International Academy of Sex Research

Transcription

International Academy of Sex Research
(IASR)
August 19 - 22, 2009
San Juan, Puerto Rico
BOOK OF ABSTRACTS
Keynote Speakers
Symposium Speakers
Brief Communications
Poster Presentations
Acknowledgements
The International Academy of Sex Research would like to thank the
University of Puerto Rico for a $5000 grant to support speaker travel and
Church & Dwight Co., Inc. for their donation to help support the 2009
meeting.
We would also like to thank Rums of Puerto Rico for sponsoring the Rum
Tasting at Barrachina Restaurant. A special thanks goes to The Puerto Rico
Convention Bureau for their assistance with the annual meeting, Rebecca
Giguere, MPH, Research Project Manager, HIV Center for Clinical and
Behavioral Studies, University of Puerto Rico volunteers, Eternal Fire Lounge
for sponsoring the Welcome Reception, and Joel Burgos, Group &
Convention Services Manager, and staff at the Condado Plaza for helping
make this a successful meeting.
Thank you Printing Boutique for the discount on printing the program
booklet and abstract packet.
Phone: 787-764-4412
Email: printingboutique@gmail.com
Psychophysiological Predictors of Sexual Functioning and Satisfaction Differ by CSA
Status
Ahrold, T.K., M.A. & Meston, C. M., Ph.D., Department of Psychology, University of Texas at
Austin, 1 University Station, A8000, Austin, TX 78712 USA, tierney.ahrold@mail.utexas.edu
A history of childhood sexual abuse (CSA) has been widely shown to be associated with lower
rates of sexual functioning and satisfaction in women (e.g., Browne & Finkelhor, 1986).
Cortisol, a stress hormone that is often high in women who have CSA histories (Yehuda, 2003),
has been implicated in lower sexual functioning (Hamilton, Rellini, & Meston, 2008). Similarly,
it has been suggested that sympathetic nervous system (SNS) activation during sexual arousal,
although facilatory in sexually healthy women (Meston & Gorzalka, 1996), may be too high in
CSA women, inhibiting sexual response (Rellini & Meston, 2006). We compared cortisol and
SNS activation responses to sexual stimuli in large group of women with CSA histories (N =
114) and women with no history of CSA (N = 44). Participants wrote about their day for 20
minutes (neutral condition) and then about their sexuality for 20 minutes (sexual condition),
during which their heart rate (HR) was collected, as well saliva samples from which cortisol was
determined. Percent changes between conditions for each participant were calculated for cortisol,
heart rate, and heart rate variability (HRV), a measure of SNS activation. Participants also filled
out questionnaires about their sexual functioning, sexual satisfaction, and relationship
satisfaction. For women with a history of CSA (but not for non-CSA women), percent change in
heart rate and HRV significantly predicted sexual satisfaction and functioning such that an
increase in heart rate (as well as HRV) from the neutral to the sexual condition predicted lower
sexual satisfaction and functioning. For women with no history of CSA only, the percent change
in cortisol predicted relationship satisfaction such that decreases in cortisol from the neutral to
the sexual condition predicted higher satisfaction. It appears that sympathetic nervous system
response to self-relevant sexual stimuli is negatively predictive of poorer sexual satisfaction in
CSA women. Cortisol may also be a selective predictor, acting differently for women with and
without sexual abuse histories.
Funding Source: Grant Number R01 HD51676-3 to Cindy Meston from the National Institute of
Child Health and Human Development
Medication Attribution Predicts Response to Side Effect Education
Ahrold, T.K., M.A. & Meston, C. M., Ph.D., Department of Psychology, University of Texas at
Austin, 1 University Station, A8000, Austin, TX 78712 USA, tierney.ahrold@mail.utexas.edu
While education about sexual side effects (SSE) of medications is necessary for informed
consent and treatment planning, some doctors are wary of warning patients about potential SSE
for fear that it may increase the patient’s expectation of experiencing those SSE (Ong, deHaes,
Hoos, & Lammes, 1995) or shift a patient’s attribution of previously existing symptoms towards
their medication (Morris & Kanouse, 1982). This study empirically tested these predictions with
an online educational pamphlet for SSE of selective serotonin reuptake inhibitors (SSRIs) with
specific emphasis on assessing the role of medication attribution on patient’s experience of SSE.
First time SSRI users (N = 92) were recruited online to fill out a 3 session survey. In the baseline
session, participants completed a questionnaire on SSRI use, sexual functioning and satisfaction,
and attribution of sexual symptoms to SSRIs. Participants then received one of three online
psychoeducational interventions: the High Attribution intervention, which emphasized the role of
SSRIs in causing SSE; Low Attribution, which de-emphasized the likelihood of an SSRI directly
causing SSE; or the Neutral condition, which made no explicit links between SSRI use and
sexual symptoms. Participants filled out a follow-up survey two and six weeks later. Participants
in the psychoeducation condition were significantly less likely than control participants to report
a decrease in sexual functioning over the two and six week follow-ups; this effect was more
robust in women than in men. Change in medication attribution was significantly correlated with
changes in sexual dysfunction scores, indicating that those who changed in attribution towards
attributing sexual problems to their SSRI medication were less likely to report sexual
dysfunction. There was no significant difference in medication attribution change between the
three conditions, indicating that the framing condition had no effect on shifting attributions. It
was shown that medication attribution is an important factor in patient education about sexual
side effects. Namely, shifting a patient’s focus from external (medication) factors to internal
(personal) factors changes their experience – and reporting – of those side effects. Moreover,
although the method of presentation was not important, receiving information seemed to have a
buffering effect on initial side effect experience. These findings suggest that the risks of
educating patients about potential sexual side effects of antidepressant medications is far
outweighed by the benefits, both indirect (patient satisfaction with care) and direct (lowered
adverse event reporting).
Funding Source: Grant Number R01 HD51676-3 to Cindy Meston from the National Institute of
Child Health and Human Development
The Effect of Sexual Activity on Testosterone in Men and Women in Long Distance
Relationships
E. Eve Andrews, Lisa Dawn Hamilton, & Cindy M. Meston, Department of Psychology,
University of Texas at Austin, 1 University Station, A8000, Austin, TX 78712
USA, lisadawn462@gmail.com
In 1970, an anonymous researcher working alone on an island published a case study in Nature
in which he demonstrated that his beard growth (an indirect testosterone assay) increased on the
days immediately before his scheduled returns to the mainland to be reunited with his sexual
partner. Since then, there have been numerous studies examining changes in testosterone related
to sexual intercourse, masturbation, and sexual arousal. The results of these studies have been
mixed with some showing an increase in testosterone related to sexual activity, while others
show no change. The present study was designed to isolate sexual activity between periods of
abstinence so that any changes in testosterone related to sexual activity would start from a
baseline of no sexual contact with a partner. We hypothesized that testosterone would be highest
in anticipation of sexual activity and after sexual activity. Participants were all in long distance,
monogamous relationships and saw their heterosexual partners once per month or less. Each
participant provided 5 saliva samples: one week before seeing their partner (and at least 2 weeks
since their last sexual contact), the day before seeing their partner, when they were with their
partner but prior to engaging in sexual activity, the day after their first sexual activity, and three
days after their last sexual activity. Testosterone levels were standardized by calculating percent
change over baseline for all samples. Repeated-measures ANOVA showed that there was a
significant change in salivary testosterone levels over the course of the study for both men and
women. Post-hoc analyses found that testosterone levels in the three samples surrounding sexual
activity (day before, with partner, and day after intercourse) were significantly higher than
baseline for men. Women also had higher testosterone the day before and the day after
intercourse, but showed an unexpected drop when first reuniting with their partners. These
findings demonstrate that both the anticipation of sex and having sex increase testosterone in
men and women. The decrease in women’s testosterone when first seeing their partner may be
due to related, but non-sexual emotions such as nervousness or excitement.
Funding Source: NIH
Same-sex Relationships and Psychological Well-being Among LGB Youth
Jose A. Bauermeister, Marc A. Zimmerman, & Cleopatra H. Caldwell
University of Michigan - School of Public Health, 109 S. Observatory St., Rm 3706 SPH I, Ann
Arbor, MI 48109-2029, jbauerme@umich.edu
The association between neighborhood characteristics and HIV/AIDS risk behaviors among
youth has received limited attention. We examine the association between neighborhood
characteristics and condom use using a longitudinal data set of youth interviewed during
adolescence (N = 850; 80% African American; 50% female). Using a 3-level hierarchical linear
model, we examined the associations between neighborhood characteristics, individual factors,
and condom use over time. We accounted for sex, race, SES, self-acceptance, depression and
alcohol use at Time 1, and pregnancy concerns, sexual intercourse frequency, and number of
partners over time. Youth reporting greater pregnancy concerns, sexual intercourse frequency,
and number of partners reported more condom use over time. Neighborhood disadvantage and
racial density were associated with youth’s baseline condom use and self-acceptance, and
indirectly related to condom use through other sexual risk correlates. Neighborhood disadvantage
moderated the relationship between condom use and pregnancy concerns and number of
partners, respectively. We discuss the implications for HIV/AIDS prevention among youth.
Funding Source: National Institute on Drug Abuse
The Role of Neighborhood Disadvantage and Racial Density on Condom
Use During Adolescence
Jose A. Bauermeister, Marc A. Zimmerman, & Cleopatra H. Caldwell
University of Michigan - School of Public Health, 109 S. Observatory St., Rm 3706 SPH I, Ann
Arbor, MI 48109-2029, jbauerme@umich.edu
The association between neighborhood characteristics and HIV/AIDS risk behaviors among
youth has received limited attention. We examine the association between neighborhood
characteristics and condom use using a longitudinal data set of youth interviewed during
adolescence (N = 850; 80% African American; 50% female). Using a 3-level hierarchical linear
model, we examined the associations between neighborhood characteristics, individual factors,
and condom use over time. We accounted for sex, race, SES, self-acceptance, depression and
alcohol use at Time 1, and pregnancy concerns, sexual intercourse frequency, and number of
partners over time. Youth reporting greater pregnancy concerns, sexual intercourse frequency,
and number of partners reported more condom use over time. Neighborhood disadvantage and
racial density were associated with youth’s baseline condom use and self-acceptance, and
indirectly related to condom use through other sexual risk correlates. Neighborhood disadvantage
moderated the relationship between condom use and pregnancy concerns and number of
partners, respectively. We discuss the implications for HIV/AIDS prevention among youth.
Funding Source: National Institute on Drug Abuse
Effects of Interventions to Prevent Female Genital Mutilation/Cutting: A Meta Analysis
Rigmor C Berg, Eva Denison, Simon Lewin, & Atle Fretheim
Norwegian Knowledge Center for the Health Services, Boks 7004 St. Olavs plass, 0130 Oslo,
Norway, rigmor.berg@nokc.no
Female genital mutilation/cutting (FGM/C) refers to a traditional practice that involves intentionally
altering or injuring the external female genitalia for cultural or other non-therapeutic reasons. The WHO
typology identifies clitoridectomy, excision, and infibulations as the most common types. While FGM/C
is becoming a global problem due to increased population movements and migration, FGM/C is mainly
practiced in African countries. Estimates suggest there are 100-130 million girls and women currently
living with the consequences of FGM/C: Cut females face irreversible lifelong health risk, and
psychosocial and sexual problems. Furthermore, the practice violates a series of well-established human
rights principles, such as the Universal Declaration of Human Rights. Despite intensive efforts to end the
practice, prevalence of FGM/C around the world is roughly the same as it was a few decades ago.
As one of four systematic reviews about FGM/C, the current systematic review analyzed literature on
interventions to prevent FGM/C in an effort to classify the most effective approaches and to take stock of
progress to date. The procedures were in accordance with the Cochrane handbook. We searched 12
electronic databases (e.g., African Index Medicus, EMBASE, PsycINFO) ending February 2009. Crossreferencing, hand searching, and contacting experts yielded one additional citation. We included any
before and after study with a comparison group evaluating FGM/C programming intended to prevent
FGM/C, such as legislation, education, and alternative rites. Outcomes of interest were knowledge,
attitudes, beliefs and (intended) behaviors related to FGM/C, and rates of FGM/C.
Two reviewers independently appraised 3666 records and 15 full-text papers for inclusion and
methodological quality. Five evaluations were included. The studies' methodological quality was low and
the Cochrane risk of bias tool yielded high risk of bias for one or more key domains. Studies involved
between 108 and 2259 females and males from Burkina Faso, Ethiopia, Kenya, Mali, Nigeria, and
Senegal. With the exception of one program that was delivered in health care clinics, all programs were
community-based, and involved educational and/or advocacy activities. Only nine outcomes were
reported in two or more studies and meta-analyses are ongoing.
Several studies reported that compared to various controls the intervention significantly increased the
participants' knowledge of harmful consequences of FGM/C; belief that FGM/C is against women's
rights; belief that there are no benefits of the practice; belief that the practice is unnecessary; and the
perception that their partner disapproves of FGM/C. On average, 17.8% more women in the intervention
groups disapproved of FGM/C than women in the control groups, and an average of 24.5% more
intervention group participants regretted having had their daughter cut. The intention not to have any girl
in the family cut also decreased among intervention participants: On average, 17.6% fewer intervention
participants did not intend to have their daughter cut. Only two studies examined prevalence rates of
FGM/C, but both studies reported a positive decrease among daughters of women exposed to the
intervention.
This effectiveness review suggests there is reason to be optimistic that with interventions and worldwide
support, FGM/C can be ended within a few generations. However, to identify the most effective
approaches to end FGM/C future funding should support rigorous evaluations with behavioral or
biological outcomes.
Funding Source: Norwegian Knowledge Center against Violence and Traumatic Stress
Who’s Afraid of Vaginal Wolf? A Review of Spasmodic Attention to the
Diagnosis of Vaginismus
Irv Binik, McGill University, Dept. of Psychology, McGill University, 1205 Dr. Penfield Ave,
Montreal, Quebec, Canada, H4A 3M2, binik@ego.psych.mcgill.ca
Vaginismus is one of the most long-lived psychiatric diagnoses. This longevity suggests validity
and utility. Three questions relating to the validity and utility of this diagnosis will be addressed:
1. Does muscle spasm characterize vaginismus? 2. Is vaginismus a “distinct affection”? 3. Can
we differentially diagnose vaginismus from dyspareunia? Based on this review, new
classification strategies for vaginismus will be proposed.
Funding Source: Canadian Institutes for Health Research
Sexual Orientation and Physical Size: Analysis of the Chinese Health and
Family Life Survey
Bogaert, A. F. and Liu, J. , Brock University, St. Catharines, Canada, tbogaert@brocku.ca
In the present study, the relationship between sexual orientation and physical size was examined.
Participants were men and women comprising the Chinese Health and Family Life Survey (N >
3,500), which employed a national probability sample of China. This survey is important
because no research has examined these issues in a representative, non-Western sample.
Participants completed self-report measures of sexual orientation, height, and weight. Some
evidence was found that gay men were significantly shorter than heterosexual men. There was
also evidence that lesbians were significantly taller and heavier than heterosexual women,
although the findings were stronger for weight than height. The results add to some prior
research suggesting that gays and lesbians have a different pattern of growth and development
relative to heterosexual comparisons. The results also suggest that a biological factor (e.g.,
prenatal hormones) consistently affects sexual orientation development, along with physical
development, across diverse cultures and different ethnic/racial groups.
Funding Source: Brock University's Chancellor's Chair for Research Excellence
Object of Desire Self-Consciousness and Sexual Fantasies
Anthony F. Bogaert, Julie A. Pozzebon, Beth A. Vissor, & Kimberly J. Orlowski
Brock University, St. Catharines, Canada, tbogaert@brocku.ca
In two review papers, Bogaert & Brotto (2008a; 2008b) discussed “object of desire selfconsciousness,” awareness that one is romantically and sexually desirable in another’s eyes. We
argued that it can function as part of a self-schemata or script related to romance and sexuality.
We also indicated that object of desire self-consciousness may be an adaptive, evolved
psychological mechanism allowing sexual and romantic tactics suitable to one’s mate value. We
also reviewed literature suggesting that this phenomenon derives its origin from both
psychosocial/cultural and biological/evolutionary factors. Finally, we presented evidence,
largely indirect, that it is more relevant to women’s sociosexuality (i.e., linked to their desire and
arousal) than to men’s. In the present study, we attempted to find direct evidence that object of
desire themes are linked more to women’s sexual desire and arousal than they are to men’s by
examining sexual fantasies. Sexual fantasies are important within this context—perhaps more so
than actual behaviors—because behavior, particular partnered behavior, is the compromise of the
individuals comprising the dyad. Fantasies do not reflect this compromise: they usually only
reflect the desires of the individual herself. Approximately 200 men and women reported on
arousing themes in sexual fantasies using three methodologies: sentence completion of sexuallycharged scenarios, endorsement of items on a sexual fantasy questionnaire, and open-ended
sexual fantasies. In the sentence completion task, an example object of desire theme linked to
arousal occurred when a participant completed the following sentence “I’m becoming
increasingly turned on” with “the desire I am arousing in my partner.” On the sexual fantasy
questionnaire, an example object of desire theme was “showing off my body to tease and arouse
onlookers.” In the open-ended fantasies, an example of an object of desire theme was if a
participant referred to an observer(s) watching his/her body. The men and women also were
rated on attractiveness by themselves (self-perceived) and by two female experimenters (otherrated). Composite scales reflecting object of desire themes were constructed on the three
measures of sexual fantasies. On all three fantasy composites, women’s exhibited more object
of desire themes than did men (all ps < .005). There also was evidence of moderation by selfperceived (but not other-rated) attractiveness. In the open-ended fantasies (but not on the other
two measures of fantasies), women high in self-perceived attractiveness were more likely to
exhibit these themes than women low in self-perceived self-attractiveness and men regardless of
their self-perceived attractiveness. The results are discussed in relation to our recent theorizing
that object desire self-consciousness can function as part of a self-schemata or script related to
romance and sexuality.
Funding Source: Brock University's Chancellor's Chair for Research Excellence awarded to
Anthony F. Bogaert
Toward a Framework for Understanding Sexual Outcomes After Hysterectomy
Andrea Bradford, Baylor College of Medicine, 4020 Blue Bonnet Blvd Apt H,
abradfor@bcm.edu
Hysterectomy is among an increasing number of treatment options for relief of benign
gynecological conditions. However, utilization of hysterectomy remains high, and concerns
about sexual outcomes are frequently voiced by women considering this procedure. Recent highquality randomized trials have demonstrated that most women do not experience worsened
sexual function after simple hysterectomy for benign conditions. However, a significant minority
of women (10-20%) report new onset sexual problems after hysterectomy. Evidence to support a
common mechanism for these problems is lacking. For instance, although there is indirect
evidence that hysterectomy may reduce the capacity for genital arousal, women report similar
levels of sexual problems after less invasive procedures. Although hormonal changes after
hysterectomy have the potential to disturb sexual function, subjective reactions to hysterectomy
vary considerably. Thus, physiological hypotheses about the effect of hysterectomy on sexual
function are inadequate to explain the range of actual outcomes. Psychological hypotheses about
the effects of hysterectomy, meanwhile, may be too limited in scope to be broadly generalizable.
Although studies have failed to find differences in sexual outcomes for different surgical
approaches and techniques, other factors have been shown to influence subjective outcomes. A
woman’s experience of sexual function after hysterectomy is likely to be influenced by her
sexual function prior to surgery, her expectations of surgery, her partner’s perceptions and
support, and education about the procedure. These factors may help explain how sexual changes
in the immediate period after surgery, which are relatively common, convert to longstanding
problems. Thus, sexual adjustment after hysterectomy is reframed as an individual, meaning
dependent response, influenced by the woman’s expectations, reactions from significant others,
and perception of and adjustment to physical changes. No data are available on interventions
before or immediately after surgery to reduce sexual problems associated with simple
hysterectomy. However, similar work in related areas suggests that education and psychotherapy
may be useful strategies. When physical changes are a significant part of the clinical picture,
adapting existing models of disease acceptance may help address sexual problems. Potential
barriers to addressing women’s concerns in the clinic include minimization of sexual health
concerns, an overly medicalized conceptualization of sexual problems, and low levels of
sophistication in discussing sexual topics.
Funding Source: None
Behavior and Symptom Change Among Women Treated with Placebo
for Sexual Dysfunction
Andrea Bradford & Cindy Meston, University of Texas at Austin, Department of Psychology, 1
University Station A8000, University of Texas at Austin, Austin, TX 78712, USA,
a.bradford@mail.utexas.edu
In clinical trials of drug treatments for women’s sexual dysfunction, placebo responses have
often been substantial. Little is known about the nature and time course of symptom reduction
with placebo treatment. It is also unknown to what extent placebo responses might be associated
with individual characteristics, such as demographic variables, that influence responsiveness to
treatment. Finally, it is unknown how sexual behavior during placebo treatment changes and
whether changes in sexual behavior account for variability in outcomes. In the present work we
investigated potential between-person and within-person variables that might explain variability
in response to placebo treatment of sexual dysfunction in women.
We tested the magnitude, time course, and correlates of placebo response in a sample of 50
women with sexual arousal and desire problems. These data were drawn from the placebo arm of
a 12-week double-blind randomized controlled trial in which measurement of symptom severity
took place at baseline, 4 weeks, 8 weeks, and 12 weeks, allowing for longitudinal analysis.
Change in sexual function during placebo treatment peaked at 4 weeks and remained relatively
stable through post-treatment. Furthermore, change in sexual function was clinically meaningful
in approximately one-third of the sample. Symptom improvement appeared to be in part a
function of increased frequency of satisfying sexual encounters during treatment. Although the
frequency of any sexual behavior increased in the first 8 weeks of treatment, it returned to
baseline levels by the final 4 weeks of treatment. However, the percentage of sexual behaviors
labeled as satisfactory steadily increased over the course of the trial. Although there was a clear
trend linking satisfactory behavior and symptom severity over the course of the trial, there was
also significant between-person variation in the strength of this relationship. Trial design
features, such as a requirement for engaging in a minimum amount of sexual behavior during
treatment and self-monitoring of sexual activity experiences, may inadvertently enhance placebo
responses. The findings will be discussed with reference to enhancing both clinical trial design
and psychological therapies in the treatment of sexual dysfunction in women.
Sexuality and Marital Stability in African-American Couples
Chalandra Bryant, Barlynda M. Bryant, and Christine E. Stanik, The Pennsylvania State
University, Dept. of Human Development and Family Studies, 211 South Henderson,
cmb34@psu.edu
Although a significant proportion of the population in the United States marries, relatively little
is known about the marital relationships of African Americans beyond reported demographic
information. According to such reports, among men about 42% of African Americans are
married, compared to 62% of Whites (non-Hispanics), 64% of Asians, and 53% of Hispanics
(U.S. Census Bureau, 2005). Among women, about 32% of African Americans are married,
compared to 58% of Whites (non-Hispanics), 64% of Asians, and 54% of Hispanics (U.S.
