Sexual Expectations Research Articles

A qualitative study on perceptions of adolescents' sexual and reproductive health education in Yogyakarta, Indonesia.

Sexual and reproductive health (SRH) education in Yogyakarta, Indonesia, is contentious due to societal and religious taboos in the Javanese Muslim community and being misunderstood as a potential catalyst for the premarital sex of unmarried adolescents. The existing practice of SRH education cannot guarantee reliable information about adolescent sexuality. The research aims to understand the intergenerational perception of SRH education conducted at high schools, which has not been comprehensively researched. This qualitative study was conducted in 2016 to explore the perspectives of adults and adolescents regarding school-based SRH education. Focus group discussions and individual interviews were used for data collection, while data analysis was conducted using a feminist perspective. The study identified gaps in the delivery of SRH education among Javanese Muslim, Indonesia. SRH education had not adequately addressed how adults and adolescents perceived sexuality as taboo due to moral panic about premarital sex and societal expectations placed on girls to maintain their virginity. Peer counsellors, responsible for imparting SRH information and facilitating communication with adolescents, reproduced adult moral values toward their peers, leading to a reluctance among adolescents to share their issues. Consequently, SRH education failed to reach those experiencing unwanted pregnancy or a toxic intimate relationship. The results of the study indicate the need to challenge intergenerational perceptions regarding sexuality and gender expectations to promote a positive gender perspective within SRH education in Indonesia.

Is mindfulness associated with decreased hopelessness among young gay and bisexual men? The roles of perceived parental support for sexual orientation and expectation of rejection

ABSTRACT This study aims to investigate the association between mindfulness and hopelessness among Chinese young gay and bisexual men, as well as the mediating roles of perceived parental support for sexual orientation and expectation of rejection. Differences between gay and bisexual men are also considered. Scales measuring mindfulness, hopelessness, perceived parental support for sexual orientation, and expectation of rejection were administered to 509 gay and bisexual men. Structural equation modelling was used to test the mediating pathways. As a result, mindfulness was negatively associated with hopelessness, with expectation of rejection acting as a mediator. Additionally, a sequential mediating effect of perceived parental support for sexual orientation and expectation of rejection was also found. Models differed significantly between gay and bisexual men, with gay men having a stronger effect on the path from mindfulness to expectation of rejection than bisexual men. In conclusion, Mindfulness may help improve hopelessness among gay and bisexual men. This may be further supported by increasing perceived parental support for sexual orientation and lowering the expectation of rejection. More mindfulness training should be provided, and this may be particularly relevant and useful for gay men.

‘Sex ed’ exemptions in Ontario schools

This project explores how ‘sex ed’ exemptions are being enacted in Ontario classrooms. In August 2019, the Ministry of Education issued Policy/Program Memorandum 162, requiring Ontario school boards to have a policy or procedure allowing Grade 1-8 students to be exempted from Human Development and Sexual Health curriculum expectations at their parents' request. However, rather than limiting exemptions to formal lessons in the HDSH expectations of elementary Health and Physical Education, many teachers believe that they must exempt students from any conversation, formal or not, involving 2SLGBTQ+ topics. This has the potential to further stigmatize queer identities, as well as related topics and discussions. This research is also connected the conversation of how much sway “parental rights” have in the classroom. The first stage of this project has involved collecting exemption policy documents and board exemption forms, along with tracking how findable these documents are. As of today, 56 boards appear to have responded to PPM 162, either by passing a new policy or revising an existing one. Only 41% of school boards have a description of their exemption process available through Google search, while 30% of boards do not have their process available online at all. Unfortunately, problematic organizations like Parents as First Educators and Canadian Gender Report—both of which publish ‘resources’ claiming that parents have the right to exempt their children from all content about gender and sexual diversity—have materials which appear easily on Google search, sometimes even before authorized school board pages. If school boards do not have official exemption processes and forms readily available online, it is possible that parents will turn to these problematic documents instead. These gaps in the online availability of official board information may contribute to the dangerous misunderstandings present in how ‘sex ed’ exemptions are handled in Ontario schools.

Sexual Alcohol Expectancies, Alcohol Intoxication, and Sexual Behavior in MSM: An Experience Sampling Study.

