Sexual Perceptions Research Articles

Sexual health and gynecological cancer: conceptualizing patient needs and overcoming barriers to seeking and accessing services

Objective: The current study explored the subjective experiences of women treated for a gynecological cancer, with a focus on filling gaps in the current literature. Topics explored were: (1) women’s own definitions of healthy sexuality; (2) services desired to meet needs; and (3) barriers to participation in sexual health-related services. Methods: Fifteen women participated in a one-on-one, semistructured interview. Data collection and analysis were based on guidelines of interpretive description. Results: Definitions of healthy sexuality included emotional intimacy, body image, sexual self-schema, and sexual response. Unmet sexual needs were reported when women’s current sexual experiences did not correspond with their subjective perceptions of healthy sexuality. Most women desired informational services, delivered one-on-one or through written material. Younger women often did not utilize services due to practical barriers and emotional avoidance, while older women reported that shyness and stigma discouraged them from discussing sexuality with their health care team. Conclusions: In order to understand patient needs and desire for help, health care providers should assess current sexual health and patient perceptions of healthy sexuality. To increase effectiveness of distress screening and treatment interventions, potential barriers must be evaluated and addressed.

African American women's perspectives on ‘down low/DL’ men: implications for HIV prevention

African American women are disproportionately affected by HIV. Some research has explored if non-disclosing men who have sex with men and women contribute to women's HIV risk. Popular media discourse tends to refer to these men as ‘down low’ or ‘DL’. Six focus groups were conducted with 36 African American women in Washington, DC, to examine their knowledge, attitudes, beliefs and behaviours regarding DL men. Three of the focus groups were composed of HIV-positive women and three groups were composed of HIV-negative women. Data analysis reveals six central subcategories related to women's perspectives on the DL: awareness, suspicion, coping with partner infidelity (male versus female), sexual health communication, empathy and religion. No major differences were identified between the HIV-positive and HIV-negative focus groups. Findings from this study provide insight into African American women's perceptions of African American male sexuality and how these perceptions serve to influence interpersonal relationship factors and women's exposure to HIV risk.

Bisexual men and body image

Although the body images of straight and gay men have received extensive research attention, there has been little consideration of bisexual men’s perceptions of body image. In this qualitative investigation of openly bisexual men from both the United Kingdom and Australia, men discuss their perceptions of body image, masculinity and sexuality. The findings show that the ideal body described resembles the mesomorphic body image suggested to be ideal by research into both gay and straight men’s perspectives on body image. However, the participants differentiated between what they termed a ‘masculine’ body and a ‘gay’ body, with the latter being viewed as undesirable. Thus, concerning perceptions of the male body, the bisexual men in this study participate in the cultural conflation of masculinity and heterosexuality, illustrating a degree of internalised homonegativity.

“All my friends are doing it:” The Impact of the Perception of Peer Sexuality on Adolescents' Intent to have Sex

The purpose of the authors in this study was to determine if the proportionality of peers who believe other youth are having oral sex or vaginal/anal intercourse influence the youth's intention to also have oral sex or vaginal/anal intercourse in the next three months. The results supported the hypothesis that the proportionality of perceiving one's peers as sexually active was correlated with one's intent to have oral sex in the next three months (r = .34 and .39, p < .01) and one's intent to have vaginal or anal sex within the next three months (r = .51 and r = .65, p < .01). Approximately 50% of youth who intent to have oral sex are also likely to have vaginal/anal sex. The results were not moderated by age, gender, or Hispanic/White status, but were moderated by being in a special/committed relationship.

Experiencing sexuality after intestinal stoma

Objective: Identify the Social Representations (SR) of ostomized people in terms of after the stoma. Methods: An ex- ploratory, descriptive, qualitative study using the Social Representation Theory with 15 ostomized people (8 females), mean age of 57.9 years, between August and September 2005. Data obtained from transcribed interviews were submitted to content analysis, resulting in the thematic unit Giving new meaning to sexuality and subthemes. Results: The study demonstrated that the intestinal stoma interferes in the experience, showing that the meanings attributed to this experience are based on individual life stories, quality of personal relationships estab- lished in practice and perception of sexuality, despite the stoma. Conclusions: The Social Representations, in terms of experiencing after the stoma, are based on meanings attributed to the body, associated with daily life and present in the social imaginary. It is influenced by other factors, such as physiological changes resulting from the surgery and the fact of having or not a partner. Care taken during sexual practices provide greater security and comfort in moments of intimacy, resembling the closest to what ostomized people experienced before the stoma. The self-irrigation technique associated or not with the use of artificial occluder, has been attested by its users as a positive element that makes a difference in sexual practice after the stoma. The support to ostomized people should be comprehensive, not limited to technical care and disease, which are important, but not sufficient. The interdisciplinary health team should consider all aspects of the person, seeking a real meeting between subjects.