Census Bureau, 2005). Some researchers suggest that rates of marital dissolution are higher
among African Americans and that African Americans are more likely to think about divorce
than are Whites (Broman, 2002; Goodwin, 2003). About 42% of African American marriages
end within ten years, compared to 32% of White marriages (Goodwin, 2003). If happy/stable
marriages, as has been found, have the potential of providing significant benefits to well-being,
then exploring sexuality within marriage, one of many factors that influence the stability of
unions, is important. Here, we present preliminary analyses of an ongoing longitudinal study of
newlywed African American couples. Couples are slated to be interviewed once a year for five
years with the third wave of data collection currently underway. The present sample consists of
662 couples who have completed the first interview and 328 who have completed the second
interview. Our preliminary findings suggest that husbands’ frequency of second thoughts about
their current marriage was linked to their self-reported degree of experiencing sexual
dysfunction, but not to their wives’ sexual dysfunction; however, frequency of wives’ second
thoughts were unrelated to either their own or their partners’ sexual dysfunction. Husbands’
desire for more affection was significantly related with them considering more relationship
alternatives, though there was no relationship between wives’ desire for more affection and their
reported alternatives. We also explore health issues linked to marriage. We found that among
wives who reported reproductive health issues (such as endometriosis, uterine fibroids, etc.) that
did not negatively impact the marriage, there was no significant association between believing
that a good sexual relationship is important for marital success and wives' desiring more
affection from their husbands. However, that association did exist for wives who reported
experiencing reproductive health issues that, indeed, negatively impacted their marriage. In
addition to the aforementioned issues, we will address the (a) ability of spouses to discuss
physical intimacy and affection with their partners; (b) roles physical intimacy, sexual
dysfunction, and verbal affection play in couples’ reports of relationship alternatives and reports
of marital commitment/stability; and (c) degree to which husbands and wives are concordant in
perceptions of physical intimacy and affection in their relationship.
Funding Source: NICHD
G-Spot: Fiction or Friction? Results of a Survey and Classical Twin Study in 1800 Females
Andrea Burri, Lynn Cherkas, and Tim Spector, Department of Twin Research and Genetic
Epidemiology, King's College London, St. Thomas Hospital, Westminster Bridge Road, SE1
7EH London, andrea.burri@kcl.ac.uk
Introduction There is an ongoing scientific debate around the existence of the G-spot - an
allegedly highly sensitive area on the anterior wall of the human vagina. The existence of this
biological phenomenon seems to be widely accepted amongst women, despite the failure of
numerous behavioral, anatomical and biochemical studies to prove and verify its existence by
objective and consistent means. All genuine anatomical traits so far studied in humans have been
shown to be heritable and we wanted to test the G-Spot. Aim To test our hypothesis that the Gspot exists and has a heritable basis. Methods From 4625 mailed, 1804 unselected female twins
aged 22-83 completed a topic-specific questionnaire including presence or absence of G-spot.
The relative contribution of genetic and environmental factors to variation in G-spot was
assessed and quantified using a variance components model fitting approach. Results We found
a prevalence rate of 56% of women reporting having a G-spot. The prevalence increased with
age. Variance component analyses revealed that variations in G-spot are both almost entirely due
to individual experiences and random measurement error (>99.9%) with no detectable genetic
influence. Correlations with associated general sexual behaviour, relationship satisfaction and
attitudes towards sexuality refuted our original hypothesis. Discussion To our knowledge, this is
the largest study assessing the prevalence of the G-spot and the first one exploring an underlying
genetic basis. One can never with certainty rule out the existence of proposed entity if it lacks
clear definition. One alternative explanation may be that women are unable to detect their own
(true) G-spots accurately. However, we believe this is unlikely and our unusual finding that
phenotypic variance in G-spot is almost entirely due to unique environmental factors and random
error in contrasts to all other anatomical and physiological traits studied, suggests that there is no
physiological nor physical basis for the G-spot as currently perceived.
Funding Source: NHS Foundation Trust
Using Information Technology Tools to Conduct Sex Research in Puerto Rico
Alex Carballo-Dieguez and Ana Ventuneac, HIV Center for Clinical and Behavioral Studies,
NYSPI and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY 10025,
ac72@columbia.edu
Issue
Recent advances in information technology offer new tools for data collection that may be used
along well established quantitative and qualitative research methods in the behavioral sciences.
These tools can be used to assess sexual behavior in the context of microbicide use as well as
product acceptability and adherence (whether study participants like a particular product and use
it according to instructions prior to or concurrently with sexual activity).
Description
This presentation will discuss advantages and shortcomings of three data collection strategies: 1)
interactive voice response systems; 2) web-based centralized data collection systems and
computer assisted self-interviews; and 3) in-depth video interviewing. Their use in the
assessment of microbicide acceptability and adherence will be discussed with examples of
ongoing research taking place in Puerto Rico. Key challenges and considerations regarding the
feasibility of using computer- and web-based tools in microbicide studies will also be reported.
Impact of use of technology on adherence to protocol specifications will be discussed.
Conclusion
Information technology tools that are carefully incorporated into microbicide trials can decrease
recall bias and social desirability, while at the same time provide objective behavioral measures
that can be cross-validated with non-behavioral sources of data (i.e., biomarkers). They can also
cut down on paperwork, streamline data collection, and potentially improve data quality. Yet, all
tools have to be carefully tailored to the specific characteristics of each project and pros and cons
carefully considered.
Funding Source: NICHD
Exploring Patterns of Sexual Desire/Arousal Response in an Online Sample of Portuguese
Women
Carvalheira, Ana, Brotto, Lori, & Leal, Isabel, Superior Institute of Applied Psychology, Rua
Jardim do Tabaco, 34, 1149 - 041 Lisboa, Portugal & University of British Columbia,
Vancouver, Canada, ana.carvalheira@ispa.pt
The notion that sexual desire is defined by sexual fantasy frequency and desire for sexual activity
has been challenged. There is still a need for empirical research on patterns of female sexual
response that might inform the diagnostic criteria for sexual desire and arousal dysfunction in the
DSM-V.
Aim: To investigate patterns of sexual response in women: (1) to identify women who
consistently report sexual desire at the outset of sexual engagement and women who mostly
report accessing desire once they become aroused from sexual stimulation; (2) to explore the
frequency of sexual fantasies; and (3) to describe women’s experience and recognition of sexual
arousal This web-based survey consisted of a variety of questions about women’s sexual
responses. Participants (n = 3687) were Portuguese women over the age of 18 (mean age = 29.4,
SD = 8.3) who recruited through advertisements and snowball by e-mail.
Main outcome measures: Self-report measures of spontaneous and responsive sexual desire,
arousal, orgasm, sexual satisfaction, and fantasy. These measures were developed for this study
by the authors. Analyses were performed on a subsample of heterosexual women in a committed
relationship, not taking anti-depressants, not currently pregnant or breastfeeding who reported no
difficulties with sexual arousal (n=1865). 15.5% only engaged in sexual activity if they felt
sexual desire at the outset whereas 53.8% engaged occasionally in sexual activity with no initial
sexual desire but once engaged were able to get easily aroused. A minority (30.7%) typically or
always accessed desire only once they were aroused. Sexual desire at the outset of a sexual
encounter was related to relationship duration. As relationship duration increased, the percentage
of women in the initial desire group decreased (t[571.5]=-9.703, p<0.001).
A logistic regression was conducted to assess predictors of sexual fantasy. The overall model
was found to be significant (Χ²[6]=163.578, p<.001) and revealed that religion, difficulty getting
aroused, and frequency of orgasm were significantly associated with sexual fantasy. In addition,
sexual satisfaction with one’s own sexuality as well as sexual satisfaction with partner, and
length of relationship did not predict the likelihood of sexual fantasy.
Less than half of women reported genital sensations in the recognition of sexual arousal and
80.2% reported becoming conscious of sexual arousal “because I feel like having sex”. These
data show a diversity of women’s responses regarding motivation to engage sexually. Women
experience desire and arousal as overlapping entities and in a variable order.
Implications for the diagnostic criteria of hypoactive sexual desire and female sexual arousal
dysfunction are that: (a) a lack of initial desire but presence of responsive desire should not
denote dysfunction; (b) the definition of dysfunction should address diversity across women and
the influence of relationship duration; (c) sexual fantasy should not be considered central to
women’s definitions of desire or arousal; (d) most women do not differentiate between desire
and arousal and are not aware of genital sensations.
This study provides some empirical support for a model of sexual response, which recognizes the
importance of responsive sexual desire.
Funding Source: Portuguese Foundation for the Science and Technology for the first author.
Differences Between Women in Short- and Long-term Relationships in Cues for Sexual
Desire
Sexual desire is thought to decline in women as the duration of partnership increases (Klusmann,
2002). Because the diagnosis of hypoactive sexual desire disorder according to the DSM-IV-TR
requires the clinician to take into account “factors that affect sexual functioning, such as age and
the context of a person’s life” (APA, 2000), the extent to which relationship duration is
associated with, and accounts for, sexual desire problems has important implications for the
diagnosis of desire disorder. The aim was to demonstrate the psychometric properties of the
Portuguese version of Cues for Sexual Desire Scale (CSDS) (McCall & Meston, 2006) and
analyse differences in cues resulting in sexual desire between women in short-term and longterm relationships This web-based survey consisted of a variety of questions about women’s
sexual responses. Participants (n = 3687) were Portuguese women over the age of 18 (mean age
= 29.4, SD = 8.3) who recruited through advertisements and snowball by e-mail. A principal
component factor analysis with varimax rotation revealed a 5 factor solution which explained
58.8% of variance. Emotional bonding cues (F1, 10 items, α=.89), Visual/proximity cues (F2, 8
items, α=.90), Romantic/ Implicit cues (F3, 10 items, α=.88), Explicit internal/erotic cues (F4, 5
items, α=.85) and, Explicit external/erotic cues (F5, 5 items, α=.86). The scale revealed adequate
reliability (α=.91). Further analyses were performed on a subsample of heterosexual women, not
taking anti-depressants, not currently pregnant or breastfeeding and not menopausal. Women in
short-term relationships (less than 1 year, n=449, mean age = 26.3; SD = 6.3) and women in
long-term relationships (more than 10 years, n=389, mean age = 35.5; SD = 6.2). There were
significant differences between women in short- and long-term relationships. Compared to
women in short-term relationships, women in long-term relationships reported significantly less
Emotional Bonding Cues (M=40.4/M=39.0; p=.006), Visual/Proximity Cues (M=15.0/M=14.0;
p=.037), Romantic/Implicit Cues (M=34.7/M=32.4; p=.000) and Explicit internal/Erotic Cues
(M=20.0/M=19.2; p=.025), and had significantly lower CSDS total scores (129.3/124.0). No
significant differences were found on Explicit external/Erotic Cues between the 2 groups. The
Portuguese version of CSDS demonstrated adequate psychometric properties. Women in longterm relationships (more than 10 years) reported fewer cues that trigger sexual desire. Thus, the
relationship duration should be considered in the diagnostic assessment of female sexual desire.
The definition of hypoactive sexual desire disorder should take into account relationship
duration.
Funding Source: This study was funded by a grant from the Portuguese Foundation for the
Science and Technology for the first author.
Female Sexual Response and Relationship Duration in a Community Sample
of Portuguese Women
Sexual activity, sexual satisfaction and sexual desire are thought to decline in women as the
duration of partnership increases (Klusmann, 2002). Marital duration has a small and negative
effect on the quality of marital sex (Liu, 2003). Because the diagnosis of hypoactive sexual
desire disorder according to the DSM-IV-TR requires the clinician to take into account “factors
that affect sexual functioning, such as age and the context of a person’s life” (APA, 2000), the
extent to which relationship duration is associated with sexual desire problems has important
implications for our diagnosis of desire disorder.
The goal of this study was to explore the relationship between relationship duration and women’s
sexual desire, arousal and satisfaction among those women who do not report sexual problems.
This web-based survey consisted of a series of self-report questionnaires about sexual
desire/arousal, orgasm, masturbation, sexual satisfaction, and erotic fantasies. Pilot testing was
carried out to check the integrity of the website and database. Participants over the age of 18
were recruited through advertisements and snowball by e-mail. Main outcome measures: Selfreport measures of sexual desire and arousal, orgasm, masturbation, sexual satisfaction, and
erotic fantasies. These measures were developed for this study by the authors. Age was
controlled in all analyses. Results: A total of 3687 Portuguese women completed the survey.
Analyses were performed on a sub-sample of heterosexual women in a committed relationship,
and those able to achieve orgasm (n=2476). There was a significant negative correlation between
the length of relationship and the frequency with which women initiate sexual interaction with
their partner. There was also a significant negative correlation between the length of the
relationship and the level of women satisfaction with her own sexuality and sexual satisfaction
with the partner. There was a significant positive correlation between the length of relationship
and engaging in sexual activity with no sexual desire, engaging in sexual interaction to please the
partner, and difficulty achieving sexual arousal. We also found no significant correlation
between the duration of the relationship and frequency of erotic fantasies, and sexual selfdescription regarding level of conservatism. All p-values were significant at <.001. Discussion:
Data showed a negative effect of relationship duration on several of our measured variables of
women’s sexual response. Women’s initiative to engage in sexual activity and sexual satisfaction
decline as the duration of partnership increases, which is supported by prior research (Klusmann,
2002). Longer relationships were associated with engaging in sexual activity with no sexual
desire at that moment, engaging in sexual activity to please the partner, and difficulty achieving
sexual arousal. Our findings support the circular model of sexual response (Basson, 2000, 2001)
in which women in longer-term relationships often begin a sexual interaction, not with sexual
desire, but from a position of sexual neutrality.
Funding Source: Portuguese Foundation for the Science and Technology for the first author.
Sexual Health Promotion in Gay-Friendly Tourist Destinations: Recommendations of
Vacationing MSM
Anna Cejka, Marisa Green, David W. Seal, Eric G. Benotsch, Salvatore Seeley, Derrick Traylor,
Jean Redmann, Josh Fegley, Steven D. Pinkerton, & Laura Bogart
Department of Psychology, University of Colorado Denver, 1585 Osage Trail Brookfield WI
53005, dseal@mcw.edu
Background. A growing body of research has documented increased substance use and highrisk sexual behavior young, heterosexual adults vacationing in tourist areas. Less research has
been conducted with men who have sex with men (MSM) who visit gay-friendly tourist areas.
Although studies have documented increased HIV risk behavior among MSM tourists, little
research has explored potential intervention strategies to reduce HIV risk behavior among men
who are on vacation in these areas. We present data triangulated from quantitative surveys,
individual interviews, and focus group that elicited feedback from MSM vacationing in gayfriendly tourist areas about possible HIV risk reduction intervention content, format, and delivery
modality in these areas. Methods. 30 minute computer-based surveys were conducted with 722
men systematically recruited from bars in three gay-friendly tourist destinations using venueday-time sampling procedures. Additionally, a convenience sample of men were recruited in
each city to participate in either an individual qualitative elicitation interview (n=45) or a focus
group (n= 20 across 3 groups). Questions about potential intervention strategies were
administered in all 3 data collection strategies. Quantitative data were descriptively summarized,
while qualitative data were thematic content coded. Results. Men in the qualitative interview
suggested using outreach workers or service industry workers (e.g., waiters, bartenders) to pass
out condoms, safer sex information, and lube in bars, hotels, and restaurants. They also
advocated safer sex messages be omnipresent throughout the tourist area and that HIV testing be
readily available. Focus group participants also advocated for making condoms and safer sex
literature salient and widely available (e.g., provided with hotel check-in, restaurant bills). They
further suggested using young, friendly, attractive young men to deliver safer sex messages in
sexually-charged venues (e.g., bar shot boys, dancers, house party leaders). The provision of
accurate information about local HIV/STI incidence, the importance of honest serodisclosure,
and HIV transmission and prevention were emphasized. They advocated for simple and fun
messages delivered in creative condom modalities (e.g., in fortune cookies, safer sex comic
strips). They also advocated for the promotion of group norms through items such as wristband
that let people know "I advocate safer sex." On the quantitative survey, there was wide
variability in the acceptability of HIV prevention interventions in tourist destinations. Of the 3
approaches presented, media campaigns were perceived as slightly more acceptable than
messages delivered by outreach or resort workers. Overall, these approaches received only
moderate acceptability and effectiveness ratings (6-7 on a 10-point scale). Implications. Despite
elevated rates of HIV risk behavior among MSM in vacation resorts, little is known about
effective prevention strategies. Our findings suggest prevention programs will need to identify
innovative and creative methods of safer sex promotion. Possible intervention strategies will be
discussed.
Funding Source: NIMH
Development of Sexual Identity, Barriers to Intimacy, and the
Promotion of Sexual Health
Eli Coleman, PhD, Program in Human Sexuality, University of Minnesota Medical
School, 1300 S. 2nd Street, Suite 180, Minneapolis, Minnesota 55454 USA,
colem001@umn.edu
This presentation will review the development of the various aspects of sexual identity
and models of identity formation. Various sexual and gender identities will also be
explored from a cross cultural perspective. Measurement and constructions of sexual
and gender identity will be discussed. The development of a positive sexual identity is
clearly linked to the development and maintenance of sexual health. A positive sexual
identity is essential for the development of healthy intimate relationships. A model of
sexual health and a model of the development of healthy intimate relationships will be
presented. A variety of common barriers to intimate relationships will be discussed.
Finally, it is recognized that healthy identity and intimacy functioning is dependent
upon a sexually healthy environment. The aspects of this environment will be
discussed as well as a review of current efforts to promote a sexually healthier world
from a public policy perspective.
Funding source: National Institute of Mental Health
The Effects of Treating Male Hypogonadism on Couples’ Sexual Desire and Function
Helen Conaglen and John Conaglen, University of Waikato and University of Auckland,
helen@tpc.org.nz
Introduction. Male hypogonadism is a common endocrine condition characterized by low levels
of testosterone (T) and marked by numerous symptoms, one of which is low sexual desire.
Studies comparing T delivery systems, have suggested that partners of hypogonadal men may be
at risk from exposure to T gels. Little information is available in the literature on the impact of
hypogonadism and its treatment, on the man’s partner and the couple’s sexual function.
Aim. To assess sexual desire and sexual function in hypogonadal men and their female partners
before and after treatment with T replacement therapy.
Methods. 21 hypogonadal men and 18 partners were recruited from a tertiary endocrine clinic,
and compared with a control group of 20 eugonadal age-matched men and their partners. All
men had baseline blood tests to confirm their status as hypogonadal or eugonadal, and the
hypogonadal men had repeat tests at 3 month intervals. All participants completed the Sexual
Desire Inventory (SDI) and sexual function questionnaires at baseline and 3 month intervals until
the hypogonadal men attained normal T levels.
Main Outcome Measures. Pre- and post-treatment SDI and sexual function questionnaires were
compared once T normalisation was achieved. Between and within group comparisons were
carried out.
Results. Pre-treatment hypogonadal men recorded lower levels of sexual desire and function than
controls, but significantly improved once hypogonadism was corrected. Eugonadal controls
recorded no significant changes in either sexual desire or function during the study. Partners of
the hypogonadal men reported no changes on the SDI, but significant improvements in sexual
function as their partners recovered.
Conclusion. This study provides patients and clinicians alike with a positive rationale for
treatment of hypogonadism – for the sake of the partner. In addition the findings highlight the
importance of involving and understanding partners in conditions where sexuality is affected,
such as hypogonadism.
Funding Source: Waikato Clinical School Summer Studentship funds
Understanding the Gender Dynamics of the Clark and Hatfield (1989) Casual Sex
Paradigm
Terri Conley, University of Michigan, 530 Church Street; Department of Psychology; University
of Michigan, Ann Arbor, MI 48109, conleyt@umich.edu
In a highly influential paper, Clark and Hatfield (1989) demonstrated that men were quite likely
to accept a casual sexual offer from a confederate research assistant (roughly 70% agreeing
across several studies); however, no women ever accepted such an offer in their research. The
current research provides a more in-depth examination of the dynamics surrounding this gender
difference. Using a person- perception paradigm, we assessed perceptions of women and men
who proposed a casual sexual encounter in the same manner that confederates in Clark and
Hatfield (1989) did. Women and men agreed that female proposers were less dangerous, more
intelligent, and more sexually skilled than men who made the same proposals. Men who made
such proposals were perceived as relatively sexually incompetent and inept. Therefore, the large
gender differences Clark and Hatfield observed in acceptance of the causal sex offer may have
more to do with characteristics of the female vs. male proposers than with gender differences
among Clark and Hatfield’s participants. Next, we assessed how women and men believed that
they would be perceived if they accepted sexual offer from a stranger. Women (in comparison to
men) thought that they would be perceived as more sexually desperate, unintelligent,
promiscuous, and mentally unstable if they accepted the offer. Third, we assessed factors
associated with likelihood of agreeing to a casual sex offer. The extent to which women and
men believed that the proposer would be sexually skilled/attentive predicted how likely they
would be to accept the casual sex offer. This was the only significant predictor of acceptance of
the offer (beyond gender). Factors suggested by sexual strategies theory (Buss & Schmitt, 1993)
to explain gender differences in sexual behaviors (such as the perceived status of the proposer,
the likelihood of successful reproduction with the proposer, the faithfulness of the proposer) did
not influence the likelihood participants’ agreement to a short-term relationship with the
proposer. Finally, we demonstrated that the large gender differences from the original Clark and
Hatfield study can be eliminated. These differences dissipated when we asked participants to
imagine proposals from (attractive and unattractive) famous individuals, or from an opposite sex
non-romantic friend. In addition, lesbians and gay men did not differ in their likelihood of
accepting a casual sex offer from someone of the same gender. These findings suggest that, for
women, comfort and familiarity with an individual may reduce concerns about safety and
increase their likelihood of accepting the sexual offer.
Funding Source: none
Female Sexual Dysfunction and Diabetes Mellitus Type 1: Current State-of-the-Art
Paul Enzlin, Institute for Family and Sexuality Studies, Catholic University Leuven, UH Leuven,
Campus St-Rafaël, Department of Psychiatry, Kapucijnenvoer 33 - blok i - bus 7001, B-3000
Leuven, Belgium, paul.enzlin@uzleuven.be
Diabetes is known to be a major cause of impaired sexual function. Especially men have shown
to have an increased risk of erectile and other sexual dysfunction. Although women with diabetes
have similar rates of cardiovascular and neurologic complications, sexual functioning of women
with diabetes has received far less attention in research.
In this presentation, the literature on sexual functioning in women with diabetes will be given
reviewed.
In a first part, we will shortly situate this lack of studies of female sexual functioning in its
historical context and review the reasons why the study of women has so lagged behind that of
men. Apart from these ‘contextual’ factors the small number of studies that has been performed
also had significant design and methodological drawbacks – e.g. small sample sizes, lack of
adequate characterization of the disease - particularly with regard to glycemic control,
neurovascular complications, psychological adjustment to diabetes - that hinder final
conclusions.
