Measures Of Sexual Satisfaction Research Articles

(009) Sexual Function & Sexual Satisfaction Differences Between Cisgender Women of Different Age Groups

Abstract Introduction As the average life expectancy increases, so does the need to improve older adults’ quality of life. Sexual function and satisfaction have been intimately tied to well-being, and older age has been associated with a decline in sexual activity, sexual function, and desire. However, there is limited research that focuses on the association between age and specific measurements of sexual function, such as orgasm parameters, frequency of sexual activity, and sexual satisfaction. Objective To describe and compare measures of sexual activity, orgasm quality, and satisfaction between women of different ages. Methods Respondents were recruited via Qualtrics and administered an anonymous online survey. Respondents were separated into groups based on age ranges: younger adults (<40 years old), middle-aged adults (40 to 59 years old), and older adults (≥60 years old). Additional demographic characteristics and sexuality measures were documented, including sexual orientation, partnership status at the time of survey, ability to orgasm, frequency of masturbation and sexual activity, and sexual satisfaction (as measured by the validated New Sexual Satisfaction Scale (NSSS)). An orgasm quality inventory queried the following six variables, under the control condition of masturbation: (1) time to orgasm; (2) duration of orgasm; (3) refractory period between orgasms; (4) experience of orgasm as a single or multi-peak event; (5) bodily location of orgasm experience; and (6) satisfaction with orgasm quality. Results A total of 423 sexually active cisgender women (average age ± standard deviation: 48.9 ± 15.6 years old) completed our survey. Older women were significantly more likely to identify as heterosexual and deny dating or being in a current relationship (both p<0.001). Additionally, older women were significantly more likely to deny masturbation and sexual activity with a partner (p<0.001). There was no statistically significant difference in ability to achieve orgasm between age groups (p=0.5). With respect to orgasm parameters (Table 1), younger women reported a significantly lower refractory period between orgasms, as compared to middle-aged and older women. Compared to other age groups, significantly more older women reported their orgasm as a multi-peak event (p<0.04) and were more likely to report the location of orgasm sensation as occurring in their genitals, as opposed to extragenital areas (e.g., arms, thighs, face, back) or whole body (p<0.01). There were no statistically significant differences between age and lead time to orgasm, duration of orgasm, or satisfaction with orgasm. Differences in sexual satisfaction (as measured by the NSSS, with higher scores indicating greater sexual satisfaction) were found to be statistically insignificant as well. Conclusions While older women reported a significant decrease in frequency of masturbation and sexual activity, they only differed in three out of six measures in our orgasm inventory. While these measures indicate a difference in older women’s experience of orgasm, it is important to note that there were no significant differences across multiple measures of sexual satisfaction between women of different ages. Disclosure No.

The Development and Psychometric Evaluation of the Sexual Fantasy Experience Scale.

Clinicians and researchers consider sexual fantasies to be a central aspect of human sexuality. Although these are subjective experiences, most studies have assessed only their frequency and content. A measure that assesses individuals' subjective experience of sexual fantasies is therefore needed. The aim of this study was to evaluate the psychometric properties of a new measure, the Sexual Fantasy Experience Scale (SFES). In Study 1, the SFES was administered to 391 participants (240 defined themselves as women, 149 as men, and2 as other). In Study 2, the SFES was administered to 426 participants (255 defined themselves as women,167 as men, and 4 as other), along with a battery of questionnaires including the New Sexual Satisfaction Scale Short Form and the Global Measure of Sexual Satisfaction, both of which measure sexual satisfaction, as well as the Sexual Fantasy Checklist, which evaluates the content of sexual fantasies and their frequency. Five reliable SFES subscales emerged from Study 1: playfulness, limitlessness, functionality, intrusiveness, and shame. In Study 2, a confirmatory factor analysis confirmed the scale's underlying factor structure, which was obtained in Study 1. The subscales of the SFES contributed to the explained variance of the assessments of sexual satisfaction, beyond the contribution of the fantasies' content and frequency, demonstrating the incremental validity of the subscales. The results of the present analyses suggest that the SFES has good psychometric properties, making it useful as an assessment tool for future research, clinical practice, and sex education.

Adaptation and validation of the Chinese version of the New Sexual Satisfaction Scale-Short Form in a sample of Chinese women.