Perceptions of sexuality and sexual health among young people in the Netherlands

Sexual health problems are not uncommon among young people in the Netherlands and finding the proper treatment for such problems is often challenging. More insight regarding young people's perceptions of sexuality and its associated problems is needed to improve both treatment and education. This qualitative study of 22 young people (aged 13 to 25 years) explored perceptions of sexuality and sexual health. The results show that sexuality is narrowly defined by young people, with focus clearly being placed on physical aspects of sexuality, and sexual intercourse in particular. Sexual problems are usually defined as physical or medical problems. The data show that participants had limited knowledge regarding sexual problems associated with sexual functioning. Schools, parents and culture all appear to play a role in perceptions of sexuality and sexual health. In their totality, the findings suggest that knowledge about the complexity of sexuality and sexual health is lacking among young people in the Netherlands. We recommend broader sexual health education programs in schools that include the discussion of multiple aspects of sexuality, including pleasure. We also suggest that parents take a more prominent role in educating their children about sexuality.

Abstract P092: Sexual Self-Perception and Adjustment of Cardiac Patients: A Psychometric Analysis

Introduction: The psychological impact of a cardiac event includes feelings of sexual inadequacy, poor sexual quality, and less sexual satisfaction. Few studies have examined sexual self-perception of cardiac patients. Aim: Validate the Sexual Self-Perceptions and Adjustment Questionnaire (SSPAQ) in cardiac patients. Methods: Mailed questionnaires sent to those previously hospitalized during a 1-year period with specific cardiac diagnoses (336 respondents). The SSPAQ was developed and significantly revised from another instrument, adding 5 items (total 30 items), rewording double barreled/redundant items, and making response sets more understandable. Subscales included sexual anxiety, depression, self-efficacy, and satisfaction. The scale-level content validity index was 0.97. Statistical analyses: correlation matrices for item representativeness of underlying factors, and construct validity with confirmatory factor analysis and with known groups, comparing sexually active to not active using t-tests. Results: After item analysis, 28 items were retained, 7 per subscale; Chronbach's alpha were &gt;0.90, indicating item appropriateness for the combined scale (0.97). Using confirmatory factor analysis, factor loadings showed items were related to the 4 latent factors. For sexual anxiety, depression, and self-efficacy, loadings were above 0.60, and sexual satisfaction had 1 loading of 0.54, but all other loadings were above 0.70, suggesting subscales were reliable and valid. Construct validity comparing sexually active to inactive showed those not active had significantly lower sexual self-perception ( Table ). Conclusions: The SSPAQ is reliable and valid for measuring sexual anxiety, sexual depression, sexual self-efficacy, and sexual satisfaction, and overall sexual perception and adjustment. The instrument may be useful in both research and clinical settings to further assess cardiac patient adaptation, allowing better assessment of this aspect of sexual quality of life. Sexual Self-Perception &amp; Adjustment Factors and Sexual Activity Factor Not Sexually Active Sexually Active T-test Mean SD Mean SD Sexual Anxiety (R=7-35) 17.71 7.52 13.81 6.04 3.45 ** Sexual Depression (R=7-35) 21.36 6.08 14.65 6.33 6.20 *** Sexual Self-Efficacy (R=7-35) 19.88 7.16 26.38 5.77 −5.42 *** Sexual Satisfaction (R=7-35) 18.37 6.18 25.84 5.87 −6.19 *** Total Sexual Self-Perception(R=28-140) 85.00 22.10 108.85 20.52 −5.12 *** ** p&lt;.01 *** p&lt;.001 Higher scores= more of subscale attribute; total=greater self-perception

The Effects of Male Attractiveness and Sexual Attitudes on Women’s Risk Perception

This study examined the effects of male attractiveness, sexual attitudes, and victimization history on women's ratings of sexual risk. Women with more liberal sexual attitudes rated vignettes as less sexually risky than women with more conservative sexual attitudes. There was an interaction between situational risk and attractiveness, suggesting the relationship between attractiveness and sexual risk ratings varies across high and low situational risk. Findings emphasize the importance of using high and low risk situations to evaluate sexual risk perception and of investigating variables that may moderate women's risk perception.