In a second part, we will give an overview of all the studies that have hitherto been performed in
this field and will show that women with diabetes (also) report a high prevalence of sexual
dysfunction and that studies yield a mixed pattern of sexual symptoms. In contrast to studies in
men, there is strong evidence that there is no association between sexual dysfunction and
diabetes related somatic factors; it has been suggested that female sexual dysfunction in diabetes
is more directly related to psychological factors, i.e. the presence of depression.
Funding Source: Catholic University Leuven
Subjectively and Objectively Measuring Pelvic Pain and Sexual Dysfunction in Men: CPPS
Sufferers are a Distinct Group
Davis, S. N., Binik, Y. M. & Carrier, S., McGill University, Department of Psychology, 1205 Dr.
Penfield Avenue, Montreal, QC H3A 1B1, Canada, seth.davis@mail.mcgill.ca
Background:
Chronic Pelvic Pain Syndrome (CPPS) is a common, yet poorly understood problem, affecting 510% of men (Clemens, Meenan, O'Keeffe Rosetti, Gao, & Calhoun, 2005; Collins et al., 2002).
Symptoms are a heterogeneous mixture of pelvic and genital pain, with a high prevalence of
sexual dysfunction, most often premature ejaculation and erectile dysfunction (Davis, Binik &
Carrier, 2009). Unfortunately, due to the wide variation in symptoms and unknown etiology,
treatment success is often limited at best. Future attempts to better classify CPPS will require
better subjective and objective measures of pain within the diagnosis of CPPS, and examination
of the effects of pain on sexual dysfunction. The purpose of this study was to examine subjective
reports of pain, and pain thresholds in comparison to healthy men, as well as to examine co
morbid sexual dysfunction.
Procedure:
As part of an ongoing study we compared 39 men with CPPS (aged 19-74) to 24 healthy men
(aged 19-66). All participants answered a variety of questionnaires examining pain, sexual and
relationship functioning, and other psychosocial measures. Each participant was also given a
structured interview about the pain they experience, including its location, intensity, descriptors
based on the McGill Pain Questionnaire, and what activities initiate or exacerbate the pain. We
then used a digital algesiometer to measure pain thresholds on various areas of the coccyx,
perineum, testicles, penis, and abdomen.
Results:
Compared with controls, men with CPPS had lower ejaculatory and erectile functioning. Sexual
satisfaction and relationship quality was not significantly different between the two groups. On
all other psychosocial measures (e.g. anxiety, pain catastrophizing) men with CPPS were less
healthy. On subjective ratings of pelvic pain location and intensity, men with CPPS also rated
significantly more pain. Finally, for every area in the pelvis and genitals, men with CPPS had
significantly lower pain thresholds.
Discussion:
Despite ejaculatory and erectile difficulties, men with CPPS do not experience reduced sexual
satisfaction or dyadic adjustment. Why this is so is not clear. Reduced sensory thresholds may
help to explain the pattern of sexual dysfunction as well as the experience of pain. Further
research will confirm these results with a view to understanding the mechanisms within CPPS so
as to provide treatment.
Funding Source: CIHR
Individual Differences in Female Orgasmic Responsiveness, Physiological and Anatomical
Characteristics: A Self-report Study
Lara Eschler and Melissa Hines, University of Cambridge, Darwin College, Silver Street,
Cambridge, UK CB3 9EU, lpe20@cam.ac.uk
Background: Individual variations in genital morphology (i.e. clitoral size or its location in relation to the
vaginal opening) of healthy women remain largely unexplored and there is little information on the
possible effects of these variations on orgasmic response. Variability in male physiological
characteristics (e.g. penis size, angle of erection, etc.) and/or sexual technique could also prove useful in
explaining female variation in coital orgasmic response but are also understudied. Aim: This study aimed
to better characterize normal variation in female orgasmic response considering both the contribution of
physiological factors and the adequacy of stimulation received during different sexual contexts. Methods:
74 women, (mean age=28.02, s.d.=5.07, 21-51), who reported having sex with men and having no history
of genital surgery, participated. Most women were regularly menstruating (87.7%). The study was
conducted as a self-administered survey. participants completed questions pertaining to demographics,
sexual behaviour, sexual desire (SDI, Spector, Carey and Steinberg, 1996), characteristics of previous
male sexual partners (angle of erection and penetration, penile dimensions, sexual technique), and the
SAGASF-F (Self-Assessment of Genital Anatomy and Sexual Function, Schober and Meyer-Bahlburg,
2008). This self-report measure consists of genital pictures and descriptions that allow females to selfassess the dimensions and location of their external genitalia. This instrument was supplemented by
questions on the occurrence and frequency of orgasm from different types of sexual activities (coital
versus non-coital and partner induced orgasm or self-induced). Participants also provided measures of the
length of their 2nd and 4th digits: (2D:4D, The ratio between the 2nd finger (index) and the 4th finger
(ring finger) which is thought to reflect pre-natal androgen exposure, e.g. Manning, 2002). Results: Most
women reported their clitoris to be ‘small and raised’ (67.6%) followed by ‘moderate sized raised’
(20.3%), ‘large, raised’ (6.8%), large and slightly long (4.1%) and 1.4% were unable to locate their
clitoris. Most women indicated their clitoris being ‘at the top of the labia’ (87.8%), followed by ‘Clitoris
is just below the pubic bone’ (6.8%), Clitoris is on the pubic bone’ (4.1%), 1.4% said ‘I cannot locate my
clitoris’. There was a significant negative correlation between left 2D:4D (but not right 2D:4D) and
clitoral size (Spearman’s Rho =-.206, p=.044). Coital orgasmic ability was significantly related to the size
of the clitoris (Spearman Rho =0.695, p<.000), as was the frequency of orgasm from coitus (Spearman’ s
Rho= .283, p<0.001). Clitoral size did not predict the frequency of orgasm from other types of sexual
activities including masturbation or the ability to reach orgasm during non-coital partnered sexual activity
and masturbation. The degree of direct clitoral stimulation during coitus was linked to the likelihood of
orgasm during coital sex (Rho=.228, p<0.05). Clitoral location closer to the vaginal opening was
significantly related to coital orgasmic ease (Spearman Rho=.280, p<0.05). Size and location of the inner
and outer lips did not predict orgasmic ease. Contrary to prediction, reporting visible clitoral engorgement
during arousal was not correlated to ease of orgasm. Sexual desire was not linked to coital orgasmic ease
or to frequency of orgasm from coital versus non-coital sexual activities. None of the reported partner‘s
physiological characteristics such as penile length, penile shape, and angle of erection were associated
with self-reported orgasmic ease. Penile girth was mildly correlated to female coital orgasmic ease but the
correlation failed to reach significance (Rho=.16, p=.09). Conclusion: These results suggest that
individual differences in sexual anatomy might be implicated in differences in coital orgasmic ease. They
also suggest that hormones acting prenatally may influence clitoral size among women in the general
population, and perhaps coital orgasmic ease as well. The findings add to our understanding of normal
orgasmic response in women and highlight the need to have a better understanding of the anatomical and
physiological factors, (e.g. clitoral size and position, hormonal influences during early development), as
well as psychological and contextual factors, implicated in women’s orgasm.
Sexual Re-Pleasuring: Male Substance Users and Abusers Working Sexual Pleasure as
Relapse Prevention While Living in a Therapeutic Community
Jesús Estrada, Independent Practice, WW 31 21st Street, Urb. Caná, Bayamón, PR 00957,
drjestrada@hotmail.com
Some drug users or abusers use illicit drugs as way to reach sexual enhancement. Rehabilitation
is a lifelong process to prevent relapse. To prevent relapse via sex the drug rehabilitation
participants might live the experience that sex per se (free of illicit drugs) can be pleasurable, and
that they may find and create their own drug free sexual enhancement situations. This work
stresses on how a small male substance use and abuse group living in a therapeutic community is
empowered through sex education, counseling and therapy to experience new ways of sexual
enhancement so they may be able to be drug free on sexual encounters once they resume their
life out of the therapeutic community, and, consequently, be able to see sex as a relapse
prevention strategy. The process is divided into four phases: a) Playful Integration Phase
devoted to build trust and group integration. It works Mourier/Herriot’s sexual archetypes and
PLISSIT’s Permission modality to work and explore new sexual patterns; b) Socialization and
Sexuality Phase to work their culture’s view of male sexuality, and Ira Reis’ concept of social
scripts; c) Physiological/Psychological Phase to work the physiology of sex either on drugs or
not, Masters and Johnson’s ejaculatory control, the psychology of sex, and Zilbergeld’s
conditions for good sex concept to get participants to know which conditions fit their sexual
needs the best; d) Enrichment/Sensory Phase which works The Institute for the Advanced Study
of Human Sexuality’s (IASHS) Sexual Enrichment and Education program and the Sensorium
sexological program to experience new, drug-free levels of sexual sensations. It also applies
Carol Well’s guided imagery and sexual creativity exercises along with PLISSIT’s Permission.
In a Rogerian sense the program aims to give participants an unconditional acceptance space that
let them realize what sexual activities/situations enhance sexual sensation and pleasure for them
so they may feel empowered to not choose illicit substances as sexual enhancers.
Funding Source: No funding sources.
Innocent Crimes: Changes in Attitudes Toward Child Nudity and Adult Genitals in the
Puerto Rican Culture After the Industrialization Era
Jesús Estrada, Independent Practice, WW 31 21st Street, Urb. Caná, Bayamón, PR 00957,
drjestrada@hotmail.com
By the middle of the 20th century the Island of Puerto Rico underwent a huge economical
change that turn it from an agrarian into an industrialized culture bringing also major changes in
the Island’s social structures. Before the Industrialization Era child nudity was commonplace for
a Puerto Rican as it was commonplace to man to stop halfway in his route to town and publicly
expose his genitals to urinate in front of a tree at a rural way or at the town’s square itself, rarely
experiencing any viewer’s discomfort (seeing no indecent exposure). It was quite common as to
see a mother publicly breastfeeding her baby without concealing her breast. Nowadays, for a
man to expose his genitals to urinate as it used to be in the past is completely banned, and in
regard to women baby breastfeeding, this should be done privately. Today many of them feel
either shame for expose a private part, or express fear of being discriminated, harassed or even
stigmatized as immoral, indecent women. Some breastfeeding women have even been expelled
from stores as others have been accused of child pornography for taking pictures of them while
breastfeeding. Concerning child nudity and child genitals, once the Island’s industrialization
began, American anthropologists visited the Island to make field studies (e.g., Julian H. Steward
et al. (1956), The people of Puerto Rico. A study on social anthropology. Chicago University
Press: Urbana Chicago) and found what was the norm: boys were “permitted to wear only their
little shirts and nothing more” (Mintz 1956, pp. 384), and it was “common practice to stimulate
the child erotically by fondling or kissing his genitals” (Manners 1956, pp. 146), and not only
parents, but friends also “will often fondle boys’ genitals to tease them or to placate them”
(Mintz 1956, pp. 384). Those were cultural accepted practices that represented no moral or legal
concerns. Notwithstanding, to do that today and one would be charged with child sexual abuse. I
theorized and wanted explore via research review, interviews, historic documentation review, a
survey, and testimonials the following: a) to explore how for the Puerto Rican men and women
the exposure of the male genitals and the female breasts primarily entailed not indecent exposure
but the simple and natural expression of human physiological needs; b) that an adult fondling or
kissing a boys genitals was a mere manifestation of adult affection toward and a way to pamper
the child instead of a form of child sexual abuse as it is seen today; c) to explore both our Puerto
Rican attitudes toward child sex as it was then (as adequate) and as it is now (as child sexual
abuse), and our cultural attitude toward breastfeeding and genital concealment in relation to a
process of acculturation brought through the above mentioned industrialization; d) and finally,
to theorize about how sex per se, and the absence of human restraints on it, would work as a tool
that may help us in our human, natural process of becoming an actualized human being.
Funding source: none
Paraphilic Behaviors Among Gay Men in Puerto Rico
Edward H. Fankhanel, American Academy Clinical Sexologists, 134 Zambeze St. RPH San
Juan, Puerto Rico 00926, Fankhanel@prtc.net
This study was design to gather basic descriptive data about paraphilic behaviors among gay men
in Puerto Rico and the relationship of such behaviors with their mental and emotional state.
Participants (N = 429) were recruited by availability at gay men socializing venues and events
across the entire island of Puerto Rico. As such, results cannot be generalized to the entire gay
men population of Puerto Rico. The results reflect that, the DSM-IV-TR paraphilias most
reported by the participants were Voyeurism and Exhibitionism. The most reported least
common sexual fantasies, desires and/or behaviors were observing erotic pictures and partialism.
Other DSM-IV-TR specific paraphilias, along with sexual fantasies, desires, and/or behaviors
that could be considered under Paraphilias NOS, were also reported by some participants.
However, the design of the study did not allow differentiating between participants that only
fantasized such paraphilias, versus those that have sexual desires and/or act out such behaviors.
Over 90% of the participants reported good self esteem and stable mental and emotional health at
the time of the study. Additionally, two-thirds of the participants aver feeling good during the
experience of a less common sexual fantasy, desire, and/or behavior; feeling that remains, for the
most part, after such fantasies, desires, and/or behaviors have culminated. Moreover, participants
tend to view these fantasies, desires, and/or behaviors as normal. In general, participants do not
seek help for these behaviors, however, those who did seek help for their less-common sexual
fantasies, desires, and/or behaviors chose gay friends as the first alternative, while psychologists
were the professionals of choice, reporting self-acceptance as the main need for help. The results
suggest that gay men in Puerto Rico, who report a less-common sexual fantasy, desire, and/or
behavior, enjoy stable mental and emotional health. Therefore, further studies should address
specific differences between paraphilic fantasies versus behaviors and how these differences may
be utilized when determining diagnostic criterion in the upcoming DSM-V.
Funding Source: Doctoral Dissertation - No funding source
“Not Tonight, dear”: Sex Differences in Decreased Sexual Behavior During Genital and
Non-genital Pain
Melissa A. Farmer, Lindsay J. Chan, Emily Foxen-Craft, Julian Becher, Yitzchak M. Binik,
James G. Pfaus, & Jeffrey S. Mogil, McGill University, Department of Psychology, 1205 Dr.
Penfield Avenue, Montreal, QC H3A 1B1, Canada, Melissa.Farmer@mail.mcgill.ca
Pain is thought to impact diverse motivational states in humans and rodents. The relationship
between pain and sexual motivation remains largely unexplored, despite the frequent
comorbidity between clinical pain conditions and impaired sexual desire. Vaginocervical
stimulation- and copulation-induced analgesia indicate a physiological interaction between
sexual activity and the experience of pain. Our study objectives were to a) assess the negative
impact of tonic, inflammatory pain on sexual motivation, b) compare the sexual impact of genital
versus non-genital pain, c) determine possible sex differences in pain-influenced sexual
behavior, and d) use paced mating versus open field sexual behavior paradigms in mice to
discern differences in male versus female sexual motivation. We compared male and
hormonally primed female mice experiencing genital (vulvar or penile) or non-genital (dorsal
aspect of hindpaw) pain with respective saline controls and a no treatment control group. For
pain groups, genital or non-genital zymosan (0.5 mg/ml in 10 µL volume) injections were given
4 h before sexual behavior testing so that the peak of zymosan-induced hypersensitivity
corresponded with the beginning of testing. Behaviors associated with female sexual motivation
were observed using a partitioned mating chamber, which allowed the female to control the rate
of sexual activity by confining the pain-free male to one side and providing female-sized escape
holes leading to a chamber inaccessible to the male. Behaviors for male sexual motivation were
obtained using an open field test, where the male had constant access to a pain-free, sexually
receptive female. Results indicate that genital pain reduces sexual behavior in both sexes.
However, female sexual behavior is equivalently reduced by hindpaw pain, whereas male sexual
behavior remains unaltered, despite evidence that males and females show comparable levels of
zymosan-induced hindpaw hypersensitivity. The negative impact of pain on sexual behavior is
an intuitive relationship that has not previously been demonstrated experimentally. The sex
difference in sexual behavior secondary to non-genital pain points to the robustness of male
sexual motivation and/or the context-sensitive nature of female sexual motivation. Evolutionary
theory supports both interpretations, given that male reproductive success would be maximized if
sexual motivation was resilient to distractions (such as physical injury). In contrast, female
sexual motivation—defined by selectivity of mates, resources, and context—would be more
vulnerable to factors that disrupt sexual response.
Funding Source: National Vulvodynia Association
Multi-Prong Approaches to Strengthening Internet Child Safety
J. Paul Fedoroff, Robert Prentky, Ann Burgess, Elizabeth Dowdell, & Neil Malamuth, University
of Ottawa Institute of Mental Health Research, Royal Ottawa HCC/1145 Carling Avenue/Ottawa
Ontario CANADA K1Z 7K4, PaulBev@mac.com
This poster presentation reports on preliminary findings from a three-year research project to
explore multiple facets of child sexual victimization via the Internet. Using three parallel
versions of a questionnaire, we gathered response data from participants in three sample
domains: high school students, college students, and adult offenders.
The threat posed by offenders who use the Internet as a vehicle for victimizing children and
adolescents is an issue that continues to demand empirical research. Extant research on Internet
sexual offenders has failed to provide useful taxonomic differentiation, thereby undermining
informed assessments of risk, as well as our ability to design more effective primary prevention
strategies and secondary interventions.
Data were collected on a diverse sample of offenders from a variety of settings, including prisons
and outpatient treatment programs. Included in our sample were offenders charged or arrested
with an Internet sexual offense, which was the primary targeted group (n = 128). A second
group consisted of offenders who had access to the Internet but whose known sex offenses were
non-Internet related (n = 226). A third group included offenders with only non-sexual offenses (n
= 51). The information provided by these groups focused on critical antecedent life events,
indices of social competence, history and patterns of criminal behavior, exposure to, and use of
adult and child pornography, Internet familiarity and frequency, sexual attitudes and beliefs and
current treatment interventions. We also gathered data on a sample of college students (n = 1108)
to: (1) examine Internet use, technological knowledge of the Internet and exposure to
pornographic images via the Internet, and (2) examine antecedent life events, exposure to sexual
materials, antisocial behaviors and attitudes about social relationships. We gathered parallel data
on a high school sample (n = 926) to better understand how some children and adolescents fall
prey to Internet offenders. We surveyed their knowledge and experience with Internet safety
programs and filters, Internet risk behaviors, health behaviors such as drug/alcohol use and
exposure to a wide range of violence and wanted and unwanted sexual experiences on the
Internet. Similar information was collected on middle school students during the initial phase of
the project. The overall objective of this project is to employ a cross-sectional strategy,
beginning with middle school students, high school students, college students, and eventually
adult offenders, to better understand the backgrounds, the evolution and the motives that drive
Internet sexual offenders. For the purposes of this poster presentation we will report only on the
offender population and present some interesting, theoretically meaningful differences between
these offender groups that establish the Internet offenders as a “unique” subset of offenders.
Funding Source: United States Department of Justice, Office of Juvenile Delinquency and
Prevention (#2006-JW-BX-K069)
Empirical Research on Risks from Studies on Sexuality and Other Sensitive Topics: What
We Don’t Know May Be Hurting Us
Michael Fendrich, University of Wisconsin-Milwaukee, Enderis Hall Room 1191 P.O. Box 786
Milwaukee, Wisconsin 53201, fendrich@uwm.edu
This presentation will begin by summarizing several empirical studies evaluating potential
“psychological harms” to participants resulting from their involvement in research focused on
sexuality, drug use, and violence. There is a lack of research addressing this topic and
conclusions presented here should be regarded as preliminary. While substantial minorities of
subjects may typically report discomfort when asked about their reaction to answering questions
about sensitive topics, research does not support the notion that questions about sexuality, drug
use and violence are upsetting to most respondents. The presentation will also discuss a 2005
APA IRB survey of psychologists who were recipients of NIH grants, with particular emphasis
on 1) findings relating to investigator “self-censorship” and research plan modification in
reaction to IRB concerns; and 2) findings relating to investigator knowledge about regulatory
requirements pertaining to IRBs. Implications for future research and the persistent need for
strengthening collaborative efforts between IRBs and researchers are discussed.
Funding Source: NIDA R01DA018625
Do Good Values Make Bad Science?
William Fisher, University of Western Ontario, London Ontario Canada, fisher@uwo.ca
This presentation considers the potential animating—and biasing—effects of the values that
often inspire our commitment to sexual science. Examination of research traditions in the areas
of HIV/AIDS prevention, effects of pornography on behavior, and models of female sexual
response make compelling cases that exemplary values very often make for bad science.
Discussion concludes with a call for sexual scientists to assert our values strongly, and collect
our data carefully, and to do so on separate, parallel tracks, to the extent possible.
Funding Source: US National Institute of Mental Health
Cross-Cultural Evidence that Separation Anxiety is Linked to Male Androphilia
Laura M. Gothreau, Doug P. VanderLaan, Nancy H. Bartlett, Paul L. Vasey, University of
Lethbridge, Department of Psychology, 4401 University Drive, Lethbridge, Alberta, Canada,
T1K 3M4, E-mail: laura.gothreau@uleth.ca
Separation anxiety during childhood (i.e., anxiety in response to separation from significant
attachment figures) occurs more often among girls than boys. However, boys who exhibit
extreme feminine behavior exhibit elevated separation anxiety during childhood. Such boys have
a greater than average chance of being androphilic (i.e., sexually attracted/aroused by adult
males) in adulthood. Given that male androphilia is associated with certain types of femaletypical psychology and behavior (e.g., childhood play behavior), we hypothesized that male
androphilia, as opposed to male femininity, per se, is associated with elevated separation anxiety
during childhood. We examined sex and sexual orientation differences in retrospective reports of
childhood separation anxiety in two cultures, Canada (N = 399) and Samoa (N = 444). Canadian
participants included 105 androphilic males, 88 gynephilic (i.e., sexual attraction/arousal to adult
females) males, 111 androphilic females, and 95 gynephilic females. Canadian participants were
recruited from Gay, Lesbian, Bisexual and Transsexual Community Organizations, sports teams,
and university organizations across Canada. Samoan participants included 170 gynephilic males,
123 androphilic females, and 151 fa’afafine (i.e., transgendered, androphilic males). Participants
reported the level of distress experienced from ages 6 to 12, inclusive, in response to each of the
items used in the DSM-IV-TR to diagnose Separation Anxiety Disorder. In both cultures,
females reported elevated separation anxiety during childhood compared to gynephilic males,
and androphilic males showed a more female-typical pattern. These results suggest male sexual
orientation is associated with separation anxiety during childhood, and that this association is
cross-culturally universal.