Existing research on sexual satisfaction has been carried out primarily in Western samples, lacking insights from less sexually permissive cultures such as China, particularly in the case of heterosexual and sexual minority women. This study aimed to culturally adapt and validate the New Sexual Satisfaction Scale-Short Form (NSSS-S) in a sample of Chinese women with diverse sexual identities. The standard forward-backward translation procedure and cognitive debriefing were conducted to translate the NSSS-S into Mandarin Chinese (NSSS-SC). The psychometric properties of the NSSS-SC were assessed in this cross-sectional survey. The primary outcome measure was the NSSS-S. The World Health Organization Quality of Life-Abbreviated Form, the Positive Sexuality Scale, the Female Sexual Function Index, and a single-item measure of sexual satisfaction were used to test the measure's validity. A total of 336 Chinese women were recruited, with an average age of 26.82years (SD,6.03; range, 18-56). The 1-dimensional model had a good fit to the data and was invariant across 2 sexual identity groups (cisgender heterosexual and sexual minority women) and age. The NSSS-SC had good reliability; no significant floor and ceiling effects were observed. We found moderate to strong correlations between the NSSS-SC scores and the sexual satisfaction, sexual function, positive sexuality, and quality-of-life indicators. On average, cisgender heterosexual women were characterized by higher sexual satisfaction scores when compared with sexual minority women. The NSSS-SC can be used as a reliable and culturally appropriate measure of sexual satisfaction in women of different ages and sexual identities, which could be used in future sex-related surveys. This study is the first to translate the NSSS-S into Chinese and validate the NSSS-SC in a sample of Chinese women with varied sexual identities. However, this study recruited only female participants; future studies should also validate the NSSS-SC in Chinese men. The NSSS-SC is linguistically equivalent to the original scale and has solid psychometric properties, which can be used to assess sexual satisfaction levels in diverse samples of Chinese women.

Body Dissatisfaction, Cognitive Distraction, and Sexual Satisfaction in a Sample of LGB+ People: A Mediation Study Framed by Cognitive Psychology Models of Sexual Response.

Introduction: Body dissatisfaction is a well-established risk factor for emotional problems and low levels of well-being indicators, such as sexual health. Cognitive models propose that dissatisfaction with one's body can cause cognitive distraction related to physical appearance during sexual activity. This may compromise sexual response, namely, sexual satisfaction in heterosexual cis women. However, this relationship has only been studied within heterosexual samples. The present study aims to test a mediation model using cognitive distraction related to body appearance during sexual activity as a mediator between body dissatisfaction and sexual satisfaction in LGB+ cis people (lesbian, gay, bisexual, and other minority sexual orientations). Methods: This cross-sectional online study comprised 165 cisgender LGB+ participants (n = 67 cis women, 40.6%; n = 98 cis men, 59.4%). Self-report questionnaires were used: the Global Body Dissatisfaction Scale, the Body Appearance Distraction Scale, and a Single-Item Measure of Sexual Satisfaction. Results: Cis women and cis men experience similar levels of body dissatisfaction, cognitive distraction with body appearance during sexual activity, and sexual satisfaction. Body appearance cognitive distraction during sexual activity mediated the relationship between body dissatisfaction and sexual satisfaction only in the men's sample. Discussion: Overall, in terms of gender and body dissatisfaction, our results reveal a reversed pattern than those found in heterosexual samples. This may be because LGB+ cis women may conform less to societal pressure, leading to less meaning given to body dissatisfaction in relation to sexuality, which may lead to more positive sexual outcomes. Likewise, LGB+ cis men present higher body dissatisfaction and experience lower sexual satisfaction, possibly due to the emphasis on physical appearance in the gay subculture. The results confirm the validity of cognitive models of sexual response.

Sexual script flexibility and sexual well-being in long-term couples: a dyadic longitudinal study.

Couples in long-term relationships often face sexual challenges (eg, sexual response difficulties) that may disrupt their typical sexual routine or sexual script. Individuals with more rigid sexual scripts (eg, sex must include penile-vaginal intercourse) may struggle to navigate their sexual difficulties, potentially resulting in lower sexual well-being for themselves and their partners. In a dyadic longitudinal study, we examined whether individuals' greater sexual script flexibility when coping with recent sexual challenges was associated with their own and their partner's greater sexual well-being (ie, dyadic sexual desire, sexual satisfaction, low sexual distress). Seventy-four mixed- and same-gender/sex couples in long-term relationships completed online surveys about sexual script flexibility and facets of sexual well-being at baseline and 4 months later. Dyadic data were treated as indistinguishable and analyzed using multilevel modeling guided by the actor-partner interdependence model. Self-report measures of dyadic sexual desire (Sexual Desire Inventory-2), sexual satisfaction (Global Measure of Sexual Satisfaction), and sexual distress (Sexual Distress Scale-Short Form) were assessed at baseline and follow-up. Cross-sectional results showed that when individuals reported greater sexual script flexibility in response to recent sexual challenges, they and their partners reported greater sexual satisfaction. Individuals' greater sexual script flexibility was also linked to their own greater dyadic sexual desire and lower sexual distress. Unexpectedly, individuals' greater sexual script flexibility was associated with their partner's lower dyadic sexual desire at baseline and their own lower dyadic sexual desire 4 months later. No other associations were found between sexual script flexibility and sexual outcomes 4 months later and there were no interactions between individuals' gender and sexual script flexibility for the cross-sectional models. The cross-sectional associations between sexual script flexibility and sexual well-being provides some support for the idea that modifying rigid sexual scripts in sex and couple therapy may promote contemporaneous sexual well-being. This is the first dyadic study, to our knowledge, to assess the assumed benefits of greater sexual script flexibility for couples' sexual well-being. The relatively small and homogeneous sample of community couples who had largely intact sexual well-being limits generalizability. Findings provide preliminary evidence of cross-sectional links between sexual script flexibility and sexual well-being for individuals and couples, lending empirical support to the convention of promoting sexual script flexibility to help couples cope with sexual challenges. The mixed findings for the association between sexual script flexibility and dyadic sexual desire warrant additional study and replication.