Sexual Minority Status and Long-Term Breast Cancer Survivorship

Sexual minority women, such as lesbians, bisexuals, and women who have a woman partner face unique challenges, such as deciding on disclosing their sexual minority status to health providers. The purpose of this qualitative study was to explore the perceptions of sexual minority women who were long-term breast cancer survivors. Twenty-two sexual minority women, diagnosed with non-metastatic breast cancer between 2000 and 2005, participated in semi-structured, open-ended interviews. Interviews were audio-recorded, transcribed, and analyzed to identify emergent themes to summarize sexual minority women's perceptions of breast cancer survivorship. Participants' perceptions about the impact of their sexual minority identity on breast cancer survivorship consisted of: (1) breast cancer is a women's issue, not a lesbian issue; (2) I can manage my identity in the context of breast cancer; and (3) I am better off than heterosexual women. The authors' findings suggest a possible disconnect between sexual minority women with breast cancer who de-emphasized the importance of sexual minority status and the research community that emphasizes the importance of this status. Prior to counting on sexual minority women's interest in studies, researchers may need to educate sexual minority women about the need of breast cancer studies.

The Relationship Between Depression and Perception of Sexuality in Patients with Type II Diabetes: In Turkey

This descriptive study investigated the relationship between depression and perceptions of sexuality in people with type II diabetes. The study population comprised all patients who came for check-ups at the polyclinic for diabetes at Istanbul Okmeydani Training and Research Hospital between November 2010 and February 2011. One hundred patients were willing to participate in the study and met the participant criteria. Socio-demographic characteristics, perceptions of sexuality, and other factors related to diabetes were evaluated from information provided by participants. The Beck Depression Inventory-II (BDI-II) was used to evaluate depression. Results revealed an average depression score of 16.34 ± 8.06. The average level of depression was higher in women, those whose level of education was low, and the unemployed. Of the participants, 53% reported that diabetes has affected their sex life adversely. There was no relationship between level of depression and aspects of the illness. However, level of depression was related to sexual satisfaction. Findings suggest that depression and sexually related problems should be addressed when providing care for people diagnosed with type II diabetes.

‘Nice girls don't play cricket’: the theory of established and outsider relations and perceptions of sexuality and class amongst female cricketers

The purpose of this article is to explore divisions between female cricketers in the UK utilizing Elias and Scotson's theory of established and outsider relations (Elias, N., and J. Scotson, eds. The Established and the Outsiders. Dublin: University College Dublin Press, 2008). This article begins by discussing the adoption of the theory of established and outsider relations within sport to a variety of established and outsider figurations, particularly those focusing on gender relations in sport. The focus of the article is on an outsider group, female cricketers and seeks to explore divisions between them as a characteristic of being an outsider group within the context of an established–outsider figuration. The article draws on ethnographic data with an U15 girls' county cricket team alongside semi-structured interviews with 31 female cricketers. The data presented identifies that power relations exist between female cricketers, specifically in relation to their perceptions of sexuality and class in cricket. The article concludes by suggesting ways in which the theory of established and outsider relations could be developed to explore the divisions of power between outsider groups.

A qualitative study of undergraduate students’ learning experience in sexology

This study responds to significant issues related to the problematic nature of perceptions of sexuality in Australian society. It also explores the extent to which the students’ view of sexuality can be influenced through a sexuality education programme delivered at tertiary level. %%%%An investigation of the literature, comprehensive interviews and feedback from students identifies the factors which form the perceptions of sexuality that students have by the time they reach young adulthood and enter the sexology class. %%%%The qualitative study provides insights into how higher education students extend their understanding of sexuality. These insights, elicited through the study, supports the considerable body of anecdotal evidence that has been gathered over thirty years in the award winning1 sexuality education programme at Curtin University. The study provides an understanding of the impact of sexuality education in an adult learning environment, using ethnographic methods to reveal ways in which undergraduate students perceive and interpret new knowledge acquired from formal studies.%%%%The study also illuminates how the learning strategies and content from the sexology class influence participants’ perceptions of their own sexuality and the sexuality of others. Students’ responses to the class were ascertained through reflective writing, interviews and focus groups. Participants demonstrated that they had responded to the ‘sex-positive’ approach to teaching and learning by revealing a more open-minded, less judgemental disposition, with an enhanced body image and added confidence to discuss sexual issues.%%%%The rich body of information emerging from this study can be used to enhance the development of sexuality education programmes in tertiary institutions and the wider community. The information includes the approach, processes, key content and the learning outcomes.%%%%It is hoped that the participants’ stories throughout this report will resonate with the reader. The aim of this report is to make a contribution to an important issue that has thus far received scant attention in the literature.

