Sexual Images Research Articles

Quality of Life Assessment Four Years after a More than Ninety Percent Total Body Surface Area in Two Survivors with Burns: Case Report.

There are few reports in the literature detailing the Quality of Life (QOL) of survivors with greater than 90% total body surface area (TBSA) burns. The objective was to assess two such individuals seen at our center with the Burn Specific Health Scale-Brief (BSHS-B) survey four years after discharge. Subject responses were categorized into their respective BSHS-B health domains (heat sensitivity, affect, hand function, treatment regimens, work, sexuality, interpersonal relationships, simple abilities, and body image) and a raw score was calculated for each domain. Lower scores indicated a greater perceived decrease in QOL. The nine domains of BSHS-B survey questions were further separated into three categories: physical (hand function, work, simple abilities), treatment (treatment regimens and heat sensitivity), and psychosocial (interpersonal relationships, affect, body image, sexuality). The psychosocial category had higher scores and better outcomes, while the physical and treatment ones had lower scores and worse outcomes compared to the other categories. For both individuals, interpersonal relationships and simple tasks domains were considered important in their QOL, while work, heat sensitivity and hand function received lower scores. Family support, intense physical rehabilitation, and psychosocial management were crucial during the postoperative and follow-up periods.

Associations between Sexuality, Body Image and Health-Related Quality of Life in Patients Treated for Diffuse Large B-Cell Lymphoma – A Cross-Sectional Study

BackgroundSexuality and body image are closely related to health-related quality of life (HRQoL), but these factors are less investigated in patients treated for lymphoma.Therefore, the aim of this study was to describe and explore the associations between sexuality, body image, comorbidities and HRQoL in patients treated for diffuse large B-cell lymphoma. MethodA cross-sectional study with 257 patients (25% response rate) was conducted in 2019 using measures for sexuality, HRQoL and body image and data from the Swedish National Quality Registry for Leukemia–Subregistry for Lymphoma. ResultsThe participants had a mean HRQoL of 69.75 on a 1 to 100 scale, and the functional scales ranged from 68.50 for Role to 80.82 for Social functioning. The symptoms ranged from 5.56 for nausea and vomiting to 37.73 for fatigue. Regarding body image, the participants scored a total of 14.47 (reference values 10–40). The total score for Sexual adjustment was 3.02, and for the subscales Sexual Interest 2.63, Sexual Relation 2.72, Sexual Function 3.62 and Sexual Satisfaction 3.50. HRQoL was positively associated with Sexual Relation; however, negative body image and comorbidities showed negative associations. The model explains 39.6% of the variation in HRQoL. ConclusionThe positive impact of sexual relationships on HRQoL was highlighted, which emphasised the unfavourable effect of negative body image and comorbidities on HRQoL for lymphoma patients. Cancer nurses should address these topics with patients to improve their long-term well-being.

Large Language Models in an App: Conducting a Qualitative Synthetic Data Analysis of How Snapchat’s “My AI” Responds to Questions About Sexual Consent, Sexual Refusals, Sexual Assault, and Sexting

ABSTRACT Comprehensive sexual health education for young people often remains largely inaccessible, leaving gaps in knowledge about sexual consent, refusals, sexual assault, and sexting. Snapchat’s My AI, tailored to its users, offers accessible and potentially stigma-free responses to sexual health queries, showing promise in addressing these gaps. This study aimed to evaluate My AI’s effectiveness in handling questions related to sexual communication, assault, and sexting, and its response consistency across users. Collaborating with young adults and leveraging prior literature, our team formulated questions on sexual consent, refusals, sexual assault, and sexting submitted to My AI by 15 researchers. Each team member opened a chat with My AI in Snapchat and asked it a set of questions in the same order. We then conducted a qualitative content analysis to assess for consistency across users. My AI responses emphasized the importance of clear, honest consent and refusal communication through physical contact or direct conversation. With potential experiences of sexual assault or sexting, it advised consultation with a trusted caregiver. While My AI provided similar responses across researchers, variations were noted. My AI’s responses mirrored common sexual health education messages and the responses used language reflective of sympathy toward potential assault victims or those who were asked for sexual images. My AI’s potential to enhance accessibility to sexual health information could empower young people in making informed sexual health decisions. However, variability in responses may limit impact and comprehension, underscoring the importance of educators complementing these tools.