Partner responses to low desire among couples coping with male hypoactive sexual desire disorder and associations with sexual well-being.

Hypoactive sexual desire disorder (HSDD) is characterized by persistently low desire and associated distress. Low desire is one of the most common sexual complaints among men and is associated with poor well-being. Interpersonal factors are key to understanding low desire, yet there are few dyadic studies of HSDD in men. Previous work on genito-pelvic pain and low desire in women has established that greater facilitative (eg, affectionate) partner responses are associated with greater sexual satisfaction and function and that more negative (eg, critical) or solicitous (eg, sympathetic, avoidant) partner responses are associated with lower sexual satisfaction and function. Examining how partner responses are associated with adjustment to HSDD may shed light on the interpersonal dynamics of this understudied sexual dysfunction. In a cross-sectional study, we examined whether partner responses to low desire in men were associated with sexual desire, sexual satisfaction, and sexual distress for both members of the couple. Men with HSDD and their partners (N = 67 couples) completed measures of facilitative, negative, and avoidant partner responses to men's low sexual desire-as perceived by the man with HSDD and self-reported by their partner-and sexual desire, sexual satisfaction, and sexual distress. Data were analyzed using multilevel modeling guided by the actor-partner interdependence model. Outcomes included the partner-focused subscale of the Sexual Desire Inventory-2, Global Measure of Sexual Satisfaction, and Sexual Distress Scale-Revised. When men with HSDD perceived more facilitative partner responses to their low desire, they and their partners reported greater sexual satisfaction. When men with HSDD perceived and their partners self-reported more negative partner responses, they each reported lower sexual satisfaction. In addition, when men with HSDD perceived more avoidant partner responses, their partners reported greater sexual distress. Partner responses were not associated with sexual desire for either member of the couple. Findings support the importance of the interpersonal context for HSDD in men and suggest potential future targets of treatment when working with affected couples. This study is one of the only dyadic studies of HSDD in men, as assessed via clinical interview or self-report symptoms reviewed by the clinical team. Despite our best efforts to recruit this sample over 6 years, the small size limited power to detect all predicted effects. More facilitative and fewer negative or avoidant partner responses to low desire are associated with greater sexual well-being in couples coping with HSDD.

Differences in solitary and dyadic sexual desire and sexual satisfaction in heterosexual and nonheterosexual cisgender men and women.

Gender differences in sexual desire have been documented in the literature, with sexual desire being correlated with sexual satisfaction; however, data on sexual desire and sexual satisfaction among nonheterosexual samples are more limited, as are data examining sexual desire toward oneself (solitary) and another person (dyadic). To examine differences between men and women, between heterosexuals and nonheterosexuals, and the interaction of gender and sexual orientation in solitary and dyadic sexual desire (partner and attractive person related) and sexual satisfaction, and to explore the predictive role of solitary and dyadic sexual desire on sexual satisfaction, controlling for gender and sexual orientation. A cross-sectional study was conducted with an online sample of 1013 participants recruited between 2017 and 2020 (552 women, 54.5%; 461 men, 45.5%; 802 heterosexuals, 79.2%; 211 nonheterosexuals, 20.8%). Participants completed a web survey with a sociodemographic sheet, the Sexual Desire Inventory-2, and the Global Measure of Sexual Satisfaction. Current findings indicated that men scored significantly higher on solitary sexual desire (P < .001, partial η2 = 0.015) and attractive person-related desire (P < .001, partial η2 = 0.015) when compared with women. Likewise, nonheterosexuals scored significantly higher on solitary sexual desire (P < .001, partial η2 = 0.053) and attractive person-related desire (P < .001, partial η2 = 0.033) vs heterosexuals. In addition, partner-related desire (β = 0.33, P < .001) was a positive and significant predictor of sexual satisfaction, whereas solitary desire (β = -0.18, P < .001) and attractive person-related desire (β = -0.23, P < .001) were negative predictors. Sexual desire toward an intimate partner appears to be experienced in similar levels among heterosexual and nonheterosexual men and women, while solitary and attractive person-related sexual desire appears to be more strong among men and nonheterosexual individuals. The current study did not use a dyadic-centered approach, only individual perceptions and experiences. However, it explored solitary sexual desire and partner- and attractive person-related sexual desire in a large sample of heterosexual and nonheterosexual men and women as predictors of sexual satisfaction. Overall, men and nonheterosexual individuals experienced more solitary and attractive person-related sexual desire. In addition, partner-related sexual desire was a positive predictor of sexual satisfaction, whereas solitary sexual desire and attractive person-related desire were negative predictors of sexual satisfaction.