Sexuality of Repartnered Men and Women in France: Sexual Behaviors, Perceptions, Expectations and Sexual Dysfunctions

Introduction. Although many epidemiological studies on sexuality have been published, none have specifically addressed male and female sexuality in repartnered couples. Aim. To investigate men and women’s sexual behaviors, perceptions and expectations, and the frequency of their sexual dysfunctions, with a focus on repartnered couples, i.e, subjects living with a partner in a stable relationship after divorce or widowhood (including both remarried couples and cohabitating unmarried couples). Methods. Analysis of telephone survey data collected from 1,002 French subjects (483 men, 519 women) ≥35years. Of these, 748 were living with their partner as part of a heterosexual couple. For these subjects, the sexuality of 149 repartnered subjects was compared to that of the other 599 subjects. Main Outcome Measures. A 39-item questionnaire assessing subjects' perceptions, expectations, sexual behaviors and dysfunctions. Results. Compared with other subjects, men and women in repartnered couples had more active sexuality and more interest in sexuality (men 93% vs 80%, P < 0.01, women 73% vs 65%, P < 0.05). They were generally more sensitive to feelings and emotions linked to their sexuality, and these feelings seemed to increase steadily with age. Their sexuality was more attuned to their partner’s pleasure (men 79% vs. 59% P < 0.001, women 50% vs. 34% P < 0.01). Concern for the future of the relationship and for sexuality was equally present for both groups, although repartnered couples were more often concerned about potential inadequacy and conflicts between the two partners. Although repartnered men seemed to be less affected by diminished desire, they had slightly higher rates of premature ejaculation and erectile dysfunction, and considered their quality of life to be more affected by these problems. Conclusion. The sexuality of repartnered couples remains poorly studied, but seems to differ from that of non-repartnered couples. Our findings open interesting avenues of research on the diagnosis and management of repartnered couples.

The Performance of Softer Masculinities on the University Dance Floor

In this article we examine the masculinities of heterosexual men in English university dance club settings. We highlight that multiple influences shape perceptions of gender and sexuality—influences that are also used to subvert a polarized gender and sexuality order. This is evidenced by how straight men dance, interact, and even kiss each other. Accordingly, we ask what it means when queer masculinities are performed by otherwise straight-identifying men. We examine the implications that the queering of straights has on understandings of gender and sexuality, arguing that, whether the context is a sporting event or a dance hall, social terrains rely on a body of assumed knowledge that helps construct the social meanings inculcated in and performed by moving bodies. We suggest that homosocial intimacy expressed through men's dancing together, which used to be considered subversive in the 1980s, is increasingly found in the domain of popular and normative heterosexual youth culture today.

Image versus Health: The Role of Perceptions of Masculinity on Sexual Risk Behaviors among HIV-Positive African American Men who have Sex with Men and Women

HIV prevention has rarely explored the impact of childhood sexual abuse (CSA) across health domains among African American men who have sex with men and women (MSMW). Early sexual experiences may influence perceptions of gender roles, sexual identity, and risks for HIV/AIDS. The attribute of masculinity is commonly associated with strength and success. However, a legacy of racism and oppression may pose challenges for African American men in achieving gender-based milestones. Instead, proxies for success may include masculinity constructs with hypersexual posturing and prowess that contradict sexual health messages. Two groups, each meeting twice for 90-minutes, of HIV-positive African American MSMW participated in discussions focusing on masculinity and sexual experiences. Participants were bisexual HIV-positive African American men who engaged in unprotected sex and had histories of CSA. Discussions were recorded, transcribed, and analyzed using consensual qualitative research and a constant comparison qualitative method. Participant mean age was 40.5 years (n=16). Majority had a high school education (69%), half were unemployed, and almost two-thirds earned less than $20,000 annually. Three themes, each with two subthemes, emerged that described the sociocultural context for engaging in high-risk sexual behaviors, and included: 1) the importance of inhabiting a "traditional" masculine gender role with: a) general and b) sexual masculine traits; 2) the influence of conceptions of masculinity on sexual identity with the associations: a) between being gay and being effeminate and b) between being gay and being HIV-positive, and; 3) CSA experiences with: a) appraisal of CSA and b) early sexual experiences as rites of passage. Attempts to be masculine may contribute to high-risk sexual behaviors. Research needs to explore how early sexual experiences shape perceptions of masculinity and masculinity's influence on receiving health messages for African American MSMW who may prioritize a specific image over sexual risk reduction.