Funding Source: University of Lethbridge and the Natural Sciences and Engineering Research
Council of Canada (NSERC)
Factors Influencing HIV Risk and Preventive Behavior among MSM Vacationing in GayFriendly Tourist Destinations
Marisa Green, Anna Cejka, Eric G. Benotsch, & David W. Seal, Jean Redmann, Josh Fegley,
Derrick Traylor, Salvatore Seeley, Laura Bogart, & Steven D. Pinkerton, Department of
Psychology, University of Colorado Denver, 1585 Osage Trail Brookfield WI 53005,
dseal@mcw.edu
Background. A growing body of research has documented increased substance use and highrisk sexual behavior among young, heterosexual adults vacationing in tourist areas. Less research
has been conducted with men who have sex with men (MSM) who visit gay-friendly tourist
areas. Although studies have documented increased HIV risk behavior among MSM tourists,
relatively little is known about the psychosocial correlates of such behaviors. If effective
interventions are to be developed for MSM leisure travelers, more information is needed about
their motivations for travel, intentions to seek new sexual partners while on vacation, perceptions
of vulnerability to HIV during travel, self-efficacy for engaging in HIV preventive behaviors
while traveling, and other contextual and individual factors related to risk behaviors associated
with leisure travel.
Methods. Semi-structured qualitative interviews were conducted with 45 MSM recruited
from one of three popular gay tourist destinations. We present data summarizing men's
perceptions of HIV risk and preventive behavior and correlates while vacationing in gay-friendly
tourist areas.
Results. MSM indicated that the anonymity of the tourist sites, combined with the frequent
and often heavy substance use, enticed men to "let go," relax and escape, fulfill sexual fantasies,
and engage in risk behavior they otherwise would not practice (e.g., unprotected anal intercourse,
orgies). This theme was observed not only at an individual-level, but also a couples-level. That
is, respondents indicated that some couples who vacationed together relaxed boundaries on
monogamy that they otherwise upheld at home (e.g., actively sought threesomes, allowed sexual
behavior with other partners). Men also cited the sexually-charged nature of many vacation sites
and the saliency of physically attractive partners seeking sex. Although sexually stimulating,
these same factors were perceived to impede safer sex communication and practice due to the
lack of familiarity between partners and the knowledge that sexual relationships would not be
sustained beyond the trip. MSM said that men who protected themselves while visiting tourist
sites were people who held strong beliefs and values about consistent condom use and had
efficacy to enact this behavior. Such men were perceived to be open about their intent to practice
safer sex early in conversation with potential sex partners. Peer or environmental (e.g., condoms
in hotel rooms) support for safer sex were also perceived to be important preventive factors,
although many men noted a lack of safer sex promotion and advertisement within tourist sites.
Implications. Many MSM who engage in high-risk sexual behavior while vacationing in
tourist sites reside in low HIV prevalence cities. To the extent that some of these men contract
HIV or other STIs while on vacation, there may be an epidemiologically-important “bridge”
group that inadvertently facilitates the dissemination of HIV/STIs to areas not widely affected by
infectious disease. Effective interventions are needed to increase and support safer sex behavior
among MSM leisure travelers.
Funding Source: NIMH
Sexual Compulsivity and Co-Occurring Psychosocial Health Problems in a CommunityBased Sample of Gay and Bisexual Men: Further Evidence of a Syndemic
Christian Grov, PhD, MPh, Sarit A. Golub, PhD, MPH, & Jeffrey T. Parsons, PhD, Brooklyn
College of the City University of New York and Hunter College's Center for HIV/AIDS
Educational Studies and Training, 250 West 26th Street, Suite 300, New York, NY. 10011,
cgrov@brooklyn.cuny.edu
Introduction: The term “syndemic” describes multiple epidemics and risk factors interacting with
each other, often developing under conditions of health and social disparity (typically within
marginalized social groups). Taken together, these multiple epidemics/risk factors synergistically
compound the consequences of disease. The syndemic framework has been applied to HIV risk
among men who have sex with men (MSM), supporting the concept that a syndemic of health
and psychosocial conditions contribute to HIV-related risk among MSM. In tandem, researchers
have consistently connected sexual compulsivity (SC) to high-risk sexual behavior, in addition to
a host of negative psychosocial health outcomes. Yet, this has not been investigated within the
framework of a syndemic.
Method: Data are taken from the 2003 Sex and Love Study, a community-based sample of gay
and bisexual men in New York and Los Angeles (n = 669). Consistent with prior syndemic
studies with MSM, participants completed measures for polydrug use (3+ drugs < 90 days),
depression (CES-D), partner violence, and childhood sexual abuse. Additionally, participants
completed measures for sexual compulsivity, high risk sex, and demographic characteristics.
Results: We found strong positive interrelationships among syndemic factors including SC,
depression, childhood sexual abuse, intimate partner violence, and polydrug use. Hold for
childhood sexual abuse, syndemic health outcomes were all significantly and positively related
to HIV seropositivity and high risk sex. In a series of multivariate models using the four
syndemic factors to predict the fifth (adjusting for demographic characteristics), combinations of
at least two other psychosocial health conditions appeared as independent correlates. Finally, we
found amplified effects of the five psychosocial health outcomes (i.e., experiencing none, one,
two, or three+ syndemic factors) to predict HIV seropositivity and likelihood of engaging in
high-risk sexual behavior.
Conclusion: A syndemics framework highlights the need to understand multiple risk factors in
tandem with each other. Our data provide further evidence in support of a syndemics framework
for HIV risk among MSM. In addition, it suggests SC may be an additional component of this
theory. Data highlight that interventions seeking to reduce HIV transmission need consider
overlapping and compounding effects of other negative psychosocial health outcomes.
Funding Source: Center for HIV/AIDS Educational Studies and Training (CHEST)
Neurocognitive Deficits and Daily Diary Evaluations in MSM with Sexual Compulsivity
and MSM Without Sexual Compulsivity
Christian Grov and Jeffrey Parsons, Brooklyn College of the City University of New York and
Hunter College's Center for HIV/AIDS Educational Studies and Training, 250 West 26th Street,
Suite 300, New York, NY. 10011, cgrov@brooklyn.cuny.edu
Researchers have consistently identified a strong link between sexual compulsivity (SC) and
risky sexual behavior in a variety of populations, particularly among men who have sex with
men (MSM). Most studies compare SC MSM with other MSM without controlling for general
rates of sexual behavior or numbers of partners. Our research suggests that there are significant
numbers of MSM who are behaviorally similar to SC MSM (i.e. they have equivalent numbers
of sexual partners and engage in sexual behaviors with equivalent frequency), but are
psychologically very different from SC MSM (i.e. they do not report distress about their sexual
behavior, loss of control, or that their sexual behavior interferes with their personal and
professional lives). These men – highly sexually active, but non-SC MSM – can provide a
critical window into the mechanisms by which SC is associated with greater risk for HIV. Data
were taken from the Pillow Talk Project, a pilot study conducted in 2008-09 with 50 highly
sexually active (9 or more male sex partners in the past 90 days) MSM, of which 50% displayed
SC symptoms and 50% did not). Men completed a daily diary online for 30 days in addition to a
battery of neurocognitive tests to assess for impaired decision-making and impulsivity. SC and
non-SC participants did not significantly differ in the number of male sex partners in the last 90
days (i.e., men’s elevated SCS scores were not due to the frequency of sex partners.)
Nevertheless, SC men were significantly higher on several risky sexual behavioral outcomes
with male partners. In total, 86% (n = 43) of participants demonstrated consistent adherence to
the daily diary, completing a mean of 24.40 days (SD=5.97), median = 27 days. There were no
between-group differences on number of diary days completed. We conducted HLM analyses
inputting daily affect (Level 1) and sexual compulsivity (Level 2) to predict sexual behavior
outcomes. Overall, negative activation (characterized by emotions such as fear, sadness, anger,
and disgust) reduced sexual risk behavior, but less so among SC MSM. Scores on the
neurocognitive assessments were normally distributed (skewness within ± 2.5 SE), indicating
sufficient variance to detect differences both between and within SC cohorts. Analyses suggest
different patterns of the relationship between neurocognitive factors and SC scores for SC and
non-SC MSM. Among SC MSM, SC scores were marginally correlated with: a) hypersensitivity
to reward (r = .38, p < .09); b) insensitivity to future consequences (r = .38, p < .09); and c)
deficits in cognitive flexibility (r =.44, p < .07). This pattern of association was not observed
among non-SC MSM. Our data highlight that affective factors (captured within individuals using
daily diaries) and neurocognitive deficits may play differential roles in explaining the behaviors
of SC and non-SC MSM. In further developing preventative interventions targeted toward MSM,
these data suggest the need to further explore resilience and protective factors that differentiate
highly sexually active men who do not experience SC from highly sexually active MSM who do.
Funding Source: Center for HIV Educational Studies and Training
Differences in Brain Activity Between Monogamous and Non Monogamous Men
Lisa Hamilton & Cindy Meston, University of Texas at Austin, Department of Psychology, 1
University Station A8000, University of Texas at Austin, Austin, TX 78712, USA,
lisadawn462@gmail.com
Although research on pair-bonding and mating reveals that monogamy is rare and occurs in only
3% of non-human mammals (Kleinman, 1977), modern western society strongly promotes
monogamy as the social norm. Within our society, people exhibit a spectrum of monogamous
and nonmonogamous behaviors. The animal model for monogamy and promiscuity compares the
closely related montane vole and prairie vole. The prairie vole is socially monogamous, and
males and females form long lasting pair bonds, share nests, and rear their offspring together.
The montane vole does not form pair bonds and mates freely with many partners (reviewed in
Carter, DeVries, & Getz, 1995). Multiple brain areas in the dopamine-reward pathway and the
limbic system have been identified as playing a role in the monogamous and promiscuous
behaviors of the voles. The goal of the present study was to examine the neural differences
between monogamous and nonmonogamous men in response to neutral, romantic, and sexual
pictures. Ten monogamous and ten nonmonogamous age-matched men participated in a blockdesign function magnetic resonance imaging (fMRI) study. Data were acquired with a 3T GE
scanner and analyzed using FSL. Preliminary results showed that overall, participants had more
subcortical, reward-related activation to the sexual pictures, and more cortical activation for the
romantic pictures when compared to the neutral pictures. Analyses of group differences revealed
that monogamous men showed higher levels of reward-related activation in response to the
romantic pictures compared to the nonmonogamous men. In response to sexual pictures,
monogamous men showed more sensory and motor cortex activation, while nonmonogamous
men showed more inferior temporal and medial occipital activation. These findings suggest that
there may be differences in the way monogamous and nonmonogamous men process stimuli
related to sex and relationships.
Associated Risk Factors for Recreational Use of Erectile Dysfunction Medications in Male
Undergraduates in the United States: A National Study
Christopher B. Harte & Cindy M. Meston, University of Texas at Austin, Department of
Psychology, 1 University Station A8000, University of Texas at Austin, Austin, TX 78712,
USA, charte@mail.utexas.edu
Introduction: There are 3 FDA approved medications to treat erectile dysfunction (ED) (Viagra,
Cialis, Levitra) and these are all well tolerated and effective. A growing body of literature
indicates that these erectile dysfunction medications (EDMs) are being used recreationally by
men without a medical indication. This has raised concern particularly with respect to EDM use
and its association with increased sexual risk behavior, and concomitant illicit drug use, some of
which are medically contraindicated by EDMs. The aim of the present study was to investigate
the associated risk factors of recreational EDM use among a nationally representative sample of
college men.
Methods: 1,944 men (M = 21.3 years) were recruited from 497 undergraduate institutions within
the Unites States between January 2006 and May 2007. Participants completed an anonymous
online survey that assessed EDM use, as well substance use, sexual behavior characteristics, and
demographic characteristics. Bivariate and multivariate logistic regression analyses examined
correlates of recreational EDM use.
Results: On the univariate analyses, EDM use was found to be associated with age, sexual
orientation, number of drug use occasions, number of different drug types used, number of
instances drunk, number of sex partners (prior month, lifetime), number of one-night stands, STI
status, erectile functioning, and risky sexual behaviors such as unprotected receptive and
penetrative anal intercourse, and unprotected vaginal intercourse. After controlling for these
statistically significant correlates, multivariate analyses indicated that significant independent
risk factors for recreational EDM use were: increased age (AOR = 2.73; 95% CI = 1.59-4.70),
non-heterosexual sexual identity (gay: AOR = 2.83; 95% CI = 1.54-5.18; bisexual: AOR = 3.46;
95% CI = 1.11-10.86), and >50 drug use occasions during the past year (AOR = 3.23; 95% CI =
1.27-8.23). Number of drug types used during the past year showed a dose response with those
using 2-4 drug types and those using >4 drug types exhibiting AORs of 4.23 (95% CI = 2.108.53) and 4.41 (95% CI = 1.77-11.01), respectively. Other independent risk factors for
recreational EDM use were >50 lifetime sex partners (AOR = 9.99; 95% CI = 3.16-31.54);
number of one-night stands also displayed a dose response with men reporting 1-5 and >5 onenight stands having AORs of 3.10 (95% CI = 1.39-3.25) and 7.25 (95% CI = 2.93-17.92),
respectively.
Conclusions: Data from this national cross-sectional sample of college men in the Unites States
demonstrate that recreational EDM use is associated with a variety of sexual risk behaviors and
substance abuse. Although more prospective studies are needed, these results have implications
for assisting researchers, healthcare providers, educators, and regulatory bodies on the trends and
dangers of recreational EDM use.
Funding Source: This study was supported by Grant 5 RO1 AT00224-02 from the National
Center for Complementary and Alternative Medicine
Recreational Use of Erectile Dysfunction Medications in Undergraduate Men in the United
States: Descriptive Characteristics
Christopher B. Harte & Cindy M. Meston, University of Texas at Austin, Department of
Psychology, 1 University Station A8000, University of Texas at Austin, Austin, TX 78712,
USA, charte@mail.utexas.edu
Introduction: Mounting evidence indicates that erectile dysfunction medications (EDMs) have
become increasingly used as a sexual enhancement aid among men without a medical indication.
Recreational EDM use is a rising public health concern because of its association with sexual
risk taking behaviors and illicit drug use. The vast majority of studies have sampled from highrisk populations, (such as patients at STI/HIV clinics, and men who have sex with men (MSM)
attending sex-related venues) and therefore little data is available regarding EDM use among
relatively lower risk men. Additionally, the preponderance of studies has used relatively small
convenience samples recruited from specific geographic locales, which has limited the
generalizability of these findings. The aim of the present study was to investigate the prevalence
and descriptive characteristics of recreational EDM use among a geographically diverse sample
of young men. Methods: A cross-sectional sample of 1,944 men (M = 21.3 years; SD = .09)
were recruited from 497 undergraduate institutions within the Unites States between January
2006 and May 2007. The online survey assessed patterns of EDM use, as well as demographic,
substance use, and sexual behavior characteristics. Results: The majority (86%) of respondents
identified as being heterosexual with 12% and 2% identifying as gay and bisexual, respectively.
Four percent of respondents had recreationally used an EDM at some point in their lives, with
1.4% reporting current use. Viagra was the most commonly used EDM (89%), compared to
Cialis (24%) and Levitra (23%). The most common motive for initial use was curiosity (75%),
followed by the aim to counteract substances that decrease erectile functioning (29%). The
primary reason for current use was to increase erectile rigidity (24%). Forty-four percent of men
reported that they have combined substances with an EDM, the most common of which were
marijuana (61%), alcohol (46%), ecstasy (42%), methamphetamines (36%), and cocaine (30%).
Of men who reported mixing EDMs with illicit drugs, a substantial proportion reported doing so
during sexual activity. The majority of recreational EDM users also reported engaging in
unprotected sex with a partner of serodiscordant or unknown HIV status. Conclusions: A sizable
portion of undergraduate men recreationally use EDMs. These data are in line with the growing
body of literature supporting the link between recreational EDM use and risky sexual behaviors
and/or illicit drug use in samples of male high-risk populations. Results of this study suggest that
recreational EDM use is prevalent in heterosexual men and that recreational use does not solely
occur within and surrounding venues that cater to MSM. It is our hope that the results of this
study may be used as mounting evidence to inform researchers, healthcare providers, educators,
and regulatory bodies on the trends and dangers of recreational EDM use.
Funding Source: This study was supported by Grant 5 RO1 AT00224-02 from the National
Center for Complementary and Alternative Medicine
The Hamburg Model of Couple Therapy in the Treatment of Sexual Dysfunctions: New
Empirical Data
Margret Hauch, Institut für Sexualforschung University Clinic Hamburg, Martinistr.52, 20249
Hamburg Germany, hauch@uke.uni-hamburg.de
The Hamburg Model of Couple Therapy is a treatment format developed at the Department of
Sexual Research at the Hamburg University Clinic, integrating traditional sex therapy elements
with psychodynamic and systemic approaches. 82 heterosexual couples with different sexual
dysfunctions have been treated at the Department of Sexology at the Hamburg University Clinic
in a special compact format comprising 3 weeks treatment with daily sessions. Questionnaires
focusing on change concerning sexual Functioning, sexual satisfaction and relationship quality
were filled in by the couples at the end of treatment and at two follow-up times that is after about
3 month and about 18 month. Furthermore the Therapist assessed the outcome along this
schedule. Selected Data on outcome and stability of results will be presented in the poster.
Funding Source: University Clinic Hamburg
Sexual Behaviors and Long-term Heterosexual Relationships Across Five Continents
Julia Heiman, J. Scott Long, Shawna N. Smith, William A. Fisher, Michael S. Sand and
Raymond C. Rosen, The Kinsey Institute at Indiana University; University of Western Ontario,
Canada; New England Research Institutes, USA, Kinsey Institute, Indiana University, Morrison
Hall 313, 1165 E. Third St., Bloomington, IN, USA 47408, jheiman@indiana.edu
Sexuality research focuses almost exclusively on individuals rather than couples, though ongoing
relationships are very important for most people and cultures and sexual activity often takes
place in a relationship context. The present study is the first to examine sexual and relationship
parameters of middle-aged and older couples in committed relationships of 1-51 years duration.
Survey research was conducted in Brazil, Japan, Germany, Spain and the U.S. targeting 200 men
40-70 and their female partners in each country. Key demographic, health, physical intimacy,
sexual behavior, sexual function and sexual history variables were used to model relationship
happiness and sexual satisfaction. Final total sample included 1,009 couples (2018 individuals),
median ages 55 (men) and 52 (women), and median relationship duration of 25 years.
Relationship satisfaction in men depended on health, physical intimacy, and sexual functioning,
while in women only sexual functioning variables was predictive of relationship satisfaction.
Models predicting sexual satisfaction included physical intimacy and sexual functioning
variables for both genders as well as health, more frequent recent sexual activity and fewer
lifetime partners for men. Longer relationship duration predicted increased levels of relationship
and sexual satisfaction for men. Women showed this pattern to a more pronounced degree in
predicting sexual satisfaction, with lower sexual satisfaction early and greater sexual satisfaction
later in comparison to the men’s levels. However, duration had a negative effect on women’s
relationship satisfaction during the relationship years 1-15, increasing after year 20 and
remaining significantly lower than men between relationship years 20 and 40. Within the longterm committed relationship context, there were significant gender differences in correlates of
sexual and relationship satisfaction, with sexual functioning a common predictor of both types of
satisfaction and physical intimacy being a more consistent and salient predictor for men.
Findings are discussed in terms of the value and limitations of a couple’s perspective and crossnational survey methods.
Funding Source: Bayer-Schering, Inc.
Prevalence and Characteristics of Vibrator Use by Women in the United States: Results
from a Nationally Representative Study
Debby Herbenick, Michael Reece, Stephanie Sanders, Brian Dodge, Annahita Ghassemi, & J.
Dennis Fortenberry, Center for Sexual Health Promotion, Indiana University, HPER 116, 1025
East Seventh Street, Bloomington, Indiana, 47405, mireece@indiana.edu
Introduction. Although vibrators are commonly recommended by clinicians as adjunct to
treatment for female sexual dysfunction, and for sexual enhancement, little is known about their
prevalence or correlates of use.
Aim. The aim of this study was to determine the lifetime and recent prevalence of women’s
vibrator use during masturbation and partnered sex, and the correlates of use related to
sociodemographic variables, health behaviors, and sexual function.
Methods. A nationally representative sample of 3,800 women aged 18–60 years were invited to
participate in a cross-sectional Internet-based survey; 2,056 (54.1%) participated.
Main Outcome Measures. The prevalence of vibrator use, the relationship between vibrator use
and physical and psychological well-being (as assessed by the Centers for Disease Control and
Prevention [CDC] Healthy Days measure) and health-promoting behaviors, the relationship
between vibrator use and women’s scores on the Female Sexual Function Index, and an
assessment of the frequency and severity of side effects potentially associated with vibrator use.
Results. The prevalence of women’s vibrator use was found to be 52.5% (95% CI 50.3–54.7%).
Vibrator users were significantly more likely to have had a gynecologic exam during the past
year (P < 0.001) and to have performed genital self-examination during the previous month (P <
0.001). Vibrator use was significantly related to several aspects of sexual function (i.e., desire,
arousal, lubrication, orgasm, pain, overall function) with recent vibrator users scoring higher on
most sexual function domains, indicating more positive sexual function. Most women (71.5%)
reported having never experienced genital symptoms associated with vibrator use. There were no
significant associations between vibrator use and participants’ scores on the CDC Healthy Days
Measures.
Conclusions. Vibrator use among women is common, associated with health-promoting
behaviors and positive sexual function, and rarely associated with side effects. Clinicians may
find these data useful in responding to patients’ sexual issues and recommending vibrator use to
improve sexual function. Further research on the relationships between vibrator use and sexual
health is warranted.
Funding Source: Church & Dwight Co., Inc.
Do We Know What They’re Telling Us? Diversity in Conceptualizations About Having
“Had Sex.”
Brandon J. Hill, Stephanie A. Sanders, William L. Yarber, Cynthia A. Graham, Richard A.
Crosby, & Robin R. Milhausen, The Kinsey Institute, Indiana University, 1165 East Third Street,
Morrison Hall 313, Bloomington, IN, 47405, USA, brjhill@indiana.edu
Background: Understanding the signification of the word “sex” has implications for both medical
research and clinical practice. Little is known about how older people define sex and how
situational qualifiers influence definitions across age groups. To our knowledge, this is the first
study of a representative sample to access attitudes about which sexual behaviors constitute
having “had sex” and to examine possible mediating factors (gender, age, giving/receiving
stimulation, male ejaculation, female orgasm, condom use, or brevity). Methods: A telephone
survey of English-speaking residents of Indiana (USA) using random-digit-dialing produced a
final sample of 204 men and 282 women (n=486) ranging in age from 18-96 years. Questions
accessed attitudes about manual-genital (MG), oral-genital (OG), penile-vaginal (PVI), and
penile-anal activities (PAI).