Time for a Measurement Check-Up: Testing the Couple's Satisfaction Index and the Global Measure of Sexual Satisfaction Using Structural Equation Modeling and Item Response Theory.

Relationship and sexual satisfaction are two central outcomes in the study of relationships and are commonly used in both academia and applied practice. However, relationship and sexual satisfaction measures infrequently undergo specific psychometric investigation. Ensuring that measures display strong psychometric performance is an important but under-tested element of replication that has come under more scrutiny lately, and adequate measurement of constructs is an important auxiliary assumption underpinning theory-testing empirical work. A measurement check-up was conducted, including Confirmatory Factor Analysis (CFA) to test factorial validity, measurement invariance to test for group comparability, and Item Response Theory (IRT) to assess the relationship between latent traits and their items/indicators. This format was used to evaluate the psychometric properties of the Couple's Satisfaction Index (CSI) and the Global Measure of Sexual Satisfaction (GMSEX), two commonly used scales of relationship and sexual satisfaction with a sample of 640 midlife (40-59years old) married Canadians who were recruited by Qualtrics Panels. Results of CFA suggested that both models were satisfactory. Invariance testing provided robust support for intercept invariance across all the groupings tested. IRT analysis supported the CSI and GMSEX, however, there was evidence that the GMSEX provided somewhat less information for those high on sexual satisfaction. This measurement check-up found that the CSI and GMSEX were reasonably healthy with some caveats. Implications are discussed in terms of replicability and meaning for scholars and practitioners.

A Validation Study of the Global Measure of Sexual Satisfaction in Sexually Active Adolescents

ABSTRACT Positive views of adolescents’ sexuality have only begun to garner interest in the last two decades. Despite great strides in this emerging area, progress is limited by the paucity of valid and reliable measures among this population. The goal of this study was to validate the widely used adult five-item Global Measure of Sexual Satisfaction (GMSEX) in a large sample of sexually active adolescents. A total of 1,036 adolescents (516 girls, 49.8%) aged between 14 and 17 years (Mage = 14.62; SD = 0.66) were recruited to investigate the reliability and validity of the GMSEX. The GMSEX yielded strong psychometric properties in adolescents, including factor structure, measurement invariance, and reliability. Results showed that the scale works similarly for boys and girls as well as for heterosexual, cisgender, and sexual minority adolescents. The GMSEX is a short, reliable, and valid measure of sexual satisfaction that can be used in future studies focusing on adolescents’ sexuality and relationships.

The portuguese version of the sexual distress scale: psychometric properties in male and female samples

<h3>Objectives</h3> The Female Sexual Distress Scale is one of the most widely used self-report instruments to assess sexual distress. This scale has been validated across populations, but no version for use in the Portuguese population is available to date. The aim of this study was to develop a Portuguese version of the scale—herein called the Sexual Distress Scale (SDS)—and to examine its psychometric properties in samples of women and men with and without distressing sexual problems. <h3>Methods</h3> A sample of 382 (283 women) and 1,109 (761 women) participants (age range = 18 to 72 years) with and without distressing sexual problems, respectively, completed a survey that included a sociodemographic and health questionnaire, the Portuguese version of the SDS, and validated measures of sexual satisfaction, sexual quality of life, sexual dysfunctional beliefs, sexual function, dyadic adjustment, and psychological distress. <h3>Results</h3> The Portuguese SDS replicated the unifactorial structure of the original scale. The Portuguese SDS also showed good evidences of validity based on content and on relations with other variables. Internal consistency and test-retest (1 month) reliabilities were excellent. The SDS scores did not flag differential functioning of items and test (DFIT) across gender, but flagged DFIT between participants with and without distressing sexual problems. <h3>Conclusions</h3> The Portuguese version of the SDS can be used to assess sexual distress in Portuguese women and men and can be used to compare between these two groups. Without further evidence the authors do not recommend using the SDS to compare the scores of individuals with and without distressing sexual problems as some items and the total score are biased against the former. <h3>Conflicts of Interest</h3> The authors report no conflicts of interest.

Sexually Explicit Material and Its Relationship with Sociodemographic Variables, Sexual Satisfaction, and Relationship Satisfaction in a Spanish Sample.