Despite advances in prevention and treatment, the transmission of human immunodeficiency virus remains a significant problem in the United States, especially among men who have sex with men (MSM). Alcohol use can promote risky sexual decisions, and alcohol expectancies may influence the role of alcohol in decision making. The present secondary analysis tests the moderating role of sexual alcohol expectancies (SAEs) in the relation between daily alcohol intoxication and sexual behavior in a sample of 248 moderate- to heavy-drinking MSM. SAEs were assessed with the Sexual Alcohol Expectancies Questionnaire at baseline, followed by two 23-day bursts of ecological momentary assessment including self-initiated morning assessments of sexual behavior and the prior night's perceived intoxication, as well as nine daily random alcohol assessments. Multilevel modeling showed that SAEs moderated a curvilinear association between intoxication and anal intercourse with a condom such that the relation between daily intoxication and anal intercourse with a condom is a more pronounced inverted u-shape among individuals with strong SAEs, and this moderation effect was not seen for condomless anal intercourse (CAI). While SAEs do appear to influence the association between intoxication and sexual behavior in MSM, they do not appear to moderate the association between alcohol intoxication and CAI.

“The Nurse Told Her to Get Checked More Regularly Because She is Having Sex with Black Men”: An Exploration of the Sexual Health Experiences of Black Heterosexual Men in London

ABSTRACT Drivers of poor sexual health outcomes among Black heterosexual man are poorly understood. Previous research has identified a need to understand Black men’s behavioral experiences and motivators in the UK. This study aimed to address this gap through a phenomenological exploration of the sexual health experiences and motivators of Black heterosexual men with experience of higher-risk sexual behaviors living in London. Semi-structured interviews were conducted with 10 participants (18–58 years) recruited through barbershops. Reflexive thematic analysis was used to analyze the data. Five themes were generated. For relevance, three themes are discussed in this paper: 1) The Black Man’s Battle; 2) Sexual Socialization; and 3) Sexual Behaviors, Relationships, and Health. Race and gender combined to shape experience of sexual socialization. Exposure to explicit media content from a young age promoted multiple sexual partners. Racist sexual stereotypes exposed participants to fetishization and created pressure to meet sexual expectations. Condom use motivators were complex and multifaceted. Experience of institutional racism created a lack of trust in services. However, actual experiences with sexual health services were positive and counteracted the mistrust created by racism. Sexual health services should better tailor their work to Black heterosexual men and diversify their offer. Services should collaborate with Black community organizations to deliver services outside clinical settings.

Network Analysis of the Association between Minority Stress and Activism in LGB People from Poland.

(1) Background: This paper presents an analysis of the associations between minority stressors and activism in the population of lesbian, gay, and bisexual individuals in Poland. (2) Methods: The cross-sectional online-based research was conducted among 192 lesbian, gay, and bisexual (LGB) people in two groups: activists (n = 51) and people not engaged in activism (n = 141). Four scales of the Sexual Minority Stress Scale were used: Internalized Homophobia, Expectation of Rejection, Concealment, and Sexual Minority Negative Events Scale. Activism was measured using the Activism Scale and a single item asking about belonging to an activist group. (3) Results: Activists, lesbians, and gays scored significantly higher in the Sexual Minority Negative Events than people not involved in activism and bisexual individuals. Attitude toward LGBT+ activism correlated weakly and positively with Sexual Minority Negative Events and Expectation of Rejection while negatively with Internalized Homophobia. The Network Analysis showed that positive attitudes toward LGBT+ activism, the expectation of rejection, and negative events in minority stress are the most influential variables in the network model, playing a crucial role in the interaction between particular dimensions of minority stress. (4) Conclusions: Prevention and intervention programs should focus on reducing minority stress, especially negative events and rejection, especially among lesbians, gays, and people engaged in LGBT+ activism. The cooperation of politicians, lawyers, social workers, and psychologists is required to decrease homophobia and the stigmatization of people representing sexual and gender minorities.