Results: There was no universal consensus on which behaviors constitute having “had sex.”
Greater than 90% counted PVI, but 1 in 5 said “no” to PAI, 3 in 10 said “no” to OG, and about
half counted MG. Fewer endorsed PVI with no male ejaculation (89.1%) compared to PVI
without a qualifier (94.8%, P<.001). MG was endorsed more often when received (48.1%) than
given (44.9%, P<.001). Among men, the oldest and youngest age groups were significantly less
likely to “count” certain behaviors as having “had sex.” Conclusions: These findings highlight
the necessity of using behaviorally specific terminology in sexual history taking, sex research,
sexual health promotion, and sexuality education. Researchers and medical practitioners should
exercise caution and not assume that their own definitions of having “had sex” are shared by
their research participants or patients.
“Field” Conditioning of Sexual Arousal in Humans
Hoffmann, H., Peterson, K., & Garner, H., Knox College, Galesburg, IL 61401,
hhoffman@knox.edu
Human sexual classical conditioning effects are less robust compared with those obtained in
other animals. This may be because of the artificiality of the laboratory environment and/or
because of the US used (e.g., watching erotic film clips as opposed to participating in sexual
activity). Although a field study is not as controlled as a laboratory experiment, it offers the
potential of a more appropriate context for experiencing sexual arousal and a more effective US
(i.e., partnered sexual interaction). Further, evaluative or affective learning (i.e., changes in
valence of stimuli) may be stronger in real world settings. Seven heterosexual couples were
instructed to include a novel, neutrally-rated scent (geranium or basil essential oil) as the
conditioned stimulus (CS+) during sexual interaction and the other novel scent (as the "CS-")
during nonsexual coupled-interaction (e.g., watching a movie, studying together). Odors were
ambient in the room (disbursed via aroma fans) and were placed on t-shirts worn by the female
partner. Seven control couples used both scents during nonsexual interaction. Conducted over a
two week period, both experimental and control couples had three sexual interactions (oral sex
and/or intercourse). In addition, experimental couples had three, while the controls had six, nonsexual interactions. Genital responding to and affective preference for the odors were assessed
in the lab before and after the experience in the men. We found evidence of conditioning using
both genital and affective measures. Specifically, we observed significantly increased genital
responding to the CS+ in the experimental relative to the control group however, conditioned
responses (CRs) were not much stronger than those obtained during laboratory conditioning.
One reason for the relatively weak learning may have been that the males, although instructed to
contact the experimenter as soon as they finished the study, did not return to the lab until several
days (up to 11) after completion. However there was no correlation between retention interval
and strength of the CR. Experimental males also showed a trend for increased preference for the
CS+ odor and there was a significant decrease in preference for the CS- odor. Although we did
not confirm that the CS- became a conditioned inhibitor, men may have learned that this odor
predicted that sexual interaction with their partner would not occur. The present study provides
another demonstration of conditioned sexual arousal in men, specifically an instance of such
learning that happened in a real world setting. It also suggests that inhibitory learning may
occur, at least with the affective measure. Exploring human sexual classical conditioning has
implications for enhancing learning based therapies used to alter problematic sexual responding.
Funding Source: Howard Hughes Medical Institute (HHMI)
Life-threatening Manifestations of Sexual Masochism: A “Disorder” Justifying
Therapeutic Concern and Preventive Strategies?
Steven Hucker, Box 10126 27 Legend Court, Ancaster, Ontario L9K-1P3, Canada,
Stephen.hucker@utoronto.ca
There have been a small number of studies of self-identified sadomasochists. These seem to
indicate that most of these individuals show little or no evidence of any other significant
psychopathology and are generally high functioning, otherwise well-adjusted people. In a small
proportion of them there is a suggestion that their sexual interests may be associated with earlier
life experiences. Absence of other mental symptoms, however, can be no impediment to the
characterization of certain BDSM practices as intrinsically mental disordered on other grounds.
There appear to be better reasons to regard this type of behaviour, at least in its most extreme
manifestations, as a “mental disorder”. Several examples of these types of severe behaviour will
be presented and discussed to justify this position.
Funding source: none
Intimate Surgery
Janackova, L. & Weiss, P., Institute of Sexology, Charles University, Apolinarska 4, 128 00
Prague 2, Czech Republic, weisspetr@volny.cz
The authors describe several psychological and sexological aspects of genital surgery in men and
in women. There are described the most common forms of genital surgical interventions (such as
labioplasty/labia reduction, penis enlargement etc.) as well as psychological aspects
of motivation for these medical interventions. Finally outlined the risky patients who tend to be
unsatisfied with the correction results.
Sexual and Marital Satisfaction in Newlywed Couples
Erick Janssen, Sarah Hahn, Julia Heiman, Amy Holtzworth-Munroe, Dennis Fortenberry, Eshkol
Rafaeli, and Uzma Rehman, The Kinsey Institute, Indiana University, Morrison Hall 313,
Bloomington, Indiana 47405-3700
Studies of heterosexual marriage have shown that low sexual satisfaction is among the strongest
predictors of marital instability, that sexual and overall well-being are inextricably linked, and
that sexuality-related problems (including sexual incompatibility and infidelity) are among the
most commonly cited reasons for divorce. Yet, little is known about how and for whom sexuality
contributes to marital problems or, conversely, how and for whom it may contribute to a longlasting and happy marriage. The presented research aims to examine a number of individual- and
dyadic-level sexual and nonsexual variables and to explore their joint impact on sexual and
marital satisfaction. The research is guided by a theoretical model that represents an integration
of processes and variables that have been identified as being important in the prediction of
marital satisfaction – including the role of affective processes, communication, and perceived
partner responsiveness (a construct related to intimacy) as well as sexual variables, including the
role of desire and individual differences in sexual excitation and inhibition. These variables, and
their interactions, are proposed to mediate and moderate the effects of life events and stressors on
sexual and marital satisfaction, and to be relevant to the prediction of changes in the two over
time. A first study that will be presented involves a sample of 35 first-time newlywed
heterosexual couples. The couples, married for an average of 9 months, were asked to complete
daily diaries for 30 days. The diaries were presented on smartphones and included questions
about mood, emotional closeness, perceived partner responsiveness, daily activities, arguments,
sexual desire and behavior, and sexual and marital satisfaction. Diary completion rates were
high, with fewer than 4% of diary days missing. Using SAS’ MIXED procedure, a series of
multilevel models examined predictors of day-to-day fluctuations in sexual desire, sexual
activity, and sexual and marital satisfaction.
A second study focuses more specifically on the associations among sexual and nonsexual
communication and sexual and marital satisfaction, in a small sample of 15 newlywed couples. A
number of studies on communication in marriage have found that the affective components of a
couple’s exchanges are important predictors of the course of marital satisfaction and stability. In
this type of research, communication is typically assessed using videotaped problem solving or
conflict discussions, and operationalized in terms of how partners exchange positive/negative,
approach/withdrawal, or supportive/hindering behaviors during such discussions. Most studies
using this paradigm let couples select topics themselves. Although sexuality can be such a topic,
spouses are usually allowed to veto a topic, and the vast majority of publications do not specify
how often sexual topics were proposed or vetoed. The presented study is, to our knowledge, the
first to explicitly ask couples to discuss both a sexual and nonsexual topic, allowing for the
comparison of the predictive value of couples’ sexual and nonsexual communication styles.
Funding Source: Faculty Research Support Program (FRSP), Indiana University
Riding a Heat Wave of Measurement: Establishing the Validity of Thermography as a
Physiological Measure of Sexual Arousal
Tuuli M. Kukkonen, Yitzchak M. Binik, Rhonda Amsel, & Serge Carrier, McGill University,
Department of Psychology, 1205 Dr. Penfield Avenue, Montreal, QC H3A 1B1, Canada,
kukkonen@ego.psych.mcgill.ca
Current physiological measures of sexual arousal are intrusive, hard to compare between
genders, quantitatively problematic and not clinically useful. Data from 3 studies examining the
reliability and validity of thermographic imaging provide support for this technology as a
solution to these problems. In the first two studies, 157 healthy participants (78 men, 79 women,
age range=18-45 years) viewed a neutral film clip after which they were assigned to view one of
four other videos: 1) neutral (n=39); 2) humor (n=39); 3) anxiety provoking (n=40); 4) sexually
explicit (n=40). Genital and thigh temperature were continuously recorded using a TSA ImagIR
thermographic camera. Subjective measures after each film, and a continuous recording of
subjective sexual arousal, provided indications of convergent validity. In a third study,
participants (N=40, age range = 18-45) viewed 3 different neutral and erotic films on three
separate sessions over three months while genital and thigh temperature were recorded. RM
ANOVAs followed by trend analyses on the data from the first two studies demonstrated that
both men and women viewing the sexually arousing film had significantly greater (p<.05) genital
temperature (m=33.36°C) than those in the humor (m=32.05°C), anxiety (m=32.02°C) or neutral
(m=32.03°C) conditions. Furthermore, genital temperature was significantly correlated with
subjective sexual arousal (range r=0.25-0.65, p<.05). There were no significant differences in
thigh temperature throughout testing, indicating that temperature increases during sexual arousal
were specific to the genitals. RM ANOVAs on the participants from the third study showed that
there were no significant differences in baseline genital temperature across the three testing
sessions, nor were there any differences in genital temperature between the three different erotic
films. Finally, there were no significant differences among the three erotic films regarding the
relationship between genital temperature and subjective sexual arousal. These results provide
evidence for the convergent and discriminant validity of thermal imaging as a measure of
physiological sexual arousal as well the reliability of genital temperature measurement. Current
research is examining thermography as a tool for the diagnosis and treatment evaluation of
sexual arousal difficulties.
Funding Source: FRSQ, CMSHC, Pfizer, CIHR
The Relation Between Peak Response Magnitudes and Agreement in Diagnoses Obtained
from Two Different Phallometric Tests for Pedophilia
Amy D. Lykins, James M. Cantor, Michael E. Kuban, Thomas Blak, Robert Dickey, Philip
Klassen, & Ray Blanchard, Centre for Addiction and Mental Health, Law and Mental Health
Program, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario, M5T 1R8,
Canada, Amy_Lykins@camh.net
Phallometric testing is widely considered the best psychophysiological procedure for assessing
erotic preferences in men. Researchers have differed, however, on the necessity of setting some
minimum criterion of penile response for ascertaining the interpretability of a phallometric test
result. Proponents of a minimum criterion have generally based their view on the intuitive notion
that “more is better” rather than any formal demonstration of this. The present study was
conducted to investigate whether there is any empirical evidence for this intuitive notion, by
examining the relation between magnitude of penile response and the agreement in diagnoses
obtained in two test sessions using different laboratory stimuli. The results showed that
examinees with inconsistent diagnoses responded less on both tests, and that examinees with
inconsistent diagnoses responded less on the second test after controlling for their response on
the first test. Recommendations for the clinical applications of these results are provided.
Funding Source: N/A
The Effects of Similarity in Sexual Excitation and Inhibition and in the Effects of Mood on
Sexuality on Sexual Problems and Sexual Satisfaction in Newlywed Couples
Amy D. Lykins, Erick Janssen, Sarah Hahn, Julia Heiman, and Eshkol Rafaeli, Centre for
Addiction and Mental Health, Toronto, Ontario; The Kinsey Institute, Indiana University, USA;
Barnard College, NY, US, Amy_Lykins@camh.net
Although sexuality is an important aspect of many couples’ relationships, investigations into individual
differences and dyadic variables related to sexual compatibility and marital satisfaction have only
relatively recently been undertaken. A number of studies have revealed individual differences in sexual
inhibition, sexual excitation, and the impact of various mood states on sexual interest and response, but
these investigations have typically focused on the individual, rather than the couple. Thus, we sought to
investigate the relationship between partner similarity on sexual excitation and inhibition proneness, the
effects of mood on sexual interest and response, and reported sexual problems and sexual satisfaction in a
sample of newlywed couples. Thirty-five newlywed couples completed the Sexual Inhibition/Sexual
Excitation Scales, the Mood and Sexuality Questionnaire-Revised (MSQ-r), the Dyadic Adjustment
Scale, and the Global Measure of Sexual Satisfaction. Similarity was operationalized using z-transformed
within-couple correlations using all items of relevant scales. For both wives and husbands, significant
correlations were found between SIS1 and self-reported sexual arousal problems in the previous 3
months, r = .46 (p < .05), r = .59 (p < .05), respectively. In addition, for women, partner similarity on
SIS1 and SIS2 correlated negatively, and similarity in the effects of anxiety and stress on sexuality
(MSQ-Anxiety/Stress) positively, with arousal problems, r = -.42 (p < .05), r = -.38 (p < .05), and r = .32
(p < .10), respectively. None of the similarity measures correlated with men’s report of arousal problems.
Regression analyses including SIS1 scores and similarity in SIS1, SIS2, and MSQ-Anxiety/Stress,
showed a significant effect of similarity in MSQ-Anxious/Stress for women. For husbands, only their
own SIS1 scores predicted erectile problems. The analyses explained 31% of the variance in women and
28% of the variance in men. With regard to reported sexual satisfaction, for wives, SIS1 scores correlated
negatively and the effects of positive mood on sexuality (MSQ-Happy/Cheerful) positively with sexual
satisfaction, r = .38 (p < .05), r = .48 (p < .05), respectively. In addition, similarity in SIS1 was positively
correlated for women, r = .37 (p < .05). For men, SES scores correlated negatively, and the effects of
negative mood on sexuality (MSQ-Anxiety/Stress and MSQ-Sad/Depressed) positively, with sexual
satisfaction, r = -.48 (p < .05), r = .50 (p < .05), and r = .52 (p < .05), respectively. In addition, similarity
in MSQ-Happy/Cheerful was significantly correlated with husbands’ sexual satisfaction, r = .42 (p < .05).
Regression analyses showed that SES was a significant, negative predictor of sexual satisfaction for both
husbands and wives. In addition, MSQ-Happy/Cheerful scores were positively associated with sexual
satisfaction in women, and similarity in MSQ-Happy/Cheerful in husbands. The analyses explained 46%
of the variance in women and 55% of the variance in men. Overall, the findings show that similarity in
various aspects of sexuality predicts self-reported sexual arousal problems and sexual satisfaction above
and beyond one’s individual scores. For women this appears to be especially the case for sexual arousal
problems (which, in men, seem to be more strongly associated with their own sexual propensities); for
men, this seems especially true for their self-reported sexual satisfaction.
Visual Attention to Erotic Images in Women Reporting Pain with Intercourse
Amy D. Lykins, Marta Meana, & Jillian Minimi, Centre for Addiction and Mental Health, Law
and Mental Health Program, Centre for Addiction and Mental Health, 250 College St., Toronto,
Ontario, M5T 1R8, Canada, Amy_Lykins@camh.net
The coupling of sex and pain that characterizes dyspareunia creates an interesting theoretical
conundrum of clinical significance: Are women with dyspareunia distracted from sexual stimuli
(as the sexual dysfunction literature would suggest), or are they hypervigilant to sexual stimuli
because they elicit thoughts and expectations of pain (as the pain literature would suggest)? The
current study measured attention to sexual stimuli in 20 women reporting persistent pain with
intercourse, 14 women reporting hypoactive sexual desire, and 20 no-dysfunction control
women. Participants viewed a series of erotic images, each containing a semanticallyinconsistent object, while an eye-tracker measured and recorded their eye movements. Women
with pain looked less and fewer times at the sexual scene regions of the images than did both
women with low sexual desire (p = .024, and p = .018, respectively) and the no-dysfunction
control group (p < .001, and p =.003, respectively). Women with dyspareunia also looked at the
context scene region significantly more times and for longer periods than the no-dysfunction
control women (p = .013, and p = .042, respectively). Results are interpreted to be potentially
supportive of the cognitive distraction hypothesis associated with sexual dysfunction, with an
additional component of cognitive avoidance of sexual stimuli for the women reporting sexual
pain.
Male Bisexuality: Separate Identity, Embryonic Homosexuality or Simply Behaviour?
Malcolm, James P., University of Western Sydney, School of Psychology, University of Western
Sydney, Locked Bag 1797, South Penrith DC NSW, j.malcolm@uws.edu.au
While numbers of men behave bisexually and many adopt a bisexual label to describe their
sexuality, there is continuing confusion regarding the nature of the construct, and the question of
whether bisexuality represents a distinct sexual orientation remains unanswered. Much recent
research into bisexuality has been driven by HIV/AIDS epidemiological concerns and this
literature has generally not focused on questions of identity or orientation but rather on
behaviours that are relevant for the development of HIV risk reduction strategies. The current
study focused on behaviourally bisexual married men and was primarily concerned with
identifying antecedents to sexual identity and marital status transitions in such men. Quantitative
and qualitative data collected from 315 participants suggested that homosexually active married
men (HAMMs) who have sex with both men and women and define themselves as bisexual
exhibit particular patterns of sexual milestones that differentiate them from HAMMs who define
themselves as either heterosexual or homosexual. The data suggest that many bisexual men tend
to derive circumscribed sexual pleasure from homosexual contacts while maintaining primary
heterosexual intimacy and attachment concerns. Others define as bisexual prior to subsequent
self-labelling as gay. There was little in the data to support the notion of bisexuality as a
separate and distinct sexual orientation reflecting truly dualistic sexual interests and attachment
potential.
Funding Source: UWS
Infidelity in Heterosexual Couples: Demographic, Interpersonal, and Personality-related
Predictors of Extradyadic Sex
Kristen P. Mark, Erick Janssen, & Robin R. Milhausen, University of Guelph, 273 Portview Rd.,
Port Perry, Ontario, Canada L9L1B4; Indiana University, Bloomington, IN, kmark@uoguelph.ca
This study aimed to assess the relative importance of demographic, interpersonal, and personality
factors in predicting infidelity in heterosexual couples. A convenience sample of in total 506
men (mean age = 32.86, SD = 10.60) and 412 women (mean age = 27.66, SD = 8.93), who
indicated they were in a monogamous sexual relationship, completed a series of online
questionnaires, including the sexual excitation/inhibition (SIS/SES) scales and the Mood and
Sexuality Questionnaire (MSQ), and answered questions about, among others, religiosity,
relationship and sexual satisfaction, and sexual compatibility. Almost one-quarter of men
(23.2%) and 19.2% of women indicated that they had “cheated” during their current relationship
(i.e., engaged in sexual interactions with someone other than their partner that could jeopardize,
or hurt, their relationship). A logistic regression analysis using the data collected in men
explained 17% of the variance and revealed that a higher propensity of sexual excitation (SES)
and sexual inhibition due to ‘the threat of performance concerns’ (SIS1), a lower propensity for
sexual inhibition due to ‘the threat of performance consequences’ (SIS2), and an increased
tendency to engage in regretful sexual behavior during negative affective states, were all
associated with infidelity. In women, 21% of the variance in engaging in infidelity was explained
by a combination of interpersonal and personality variables: in addition to SIS1 and SIS2, for
which the same patterns were found as for men, low relationship happiness and low
compatibility in terms of sexual attitudes and values were predictive of infidelity in women.
Clinical implications of these findings and suggestions for future research will be outlined.
Funding Source: National Institute of Child Health and Human Development (NICHH; R01
HD043689, Erick Janssen, PI)
Why Don’t They Understand? Issues in Communication Between Sex Researchers and
IRBs
Michael Miner, University of Minnesota, P.H.S., 1300 So. Second Street, Suite, 180,
Minneapolis, MN. 55454 USA, miner001@umn.edu
This paper explores the problems encountered by sex researchers in gaining approval from
Institutional Review and Ethics Boards. It will explore the issues of communication, both from
the perspective of the IRB reviewer and from that of a sex researcher. The speaker will provide
examples from his experience as a reviewer of research and an IRB chair at a major research
university and will discuss problems that he has encountered with his own applications. This
presentation will stress the importance of clear, concise communication and will discuss
common mistakes made when responding to stipulations and deferrals. The focus of IRB
reviews will be discussed and how this focus results in questions about design and methods,
which appear to many researchers to indicate mission drift in IRB panels. The presentation will
also discuss ways to educate IRB members in the issues confronted in planning and conducting
human sexuality research and will highlight common mistakes that the speaker has encountered
when reviewing protocols for sex research.
Impulse Control and Frontal Lobe Abnormalities in Impulsive/Compulsive Sexual
Behavior
Michael Miner, University of Minnesota, P.H.S., 1300 So. Second Street, Suite, 180,
Minneapolis, MN. 55454 USA, miner001@umn.edu
This presentation describes the results of a pilot study to investigate whether impulsivity as a
general trait is associated with what Eli Coleman has come to refer to as Impulsive/Compulsive
Sexual Behavior (ICSB). The neurocognitive and self-report data have been recently published
(Miner et al., 2009), however, the neuroimaging data reflect more detailed investigation of the
areas of the brain implicated in impulse control disorders. Participants were 8 men who were in
treatment at the Program in Human Sexuality for compulsive sexual behavior as defined by
Coleman and colleagues (Coleman, 1991; Coleman, 2005; Coleman, et al., 2003) and 8 nondisordered age-matched male controls. All participants were screened for major psychiatric
disorders using the Structured Clinical Interview for the DSM-IV (SCID: First et al., 1995) and
the CSB diagnosis was confirmed using a SCID-type section designed to assess Coleman’s
criteria (Coleman, et al., 2000). This multi-method study included a neurocognitive assessment
(Go/No-go procedure) and psychometric testing (Barrett Impulsivity Scale, Multidimensional
Personality Questionnaire: MPQ). Neuroimaging included magnetic resonance imaging
assessments of cortical thickness and diffusion tensor imaging, which is a method that measures
the self-diffusion of water in tissue to quantify white matter organization and integrity.
We found significant differences on the Go-No go task and in multiple self-report scales (Barrett
Impulsiveness Scale and MPQ subscales Constraint and Negative Emotionality) indicative of
impulsivity. We also found neuroanatomical differences, reduced cortical thickness in the left
hemisphere rostral anterior cingulate, with a trend for a difference in the right hemisphere,
indicative of abnormalities associated with impulse control disorders. However, our DTI data
provide a mixed picture, with some differences consistent with impulse control disorders, lower
FA in the medial orbitofrontal region and higher MD in the left hemisphere medial orbitofrontal
and right hemisphere lateralorbitofrontal areas, and some findings that are not consistent with
impulse control disorders, lower MD in the left hemisphere rostral middle frontal area and higher
FA in the superior frontal region. Correlational analyses between the Barrett Impulsivity Scale
and each brain region and the Compulsive Sexual Behavior Inventory and each brain region
indicate that brain abnormalities associated with ICSB are different that those associated with
impulsivity. Our data suggest that ICSB may not consistently reside on an impulse control
spectrum. These results are based on a small sample and thus should be interpreted with care.
Funding Source: University of Minnesota Grant in Aid
Attachment Anxiety, Isolation, and Inadequacy: Unique Risk Factors for Sexual Crimes
Against Children or Indications of an Underlying Internalizing Disorder?