Previous research that has examined the use of sexually explicit material (SEM) in the Spanish population and its relationship with sociodemographic variables, sexual satisfaction, and satisfaction with the relationship are practically non-existent. Therefore, the main goal was to analyze the pattern of use of SEM (frequency, format, context, content, and purpose of its use) and its relationship with sociodemographic variables (sex, age, sexual orientation, educational level, religiosity, status of partner, number of sexual partners, and age of first exposure to SEM), sexual satisfaction, and relationship satisfaction. The sample consisted of 221 participants, with an average age equal to 29.88 years (SD = 9.73) and of Spanish nationality. All participants completed a sociodemographic questionnaire, as well as the Spanish adaptations of the Sexual Media Questionnaire, Global Measure of Sexual Satisfaction, and Global Measure of Relationship Satisfaction. Based on the results, it was found that men use SEM more frequently than women, that the age of first exposure is 14 years old, the most used pattern of SEM is internet websites with sexual content in which adult men and women appear, and the way to visualize it is alone as private stimulation. In addition, it was shown that a higher frequency of SEM use implies a decrease in sexual satisfaction and vice versa, while there is no association between the frequency of SEM use and satisfaction with the relationship. The importance of considering the use of SEM, both in research on sexual satisfaction and in clinical practice, is discussed.

Substance Use in Sexual Relationships: Association with Sexual Assertiveness and Sexual Satisfaction.

Background: The main objective was to examine sexual assertiveness and sexual satisfaction in people who have sex under the influence of alcohol and drugs, considering the type of substance consumed, the frequency of consumption, gender, and sexual orientation. Methods: The sample consisted of 274 adults who had sexual relationships consuming substances. A questionnaire composed of sociodemographic, sexual history and substance use items, the Sexual Assertiveness Scale and the Global Measure of Sexual Satisfaction were administered. Results: Gender differences were found in sexual assertiveness and in the frequency of substance use. Women reported greater sexual assertiveness and greater alcohol consumption. Men reported greater consumption of different types of substances. Furthermore, bisexual participants showed greater assertiveness and STI prevention. Homosexual participants reported a higher frequency of the consumption of poppers, mephedrone, and GBL/GHB. Sexual assertiveness was associated with sexual satisfaction. Greater consumption of some types of substances was related to sexual assertiveness, STI prevention, and sexual satisfaction. Conclusions: The association found between sexual assertiveness and sexual satisfaction in a specific context of substance use in sexual relationships corroborates the important role that these psychosexual variables have in sexual health, in view of the frequency and type of drug consumed, gender, and sexual orientation.

Going beyond "With a Partner" and "Intercourse": Does Anything Else Influence Sexual Satisfaction among Women? The Sexual Satisfaction Comprehensive Index.

The validated tools for measuring sexual satisfaction (SS) assess in fact other phenomena such as sexual functioning, assess SS within the context of a romantic heterosexual relationship and intercourse-type activity or were designed to be applied only in therapeutic or rehabilitation contexts. Consequently, they offer an incomplete understanding of SS, particularly among women. We thus developed an alternative measure of SS, the Sexual Satisfaction Comprehensive Index (SSCI), considering both the individual and with-a-partner dimensions, as well as the actual and desired experiences of satisfaction, along with other dimensions affecting SS, and explored its psychometric properties. A total of 1080 young to mid-aged women with different sociodemographic, relationship and sexual identity backgrounds voluntarily completed several measures of SS, including the SSCI. Results showed that the SSCI is a reliable measure for assessing SS. An exploratory and a confirmatory factor analysis confirmed the latent multidimensional structure of the SSCI, supporting its factorial validity. In addition, the SSCI showed appropriate convergent validity with other measures commonly used to assess SS. In sum, the SSCI was revealed to be a useful multidimensional index of SS for research and practice contexts which allows the practitioner or the researcher to make decisions on which dimension(s) are to be evaluated. This study focused on women’s SS, and future research with other gender, sexual and cultural identities is necessary to support its utility in multi-identity and multi-sexuality scenarios.

Interpersonal autonomic synchrony and sexual satisfaction: A preliminary examination

IntroductionA growing body of literature has increased our understanding of interpersonal autonomic synchrony (IAS), or exchanges across biological systems resulting in physiological covariation. While research suggests that IAS is more likely in relationships characterized by emotional intimacy, no research to date has examined the connection between IAS and the quality of sexual relationships.ObjectivesThe current study seeks to elucidate the relationship between IAS and sexual satisfaction (SS) using tasks that have previously been used to assess synchrony (i.e.,gazing, mirroring), as well as several conversation-based tasks (i.e., neutral and sex-related conversation tasks).MethodsCouples (n=28) completed procedures in a laboratory-based setting where they completed survey measures of SS before connecting to an electrocardiogram. Subsequently, heart rate (HR) data for each dyad were analyzed using a moderated multi-level modeling approach.ResultsIAS was detected, with men reliably predicting the HR of female partners, and women reliably predicting the HR of male partners (respectively, β=0.383, p&lt;0.001; β=0.222, p&lt;0.001). AIC values indicate a better fitting model for men predicting female HR. As such, moderation analyses were conducted for that model by study task, finding a significant interaction between SS and observed IAS during the mirroring task (β=0.004, p=0.009) and neutral-conversation task (β=0.016, p=0.009).ConclusionsThese findings reflect evidence that IAS may be relevant to SS at the couple-level. The ability of couples to coregulate while attempting to synchronize (as in the mirroring task) or exchange information (as in the neutral-conversation task) may meaningfully change how they experience their sexual relationship.DisclosureNo significant relationships.