Understanding Adolescent Criminal and Risky Online Sexual Behaviors in the Context of Mental Health and Well-Being: Findings from a Multi- National European Cybercrime Study

ABSTRACT Using a large multi-national data set of young people in Europe, this paper considers (i) the prevalence of three risky online sexual behaviors: sexting, self-generated sexual images, and watching pornography; (ii) demographic differences with respect to age and gender; and (iii) whether these three risky behaviors are associated with depression, anxiety and stress. Findings indicate that males engaged in all three behaviors more than females. Engaging in all three behaviors was associated with significantly higher levels of depression, anxiety, and stress. The implications for educational programs and policy are discussed in the context of the findings.

The Social Reality of Meaning Making: The Dichotomy in the Illness Narratives of Women With Breast Cancer and Biomedical Practitioners in Nigeria.

Despite the increasing burden of breast cancer in the developing world, there is a misunderstanding of the complex and multifaceted relationship between culture and cancer, particularly breast cancer. Hence, a dichotomy of illness narratives exists due to differential meaning making concerning breast cancer. While clinicians always recommend biomedical treatment, women with breast cancer often seek alternative treatment pathways. To explore the experiences of women with breast cancer and clinicians in Nigeria on the dichotomy in the illness narratives. This qualitative study used in-depth interviews and focus group discussion to explore the experiences of 22 women with breast cancer and 7 clinicians in Nigeria on the dichotomy in the illness narratives using grounded theory method analysis. This study revealed that many women living with breast cancer (WLBC) hold health beliefs that are contradictory to the biomedical norm. They mostly sought treatment based on the perceived aetiology of breast cancer. The treatment pathway follows faith and traditional healing as alternatives or sometimes in combination with biomedicine. WLBC reported a constant fear of biomedical treatment, perceived to be harmful to women's sexuality, fertility and body image. Hence, after perceived treatment failure from alternative care, biomedical care becomes the last resort, usually at an advanced stage of breast cancer, often responsible for poor prognosis. There is a dichotomy of illness construction between sufferers and health practitioners. To guide women with breast cancer on the path of care, modern care practitioners should consider some cultural norms and practices without compromising professional ethos.

Similarities and differences in the functions of non-suicidal self-injury (NSSI) across gender non-conforming and cisgender young adults

BackgroundNon-suicidal self-injury (NSSI) can be motivated by a broad range of functions and many individuals report multiple reasons for self-injuring. Most NSSI research has involved predominantly female samples and few studies have examined gender similarities and differences in function endorsement. MethodsWe characterise the prevalence and versatility of NSSI functions within a gender-diverse online sample of cisgender women (cis-women; n = 280), cisgender men (cis-men; n = 176), and transgender, non-binary, and other gender non-conforming young adults (TGNC; n = 80) age 18–30 (M = 23.73, SD = 3.55). The Ottawa Self-Injury Inventory (OSI-F) assessed 24 intrapersonal and social functions across nine domains: affect regulation, self-punishment, anti-dissociation, anti-suicide, sensation seeking, sexuality, interpersonal influence, and body image. ResultsTGNC participants and cis-women were significantly more likely to report intrapersonally motivated NSSI and greater function versatility than cis-men. Low mood, emotional distress, suicidality, and trauma symptomology appeared to contribute to gender differences in function endorsement. Gender similarities also emerged; across groups, intrapersonal functions were substantially more common than social functions, and the most endorsed domains were affect regulation and self-punishment. No domains were gender specific. LimitationsThe OSI-F was developed from majority female samples and may not adequately capture the experiences of other gender groups. ConclusionsInterventions which reduce distress and strengthen emotion regulation are likely to benefit individuals who self-injure regardless of gender. However, most individuals report multiple NSSI functions and person-centred interventions which address this complexity are needed. Future research should develop gender-informed treatment models which consider the unique experiences of TGNC individuals and cis-men who self-injure.

Religious Disaffiliates' Experiences and Challenges with Sex, Sexuality, and Body Image.