Healthcare Providers' Perceptions of the Sexual and Reproductive Health Needs (Including Family Planning) of Elderly Women from Selected Sites in Botswana

Much of the sexual and reproductive health services and service delivery including family planning target women of child bearing ages (15 - 49 years) and sometimes men. Hardly are there programmes/interventions that specifically target the needs of the elderly women (50 years and above), yet this group has serious sexual and reproductive health needs as many of them are still sexually active. This cross-sectional study obtained the views of a stratified random sample of 169 healthcare providers (doctors, nurses and pharmacists) from four selected sites, Gaborone, Selibe Phikwe, Barolong and Kweneng East health districts in Botswana on how the healthcare system in the selected sites is meeting the SRH/FP needs of the elderly women. The study found out that while overwhelming majority of the healthcare providers feltthat the healthcare system has no programme that specifically target the SRH/FP needs of this significant others and their SRH/FP needs are not being met ,less than 15% indicated that Pap smear screening as well as screening of cervical cancer were on-going. Although there are SRH/FP services available in the healthcare system, the elderly women are minimally accessing these services. Only condom, combined oral contraceptives, progestogen-only pills, treatment of STIs, screening for HIV/AIDS and screening for cervical cancer are accessed and information is also limited to these services. Reasons given by the healthcare providers for the non-accessibility of these services were cultural diversity (80%), people's sexual behavior and perceptions about sex (79%), lack of knowledge about the desired SRH/FP services (76%), religion (73%) and gender issues (62%). The study, advocates as part of policy options to mitigate the obstacles to accessing SRH/FP services, the expansion of counseling programmes, screening and treatment for breast cancer, public awareness campaigns, production and circulation of appropriate educational materials, effective training of healthcare providers and the establishment of separate clinic days for the elderly women' SRH/FP services.

P2-16-13: Life after Mastectomy without Breast Reconstruction – Are the Needs of Caribbean Women Different?

Abstract Aim: The standard of care in the United States and United Kingdom for women undergoing mastectomy is to be offered breast reconstruction surgery (BRS), either immediate or delayed. In Trinidad, for a variety of reasons, patients are not routinely offered this option. We undertook a study to determine the impact of breast surgery without reconstruction on their perception of sexuality, body image, relationships and quality of life. The aim is to establish a benchmark for the planning and incorporation of reconstructive options into the care pathway of patients requiring oncoplastic surgery in the Caribbean. Method: A questionnaire was administered to post surgery breast cancer patients in a public oncology clinic in Trinidad. These patients had no BRS and had surgery at various institutions in Trinidad, where the primary surgical service was General Surgery. Data was collected prospectively and analysed using SPSS software. Results: Of 130 questionnaires administered to date, 80(61.5%) of those collected were adequate for analysis. 46.1%(n=35) of patients were less than fifty years of age; 44%(n=24) were Afro-Caribbean and 55.6% (n=30) East Indian-Caribbean; 61.1%(n=44) had mastectomies and 38.9%(n=28) had breast conserving surgery (BCS). Of all patients, 90%(n=70) felt attractive, feminine and satisfied with their bodies before surgery, however postoperatively, all who had BCS remained satisfied with their bodies but a significant proportion of patients in the mastectomy group were dissatisfied(p=0.006) and found it harder to look at themselves naked(p=0.025) and be seen naked by their partners (42.9%, n=15). East Indian-Caribbean women felt less attractive after surgery compared to Afro-Caribbean patients(p=0.024). Among all patients, 19.2% felt shy to go out in public after surgery, 28.8% left their house less and 35% (n=25) had fewer social interactions. When analysed by ethnicity, East Indian-Caribbean women were more likely to avoid public events(p=0.003) and had fewer social interactions(p=0.028) than Afro-Caribbean patients. This effect persisted in mastectomy patients(p=0.007), especially in the East Indian-Caribbean group(p=0.0017). 69% of patients were willing to undergo BRS, but it was offered to only 32.5%(n=13) of mastectomy patients. The interest in BRS was similar in all races, age groups and surgery types. Conclusion: This study explores the experiences and needs of Caribbean women with breast cancer in Trinidad. We found from this data that their needs mirror those of women in other countries where BRS is incorporated into the core care pathway. Our data demonstrates that even with ethnic differences, there is deterioration in self esteem and feminity with breast cancer surgery, with lasting effects. Subtle differences appear to be present in body image perception amongst East Indian-Caribbean women versus Afro-Caribbean and may be a useful template when assessing patient needs with a view to how we individualize care in the Caribbean setting. This data also emphasizes the potential benefit in incorporating an Oncology-Plastic Surgery Team approach in our setting and supports the view that providing BRS to patients as early as possible can help to maintain a positive outlook in personal and social interactions. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-16-13.