Does it Matter Who You Feel Sexually Aroused By? Associations Between Sexual Arousal, Relationship Quality, and Sexual Satisfaction.

BackgroundDespite its integral role in normative sexual functioning, there is a dearth of research into the role of subjective sexual arousal within romantic relationships.AimThe current proof-of-concept study addresses this gap by investigating the associations between partner-induced sexual arousal, sexual arousal induced by others, and sexual satisfaction and relationship quality.MethodsOne hundred and sixteen heterosexual couples who had been together for an average of three and a half years completed an online survey. An Actor-Partner Interdependence Modelling framework was applied to analyze the dyadic data.OutcomesParticipants completed the Perceived Relationship Quality Components (PRQC) Inventory and a single item global measure of sexual satisfaction derived for the current study.ResultsFeeling sexually aroused by one's romantic partner was positively associated with one's own sexual satisfaction and relationship quality. However, feeling sexually aroused by people other than one's romantic partner was negatively associated with one's own sexual satisfaction and relationship quality. These associations were found for both men and women.Clinical TranslationTherapists and practitioners may need to place an emphasis on using strategies and techniques that specifically facilitate or heighten partner-induced sexual arousal, whilst helping couples to move away from those behaviors and situations which typically lead to sexual arousal induced by those other than their partner.Strengths & LimitationsThis proof-of-concept study provides novel findings that address the absence of research investigating the associations between sexual arousal and outcomes in romantic relationships. The well-powered dyadic study design enabled a rigorous test of the hypotheses. However, the study was cross-sectional in nature, the sample was somewhat homogenous, and assessments included brief measures of sexual arousal and sexual satisfaction.ConclusionThe findings offer the first evidence to suggest that partner-induced sexual arousal and non–partner-induced sexual arousal have differential effects in terms of sexual satisfaction and relationship quality. This not only has a raft of clinical implications, but it provides the basis for several important avenues of future research on the role of subjective sexual arousal in romantic relationships.Lawless NJ, Karantzas GC, Mullins ER, et al. Does it Matter Who You Feel Sexually Aroused By? Associations Between Sexual Arousal, Relationship Quality, and Sexual Satisfaction. Sex Med 2022;10:100523.

Gender Affirming Medical Treatment Desire and Treatment Motives in Binary and Non-Binary Transgender Individuals

BackgroundIt is currently unknown whether there are differences in desire for gender affirming medical treatment (GAMT) between binary and non-binary transgender individuals, although the latter seek treatment less prevalently. AimTo investigate differences between binary and non-binary individuals on received GAMT, desire for GAMT, and motives for (not) wanting GAMT, and to explore the association between having an unfulfilled treatment desire and general and sexual well-being. MethodsWe conducted an online questionnaire in a community sample of 125 transgender men, 72 transgender women, and 62 non-binary transgender individuals (age: M = 30.4, SD = 11.31, range 18-69). Outcome measuresUndergone GAMT, GAMT desire, motives for (not) wanting (further) GAMT, Utrecht Gender Dysphoria Scale, Satisfaction With Life Scale, Hospital Anxiety and Depression Scale, Global Measure of Sexual Satisfaction, transgender-specific body image worries, and sexual self-concept discrepancies. ResultsBinary transgender participants reported having undergone more GAMT procedures than non-binary transgender participants (P < .001 for both gender affirming hormone treatment (GAHT) and gender affirming surgery (GAS)). While binary participants reported a stronger desire for GAHT compared to non-binary participants (X2(1, N = 93) = 32.63, P < .001), the groups did not differ in their desire for GAS (X2(1, N = 247) = 0.68, P = .411). Binary and non-binary participants reported similar reasons for wanting treatment, mostly related to body and/or gender incongruence and gender affirmation. In terms of not wanting treatment, the non-binary group reported their gender identity as the most important reason, while the binary group mostly mentioned possible medical complications. The majority of both groups had an unfulfilled treatment desire (69% of binary participants and 64.5% of non-binary participants), which was related to lower levels of general life satisfaction (P < .001) and sexual satisfaction (P = .005), more anxiety (P = .006) and transgender-specific body image worries (P < .001), and larger sexual self-concept discrepancies (P < .001 for actual and/or ideal, P < .001 for actual and/or ought). Clinical implicationsSystemic barriers to GAMT (especially GAS) should be removed not only for binary but also for non-binary identifying transgender individuals to decrease the discrepancy between treatment desire and actually seeking treatment. Strengths & limitationsThis study was the first to systematically investigate differences in treatment desire motives between binary and non-binary transgender individuals, while also showing the possible negative consequences of an unfulfilled treatment desire. Given the online character of the study, results may not generalize to the broader transgender community. ConclusionSimilarly to binary transgender individuals, many non-binary transgender individuals have a desire for GAMT, and not being able to receive GAMT has a negative effect on their mental and sexual health. Further efforts should be made to make GAMT accessible for all transgender individuals, regardless of gender identity.Kennis M, Duecker F, T'Sjoen G, et al. Gender Affirming Medical Treatment Desire and Treatment Motives in Binary and Non-Binary Transgender Individuals. J Sex Med 2022;19:1173–1184.

