history of sexual coercion, sexual difficulties, and/or psychological problems.MethodsIn Australia in 2001–2002, a representative sample of 19,307 respondents aged 16–59 years was interviewed by telephone. Weighted data analysis used univariate logistic regression.Main Outcome MeasuresSelf-reported demographic and psychosocial factors; sexual behavior and identity; sexual difficulties.ResultsIn total, 1.8% of sexually active people (2.2% of men, 1.3% of women) said they had been involved in BDSM in the previous year. This was more common among gay/lesbian and bisexual people. People who had engaged in BDSM were more likely to have experienced oral sex and/or anal sex, to have had more than one partner in the past year, to have had sex with someone other than their regular partner, and to have: taken part in phone sex, visited an Internet sex site, viewed an X-rated (pornographic) film or video, used a sex toy, had group sex, or taken part in manual stimulation of the anus, fisting or rimming. However, they were no more likely to have been coerced into sexual activity, and were not significantly more likely to be unhappy or anxious—indeed, men who had engaged in BDSM scored significantly lower on a scale of psychological distress than other men. Engagement in BDSM was not significantly related to any sexual difficulties.ConclusionOur findings support the idea that BDSM is simply a sexual interest or subculture attractive to a minority, and for most participants not a pathological symptom of past abuse or difficulty with “normal” sex. Richters J, de Visser RO, Rissel CE, Grulich AE, and Smith AMA. Demographic and psychosocial features of participants in bondage and discipline, “sadomasochism” or dominance and submission (BDSM): Data from a national survey.     

Sexual Experience before Treatment for Vaginal Agenesis: A Retrospective Review of 137 Women

Study ObjectiveTo summarize the self-reported sexual experiences of women with vaginal agenesis before treatment and discuss the clinical implications.DesignA retrospective review of pretreatment baseline sexuality data and medical records of women with vaginal agenesis seeking vaginal construction.SettingA specialist multidisciplinary center for women with genital differences associated with diverse sex development.ParticipantsOne hundred thirty-seven women with untreated vaginal agenesis associated with Mayer-Rokitansky-Küster-Hauser Syndrome and complete androgen insensitivity syndrome aged 15 to 41 years (mean age, 20 years).InterventionsGynecological examination and completion of questionnaires.Main Outcome Measures(1) Sexual Experiences Questionnaire; (2) Multidimensional Sexuality Questionnaire; (3) Vaginal Self-Perceptions; and (4) vaginal length.ResultsA sizable proportion of women reported having had sexually intimate experiences before any medical intervention on the vagina. Vaginal length, which ranged from dimple to 7 cm and averaged 2.7 cm for the cohort, was unrelated to the range of sexual experiences. Most women perceived their vagina as being too small, but less than half believed that a sexual partner would notice this. Two-thirds of the cohort subsequently completed the dilation program, which was not predicted by pretreatment vaginal length or sexual experience.ConclusionContrary to the assumption that a vagina of certain dimensions is a prerequisite for women to “have sex,” many women with Mayer-Rokitansky-Küster-Hauser syndrome and complete androgen insensitivity syndrome reported having experienced genital and nongenital sexual activities with no medical interventions. It is recommended that treatment providers affirm women's capacity for sexual intimacy, relationships, and enjoyment before they introduce the topic of vaginal construction as a non-urgent choice.