In recent years, an increasing number of ultra-Orthodox Jews have left their insular communities, choosing instead to lead a secular life. This article illuminates their perceptions and experiences related to sexuality, sexual behavior, and sexual health. Based on thematic analysis of 37 in-depth, semi-structured interviews with ultra-Orthodox disaffiliates, we found that sexual experiences have played a decisive role in the disaffiliates' lives. First, some participants shared that experiencing sexual abuse during childhood led them to disaffiliate. Second, prior to disaffiliating, participants had very little knowledge about sex, which was an unspoken issue. This resulted in misunderstandings and miscommunication related to courtship and dating after disaffiliating. Moreover, the knowledge gap of secular social norms led to disaffiliates being sexually exploited, as well as to male disaffiliates behaving inappropriately and consequently suffering from social rejection and loneliness. While some participants celebrated their new sexual freedom, others were fearful and reluctant to have sex. We suggest that in transgressing social, cultural, and identity boundaries, disaffiliates experience "cleft habitus" and are situated in a prolonged liminal position that affects their sexual behavior, intimate relations, sexual health, and body image. During the liminal period, disaffiliates typically learn threshold concepts, which are often troublesome and threatening. There is a striking need to offer disaffiliates assistance and support throughout this difficult process. This analysis can shed light on other groups of religious disaffiliates and cultural immigrants.

Naked modernisation: the rise and fall of the erotic humour magazines in 1930s Turkey

This article discusses four erotic humour magazines – Piliç (Chick) (1930–1931), Bıldırcın (Quail) (1931), Çapkın Kız (The Flirtatious Girl) (1931) and Güvercin (Pigeon) (1931) – that appeared one after the other between 1930 and 1931 within the political, social and cultural atmosphere of the period in Turkey. It argues that the sudden emergence of these magazines was due to two important factors. The first factor is related to the rapidly reviving nightlife and entertainment scene in Istanbul from the 1920s onwards. The second factor is that the print media gave more space to sexual images of women to recover its sales figures, which suddenly dropped after the adoption of the Latin script in 1929. These magazines, published by well-known publishers in Istanbul and fuelled by the images in erotic magazines and postcards coming from abroad, promoted Western notions of beauty and fashion trends while glorifying monogamous relationships and sexual heteronormativity achieved through marriage along the lines of the modernist elites. This visual and textual erotica, which soon became the centre of controversy and was curbed by criminal sanctions, constitutes an important source to contribute to the literature on women's social position and sexual lives in early republican Turkey.

Understanding Social Judgments of and Proclivities to Commit Upskirting.

Against a backdrop of legislative change that sees the taking of private sexual images underneath the clothing of a non-consenting other being made a criminal offence - upskirting - there is a need to understand the public's judgments of and motivations to perpetrate said behavior. In this study (N = 490), we investigated whether judgments of upskirting differed as a function of the sex of the person who was upskirted (male, female) and their perceived attractiveness (attractive, unattractive), as well as how variation in voyeuristic interest, belief in a just world, and dark personality traits predicted judgments of and proclivity to engage in upskirting. We consistently observed more lenient judgments of upskirting behavior when the person who was upskirted was attractive and male, with such judgements predicted by older age across all conditions. Moreover, proclivity to engage in upskirting was predicted by past voyeuristic behaviors, higher psychopathic personality, and being male and of older age. We discuss our findings in the context of needing to qualitatively understand the rationale underpinning these judgments, combating barriers to disclose victimization, and practitioner implications.

The Relevance of Hypersexuality and Impulsivity in Different Groups of Treatment-Seekers With and Without (Exclusive) Pedophilia.

Hypersexuality and impulsivity are regarded as risk factors for sexual offending against children. Studies exploring these factors in undetected men who offended or are at risk of offending are rare. This study aims to investigate hypersexuality and impulsivity in treatment-seeking men with and without a diagnosis of (exclusive) pedophilia who committed child sexual abuse (CSA), consumed child sexual abuse images (CSAI), or feel at risk of offending sexually. Data were obtained from three child abuse prevention projects in Bamberg, Germany. We employed self-report (BIS-11, HBI), objective measures (TSO), and risk assessment tools (STABLE-2007). We computed Bayesian ordinal logit and binomial generalized linear models to explore differences between groups and to predict lifetime CSA and CSAI. Hypersexuality scores were particularly pronounced in patients with exclusive and non-exclusive pedophilia. Patients without pedophilia scored similarly to nonclinical samples. Impulsivity measures did not consistently differ between groups. We could not predict lifetime CSA and CSAI using impulsivity and hypersexuality measures. Sexual rather than general impulsivity seems to be an issue in men with pedophilia. The motivation to offend in patients without pedophilia is discussed.