Psychometric Validation of the Sexual Distress Scale in Male and Female Portuguese Samples

BackgroundThe Female Sexual Distress Scale and the Female Sexual Distress Scale-Revised—herein called the Sexual Distress Scale (SDS and SDS-R)—are among the most widely used self-report instruments to assess sexual distress, but no version for use in the Portuguese population is available to date. AimThe current study aimed to validate the Portuguese version of the SDS/SDS-R in samples of women and men with and without distressing sexual problems. MethodsA sample of 1,109 participants without distressing sexual problems (761 women) and 382 participants with distressing sexual problems (283 women), ages ranging from 18 to 72 years, were used to examine the psychometric properties of the Portuguese SDS and SDS-R. OutcomesParticipants completed a survey that included a sociodemographic and health questionnaire, the Portuguese version of the SDS and SDS-R, and measures of sexual satisfaction, sexual quality of life, sexual function, dyadic adjustment, and psychological distress. ResultsResults indicated that the Portuguese SDS and the SDS-R assess 1 general domain of sexual distress and showed good evidences of validity based on content and on relations with other variables. Sexual distress was associated with poorer sexual function, satisfaction, and quality of life, with higher psychological distress, and lower dyadic adjustment. Internal consistency and test-retest (1 month) reliabilities were excellent. Tests of differential functioning of items indicated that the SDS and SDS-R scores can be used to compare women and men on sexual distress, but the SDS/SDS-R scores flagged differential functioning of items and test (DFIT) between participants with and without distressing sexual problems. Clinical translationClinicians and researchers can now make use of the SDS and of the SDS-R in the Portuguese population, facilitating the assessment of sexual distress in clinical settings. Strengths & LimitationsThe Portuguese SDS/SDS-R scores can be compared between women and men, providing information on sexual distress independently of sexual function. With the current evidence, comparisons between individuals with and without distressing sexual problems should be made with caution, as the scores may be biased against the former. ConclusionThis study provides a validation of the Portuguese version of the SDS/SDS-R that can be used to assess sexual distress in Portuguese women and men and can be used to compare between these 2 groups.Tavares IM, Santos-Iglesias P, Nobre PJ. Psychometric Validation of the Sexual Distress Scale in Male and Female Portuguese Samples. J Sex Med 2022;19:834–845.

Attachment and Childhood Maltreatment as Moderators of Treatment Outcome in a Randomized Clinical Trial for Provoked Vestibulodynia

Although distal developmental factors, such as attachment and childhood maltreatment (CM), are associated with the occurrence, severity, and adjustment to provoked vestibulodynia (PVD)-the most prevalent form of vulvodynia-no studies to date have examined whether these variables are related to treatment efficacy in the context of PVD. Attachment and CM may act as moderating variables when examining different treatment modalities, whereby individuals with more insecure attachment orientations (anxiety/avoidance) or a history of CM may benefit less from treatments with higher interpersonal contexts, such as sex and couple therapy-a recommended treatment for PVD. The present randomized clinical trial (RCT) examined attachment and CM as predictors and moderators of sexual satisfaction, distress, and function at post-treatment and 6-month follow-up while comparing 2 treatments for PVD: Topical lidocaine, and a novel cognitive behavioral couple therapy focused on women's pain and partners' sexuality. One hundred eight women with PVD were randomized to a 12-week treatment of either lidocaine or couple therapy. Women completed questionnaires at pretreatment, post-treatment, and at a 6-month follow-up. (1) Global Measure of Sexual Satisfaction; (2) Female Sexual Distress Scale-Revised; (3) Female Sexual Function Index. Both attachment and CM were significant moderators of treatment outcomes. At either post-treatment or 6-month follow-up, in the couple therapy condition, women with greater attachment avoidance had poorer outcomes on sexual distress, satisfaction and function, whereas women with higher levels of CM had poorer outcomes on sexual satisfaction and sexual function, compared to women in the lidocaine condition. Although these novel findings need further replication, they highlight the importance for clinicians to take into account distal factors, for instance, attachment and CM, when treating sexual difficulties such as PVD, as these variables may affect more interpersonal dimensions of treatment (eg, trust, compliance, etc.) and ultimately, treatment progress. Using a rigorous RCT study design and statistical approach, this study is the first to examine attachment and CM as moderators in the treatment of sexual difficulties. It is however limited by the use of self-report measures, and further studies are necessary to validate the generalizability of current results to other sexual difficulties. Findings support the role of interpersonal factors in the treatment of PVD and indicate that short-term psychological interventions, such as couple therapy, may be less beneficial for women with antecedents of CM and attachment insecurity.