The influence of sexual harassment frequency and perceptions of organizational justice on victim responses to sexual harassment

Organizational justice theory was used to understand the conditions that influence how women respond when sexually harassed. Specifically, this study examined whether sexual harassment frequency interacts with perceptions of four types of organizational justice (procedural, distributive, interpersonal, and informational) to predict two types of victim responses (confrontation and reporting). With data collected from 257 female employees, it was found that the interaction between sexual harassment frequency and perceptions of distributive justice and the interaction between sexual harassment frequency and perceptions of procedural justice predicted reporting, whereas the interaction between sexual frequency and perceptions of distributive justice predicted confrontation. The interaction between sexual harassment frequency and perceptions of informational justice predicted both confrontation and reporting. Implications for organizations are discussed.

Improving Sexual Risk Communication With Adolescents Using Event History Calendars

This study was conducted to explore the effects of an event history calendar (EHC) approach on adolescent sexual risk communication and sexual activity. Adolescent school-linked health clinic patients (n = 30) who reported sexual activity self-administered the EHC that was used by nurse practitioners (NPs; n = 2) during a clinic visit. Immediately pre- and post-visit, and at 1 and 3 months, adolescents reported sexual risk behaviors and perceptions about EHC communication on questionnaires and by interview. NPs reported their perceptions of EHCs by questionnaire after the visit and poststudy interview. The EHC approach facilitated communication and adolescent awareness of their risk behaviors. Scores increased on Amount of Communication, t(29) = 8.174, p < .001; Satisfaction with Communication, t(29) = 3.112, p = .004; Client Involvement in Decision Making, t(29) = 3.901, p = .001, and Client Satisfaction with Interpersonal Style, t(29) = 3.763, p = .001. Adolescents reported decreased sexual intercourse at 1 month, p = .031. School nurses could use the EHC approach to facilitate adolescent communication and tailoring of interventions.

Cross-dressing for the fatherland: sexual humour, masculinity and German soldiers in the First World War

This article explores several interrelated questions concerning the consequences of the First World War on German front veterans' perceptions of gender and sexuality: how did soldiers respond to military and civilian attempts to control male sexuality and define masculine ideals? How did soldiers perceive sexual behaviours and masculine norms as a result of the traumatic experiences of the trenches? Focusing on sexual humour in front newspapers, this article argues that ordinary soldiers sought to escape prevailing masculine expectations and coped with the stress of the trench experience through gender transgression that included a wide range of `deviant' behaviours, including heterosexual promiscuity, homosocial and homosexual bonds, and female mimesis. Sexual humour in front newspapers reveals that many soldiers sought more than just the absorption of `feminine' characteristics into their masculine image of comradeship, as scholars have highlighted. Soldiers also fantasized and experimented with escaping from war-time violence and masculine restrictions by crossing genders. Referring to front newspapers, soldiers' letters, and documents produced by civilians and the War Ministry, this article uses archival sources recently collected at the federal archive/military archives in Berlin and Freiburg, the Schwules Archiv (Gay Archive) in Berlin, and regional archives in Stuttgart and Munich.