Michael H. Miner, Ph.D., Rebecca Swinburne Romine, M.A., Dianne Berg, Ph.D., Beatrice
Robinson, Ph.D., Jason Netland, M.A., Morgan Paldron, & Charles Helm, M.A, University of
Minnesota, P.H.S., 1300 So. Second Street, Suite, 180, Minneapolis, MN. 55454 USA,
miner001@umn.edu
Marshall and Barbaree’s Integrated Theory proposes that individuals who turn to children for
sexual gratification do so because of a need for interpersonal closeness, coupled with an
expectation of rejection by peers. It has been suggested by Smallbone and others that attachment
theory can help in exploring this hypothesis. In this poster, we present the preliminary results of
on-going study that uses multiple methods (semi-structured interview, computer administered
self-report, and chart review) to compare four groups of adolescents, sexual offenders with child
victims (n=107), sexual offenders with peer/adult victims (n=49), non-sexual delinquents
(n=122), and adolescent males in treatment for substance use or other mental health issues
(n=40). Participants were recruited from residential treatment facilities, juvenile detention
facilities, outpatient treatment programs, and juvenile probations. In previous presentations and
papers, we presented comparisons between the three delinquent groups. This poster builds on
our previous papers, which indicate that anxious attachment has an indirect association with
child sexual abuse perpetration, through its influence on perceived isolation from peers, and a
resultant anxiety toward opposite gender peers by including a group of youths with internalizing
problems, those in treatment for substance use and other mental health issues. We present a
preliminary analysis that includes this second comparison group to explore if the constellation of
findings that distinguish sex offenders with child victims from other youths with externalizing
problems are unique risk factors or are factors that indicate that perpetration of child sexual
abuse is a form of internalizing problem.
Funding Source: U.S. Office of Juvenile Justice and Delinquency Prevention and U.S. Center for
Disease Control and Prevention
Dispelling the Myths of Young Urban Black and Latino MSM:
Findings from Project Desire
Robert Moeller, Perry Halkitis & Daniel Siconolfi, New York University- Center for Health,
Identity, Behavior & Prevention Studies, rwm252@nyu.edu
In response to reports of increasing HIV incidence among young Black and Latino men who
have sex with men (NYCDHMH, 2008), a street intercept survey utilizing computer-assisted
self-interviews (CASI) on personal data assistants (PDAs) was conducted in the summer of 2008
throughout the five boroughs of New York City. Participants (N = 540) were asked which of the
following contextualized sexual behaviors occurred during their last two sexual encounters with
a main and casual partner: anal sex (with a condom/without a condom and receptive/insertive),
oral sex (with a condom/without a condom), and mutual masturbation. The sample was
ethnically diverse (30.5% Black, 27.2% Latino, 20.1% White, 12.2% API, 9.4% mixed race and
0.6% other, and participants ranged in age from 18-29 with a Mean age of 22.81 (SD = 3.43).
Preliminary data indicate no statistically significant differences in sexual behavior by participant
race/ethnicity. The majority of the sample (85.2%) had tested for HIV, and 74.6% reported an
HIV-negative status, followed by 74.6% HIV-negative, 7.6% HIV-positive and 17.7% were
unsure or had never been tested. Participants were asked to report sexual behavior with the most
recent main partner, and 20.9% reported oral sex with a condom, 47.1% reported oral sex
without a condom, 25.3% reported anal receptive with a condom, 20.4% reported anal receptive
without a condom, 20.9% reported anal insertive with a condom, 18.7% reported anal insertive
without a condom. Participants reported more episodes of sexual behavior with casual partners,
with 22.1% reporting oral sex with a condom, 44.5% oral sex without a condom, 32.2% anal
receptive with a condom, 14.2% anal receptive without a condom, 27.4% anal insertive with a
condom, 8.8% anal insertive without a condom. No significant differences were found between
participant HIV status and engagement in any particular sexual behavior. Participants also
reported the number of sexual partners over the course of the prior three months, (M = 6.17) (SD
= 15.46 ). Participants with a history of arrest (21.3%) reported greater numbers of partners in
the last three months compared to those who had not been arrested (M = 9.53, SD = 21.83 and M
= 5.26, SD = 13.10 respectively) F(1,537) = 6.97, p < .01. Additionally, participants reported
substance use over the last 3 months, with use of cocaine being the only drug significantly
related to Mean number of partners, with those participants reporting use of cocaine (7.6%)
having more casual partners than non-users (M = 12.09, SD = 27.82 and M = 5.20, SD = 12.08
respectively) F(1,537) = 13.27, p < .001. A number of casual hypotheses have been posited to
explain the dramatic increase in HIV incidence, but this data indicates that there are complex
contexts which can explain sexual partnering and sexual risk taking. These findings clarify
potential responses to the spike in incidence among young men who have sex with men, by
identifying the men most at risk for seroconversion and further, potential venues for reaching this
population.
Funding Source: New York City Department of Health and Mental Hygiene
Changing High-risk Sexual Behaviors Among Latino Gay/Bisexual Men
Eduardo Morales, CSPP-SF of Alliant International University, San Francisco, CA USA,
DrEMorales@aol.com
Latino gay, and bisexual men often compartmentalize their lives among three different social
spheres: the gay community, the Latino community and the predominantly heterosexual, White,
mainstream society. These spheres have different expectations, norms and cultures that force
Latino MSM to balance a set of often-conflicting challenges and pressures to conform within
each of the spheres. Socioeconomic, educational, and immigration status, as well as level of
acculturation of Latino MSM are also factors that must be considered in developing an effective
intervention. In the context of HIV Prevention, the most important need for Latino men is to
step forward and be aware of their HIV status and the means to protect themselves and their
community. Simultaneously, organizations must develop activities to support an individual’s
ability to create self-change. In order to achieve these objectives the El Ambiente Empowerment
Program was developed for and by Latino Gay/Bisexual men with the following seven
components and activities: a) Recruitment b) Magnet Events, c) Initial Overnight Retreats d)
Group Level Interventions, e) Individual Level Intervention - Prevention Case Management; f)
Continuous Engagement and Marketing and g) Continued Program Development. The program
evaluation data collection activities occurred between July, 2002 and June, 2005 by
administering a Risk Reduction Assessment to all new participants as baseline and referred to as
the Intake Sample (IS). In order to have a comparison group, participants in the program who
joined before July, 2002 were invited to complete a new baseline measure as is referred to as
Program Veterans (PV). A total of 319 participants completed baseline questionnaire. A total of
208 IS and 111 PV participants completed the baseline survey, and 99 IS and 55 PV completed
the 6-month follow-up, for a retention rate of 47.5% for the IS group and 49.5% for the PV. As
expected VP group reduced risky oral-receptive, anal-insertive and anal-receptive at post-test.
Oral active sex slightly increased. The IS group had an increase in risky oral-active and oralreceptive sex as well as risky anal-receptive sex. For the PV group risky oral and anal sex
decreased as well as oral sex with a condom. Anal sex with a condom increased 154.4%. For
the PV group they used a condom 72% of the time when they had anal sex at post-test as
compared to 45% at baseline. For the IS group risky oral sex increased at post-test and risky anal
sex decreased by 15%. Oral and anal sex with a condom increased at post-test for this group.
For anal sex the IS group used a condom 71% of the time they had anal sex as compared to 50%
at baseline. It appears that both groups had similar rates of condom use at post-test. The overall
findings show that the El Ambiente program helps participants reduce their risk for HIV
infection. In conclusion the findings from these data indicate that the El Ambiente Program has a
continued long-standing impact on the risk behaviors of hard to reach Latino gay/bisexual men
who participate and engage in the program activities.
Funding Source: SF AIDS Office
Preferences on Monogamy in a Sample of North American Men and Women
Taylor Anne Morgan, Lisa Dawn Hamilton, Yasisca Pujols, & Cindy M. Meston, University of
Texas at Austin, Department of Psychology, 1 University Station, A8000, Austin, TX, 78712,
ldhamilton@mail.utexas.edu
Monogamous pair-bonding is rare in non-human species, yet common in humans. In addition to
biological and evolutionary factors that likely underlie monogamy, social norms also have a
large influence. To evaluate how strongly social norms in North America encourage monogamy,
we asked participants to imagine that they lived in a society where nonmonogamy was the social
norm. We used both qualitative and quantitative methods in an online survey to examine whether
and why people would choose monogamy in a hypothetical nonmonogamous society. In our
sample of 603 participants, 60% said they would continue to be monogamous, 36% said they
would not, and 4% were undecided. Of those who said they would not continue to be
monogamous, 50% had never exhibited any nonmonogamous behavior (e.g. multiple partners,
cheating on a partner). More women than men said they would choose monogamy. We then
asked participants to provide free response answers about why they would choose monogamy or
nonmonogamy. Three independent raters coded their answers. The most common reason people
gave was that monogamy was their personal preference, followed in descending order by the
belief that: a) commitment must accompany love, b) nonmonogamy is immoral, and c)
nonmonogamy causes jealousy. For those participants who would not choose monogamy, almost
half gave as their reason the fact that nonmonogamy would be the social norm. The second and
third most common reasons were the desire to gain sexual experience and personal beliefs in
nonmonogamy, respectively. The majority of people gave personal/individualistic reasons, rather
than social norms, for their choice to be monogamous, although the minority that gave social
norms was sizable. Very few people gave relationship-based reasons.
Funding Source: NIH
BDSM: Psychopathology vs. Healthy Sexual Variant
Charles Moser, Institute for Advanced Study of Human Sexuality, 45 Castro, #125 San Francisco
CA 94114 USA, docx2@ix.netcom.com
BDSM (Bondage and Discipline, Dominance and Submission, and Sadism and Masochism)
practitioners constitute a sexual minority group. In a similar manner to other sexual minorities,
individuals with these sexual interests have been diagnosed with a mental disorder by various
psychiatric theories and with a Paraphilia in the DSM-IV-TR. There is also a belief that
individuals diagnosed with one Paraphilia are prone to exhibit other Paraphilias (e.g. pedophilia).
In fact, Paraphilias do not meet the DSM-IV-TR’s own definition of a mental disorder.
Individuals who would be diagnosed with a Paraphilia cannot be distinguished from “normal”
individuals except by their sexual behavior. There is no characteristic dysfunction associated
with an interest in BDSM and the belief in the likelihood of multiple paraphilias in the same
individual is a myth.
Leathermen: Construction of an Identity and Implications for Sexual Health
David Moskowitz, University of Texas at San Antonio, One UTSA Circle, Department of
Communication, San Antonio, Texas, 78249, dmoskowi@mcw.edu
There have been no studies that directly explore the HIV prevalence and sexual health behaviors
of submissive and dominant Leathermen. In previous research, 21% of barebackers (i.e., MSM
who eschew condoms) considered themselves Leathermen; 46% reported wanting a partner who
self-identified as a Leathermen. Thus, there is some evidence to suggest that there may be a
propensity towards reduced sexual health within this community.
We used an anonymous survey (N = 1554) administered at two independent MSM events: the
2008 International Mr. Leathermen Competition (55.9% of N; IML) in Chicago, Illinois, and the
2008 PrideFest (44.1% of N) in Milwaukee, Wisconsin. We measured affiliation with the leather
identity and leather orientations (i.e., Dominants, Submissives, Switches, or non-orienting), HIV
serostatus, last HIV/STD test, condom use, HIV disclosure, masculinity, hypermasculinity, and
sexual control.
Leathermen were about 61% more likely than Non-Leathermen to be HIV-positive. Regarding
specific leather orientations, non-orienting Leathermen and Submissives were most likely to be
HIV-positive and had a seroprevalence of 31% and 30%, respectively. Though no differences
were found regarding HIV/STD testing, Leathermen were found to use condoms less than nonLeathermen during receptive and insertive anal intercourse. Regarding specific leather
orientations, Dominants were less likely to use condoms during insertive anal intercourse.
Submissives were less likely to use them during both receptive and insertive anal intercourse.
Finally, decreased sexual power in Leathermen was influential over their lowered condom use
during receptive anal intercourse. Masculinity and sexual control were also found to negatively
influence condom use among Dominants, Submissives, and Switches across both insertive and
receptive anal intercourse.
Leathermen might be at a higher risk for acquiring HIV relative to non-Leathermen. HIVpositive Leathermen may also be more likely to engage in high-risk behaviors for HIV
transmission to other Leathermen as well as to non-Leathermen. The results indicated that the
values that underlie the leather identity (e.g., sexual control) might be driving forces that
influence condom disuse. Thus, a targeted intervention that addresses sexual control and
masculinity in order to encourage safer sex may be warranted for this group.
Funding Source: Center Grant P30-MH52776 from the National Institute of Mental Health (PI: J.
A. Kelly)
Ethical and Regulatory Issues with Conducting Sexuality Research with LGBT Youth
Brian Mustanski, University of Illinois at Chicago, 1747 W. Roosevelt Rd. Chicago, IL 60608,
bmustanski@psych.uic.edu
Conducting sexuality research with children is riddled with ethical and regulatory complications
as conflict can arise between the guiding principles of justice, beneficence, doing no harm, and
the need to respect the rights accorded to parents by federal guidelines for protecting minor
participants in research. A sophisticated understanding of these guidelines is critical as even the
definition of who is a child varies by location. LGBT youth researchers can find themselves in
the crosshairs as waivers of parental consent are likely to be necessary in order to conduct
research that can improve the health of this vulnerable group, but at the same time IRBs may be
hesitant to issues such waivers. An ongoing research study will be used to illustrate the relevant
process for applying for, justifying, and obtaining such a waiver of parental consent. Project Q2
is a longitudinal study of 250 LGBT youth ages 16-20 at baseline. In addition to reviewing the
procedures to obtain a waiver, we will also report data on what percentage of youth indicated
they would have been willing to let us contact their parents and how limiting participation to
youth who could obtain parental consent would have distorted the results.
Funding Source: American Foundation for Suicide Prevention; William T Grant Foundation
A Major Pain: Fibromyalgia and its Effect on Sexuality and Quality of Life in Women
Lin Myers and Deborah Whitten, CSU Stanislaus, One University Circle, Turlock, CA 95382,
USA, linmosaic@gmail.com
Fibromyalgia syndrome (FMS) is a chronic illness that can significantly affect quality of life.
Estimate of prevalence are between 4 to 10 million people in the U. S. alone. We investigated the
impact of FMS on quality of life (QOL) and sexual functioning in 92 women, 46 with FMS and
46 healthy age-matched controls. Participants were not required to have a current partner, but
82.6% of the FMS group reported being sexually active, compared to 70% of the healthy control
group. Measures included a revision of the Multiple Sclerosis Quality of Life questionnaire, the
Fibromyalgia Impact Questionnaire (FIQ), and both the Derogatis Sexual Functioning Inventory
(DSFI) and the Derogatis Interview of Sexual Functioning - Self Report (DISF-SR). Participants
with FMS had significantly lower levels of physical and emotional health, and overall lower
quality of life scores than healthy controls. For the FIQ, those with scores >70 (indicating severe
impact of FMS) had significantly lower overall quality of life than those with scores below 70.
While FMS participants had a significantly lower Sexual Functioning Index score, they did not
differ from healthy controls on in the Global Sexual Satisfaction Index. These findings show that
overall sexual functioning is poorer for women with FMS, but that doesn't necessarily affect their
current reported satisfaction. This study represents a first in understanding the impact of FMS on
sexual functioning of women.
Funding Source: CSU Stanislaus Research, Scholarship, and Creative Activities Grant and a
grant from the Department of Psychology Graduate Committee
“What is Good Sex?” Socio-Cultural Constructions of Sexual Satisfaction among College
Students
Titilayo A. Okoror, Ph.D., Stephanie Saur, MA, Scott M. Butler, Ph.D., & E. Thomaseo Burton,
MPH, Purdue University, 800 West Stadium Drive, West Lafayette, IN 47907, U.S.A.,
tokoror@purdue.edu
The purpose of the study is to qualitatively assess socio-cultural constructions of sexual
satisfaction among college students. Recent studies and empirical investigations have identified
a strong correlation between sexual satisfaction and relationship satisfaction in young adults
(McCabe et al., 1998; Sprecher, 2002; Auslander, et al, 2007). Auslander and colleagues (2007)
indicated that relationship quality was the highest overall predictor of sexual satisfaction.
However, no study has explored the role of culture in how students construct what they consider
to be ‘good sex’ or a sexually satisfying encounter. This is of interest since culture influences
experiences (which may be born from socio-political-economic contexts), and these experiences
are interpreted through cultural values, which then dictates the meanings attached to them.
Cultural values are needed to interpret and respond to experiences, and are used in organizing
one’s behaviors, thoughts and actions, to either enhance, compromise, or impedes one’s cultural
identity (Airhihenbuwa, 2007; Swanson, et al., 1998). This means that although students operate
within the college sub-culture, they also bring cultural values and beliefs from their individual
communities, and these influence what they interpret or describe as ‘good sex’ or sexually
satisfying encounter. Exploring the socio-cultural constructions of sexual satisfaction will not
only increase our understanding of human sexuality and the influence of culture, race and
gender, but also enable us to better assist students in their sexuality and sexual health. We
conducted five focus groups of white males and females, black males and females, and a mixed
group of white males/females. Each group had eight to ten participants, with a mean age of 21.2,
and total of 42 participants. Three general questions guided the discussion: 1) What is good sex?
2) What types of sexual relationships/experiences do you find most satisfying? 3) What do you
do if you are not sexually satisfied? Nvivo software for data management was used in data
analysis. Findings suggest that there are socio-cultural influences/factors and racial differences
in what students describe as sexually satisfying encounters. The White females group describes
sexually satisfying encounters as multiple orgasmic responses, while the Black females group
describes these as emotional attachment and bonding. Both the White and Black males groups
reported that their own satisfaction was achieved in sexual scenarios in which their partners
report being sexually satisfied. Issues of fear of being alone, communicating with partner, and
types of relationships (e.g., casual friends, friends with benefits, best-fuck buddies, open
relationships) also emerged as factors that influence participants’ constructions of what they
consider a sexually satisfying encounter or ‘good sex.’
Funding Source: Purdue University
Successes and Challenges of Sex Research with Heterosexual Latino Couples
David Pérez-Jiménez, Institute for Psychological Research/University of Puerto Rico, PO BOX
23174, San Juan, PR 00931-3174, dperez@ipsi.uprrp.edu
BACKGROUND: Heterosexual intercourse has become one of the principal modes of HIV/STIs
transmission worldwide. The transmission of HIV/STIs occur in the context of a relationships
characterized by unequal power balance where men decide how, when, and where sexual
relations take place. In this context, negotiating safer sex becomes a very difficult task for
women which make them more vulnerable to these infections. Preventive interventions
implemented with heterosexual Latino couples (HLC) to promote safer sex practices as been
scarce. However, there’s a small but growing body of research findings illustrating that it is
possible to promote sexual behavior change in the context of heterosexual relationships.
METHOD: I propose to share the findings of most relevant research conducted with heterosexual
Latino couples (HLC) in the US and PR to promote safer sex behaviors. I will present the
findings from two published studies conducted in the US with HLC. Then, I will present the
findings from two studies conducted in PR by our research team, one with adult HLC and other
with HIV discordant HLC. Finally, I will compare theses studies in terms of their outcomes,
formats, theoretical frameworks, content, and findings. RESULTS: Studies directed to promote
safer sex among HLC present inconclusive findings. While some studies present significant
differences in the intervention when compare with the control group, other show no significant
differences. Although most of these interventions have had as main outcome the promotion of
male condom use as safer sex method, other have experimented with non-traditional prevention
alternatives such as mutual masturbation. These studies have been based on different theoretical
frameworks and have used different formats to implement the interventions. Some have used a
counseling format with individual couples, other have used a group format, while other have
used mixed formats implementing group sessions and also providing for sessions where couple is
separated by gender and receive part of the intervention separately. CONCLUSIONS: Results
suggests that promoting sexual behavior change in stable relationships is feasible, but the
evidence is still scarce. While some questions have been answered, other remains unsolved. It is
not clear what format may be more effective when working with these couples. Can a format
may be more effective for young couples vs. older couples? Is it possible to promote other safer
sex strategies and not limit prevention only to the promotion of condoms? Can it be equally
effective an intervention that is designed for different ethnic groups vs. those ethnic specific?
The present and future of prevention efforts with this population urge us to answer these
questions.
Funding Source: National Institute of Mental Health
Gender Differences in the Relationship Between Orgasmic Functioning
and Sexual Satisfaction
Perlman, H., Stephenson, K. R., Bauerkemper, B., Andrews, E., & Meston, C. M., The
University of Texas at Austin, 919 E 40th St. Austin, TX 78751, krstephenson@gmail.com
INTRODUCTION: Recent research on female sexual functioning has shown that sexual
problems lead to decreases in sexual satisfaction only in a minority of cases, suggesting the
presence of important moderators between the two constructs. However, little work has been
done examining these moderators and how they may function differently in men and women.
Research on gender differences in sexuality suggests that the physical aspects of a sexual
relationship may be less important, and the wider relational context more important, for women
as compared to men. In light of these findings, the current study attempted to assess the
moderating role of gender and relationship satisfaction in the connection between orgasmic
functioning and sexual satisfaction. We predicted that poor orgasmic functioning would be
associated with a smaller decrease in sexual satisfaction for women as compared to men and that
high relationship satisfaction would protect against a decrease in satisfaction, especially for
women.
METHODS: Participants in romantic relationships (n = 325, 77.5% women) completed surveys
assessing sexual functioning, relationship satisfaction, and sexual satisfaction. We conducted
linear regression analyses assessing the role of orgasmic functioning, gender, relationship
satisfaction, and their interactions in predicting sexual satisfaction.
RESULTS: Orgasmic functioning and relationship satisfaction were significant predictors of
sexual satisfaction. Additionally, both relationship satisfaction and gender interacted
significantly with orgasmic functioning such that lower orgasmic functioning had a smaller
impact on sexual satisfaction for women and for participants who reported higher relationship
satisfaction. The three-way interaction between orgasmic functioning, gender, and relationship
satisfaction was significant such that relationship satisfaction was a more effective buffer
between low orgasmic functioning and sexual satisfaction for women than for men.
CONCLUSIONS: Results suggest that orgasmic functioning is tied to sexual satisfaction more
strongly for men than for women, and that high relationship satisfaction may act as a protective
buffer between orgasm difficulties and decreases in satisfaction, especially for women. These
findings add to literature on gender differences in sexuality, implying that sexual functioning
may impact men and women differently and that the impact of relational variables may also
differ by gender. These gender differences have important implications for the treatment of
couples experiencing sexual problems.