Single and Partnered Individuals' Sexual Satisfaction as a Function of Sexual Desire and Activities: Results Using a Sexual Satisfaction Scale Demonstrating Measurement Invariance Across Partnership Status.

Although some evidence exists to suggest that single (i.e., unpartnered) individuals are less sexually satisfied on average than are partnered individuals, it is unclear whether the variables correlating with each group’s sexual satisfaction are similar or different. This research sought to examine how desire for and actual engagement in solitary and partnered sexual activities are associated with both groups’ sexual satisfaction. We first conducted a preliminary study (n = 572) to test and refine existing measures of sexual satisfaction for applicability across relationship status. In two follow-up studies (N = 1,238), measurement invariance (across relationship status and gender) of the resulting 4-item sexual satisfaction scale was established. Further, results across the studies showed that for singles dyadic sexual desire was negatively related to sexual satisfaction, whereas no significant link was found with solitary desire. For individuals in romantic relationships, having higher sexual desire involving a partner and lower solitary desire were both associated with greater sexual satisfaction. When analyzing participants’ responses on the desired and actual frequency of engaging in specific sexual acts, we found that for both single and partnered individuals, frequent engagement in partnered acts was associated with greater sexual satisfaction. Wanting frequent engagement in partnered acts was associated with lower sexual satisfaction for both groups, but only if the current frequency of engaging in these acts was low. These findings suggest that at least during the COVID-19 pandemic, meeting desires for partnered sex plays an important role in maintaining a sexually satisfying life, regardless of one’s relationship status.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10508-021-02153-y.

Persistent Genital Arousal in Relationships: A Comparison of Relationship, Sexual, and Psychological Well-Being

Persistent Genital Arousal Disorder/Genitopelvic Dysesthesia (PGAD/GPD) is characterized by sensations of physiological genital sexual arousal (and/or other types of genitopelvic dysesthesia) that occur in the absence of subjective feelings of sexual desire. The aim of this study was to compare relationship, sexual, and psychological well-being in partnered individuals with and without distressing symptoms of PGAD/GPD. The sample (N=65 individuals with vulvas and vaginas, N=11 individuals with penises) of 152 partnered individuals (N=76 with and 76 without PGAD/GPD symptoms) participated in a one-time anonymous online survey. The questionnaires assessed relationship satisfaction (Couple Satisfaction Index-Short Form, CSI); sexual satisfaction (Global Measure of Sexual Satisfaction, GMSEX); sexual functioning (Female Sexual Functioning Index, FSFI, or International Index of Erectile Functioning, IIEF); sexual distress (Sexual Distress Scale, SDS); and psychological well-being, as determined by the presence of depression and/or anxiety symptoms (Hospital Anxiety and Depression Scale, HADS). Among individuals with vulvas and vaginas, those with PGAD/GPD symptoms reported significantly lower relationship and sexual satisfaction, greater sexual distress, and more symptoms of depression and anxiety than their counterparts in the control group. In addition, these individuals with PGAD/GPD symptoms also reported significantly worse sexual functioning (arousal, orgasm, satisfaction, and pain), and they were significantly more distressed about each aspect of their sexual functioning difficulties compared to those in the control group. Among the small sample of individuals with penises (N=11), descriptive analyses revealed that total sexual functioning scores did not differ across the PGAD/GPD symptom and control groups. In addition, 64.5% of the total sample with PGAD/GPD symptoms managed unwanted genital arousal by avoiding sex with their partner, while 55.3% managed their symptoms by having sex with their partner, and some individuals with PGAD/GPD used both strategies. The finding that PGAD/GPD symptoms impact relationships indicates that treatment for PGAD/GPD should include consideration of the well-being of one's intimate relationship(s). This study added to the small literature on experiences of PGAD/GPD in relationships, and it was the first to assess sexual satisfaction. Limitations include the small sample of individuals with penises, and the cross-sectional, correlational design, which does not allow for causal conclusions to be drawn. Results emphasize the importance of continued research of this population (and their partners) in order to improve diagnosis, intervention, and recognition within the medical community. Mooney KM, Poirier É, Pukall CF., Persistent Genital Arousal in Relationships: A Comparison of Relationship, Sexual, and Psychological Well-Being. J Sex Med 2022;19:234-248.