Under Pressure: Men’s and Women’s Sexual Performance Anxiety in the Sexual Interactions of Adult Couples

ABSTRACT Most research on sexual performance anxiety has focused on men’s experiences and links to erectile functioning and premature ejaculation, with little research attention given to women’s experiences or to relationship dynamics. At times, sexual performance anxiety has been examined in the context of dysfunction, but rarely as a focus in its own right. Study 1 asked 51 participants reporting sexual performance anxiety to describe the cognitive and affective components of their experiences, coping strategies, and perceived impact on their relationship using open-ended responses from online surveys. Through directed content analysis, Study 1 revealed that men and women experience a range of cognitive and affective processes with predominant feelings of inadequacy, and overall promoting more approach coping strategies. Study 2 used quantitative surveys to examine whether sexual performance anxiety was associated with higher sexual distress and lower sexual and relationship satisfaction in a sample of 228 community-based couples. Guided by the Actor-Partner Interdependence Model, multilevel modeling analyses indicated that higher sexual performance anxiety was linked to higher sexual distress and lower sexual and relationship satisfaction in both individuals and their partners. This work advances knowledge of sexual performance anxiety to women’s experiences, not just men’s, and to couples’ experiences. Effective treatment for those suffering from this anxiety may incorporate education around sexual beliefs and expectations.

Biological Sex, Gender Roles, and Sexual Scripts

This article examines how perception of male genital anatomy as specifically associated with the penis, and female genital anatomy associated with the vagina influences existing sexual scripts by prescribing vaginal penetration as basic form of sexual connection between female and male. Through a body-oriented and gender analysis approach, this study deconstructs how such anatomical perceptions reinforce gender roles and shape sexual behavior in both traditional (phallocentric) and egalitarian sexual scripts. The methodology employed in this article includes a comprehensive review of existing literature and qualitative analysis of data from various studies on sexual behavior and gender dynamics. This exploration contributes to a nuanced understanding of the complex interplay between anatomy, gender norms, and sexual behavior. Findings suggest that anatomical perceptions and gender roles significantly influence sexual expectations and behavior, perpetuating gender disparities even within attempts of more egalitarian sexual script.

The Role of Partner Gender: How Sexual Expectations Shape the Pursuit of an Orgasm Goal for Heterosexual, Lesbian, and Bisexual Women

Previous research has established that gendered sexual scripts shape sexual behavior. This study seeks to expand prior work on orgasm disparities for women across sexual orientations by exploring the role of partner gender. Across two studies, we examined how the gender of women’s sexual partners influenced their orgasm goal pursuit. We compared lesbian and heterosexual women’s experience with their most recent partner in Study 1, and experimentally compared bisexual women partnered with a woman or a man in a hypothetical sexual encounter in Study 2. In both studies, women reported higher clitoral stimulation and orgasm expectations when partnered with a woman compared to a man. Moreover, partner gender had a significant indirect effect on women’s orgasm goal pursuit through clitoral stimulation and expectations for orgasm. These results suggest that sexual scripts associated with partner gender play a key role in the orgasm gap for women who have sex with men.

The point of nipple erection 3: Sexual and social expectations of women with nipple erection.

The point of nipple erection 3: Sexual and social expectations of women with nipple erection.

(224) Women's Expectations and Representations of Breast Surgery Impact on their Sexual and Reproductive Life