‘We work in the grey around decision making’; how ‘thematic discretion’ can help understand police decision-making in cases of youth image-based sexual abuse

ABSTRACT In this paper, I argue that a new term, ‘thematic discretion’, can help us understand police decision-making in cases of youth image-based sexual abuse (YIBSA). YIBSA can be defined as harmful image-sharing practices amongst young people, inclusive of the non-consensual sharing of private sexual images, upskirting and cyberflashing, alongside other actions. I will be drawing on findings from a doctoral research project investigating YIBSA, which utilised a mixed methods approach, comprising of quantitative analysis of freedom of information requests from 40 police forces in England and Wales, as well as 26 qualitative interviews with police and non-police practitioners, also based within England and Wales. Research findings established that YIBSA is highly complicated, and as a result, police officers utilised discretion at a considerable rate, alongside crafting their own guidelines to direct their decision-making, which is argued to be steeped in sexist and victim-blaming narratives.

Examining gay male discursive practices in hook-up apps

Abstract Whilst there is a growing body of literature on the normalisation of abuse in youth digital sexual image exchange (Ringrose, Regehr & Whitehead 2021), mediated intimacies and sexual harms among men who have sex with men (MSM) in online contexts still remain largely neglected (Dietzel 2021). The present study builds on Russell’s (2021) study on male discursive practices and investigates sexual and gendered ideologies in 600 online dating profiles gathered from Grindr and Wapo. The discourse analysis of these profiles, on the one hand, sheds light on the existing violent nature of gay Alpha imaginaries in the short-term sexual encounters that these dating apps facilitate and, on the other hand, gives evidence of how discourses of hegemonic heteronormativity, and rape culture, seem to inform MSMs dating app profiles.

Analysis of Public Response to The Use of Chemical Castration for Sexual Offenders in Indonesia

Sexual violence includes various immoral behaviors such as sexual insults, touching unauthorized body parts, viewing and sending unwanted sexual and pornographic images, forced participation in sexual and pornographic activities, rape, sexual torture, female genital mutilation, sexual exploitation, sexual slavery, forced prostitution, forced pregnancy, forced sterilization, forced abortion, and intentional infection with sexually transmitted diseases such as AIDS. Sexual crimes also occur in a state of war, mainly as a tool to oppress a country. In Indonesia, Law no. 17 of 2020 lists chemical castration as one of the solutions in preventing repeat sexual crimes for children. Chemical castration is one of the sanctions that is condemned by the world community but has a major impact in reducing the rate of sexual crime cases. This study aims to analyze the results of the response received by the community to the existence of chemical castration punishment in sexual offenders. The research method in this study uses the type of empirical research and the nature of qualitative research, with data collection methods in the form of questionnaires and secondary data from interviews from youtube and other written documents. The results of this study. Of the 100 respondents who agreed to the existence of chemical castration by answering yes and strongly agreeing, reaching 60%. Doubts about the success of the implementation of chemical castration can have a deterrent effect on sexual offenders. However, most people agree that the existence of chemical castration needs to be carried out not only pedophilia but also perpetrators of sexual crimes against women).

"I Did Not Want to Make a Bigger Deal Out of It than It Was": A Mixed-Method Study on the Help-Seeking Behavior of Victims of Image-Based Sexual Harassment and Abuse.

Experiencing image-based sexual harassment and abuse (IBSHA), or the sending of unsolicited nude or sexual images and the nonconsensual taking, sharing, or threats to share nude or sexual images, may have severe consequences for victims' well-being. While seeking help may be beneficial, not every victim seeks help. Little research has been conducted on IBSHA victims' help-seeking behavior. Therefore, the present mixed-method study examined the help-seeking behavior of IBSHA victims, particularly the barriers and facilitators to seeking help. The study used data from an online survey (N = 163) and interviews (N = 6) among 12-to-25-year-old victims. The quantitative data indicated that the majority of victims disclosed the incident (72.8%), but only a third received help (34.4%). Help-seekers reported greater experienced barriers to help-seeking, when compared to non-help-seekers. The experienced barriers positively predicted victims' reported help-seeking behavior. From the qualitative data, four types of barriers were identified: (a) individual barriers (e.g., feelings of shame), (b) practical barriers (e.g., affordability of help), (c) interpersonal barriers (e.g., fear of negative reactions from one's social environment), and (d) sociocultural barriers (e.g., normalization of IBSHA). Moreover, two types of facilitators were identified: (a) individual facilitators (e.g., the impact of victimization) and (b) interpersonal facilitators (e.g., social support). This suggests victims experience multiple barriers, which altogether can influence their help-seeking behavior. As a help-seeking trajectory is complex and unique to the individual, victims may encounter multiple new hurdles along the way. This may explain why help-seekers reported more barriers. The findings and corresponding implications highlight the importance of providing education on IBSHA and help-seeking on various levels in society.