EEG Asymmetry Sensitive to Approach and Avoidance Motivation in Response to Sexual
Stimuli: An Application to Persons Reporting Trouble Controlling Their Viewing of Sexual
Stimuli
Nicole Prause, Idaho State University, 921 S 8th Ave., Pocatello ID, 83201
Nicole.Prause@gmail.com
Central sexual motivation is difficult to measure surreptitiously, and one promising measure fails
to distinguish approach from avoidance motivation. Specifically, when electroencephalographic
(EEG) alpha is more prominent in left anterior alpha sites, it has been shown to reliably index
anger, depression, hunger and sexual motivation or apathy states. Measuring sexual motivation
in response to sexual stimuli especially is challenging, because participants may differ in the
valence of their affective response (sexual stimuli may be viewed positively or negatively) and
may even report emotions that conflict in valence simultaneously. Currently, it is unknown
whether EEG anterior alpha asymmetry (AAA) predicts motivational states that differ in valence
within the same stimulus. This possibility that positive and negative motivational states can be
simultaneously indexed is tested. One possible application to persons who report problems
regulating their own viewing of visual sexual stimuli also is presented.
Sixty-five male and female participants viewed four films while 40-channel EEG was recorded.
A 10-minute neutral film was followed by a 3-minute, standardized sexual film in a withinsubjects design. Participants also rated their emotional and sexual feelings following each film.
EEG AAA scores were created from the natural log differences between F3 and F4 sites during
the last minute of each film.
Factor analyses support that positive and negative emotional reactions did not strongly covary,
and frequency analyses show that conflicting emotions rarely co-occurred. Consistent with
previous findings, the EEG AAA index correlated positively with reported sexual arousal (r =
.32, p = .02). Consistent with predictions, EEG AAA was positively related to reported levels of
“anxious” (r = .28, p = .04) and “angry” (r = .29, p = .04) feelings, and not significantly related to
amotivational reports of being “relaxed” or “bored.” Sixteen (24.6%) of participants reported
having some problem viewing visual sexual stimuli (e.g., “I’ve tried to stop using it, but cannot,”
“I feel bad while viewing”). These participants exhibited significantly higher EEG AAA to the
sexual film as compared to participants who did not report a problem viewing sexual stimuli
(t(58)= -2.13, p = .038)). The group difference was due to higher approach motivation in these
participants, not higher avoidance. Independent components analysis blind source localization
preliminary findings are shown to ensure co-localization of motivational level of EEG AAA
across participants with approach and avoidance motivation.
Funding Source: Alcoholic Beverage Medical Research Foundation
Body Esteem Predicts Sexual Functioning Status for Women
Reporting Childhood Sexual Abuse
Pujols, Y. & Meston, C., University of Texas at Austin, Dept. of Psychology, 1 University
Station A8000, Austin, TX 78712, yasisca.pujols@mail.utexas.edu
Introduction: Several sexuality factors have been linked to a history of childhood sexual abuse
(CSA) including sexual avoidance, decreased sexual functioning, sexual self-esteem, attitudes
towards sexuality, and overall sexual dissatisfaction (Bartoi & Kinder, 1998). Research
regarding body esteem among these women has been mostly limited to investigating risk factors
in the development eating disorders (e.g., Williams & Gleaves, 2003). The current study aims to
examine body esteem as a contributing factor in the prediction of sexual function and sexual
satisfaction between CSA and non-CSA women.
Method: Questionnaire data was collected from a community-based sample of 175 sexuallyactive women, 114 of which reported CSA (Mage= 32.4, SD= 10.7). Data from the women with
a history of sexual abuse was taken from the first session of a 6-month treatment outcome study
for sexual dysfunction among CSA survivors. Body esteem was measured using the Body
Esteem Scale (BES; Franzoi & Shields, 1984). The Female Sexual Functioning Index (FSFI;
Rosen et al., 2000) and the Sexual Satisfaction Scale for Women (SSS-W; Meston & Trapnell,
2005) were used to assess sexual function and satisfaction, respectively.
Results: Women with a history of CSA reported greater body dissatisfaction, lower sexual
function, less sexual satisfaction, and higher depression than women without a history of CSA. A
multiple regression analysis revealed that body esteem predicted a significant amount of variance
in sexual function scores (β = .42, p = .000). Among women with a history of CSA who were
currently involved in a romantic relationship, body esteem also predicted sexual satisfaction (β =
.30, p = .006). Among women without a history of CSA, only depressive symptom severity
predicted sexual functioning (β = -.46, p = .004) and satisfaction (β = .24, p = .000).
Conclusion: Body esteem seems to play a significantly greater role in the sexual functioning and
satisfaction of women with a history of CSA than in women without a history of CSA. The next
stage of our research is to determine what specific aspects of the abuse situation (e.g., age of
abuse, severity of abuse, relation to the perpetrator) have the greatest deleterious impact on
women’s body esteem. The findings presented here suggest that treatments for CSA survivors
with sexual difficulties might benefit from addressing body image concerns.
Funding Source: NIH-NICHD
Predictors of Sexual Satisfaction in a National Sample of Women
Pujols, Y., Seal, B. N., & Meston, C. M., University of Texas at Austin, Dept. of Psychology, 1
University Station A8000, Austin, TX 78712, yasisca.pujols@mail.utexas.edu
INTRODUCTION: In recent years, empirical evidence has supported the relationship between
body image and several sexual variables. However, few studies to date have weighed the
influence of specific aspects of body image on sexual satisfaction (e.g., Dove & Wiederman,
2000), and most have assessed body image using only single items. There is a need to assess a
wider range of body image variables in order to pinpoint the aspect or aspects of one’s body
image that has the greatest influence on sexual satisfaction. The aim of the present study was to
provide a comprehensive examination of the relation between specific body image components
and sexual satisfaction.
METHOD: Female participants in a sexual relationship (N = 156, mean age of 26.7 ranging from
18 to 60 years) were recruited via the Internet to complete an online questionnaire about body
image and sexuality. MAIN OUTCOME MEASURES: Four body image variables targeting
general and sexually related body image were the Body Esteem Scale, the Body Image
Avoidance Questionnaire, the Body Image Self-Consciousness Questionnaire (BISCQ), and the
Cognitive Distractions During Sexual Activity Scale. Sexual functioning was measured with the
Female Sexual Functioning Index. Sexual satisfaction was assessed using the Sexual Satisfaction
Scale for Women (SSS-W; Meston & Trapnell, 2005). RESULTS: Correlations confirmed
significant positive relationships between body image, sexual functioning, and sexual satisfaction
variables. A multiple regression analysis revealed that high esteem for body parts associated with
physical and sexual attractiveness, β = .24, p = .005, and lower frequency of sexual performancerelated thoughts predicted greater sexual satisfaction (CD), β = .22, p = .013, even after
controlling for sexual functioning status, β = .35, p = .000. CONCLUSION: Body image plays
an important role in sexual satisfaction but only as it pertains to aspects of the body that are
commonly associated with one’s sexual image (e.g., breasts, genitalia) and sexual performance
concerns (e.g., worry if one’s movements during sexual activity are pleasing). Women who
present with low sexual satisfaction may benefit from treatments that target these specific areas
of body image concerns.
Funding Source: The University of Texas at Austin
“Condom Cognition” of Homeless LGBT Youth in Manhattan
Geoffrey L. Ream & Kate F. Barnhart, Adelphi University, School of Social Work / 1 South
Avenue / Garden City, NY 11530, ream@adelphi.edu
Whether people use condoms in the context of sexual activity depends on the meaning of condom use
within the many layers of meaning that surround sexual activity. Because these meanings differ across
cultures and from one generation to the next, new data are always needed. The present study focuses on a
population that is already the target of several interventions to socialize safer sex practices and forestall
the spread of HIV: homeless and street-involved lesbian, gay, bisexual, and transgender (LGBT) youth.
Data for this study are taken from qualitative interviews with 90 homeless or formerly-homeless LGBT
youth from shelters in Manhattan. Theoretical sampling was employed to gain adequate representation of
HIV-positive youth, youth involved in sex work, and (because the vast majority of the shelters’ clients are
urban poor Black and Latino youth) white and well-educated youth. According to the theory of planned
behavior, important determinants of voluntary health behaviors (like using condoms) include beliefs and
attitudes toward the behavior, social norms and the degree to which the individual has internalized them,
beliefs about one's own control over the behavior, and actual intentions to engage in health behavior.
Qualitative interview questions covered all of these dimensions of individuals’ personal policies
regarding condoms, also seeking to capture the sources of beliefs and subjective norms in the meaning of
condoms in the context of the meaning of sexual activity. Questions were both in general and regarding
specific sexual encounters. Data are currently being analyzed by means of grounded theory methodology
with Atlas.ti 6.0.
The typical condom policy espoused in the interviews is that one must always use condoms unless they
have been with the study partner for a long time whom they trust. They were not shy about talking about
random "hookups" and sex work, and the majority were scrupulous about always using condoms in these
encounters. The conventional wisdom that homeless youth would consent to unsafe sex in sex work
because they really needed the money did not emerge; none of these shelter-homeless (as opposed to
street homeless) youth tried to make a living from sex work and refused to engage in unprotected sex
work. There were some, however, who thought it was okay to have an unprotected hookup if someone
looked "clean." A handful of others were deeply depressed or grieving and were consciously selfdestructive. Drugs and alcohol tended not to lead to non-use of condoms; some youth did not use
substances all, others maintained strict policies on keeping substance use and sex separate, and others
were so used to substance use that they could remember to use a condom no matter how intoxicated they
were. Lack of access to condoms was never an excuse because almost every program has free condoms.
Some youth had been in relationships long enough and trusted their partners to the point where they
would go ahead and have sex without a condom, and were proud of getting to that point. Cheating was
common too, however, and some respondents reported insisting on going back to condom use when they
suspected cheating or inferring that a partner was cheating if that partner insisted on using condoms again.
Of the few who were HIV-positive, all contracted it from a partner whom they trusted enough not to use a
condom. From a practice perspective, this indicates that the message is getting through about HIV risk.
However, the previous conventional wisdom of “make the condom fun,” based on a general subcultural
perspective that condoms made sex less fun, may need to be augmented to also include “make the
condom intimate” in order to tune into the connection between condoms and intimacy among this
population.
Funding Source: Adelphi University Faculty Development Grant
A Nationally Representative Study of the Prevalence and Characteristics of Vibrator Use
by Men in the United States
Michael Reece, Debby Herbenick, Stephanie Sanders, Brian Dodge, Annahita Ghassemi, & J.
Dennis Fortenberry, Center for Sexual Health Promotion Indiana University, HPER 116, 1025
East Seventh Street, Bloomington, Indiana, 47405, mireece@indiana.edu
Introduction. While vibrating products have been recommended by clinicians for the treatment of
male sexual dysfunctions, knowledge is lacking with regard to the prevalence of vibrator use
among men in the United States, the characteristics of men who use vibrators, and whether there
are relations between vibrator use and sexual function among men.
Aims. To establish lifetime and recent prevalence rates for vibrator use by men in the United
States, to document the characteristics of men who use vibrators and their reasons for using
vibrators, and to explore relations between men’s vibrator use and sexual function.
Methods. During April 2008, data were collected from a population-based cross-sectional survey
of 1,047 men aged
18–60 years in the United States. Analyses were conducted using poststratification data weights.
Main Outcome Measure. Measures included sociodemographics, health status and health-related
behaviors, sexual behaviors, vibrator use, and sexual function.
Results. For both solo and partnered sexual activities, the prevalence of men who had
incorporated a vibrator into sexual activities during their lives was 44.8%, with 10.0% having
done so in the past month, 14.2% in the past year, and 20.5% over 1 year ago. Men who had used
vibrators, particularly those with more recent use, were more likely to report participation in
sexual health promoting behaviors, such as testicular self-exam. Men who had used vibrators
recently also scored higher on four of the five domains of the International Index of Erectile
Function (erectile function, intercourse satisfaction, orgasmic function, and sexual desire).
Conclusions. Among men in the United States, vibrator use during solo and partnered sexual
interactions is common and is associated with a wide array of positive sexual health
characteristics. Future research should continue to explore ways in which men incorporate
vibrators into solo sexual acts, partnered sexual play, and sexual intercourse.
Funding Source: Church & Dwight Co., Inc.
A Test of Underlying Assumptions of Sexual Compulsivity: Do Those Exhibiting
Compulsive Sexual Tendencies Experience More Negative Outcomes?
Michael Reece, Kimberly R. McBride, and Stephanie A. Sanders, Center for Sexual Health
Promotion and Kinsey Institute for Sex, Gender, and Reproduction, Indiana University, HPER
116, 1025 East Seventh Street, Indiana University, Bloomington, IN, 47405,
mireece@indiana.edu
Background: Moving toward an outcomes-based understanding of out-of-control sexual
behaviors that includes consideration of both cognitive and behavioral outcomes may help the
field to better understand the extent to which an individual’s sexual behaviors actually lead to
negative consequences. Recently, a scale assessing such cognitive and behavioral outcomes was
developed and its psychometric properties assessed. Methods: The properties of the scale were
assessed using data from a cross-sectional sample of 391 young adults and analyses conducted to
explore whether negative cognitive and behavioral outcomes associated with sexual behavior
could be detected in a non-clinical population at sub-clinical levels. Results: Internal consistency
for the 20-item cognitive scale was high (α = .89) with a slightly lower level of reliability (α =
.75) for the 16-item behavioral scale. Principal Components Analysis with varimax rotation
resulted in the identification of a six-factor solution that explained 74.8% of the total variance.
Additional tests of validity resulted in acceptable levels of convergence with the Compulsive
Sexual Behavior Inventory and the Sexual Compulsivity Scale. Conclusions: Adopting a broader
approach to understanding out-of-control sexual behavior will allow scientists and practitioners
to obtain a more thorough understanding of the phenomenon, and hopefully lead to better
assessment and treatment strategies.
Psychopathology, Executive Functioning and Other Correlates of
Compulsive Sexual Behavior
Rory C. Reid, University of California, Los Angeles, Dept of Family Medicine, UCLA, 10880
Wilshire Blvd. Suite 1800, Los Angeles, CA. 90024, roryreid@byu.edu
This presentation will educate participants about perspectives on compulsive sexual behavior
informed by empirical research. Psychopathology measured by the MMPI-2 will be discussed
followed by insights about maladaptive shame and sexual compulsivity. Findings from an
investigation exploring alexithymia, emotional instability, and stress proneness will be shared in
order to highlight possible precipitating risk factors implicated in sexual compulsivity. Finally,
executive dysfunction will be discussed as a possible contributing factor for sexually compulsive
patients. Some clinician implications for practioners working with this population will also be
offered. Overall, this presentation will illuminate several perspectives and associated features of
sexual compulsive behavior in order to advance understanding of this phenomenon.
Prenatal Exposure to Progesterone Affects Sexual Orientation in Humans
June Reinisch, Erik Mortenson, & Stephanie Sanders, The Kinsey Institute for Research in Sex.
Gender, and Reproduction, Bloomington, IN, USA; Institute of Preventive Medicine,
Copenhagen University Hospital, Copenhagen, Denmark; HSAB.org; Institute of Public Health
and Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark; Department
of Gender Studies, Indiana University, Bloomington, IN USA; The Museum of Sex, NY
One Sentence Summary
Prenatal exposure to progesterone in humans was related to bisexuality as reflected in more
same-sex, but not diminished other-sex, sexual behavior and attraction.
Abstract
BACKGROUND: Prenatal sex hormone levels affect physical and behavioral sexual
differentiation in animals and humans. Although prenatal hormones are theorized to influence
sexual orientation in humans, evidence is sparse.
OBJECTIVES/METHODS: Sexual orientation was assessed in 34 prenatally progesteroneexposed/unexposed matched pairs (17 males, 17 females, mean age=23.2 years).
RESULTS: Regardless of sex, exposure appeared to be associated with bisexuality. Fewer
exposed individuals identified as heterosexual while more reported histories of same-sex sexual
behavior, attraction to the same or both sexes, and scored higher on Attraction to Males.
Measures of heterosexual behavior and scores on Attraction to females did not differ by
exposure.
CONCLUSIONS: Prenatal progesterone appears to affect human sexual orientation. Sexual
orientation may best be conceptualized in terms of a two-dimensional, rather than a bipolar
unidimensional, model.
Use of Immersive Virtual Reality in the Forensic Management of Sex Offenders: From
Assessment of Deviant Sexual Arousal to Future Directions in Therapeutic Applications
Rouleau Joanne-Lucine & Renaud Patrice, University of Montreal. University from Quebec in
Outaouais, Department of Psychology. University of Montreal, Po Box 6128 Succ Centreville.
Montreal Québec, Canada, H3C 3J7, joanne-lucine.rouleau@umontreal.ca
In experiment 1, to ascertain the perceived age of a series of virtual characters that we developed, we first
conducted a validation study of virtual characters with normal individuals before using them with a group
of sexually deviant subjects in a second study based on psychophysiological assessment of the sexual
arousal response using PPG (Experiment 2). Participants were 126 undergraduate psychology students
were recruited to assess the perceived age of a series of virtual characters (107 female, mean age 22.3
years, SD 2.1). Materials. The sexual stimuli were 3D virtual characters depicting realistic naked human
individuals (see figure 1). Five such stimuli were used in our study: two adults, a female and a male, both
designed to simulate individuals in their twenties; a female child and a male child, both prepubescent
between 10 and 12 years of age; and a neutral stimulus, i.e., a textureless virtual character (see figure 1).
All human-like characters were designed and developed by a team of professional 3D artists to simulate
Caucasian mesomorphic body types according to Tanner’s developmental criteria to fit the targeted age
categories (stage 5 for the adults and stage 1 for the prepubescent children; Tanner, 1973).
Experiment 2 aimed specifically at verifying the possibility of using 3D virtual characters with immersive
technologies to draw up deviant sexual preference profiles. Erectile responses obtained with virtual
stimuli were compared according to whether participants belonged to a non-deviant control group (ND) or
to a clinical group composed of sexual aggressors against children (SAAC), as well as according to the
sexual stimulus they were presented (Neutral, Male adult, Female adult, Male child and Female child).
Thirteen male SAAC participants were initially recruited to compose the clinical group. Three of these
SAAC subjects had to be removed from the study because they presented weak penile responses (see
below for criteria). Ten subjects (N=10) were then kept for analysis, nine of whom had been formally
recognized as being guilty of sexual aggression against children and one of whom admitting to have
pedophilic interests and using juvenile pornography. These participants came from the Royal Ottawa
Forensic Program, the Centre de psychiatrie légale de Montréal (CPLM) and the Centre d’Étude et de
Recherche de l’Université de Montréal, where they were involved in treatment or pre-sentence
assessment. Twenty-two non-deviant male subjects were recruited from newspaper ads to compose the
ND group.
Despite methodological limitations, the results obtained will be presented and are nonetheless interesting
in several respects. First of all, they show technically that immersive VR can be employed to conduct
sexual preference studies when combined with PPG. Furthermore, the sexual preference profiles we
obtained correspond closely to what was already known about the participants in this regard, and allowed
us to distinguish sexually non-deviant participants from those struggling with feelings of sexual attraction
to children. Although a rigorous comparative study remains to be done, the sexual preference profiles
demonstrated in our study compare well with the results that could generally be obtained with the
standard visual stimuli used in PPG. Finally, subjection to immersive presence with virtual sexual stimuli
seems to be able to generate sexual arousal responses that are probably useful in understanding sexual
preferences, whether deviant or otherwise, without the risk of crossing certain relevant ethical boundaries.
What is more, this methodology based on virtual technology may open the way to new ways of analyzing
– and possibly modifying –deviant sexual behaviour.
Funding Source: Institut de recherche en santé du Canada; (IRSC)
Body Image and Sexual Arousal Among Women With Sexual Dysfunction
Seal, Brooke N. & Meston, Cindy M., University of Texas at Austin, and 4548-204 Street
Langley, British Columbia, Canada V3A6H1, bseal@mail.utexas.edu
An abundance of research suggests that body image contributes to female sexuality. However,
there are several limitations in the existing research. For instance, most studies have employed
correlational designs and have been limited to young, non-clinical samples of college women
(e.g., Dove & Wiederman, 2000; Faith & Schare, 1993) or to women from specialized
populations (e.g., Andersen & LeGrand, 1991). While these studies have proved valuable in the
establishment of connections between body image and sexuality, conclusions cannot necessarily
be generalized to other groups of women, including those who experience sexual dysfunction.
The present study aimed to further our understanding of the influence of body image on sexual
arousal among women with female sexual arousal disorder (FSAD), subjective or combined
subtype. Forty-eight women with FSAD were randomized to participate in one of two
conditions, during which they adopted either a positive body image (PBI) or negative body
image (NBI). Each condition consisted of two counterbalanced sessions (Experimental Body
Image and Control), during which subjective mental sexual arousal and perceptions of physical
sexual arousal were measured in response to an erotic video. Results showed that levels of
subjective sexual arousal and perceptions of physical sexual arousal were significantly higher in
the experimental compared to the control sessions for both the PBI and the NBI conditions. This
is the first experimental study to show a direct connection between body image and sexual
arousal among women with FSAD. In both the PBI and NBI conditions, body awareness was
also found to be higher in the experimental compared to the control condition. This is consistent
with previous research showing that, in some cases, self or body awareness is related to
enhanced sexual response (e.g., Laan et al., 1993; Seal & Meston, 2007). Findings from the
current study suggest that the valence of the body awareness may not specifically matter, as has
been previously suggested (e.g., Seal & Meston, 2007; Trapnell et al., 1997). Rather, it may be
that increased self-awareness in general is related to enhanced arousal. It is speculated that this
may be due to a re-direction of attention away from extraneous distracting thoughts that often
occur during sexual activity (i.e., stress-related thoughts), and towards the present moment – as is
the foundation of mindfulness training. It is also feasible that women in the current study
experienced increased sexual arousal in both conditions because they were able to direct their
attention away from other distracting thoughts, become more aware of sexual feelings and
thoughts occurring in the moment (e.g., while exposed to erotic material), and possibly have a
more accurate perception of external and internal stimuli as additional and more accurate
information about their bodies and their sexuality was experienced.
Psychosexual Assessment of Women with Borderline Personality Disorder
Devita Singh, Shelley McMain, & Kenneth J. Zucker, University of Toronto, 250 College Street,
Toronto, Ontario Canada M5T 1R8, Devita_Singh@camh.net
There is some evidence in the literature that patients diagnosed with borderline personality
disorder (BPD) have a higher prevalence of a bisexual or homosexual sexual orientation (e.g.,
Dulit et al., 1993; Paris et al., 1997; Reich & Zanarini, 2008; Wilkinson-Ryan & Westen, 2000;
Zubenko et al., 1987). Less information is available on the gender identity of patients with BPD
although Wilkinson-Ryan and Westen (2000) reported that clinicians deemed their BPD clients
more “conflicted or unsure” about their own gender than patients with no personality disorder,
with a trend in the same direction compared to patients with other personality disorders.