Abstract Introduction Breast surgery is a difficult experience, whether for benign or malignant diseases. It concerns all women, regardless of their ethnic origin or socio-demographic condition. Due to the life-altering nature of this experience, patients' expectations before surgery can sometimes become unrealistic regarding their body image, sexuality, quality of life, and even fertility and reproduction. The diversity of these expectations is influenced by clinical, socio-demographic, and psychological factors. Objective The main objective of this study is to assess the factors responsible for the variability of female patients' expectations before breast surgery. The secondary objectives of this survey are to evaluate the representations of female patients of the potential impact of breast surgery on their body image, reproduction, and their sexuality. Methods We conducted a one-year cross-sectional study (2022). We included all female patients over the age of 18, with a breast disease, scheduled for elective breast surgery at our department, except those with a history of previous breast surgery. The data collection was by filling in a pre-established 9-item form including the validated translated versions of the standardized following scales: the Female Sexual Function Index (FSI), the Hospital Anxiety and Depression Scale (HADS), and the Body-Esteem Scale for Adolescents and Adults (BESAA). Patients' expectations were divided into 4 sub-categories: • Expectation on body image: 3 Items, concerning patients' perceived ideas regarding their femininity, their partner's reaction to them, and their body. • Expectations about sexuality: 9 items concerning patients' perceived ideas regarding their sex life, desire, partner's desire, excitement, lubrication, orgasm, sexual satisfaction, frequency of sexual intercourse, and dyspareunia. • Expectations on quality of life: 4 items, concerning the patients' perceived ideas regarding their daily, professional, family, and marital life. • Expectations on fertility and menopause: 8 items concerning the patients' perceived ideas regarding their fertility, menstrual cycle, contraception, early menopause, menopausal symptoms, and hormone therapy. Patients' expectations are defined as unrealistic if the expectations of two of the 4 subcategories are unrealistic. Results We included 103 participants. Patients' general expectations were unrealistic in 30.1% of cases (n=31) focusing on sexuality (unrealistic in 30.1% of cases) and body image (unrealistic in 28.2% of cases). The risk factors for developing unrealistic expectations with regard to body image were a surgery delay greater than 2 months (p=0,004; OR=8,143), a radical breast surgery (mastectomy)(p=0,006; OR=11,972), good anatomical knowledge (p=0,012; OR=9,615), and pathological HADS-A levels (p=0,032; OR=8,693). A breast surgery delay that exceeds two months was an independent risk factor for unrealistic expectations regarding sexuality (p=0,019; OR=4,273). Concerning the independent risk factors related to general unrealistic expectations, work at the time of the surgery (p=0,049; OR=4,081), a radical breast surgery (p=0,045; OR=4,757), good anatomical knowledge (p=0,037; OR=5,12), and a pathological HADS-A level (p=0,04; OR=6,698) were statistically significant. No independent risk factors were associated with quality of life and reproduction. Conclusions Our results emphasize the importance of a good knowledge of the risk factors that can promote unrealistic sexual and body image expectations prior to breast surgery. It allows for targeting high-risk patients and implementing the necessary preventive interventions. Disclosure No.

A Qualitative Study on the Experience of Assisted Reproductive Technology in Women with Dyspareunia.

This study aims to investigate the phenomenon of sexual intercourse-related fear among women utilizing assisted reproductive technology due to dyspareunia. The primary objective is to offer insights that can inform the development of targeted nursing interventions. Employing a purposive sampling approach, a cohort of 23 female patients experiencing dyspareunia and undergoing treatment at the Reproductive Medicine Center of Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, between July 2022 and December 2022, were selected as participants for this research. Semi-structured, in-depth interviews were conducted to gather qualitative data. The Colaizzi 7-step analysis method was subsequently applied to scrutinize the interview transcripts and identify emergent themes. The analysis yielded five prominent themes: psychological disturbances, incongruent cognitive perceptions, anticipations regarding conception, insufficient adaptive responses, and sexual expectations. It is imperative for medical practitioners to demonstrate reverence for patients' sexual beliefs and conditions, attune to their apprehensions, and offer efficacious emotional support. Tailored and multifaceted sexual health knowledge should be dispensed based on patients' individual requirements and their envisioned sexual experiences, thereby fostering spousal and familial harmony. By prioritizing patients' sexual well-being, cultivating a compassionate medical milieu, and augmenting the quality of assisted reproductive services, comprehensive improvements can be achieved.

Subtypes of Alcohol Expectancies Are Differentially Associated With Alcohol Use for Bisexual and Heterosexual Women

Background : Bisexual women, compared to heterosexual women, report greater amounts of alcohol use and heavy drinking. Alcohol expectancies (i.e., beliefs about alcohol outcomes) are a strong predictor of alcohol use, but few studies have examined the importance of alcohol expectancies in relation to alcohol use among bisexual women specifically or in comparison to heterosexual women. Objectives : The current study examined 262 heterosexual and 225 bisexual women using an online survey about alcohol use, sexual risk-taking, and alcohol expectancy subtypes (sexuality, tension reduction, and aggression). Results : Compared to heterosexual women, bisexual women reported greater sexuality and tension reduction expectancies after accounting for their level of drinking, but groups did not differ on aggression expectancies. Moreover, sexual identity status moderated the associations between sexuality and tension reduction expectancies and alcohol use, respectively. Specifically, our study findings suggested that sexuality and tension reduction alcohol expectancies were more strongly tied to alcohol use among bisexual women than heterosexual women. Conclusions : Taken together, in our study, bisexual women held stronger sexuality and tension reduction expectancies, as compared to heterosexual women. Interventions targeting alcohol expectancies may be considered when tailoring intervention content for this population.