Risk for Experiencing Psychological and Sexual Abuse On- and Offline: A Comparison of Bisexual, Gay/Lesbian, and Heterosexual Women and Men.

Dating abuse research on lesbian, gay, and bisexual (LGB) populations tends to aggregate LGB participants for comparisons with heterosexuals and often excludes non-assaultive dating abuse and abuse that takes place on online dating applications. In the present study, we used the Pew Research Center's 2019 American Trends Panel Wave 56 dataset (N = 4712) to compare ever experiencing several types of non-assaultive on- and offline dating abuse between bisexual women (n = 402), lesbian women (n = 207), heterosexual women (n = 1802), bisexual men (n = 225), gay men (n = 575), and heterosexual men (n = 1501). We found that gay men and bisexual women generally had the greatest odds of experiencing online dating abuse. Bisexual and heterosexual women had the greatest odds of experiencing some offline abuse (e.g., being touched in an uncomfortable way), but gay men and bisexual women and men had the greatest odds of experiencing other offline abuse (e.g., having their contact information or a sexual image of them shared non-consensually). Findings highlight how assessments of non-assaultive dating abuse in on- and offline contexts via analyses of more specified gender/sex/ual identity groups can broaden understandings of dating abuse victimization, especially among sexual minority populations.

Reoffending after convictions related to child sexual exploitation material: Data from the German Federal Central Criminal Register

BackgroundAs digitalization has made it easier to produce, copy, and distribute child sexual exploitation material (CSEM), the possession and distribution of child sexual abuse images has become more widespread. Thus, the need to assess the risk of subsequent sex offenses – above all, sexual abuse of children by individuals who have been convicted of CSEM offenses – becomes more and more important. ObjectiveThe main objective of this paper is to contribute to the understanding of the respective size of two groups of offenders: first, offenders who commit CSEM offenses without ever crossing the line to sexual abuse of children, and second, so-called crossover offenders, that is, individuals who commit CSEM offenses and engage in child sexual abuse. Identification of differences between these two groups facilitates analyzing the risk that someone convicted of a CSEM offense might in the future sexually assault children. MethodWe used data from the German Federal Central Criminal Register (Bundeszentralregister), a data set that includes information about all persons convicted of any criminal offense, including “child pornography” offenses, by a court in Germany. ResultsFor persons convicted of CSEM offenses only, with no additional concurring sex offenses, the rate of subsequent convictions for child sexual abuse is very low (1.1 % after a six-year follow-up period, adult offenders). This risk is even lower if offenders are older than 30 years of age, and it is slightly higher for offenders with previous offense-specific convictions (i.e., previous sex offenses). ConclusionsThe mere existence of a conviction for a CSEM offense is not an indication that the convicted person poses a significant risk of committing child sexual abuse. To pinpoint such a risk more accurately, the following factors should be examined: the existence of offense-specific prior records, the presence of crossover-offending in the form of concurring offenses, and the age of the offender.

Risk assessment and treatment - Evaluation of a group therapy for people with pedophilia