The Interaction of Attitude, Intention, and Behavior During Sexual Communication

Parents need to have a positive attitude in establishing sexual communication with adolescent. Sexual communication in this study is a principal means of transmitting sexual values, beliefs, expectations, and knowledge from parents to adolescent. A representative and eligible sample was randomly obtained with a total of 315 respondents. The respondents of this study were parents (41–50 years old) who had teenagers between the ages of 14 and 17 years, and had to live together for at least 6 months before the survey was conducted. Three instruments were used; scale of attitudes toward sexual communication, intention to engage sexual communication, and sexual communication behavior of parents–adolescents. Based on the results of mediation tests, it shows that parental attitudes influence parent–adolescent sexual communication behavior through the intention to engage in sexual communication (P = 0.013). A positive attitude toward sexual communication is recommended to encourage parents to conduct sexual communication with adolescents to prevent adolescents from engaging in risky sexual behavior.
 Keywords: attitude, intention, risky sexual behavior, sexual communication

Examining the Relation Between Social Anxiety and Cannabis Problems Among College Students Through Coping-Related Expectancies and Motives.

College students high in social anxiety are at increased risk for cannabis-related problems. This may be particularly true when they hold strong coping-related expectancies and motives for cannabis. However, few studies have examined these constructs together in accordance with the motivational model, which posits that substance use is proximally influenced by motives and more distally influenced by expectancies. Thus, the current study examined whether the relation between social anxiety and cannabis-related problems was indirectly explained through coping-related expectancies, motives, and cannabis use. Past-month cannabis users (N = 660; 71.6% female, 47.3% white non-Hispanic) from seven U.S. universities completed an online survey assessing social anxiety, and cannabis use frequency, problems, expectancies, and motives. A saturated path model examined social anxiety as a predictor of cannabis problems via coping-related expectancies and motives, and cannabis frequency. There was a positive indirect effect of social anxiety on cannabis problems through cognitive and behavioral impairment expectancies, depression coping motives, and cannabis use. Social anxiety also indirectly positively related to cannabis problems via social and sexual facilitation expectancies, social anxiety coping motives, and cannabis use. Further, social anxiety indirectly positively related to cannabis problems through relaxation and tension reduction expectancies, both depression and social anxiety coping motives, and cannabis use. These indirect effects were invariant by sex assigned at birth. Results support using a theory-informed model of coping-related cannabis cognitions to understand the relation between social anxiety and cannabis problems. Interventions that modify coping-related cognitions may reduce cannabis-related problems in college students high in social anxiety.

Sexual alcohol expectancies moderate the relation between alcohol use and sexual behavior among men who have sex with men

BackgroundHIV transmission remains a significant health concern for men who have sex with men (MSM) in the United States. Heavy episodic drinking (HED) is related to increased rates of condomless anal intercourse (CAI) among MSM, though evidence suggests that this association may vary by individual difference factors. The present secondary analysis tested whether sexual alcohol expectancies (SAEs) moderate the associations between frequency of HED and anal intercourse (AI) with and without a condom among moderate-to-heavy drinking HIV- MSM. MethodsTwo hundred and forty-eight moderate-to-heavy drinking MSM completed self-report questionnaires including the Sexual Behavior Questionnaire, the Modified Daily Drinking Questionnaire, and the Sexual Alcohol Expectancies Questionnaire. ResultsNegative binomial regressions indicated that SAEs moderated the association between frequency of HED and AI with a condom, but not between the frequency of HED and condomless AI (CAI). ConclusionsThese results suggest that stronger SAEs play a role in alcohol-related sexual behavior among MSM, but do not provide evidence that SAEs are associated with increased risk for HIV transmission through CAI.

"I Want to Be Really Clear": What Male Sex Workers Want to Clarify With Prospective Clients Before Agreeing to Meet for Sex.