IntroductionDeviant sexual interest for children (pedophilia, hebephilia) is associated with a higher risk of sexual offending against children (CSA) and consuming child sexual abuse images (CSAI). There is a general shortage of therapeutic programs for individuals who feel sexually attracted to juvenile bodies and are concerned about their sexual behaviour. Efforts to establish regional centres throughout Germany offering preventive support led to the prevention network “Don’t become an offender” (“Kein Täter werden”).ObjectivesTo identify dynamic risk factors (DRFs) and evaluate a treatment programme aiming to reduce CSA and CSAI among potential or existing pedosexual offenders (who have not been legally charged). In addition, changes in the course of therapy are examined to provide information about the accessibility and motivation of the target group and its therapeutic responsiveness.MethodsParticipants undergo standardized diagnostic and treatment procedures. Therapy comprises an outpatient psychotherapy program (group therapy) over the course of approx. 48 weekly sessions, optional individual and partner/relative including sessions, as well as additional pharmaceutical treatment. Assessments are carried out through self- and other-reported psychometric test batteries pre-, during and post-treatment up to a 3.5 year follow-up. The test battery includes clinical questionnaires (WHO-5, CTQ-SF), personality questionnaires (ISK-K, NEO-FFI), sexuality questionnaires (EKK-R, KV-M, MSI, HBI-19) and risk assessment procedures (VRAG-R, STATIC-99, VRS:SO). Main outcome measures are self- and externally-reported DRF changes well as offending behaviour characteristics.ResultsBy September 20, 2023, N=12 individuals were enrolled in the treatment program. All individuals had a deviant sexual preference (exclusive/non-exclusive pedo-/hebephilia). Nine individuals reported past and/or current use of CSAI. Of these, two individuals reported at least one CSA in the past. Three had no previous use of CSAI or CSA history.In the first treatment group (N=6), preliminary results show reduction in dynamic risk factors (e.g., Cognitive Bias, Sexual Compulsivity, Impulsivity) after the first 12 weeks of treatment. The evaluation of additional clinical data is pending.ConclusionsTo date, therapy for individuals with pedophilia or hebephilia has been insufficient – particularly when not offending. Ongoing evaluation of the therapy program should provide further insight into responsiveness and therapeutic motivation of this target group. In particular, the impact of therapy on changing dynamic risk factors for CSA and CSAI remains to be examined.Disclosure of InterestNone Declared

Victim‐survivors’ proposed solutions to addressing image‐based sexual abuse in the U.S.: Legal, corporate, educational, technological, and cultural approaches

AbstractSexual violence is a world‐wide health problem that has begun to escalate in online and virtual spaces. One form of technology‐facilitated sexual violence that has grown in recent years is image‐based sexual abuse (IBSA), or the nonconsensual creation, distribution, and/or threat of distribution of nude or sexual images. Using a trauma‐informed and victim‐centered framework, we asked victim‐survivors for structural solutions to IBSA based on their own experiences. Using thematic analysis on 36 semi‐structured interviews with adult U.S. victim‐survivors of IBSA, we found that victim‐survivors proposed structural solutions to IBSA along five general dimensions: legal (creating/strengthening laws, enforcing laws, facilitating legal navigation), corporate (corporate responsibility/activism and solutions for employers), educational (IBSA education, outreach and advocacy, and developing communities of support), technological (more platform accountability, improved procedures for uploading images, better avenues for reporting and removing images, and enhanced platform policies), and cultural. Many solutions built on existing structures (e.g., sexual education in schools) and frameworks (e.g., creating support groups like those for people in recovery from alcohol abuse), enabling educational professionals, policy makers, victim‐support service providers, and corporations to readily implement them.

Sexuality, intimacy, and body image among adolescents and young adults with cancer: a qualitative, explorative study

AimThe aim of this study was threefold: (1) to explore Danish adolescents and young adults’ (AYAs) thoughts concerning sexual health particularly focusing on sexuality, intimacy, and body image throughout a cancer trajectory, (2) to investigate how AYAs experience healthcare professionals address of- and respond to sexual health issues, and (3) to identify AYAs’ suggestions on how to support conversation about sexual health.MethodsA qualitative, single-center study was conducted, including AYAs (18–29 years) diagnosed with cancer recruited at the University Hospital of Copenhagen, Rigshospitalet. Individual semi-structured interviews were conducted from January–February 2023, recorded, transcribed verbatim, and analyzed using thematic analysis.ResultsTwelve participants were interviewed, aged 20–29; five were diagnosed with hematological- and seven with oncological cancer. Our analyses yielded three themes: (1) sexuality and body image as part of the identity, (2) excluding relatives in conversations about sexual health, and (3) uncertainty how to discuss sexual health with healthcare professionals. Finally, the AYAs’ suggestions to support conversations about sexual health were organized into six thematic categories.ConclusionIn this study, participants experienced altered sexual subsequent impacts on body image and self-esteem during their cancer trajectory. While some adapted to these changes, discussing them with healthcare providers was difficult, especially in the presence of relatives, as the AYAs wanted to shield them from additional concerns. To enhance support, AYAs suggest regular discussions on sexual health and the use of a dialog tool by healthcare professionals.

(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.