Men who have sex with men (MSM) and engage in sex work (MSW) frequently meet clients through dating/hookup apps. This provides an opportunity to discuss the parameters of the exchange prior to meeting and to learn things about the prospective client and the risks he might pose. Limited research has examined the specific issues or topics MSWs discuss with clients before agreeing to meet. We analyzed interview data from a sample of 180 MSWs from eight U.S. cities who engaged in exchange sex with clients they had primarily met through dating/hookup apps and websites. Participants typically asked about clients' sexual interests and expectations regarding what will transpire when they meet to make sure they were compatible with their own boundaries and limitations. Most participants inquired about clients' sexual health and often discussed condom use. Assertiveness and communication skills training might help MSWs negotiate encounters with clients that promote health and safety.

The teaching body in sexuality education – intersections of age, gender, and sexuality

ABSTRACT This paper illuminates how teachers are influenced by age, gender and sexuality in teaching about sex and relationships. In this analysis grounded in feminist theory, age, gender and sexuality are considered to be enacted as doings. Six interviews with teachers working with sexuality education in K-12 schools in Sweden were chosen from of a larger body of material consisting of 21 interviews with professionals engaged in school-based sexuality education. The six interviewees were selected because they explicitly addressed how teachers’ age, gender and/or sexuality come to matter in the classroom. Findings show how male and female teachers organise their teaching in relation to normative expectations of age, gender and sexuality. In sexuality education, the diverse life-courses of (hetero)sexual women offer a wide range of pedagogic possibilities for female teachers to address issues of sexuality, consent and relationships whereas male teachers are constrained to doing safe(r) forms of masculinity by directing attention away from their bodies and experiences. In understanding these results, I argue that the figure of the tant has been key in forming the pedagogic backdrop to Swedish sexuality education, hence embedding a normative ‘who’ in the ‘how’ to teach sexuality education.

Protocol for a closed group in inpatient and outpatient settings for persons with histories of perpetrating sexual offenses

ABSTRACT Group treatment for persons with sexual offense histories has robust empirical support and is preferred by patients over individual therapy. Manuals in this field offer group leaders various topics to explore with patients, such as emotion regulation, sexuality and sexual behavior, and expectations and beliefs about interpersonal relationships – issues that are very relevant to the treatment of this population. However, our clinical experience shows that patients are preoccupied with additional issues, such as the effects of pharmacological treatment and fear of sex offender supervision officers following release from prison. In this practice-informed article, we present a protocol for use in a closed group setting, which can be used by clinicians who are working with this challenging population, whether in a prison or an inpatient or outpatient forensic facility.

Descriptive Analysis of Preoperative Breast Reconstruction Patient Expectations Using the BREAST-Q Expectations Module

Background: Patient expectations have been shown to influence postoperative outcomes across surgical specialties. However, the impact of expectations in breast reconstruction is not well understood. The purpose of this project is to perform the first large-scale analysis and classification of BREAST-Q Expectations responses in patients undergoing implant-based reconstruction. Methods: We performed a retrospective analysis of patients who underwent postmastectomy implant-based reconstruction and completed the BREAST-Q Expectations module preoperatively between 2012 and 2021. Variables of interest included patient demographics, comorbidities, and surgical characteristics. Outcomes of interest included BREAST-Q Expectations module scores. Shapiro Wilk Normality Tests demonstrated that none of the domains had a normal distribution of scores; scores were categorized by thirds to generate thresholds for optimistic, neutral, and pessimistic scores. Results: 298 patients met criteria. The mean age of the cohort was 50.3 and the mean BMI was 25.4. Half of the patients had at least one comorbidity – most commonly obesity, followed by diabetes. About two-thirds had a psychiatric diagnosis. Scores on all domains were skewed overwhelmingly positive (expectations of Medical Team, Coping, Appearance, Self-feelings, and Sexuality) or overwhelmingly negative (expectations of Pain and Recovery), which informed score categorization and interpretation. Conclusions: Preoperative expectations in patients undergoing implant-based reconstruction skew overwhelmingly optimistic for most domains, but overwhelmingly pessimistic on expectations of Pain and Recovery. These results emphasize a need for improved preoperative patient education and counseling as well as a closer analysis of the relationship between preoperative expectations and postoperative outcomes and quality of life.