Unfortunately, these extant studies have not relied on good psychometric measures to assess
psychosexual development in patients with BPD. The present study assessed gender identity,
sexual orientation, and recalled childhood sex-typed behavior in 100 women (M age, 34.06
years; SD = 10.56) diagnosed with BPD using DSM-IV criteria. Current gender identity was
measured with the 27-item Gender Identity/Gender Dysphoria Questionnaire for Adolescents and
Adults (GIDYQ-AA) (Deogracias et al., 2007; Singh et al., 2009); sexual orientation was
measured by self-report as homosexual, bisexual, heterosexual, asexual, unlabeled, or “other,”;
recalled childhood sex-typed behavior was measured by the 19-item Recalled Gender
Identity/Gender Role Questionnaire-Revised (RGI-Rev) (Singh et al., 2009). Previous research
on the GIDYQ-AA, a cutoff score of < 3.00 (on a 1-5 point scale) identified excellent sensitivity
and specificity in establishing “caseness” for patients referred clinically for gender dysphoria
compared to clinical and non-clinical controls (Deogracias et al., 2007; Singh et al., 2009). In the
present study, none of the women with BPD had a mean GIDYQ score that would indicate
“caseness” for gender dysphoria. Of the 94 women who self-labeled their sexual orientation (as
homosexual, bisexual, or heterosexual), 28.7% identified as either homosexual (N = 9) or
bisexual (N = 18), a remarkably high rate of minority sexual orientations. Women who selfidentified as either bisexual or homosexual reported significantly more gender dysphoria on the
GIDYQ-AA and recalled significantly more cross-gender behavior in childhood on the RGI-Rev
than women who self-identified as heterosexual (both ps < .05). As in our previous study of a
diagnostically heterogeneous clinical control population (Singh et al., 2009), the present study
also found no evidence of “caseness” for gender dysphoria in a well-defined sample of women
with BPD. In both the previous study and the current one, a non-heterosexual sexual orientation
was associated with higher levels of gender dysphoria (albeit very modest levels) and more
recalled cross-gender behavior in childhood.
Funding Source: This study was partially supported by a grant from the North
Erotica Viewing Effects on Intimate Relationships and Self/Partner Evaluations
Cameron Staley & Nicole Prause, Idaho State University, 2732 Jerome ST Pocatello ID, 83201,
cameron919@msn.com
Forty-four monogamous, heterosexual couples were recruited to assess the effects of mutual and
solitary erotica viewing on self-reported arousal, intimate relationships, and self/partner
evaluations. Previous research has shown that viewing erotica has positive effects including
increased sexual arousal and sexual behaviors following viewing. Other research has shown that
erotica viewing has negative effects including higher anxiety, negative affect, and lower ratings
on partner attractiveness. The excitation transfer and social comparison models were tested as
possible explanatory models of this apparent paradoxical relationship. In this study, participants
viewing erotic and non-erotic highly arousing films reported increases in arousal, however, only
the erotic films resulted in excitation transfer and desire to be close to partner. Also, viewing
erotic films lead to positive evaluations in ratings of partner’s sexual behaviors and own sexual
behaviors contrary to social comparisons theory, however, the erotic films resulted in higher
ratings of negative affect, guilt, and anxiety.
Funding Source: Graduate Student Research Scholarship Committee
Orgasm Functioning and Sexual Satisfaction: The Selective Protective
Value of Good Relationships
Stephenson, K.R. & Meston, C.M., University of Texas at Austin, 919 E 40th St. Austin, TX
78751, krstephenson@gmail.com
Address:
INTRODUCTION: Recent research has shown that sexual difficulties are weakly connected to
levels of sexual satisfaction and distress, suggesting the presence of important moderators
between the two constructs. The current study attempted to identify two potentially important
moderators: relationship satisfaction, and attachment style. Our hypothesis was that orgasm
functioning is related to levels of sexual satisfaction differentially by levels of these moderators.
Based on past research regarding attachment and sexuality, we predicted that relationship
satisfaction would serve as a protective factor, buffering against the negative effects of orgasm
difficulties, and that this buffer would be stronger in persons low in anxious and avoidant
attachment styles. In testing these hypotheses we hope to begin answering the question of when
orgasm difficulties lead to decreases in sexual satisfaction.
assessing sexual functioning, attachment style, relationship satisfaction, and sexual satisfaction.
We conducted linear regression analyses assessing the role of orgasm functioning, relationship
satisfaction, attachment, and their interactions in predicting sexual satisfaction.
RESULTS: All three independent variables were significant predictors of sexual satisfaction.
Additionally, both relationship satisfaction and attachment anxiety and avoidance interacted
impact on sexual satisfaction for participants who reported higher relationship satisfaction or
lower anxiety and avoidance. The three-way interaction between orgasmic functioning,
relationship satisfaction, and attachment was significant such that relationship satisfaction served
as a buffer between low orgasmic functioning and sexual satisfaction only for participants who
reported low levels of attachment anxiety and avoidance.
CONCLUSIONS: Results suggested that relationship satisfaction and secure attachment both
served as buffers of the negative effects of orgasm difficulties on sexual satisfaction. It appears
that these two factors work in conjunction such that, in the context of secure attachment and high
relationship satisfaction, orgasm difficulties have virtually no effect on sexual satisfaction, or
that orgasmic difficulties lead to decreases in sexual satisfaction only in the absence of these
protective factors. These findings have important implications both for understanding the link
between sexual problems and sexual satisfaction and for identifying targets of treatment for
sexual dysfunction.
Funding Source: Grant Number R01 HD51676-3 - National Institute of Child Health and Human
Development of the National Institutes of Health
Pleasure, Self Esteem, and Expression: Expanding the Range of Sexual Motives Associated
with Sexual Satisfaction
Stephenson, K.R., Ahrold, T.K., & Meston, C.M., The University of Texas at Austin, 919 E 40th
St. Austin, TX 78751, krstephenson@gmail.com
Introduction: Past work on the relationship between sexual motivation (the reasons people have
sex) and sexual satisfaction has shown that endorsement of theory-based approach/avoidance
motives is associated with differing levels of satisfaction, but recent research suggests that
assessing a wider range of empirically derived sexual motivations may provide a more complete
understanding of the link between these two constructs. To our knowledge, no study has directly
compared categorizations based in theory (e.g., approach/avoidance categorizations) to datadriven inductive categories of sexual motives. The current study tested whether empirically
constructed categories of motives predict a greater amount of variance in SS, over and above that
explained by theory-driven categories. Method: Participants (n = 964, 70% women) completed a
survey assessing sexual satisfaction (SSS-W), and a comprehensive, empirically constructed
measure of sexual motivation (YSEX). To allow for comparison, items in the YSEX
questionnaire were categorized into both proxy scales of approach/avoidance motives, and into
more comprehensive theoretical scales of approach/avoidance and individual/social motives. We
conducted hierarchical linear regression analyses separately by gender. In all analyses we
controlled for several factors previously shown to predict sexual satisfaction, including
neuroticism, sexual functioning, and liberalness of sexual attitudes in Step 1. To compare the
amount of variance explained by each of the categorizations, we entered either the proxy scale,
the extended theoretical scale of sexual motivation, or YSEX categories previously shown to be
associated with sexual satisfaction. To test whether YSEX categories predicted additional
variance above and beyond previously used theoretical categories, we also, entered the same
control variables (Step 1), the proxy scale (Step 2), and the extended theoretical scale (Step 3)
before entering the YSEX categories (Step 4). Results: The YSEX categories predicted more
variance in sexual satisfaction than either the proxy scale or extended theoretical scale for both
men and women. While control variables and approach/avoidance motivations predicted
statistically significant amounts of variance in sexual satisfaction for both men and women,
YSEX categories of motives predicted additional variance over and above these factors
(marginally significant for men). In both cases, this additional predictive power was not due
solely to additional variables in the later models. Conclusions: Results suggest that, while
measures of approach and avoidance sexual motives are useful tools for predicting levels of
sexual satisfaction in both men and women, assessing a wider range of motives and using
empirically constructed categories may lead to a fuller understanding of how a wide variety of
motivations for sex are associated with levels of sexual satisfaction. Our results also highlight
the importance of gender, showing that men and women differ not only in their sexual
motivations, but also in how these motivations are connected to satisfaction.
Funding Source: Grant Number R01 HD51676-3 - NICHHD of the NIH
Gender Differences in the Relationship Between Orgasmic Functioning
and Sexual Satisfaction
Stephenson, K.R., Bauerkemper, B., Perlman, H., Andrews, E., & Meston, C. M.,
The University of Texas at Austin, 919 E 40th St. Austin, TX 78751, krstephenson@gmail.com
INTRODUCTION: Recent research on female sexual functioning has shown that sexual
problems lead to decreases in sexual satisfaction only in a minority of cases, suggesting the
presence of important moderators between the two constructs. However, little work has been
done examining these moderators and how they may function differently in men and women.
Research on gender differences in sexuality suggests that the physical aspects of a sexual
relationship may be less important, and the wider relational context more important, for women
as compared to men. In light of these findings, the current study attempted to assess the
moderating role of gender and relationship satisfaction in the connection between orgasmic
functioning and sexual satisfaction. We predicted that poor orgasmic functioning would be
associated with a smaller decrease in sexual satisfaction for women as compared to men and that
high relationship satisfaction would protect against a decrease in satisfaction, especially for
women.
assessing sexual functioning, relationship satisfaction, and sexual satisfaction. We conducted
linear regression analyses assessing the role of orgasmic functioning, gender, relationship
satisfaction, and their interactions in predicting sexual satisfaction.
RESULTS: Orgasmic functioning and relationship satisfaction were significant predictors of
sexual satisfaction. Additionally, both relationship satisfaction and gender interacted
impact on sexual satisfaction for women and for participants who reported higher relationship
satisfaction. The three-way interaction between orgasmic functioning, gender, and relationship
satisfaction was significant such that relationship satisfaction was a more effective buffer
between low orgasmic functioning and sexual satisfaction for women than for men.
CONCLUSIONS: Results suggest that orgasmic functioning is tied to sexual satisfaction more
strongly for men than for women, and that high relationship satisfaction may act as a protective
buffer between orgasm difficulties and decreases in satisfaction, especially for women. These
findings add to literature on gender differences in sexuality, implying that sexual functioning
may impact men and women differently and that the impact of relational variables may also
differ by gender. These gender differences have important implications for the treatment of
couples experiencing sexual problems.
Funding Source: Grant Number R01 HD51676-3 - National Institute of Child Health and Human
Development of the National Institutes of Health
Why Do Sexual Orientation Differences in Male Masturbation Exist?
Kelly D. Suschinsky & Paul L. Vasey, University of Lethbridge, Department of Psychology,
University of Lethbridge, 4401 University Drive, Lethbridge, AB T1K 3M4 Canada,
kelly.suschinsky@uleth.ca
Previous research indicates that masturbation is characterized by sex and sexual orientation
differences. Men typically masturbate more frequently than women. Homosexual men tend to
masturbate more frequently than heterosexual men. Moreover, homosexual men report that
masturbation is more pleasurable than do heterosexual men. It has also been reported that
homosexual men are more likely to masturbate in front of a mirror compared to their
heterosexual counterparts.
Given the fact that homosexual men possess the same type of sexed body that they desire, we
were interested in investigating whether elevated masturbation by homosexual men reflects
increased eroticization of their bodies relative to heterosexual men. We tested this hypothesis by
asking homosexual (n = 38) and heterosexual (n = 65) men from across Canada to complete a
10-item subscale of an autoandrophilia questionnaire, the Body Eroticization Subscale, that was
used to assess the degree to which men experience erotic feelings towards their own bodies. This
subscale included items such as “Looking at or thinking about my own naked body is sexually
arousing.” Responses were on a 7-point Likert scale.
Overall, men also exhibited significantly higher scores on the Body Eroticization Subscale
relative to heterosexual men. These results may begin to explain sexual orientation differences in
men’s masturbation frequency, experience, and behaviours. Future research should investigate
whether elevated self-directed eroticism correlates with masturbation.
Funding Source: NSERC (Natural Sciences and Engineering Research Council of Canada)
Female Feederism: A Clinical Case Report
Terry, L.L. & Vasey, P.L., University of Lethbridge, 306-600 Columbia Blvd W, Lethbridge,
AB T1K 3M4 Canada, lesley.terry@uleth.ca
The purpose of this case study was to scientifically investigate the phenomenon of Feederism,
and more specifically Feedees. Feederism is a fat fetish community that eroticises food, eating
and weight gain. Feedees are heterosexual female participants of this community who explicitly
identify food-related activities and fantasies, such as being fed and actively gaining weight, as
sexually arousing. A woman who self-identifies as a Feedee was recruited from a popular
Feederism website. She was asked a series of questions about her personality, sexual history,
food cravings, body image, fantasies and earliest Feederism experiences. Preliminary results
suggest that subjective sexual arousal is less associated with food and eating, and more
associated with engaging in active weight gain and masochistic activities such as, dominance and
humiliation. Due to the lack of literature on this phenomenon it is unclear whether feederism is a
distinct, but under-recognized female paraphilia or alternatively, if it is variant of sexual
masochism.
Funding Source: University of Lethbridge
Sexual Function Nomenclature in the DSM: An Understandable Mistake That Has Become
an Inexcusable Calamity
Leonore Tiefer, NYU School of Medicine, 300 First Avenue #8F, New York, NY 10009, US,
ltiefer@mindspring.com
“As all definitions, theirs was highly tied to the specific circumstances
in which it came about, including the paradoxes and tensions that were
inherent in this situation”
S. Timmermans & Marc Berg (2003) The Gold Standard:
The challenge of evidence based medicine and standardization in health care.
Temple Univ. Press., p. 141
If the numerous presentations and publications over recent years are any indication,
compiling the sexuality sections for the new DSM-V (disorders of identity, dysfunctions,
paraphilias) seems less a technical matter of aggregating relevant research than a tortuous and
contentious process mixing science and politics. This seems true for all the sexuality sub-areas,
although the present symposium will only focus on “female sexual problems.”
This presentation will offer an overview of how Bob Spitzer’s original DSM-III effort in
1980 to provide pragmatic and theory-neutral categories for sexual function has been influenced
over time by clinical, marketing, and political factors. Although the rhetoric governing recent
and current DSM revisions emphasizes “evidence-based research,” it is clear that relevant and
conclusive bodies of empirical evidence are in short supply and open to multiple interpretations.
This is not unusual, as Timmermans and Berg (and numerous other sociologists of science) point
out with regard to many areas in medicine. In psychiatry we see how science, medicine,
professional politics, commercial considerations, personalities and institutions have become
entangled with regard to many of the diagnoses, and consequently how the DSM has itself
become an object of sociological study!
This jumble of forces may be what has led the current DSM editors to enforce a gag rule on
participants. My presentation will argue, however, that entanglement and confusion are
appropriate and even inexorable with regard to sexuality diagnostics because of the socially
constructed nature of sexuality, sexual satisfaction, and sexual problems. The inevitable inability
to be precise, concise, and definitive about sexuality diagnostics may at first be difficult to
accept, but it ultimately points us towards better scholarship that in the long run will both
illuminate sexuality and make an end of sexuality disorders in future editions of the DSM.
Sex, Lies and Audiotapes: Social Representation of Gender and Desire in a Sample of
Puerto Rican Men Who Have Sex With Men
Jose Toro-Alfonso, University of Puerto Rico, Department of Psychology, PO Box 23345, San
Juan, PR 00931, jtoro@uprrp.edu
From the beginning of the HIV epidemic men have represented the majority of the
reported cases around the whole world. The strong gender seems to debilitate himself in a
context where masculinity comes to question. The epidemic has also revealed the social
construction of the male homoerotic desire without questioning the identities. Heterosexuallyidentified men seem to have space for male to male sex.
For this study we implemented a qualitative approach to explore the following variables:
the social representation of masculinity, gender roles expression, high-risk sexual behavior, and
the perceived vulnerability for the HIV infection among a sample of men who have sex with men
in Puerto Rico.
Participants were 38 men who have sex with men. Recruitment was done by availability
using the snow-balling technique. Participants suggested other potential candidates to get in
contact with the researchers for their participation in the study. All participants received
information about the stuffy, its risk and their rights. Informed consent was oral for further
protection of their confidentiality.
Participants were interviewed at their place of comfort; interviews were audio taped for
further transcription and analysis. The interview addressed issues of the meaning of their body,
emotions, sexual behavior, gender roles, and masculinity in their cultural context. The meaning
of a healthy body and vulnerability to HIV infection was also addressed.
We found that those participants with the highest amount of body modification (piercing)
have higher risk behaviors for HIV/STD infection, and their construction of sexuality seems
genitally centered and highly penetrative. Participants showed a poor perception of HIV risk and
vulnerability to other STD’s. Men regularly perceived themselves as healthy and this perception
is constructed on the basis of their perception of masculinity.
The construction of masculinity among men who have sex with men might be a central
issue in their perception of their body and for public health in general. At the end of this
presentation there will be a discussion about masculinity and culture, its implications for the
development of culturally competent interventions, and for the development of policies to
address these issues.
Funding Source: Dean of Graduate Studies & Research (University of Puerto Rico )
(Institutional Funds for Research)
Testosterone and Estradiol are Linked With Perceptions of Orgasm in
Women But Not Men
Sari Van Anders2 and Emily Dunn1 Departments of Psychology & Women’s Studies, Program in
Neuroscience, University of Michigan. 530 Church Street, Ann Arbor MI, 48109, USA
(smva@umich.edu), (2) Human Biology Program, Indiana University. 1165 East Third St,
Morrison Hall 101, Bloomington IN 47405, USA (emdunn@indiana.edu)
Research on hormone-orgasm associations has generally focused on peptide hormones like
oxytocin or prolactin. Still, some studies have examined links between orgasms and steroid
hormones like testosterone (T), with evidence suggestive of a trait-like associa-tion whereby
women and potentially men exhibit more frequent orgasms and higher T. There are various ways
in which T and orgasms might be linked based on theoretical and empirical considerations, and I
tested two hypotheses: (1) individuals with higher T might experience orgasms in ways that are
more positive (such that orgasms are more rewarding and reinforced); (2) individuals with higher
T might be more sexually assertive with their partners (in ways that lead to higher orgasm
frequency). I also included estradiol (E) given that various vaginal processes likely to be relevant
to orgasms are associated with E, and a strong record exists from the non-human primate and
rodent literature pointing to E-sexuality links. Participants included 86 women and 91 men
recruited from the local campus and community to participate for course credit or a small
financial reimbursement ($10). Participants were diverse in some demo-graphic characteristics
(e.g. ethnicity, religion, relationship status) but were mostly heterosexual students. No
participants were using medications that alter hormones, including hormonal contraceptives.
Participants were tested in the afternoon to control for diurnal rhythms in hormones, and
attended a lab session where they provided a saliva sample for hormone analyses and completed
a demographics and background questionnaire, the Orgasm Checklist (Mah and Binik, 2002), the
Hurlbert Index of Sexual Assertiveness (Hurlbert, 1991), and the Sexual Desire Inventory (SDI;
Spector et al., 1996). Results supported Hypothesis 1 in women but not men: T was positively
and significantly correlated with women’s evaluative perceptions of solitary and partnered
orgasms. Specifically, women’s T was significantly correlated with perceptions of relaxing,
peaceful, and soothing orgasms. Results also indicated significant correlations between women’s
E and perceptions of sensations during solitary orgasm. Specifically, women’s E was
significantly correlated with sensations of flooding, flushing, and spreading during solitary
orgasms. These hormone-orgasms showed some mediation by sexual desire and/or sexual
frequency. There were no associations between hormones and men’s perceptions of their orgasm
experiences. Results did not support Hypothesis 2 in women or men, as there were no significant
correlations between T (or E) and higher sexual assertiveness. These findings suggest that steroid
hormones are linked to perceptions of orgasms in ways that may differ by gender/sex. In
addition, evidence from this study is suggestive that T may be more associated with perceptions
of psychological experiences of orgasms, and E may be more associated with perceptions of
physical experiences of orgasms.
Male Sexual Orientation in Independent Samoa: Evidence for Fraternal Birth Order and
Maternal Fecundity Effects
Doug Vanderlaan and Paul Vasey, University of Lethbridge, Department of Psychology, 4401
University Drive, Lethbridge, Alberta, Canada, T1K 3M4, doug.vanderlaan@uleth.ca
In Western cultures, male androphiles tend to have greater numbers of older brothers than male
gynephiles (i.e., the fraternal birth order effect). In the non-Western nation of Independent
Samoa, androphilic males (i.e., fa’afafine) tend to have greater numbers of older brothers, older
sisters, and younger brothers (Vasey & VanderLaan, 2007). It is unclear, however, whether the
observed older brother effect, in the context of the additional sibling category effects, represents
a genuine fraternal birth order effect or is simply associated with elevated maternal fecundity.
The present study employed a larger, independent replication sample of fa’afafine and gynephilic
males from Independent Samoa. Fa’afafine had greater numbers of older brothers and sisters.
The replication sample and the sample from Vasey and VanderLaan (2007) were combined,
facilitating a comparison that showed the older brother effect was significantly greater in
magnitude than the older sister effect. These results suggest that fraternal birth order and
maternal fecundity effects both exist in Samoa. The significance of cross-cultural consistencies
in the existence of these effects for biological theories regarding the development of male
androphilia is discussed.
Research on Avuncularity in Samoan Male Androphiles is Consistent with the Kin
Selection Hypothesis
Doug Vanderlaan and Paul Vasey, University of Lethbridge, Department of Psychology, 4401
University Drive, Lethbridge, Alberta, Canada, T1K 3M4, doug.vanderlaan@uleth.ca
Androphilia refers to sexual attraction toward adult males, whereas gynephilia refers to sexual
attraction toward adult females. The persistence of male androphilia over evolutionary time
requires explanation when viewed within the context of natural selection, a process that favors
the evolution of reproductively viable traits. One explanation for the evolution of male
androphilia is known as the Kin Selection Hypothesis. This hypothesis holds that androphilic
males could increase their indirect fitness by channeling altruistic behavior toward close kin,
which, in principle, would allow those kin to increase their survivorship and ultimately, their
reproductive success. In keeping with the predictions of the Kin Selection Hypothesis, previous
research has shown repeatedly that Samoan androphilic males (known locally as fa’afafine)
exhibit significantly higher avuncular (i.e., uncle-like) tendencies compared to the materteral
(i.e., aunt-like)/avuncular tendencies of women and gynephilic men. In the present study, we
examine whether these avuncular tendencies translate into actual behaviour. Namely, we
demonstrate that fa’afafine give more money to their nieces and nephews, compared to women
and gynephilic men. In addition, we show that, compared to women and gynephilic men,
fa’afafine’s avuncular tendencies are significantly more dissociated from their altruistic
tendencies toward non-kin children. We argue that the disassociation of these two psychological
domains allow fa’afafine to allocate resources to nieces and nephews in a more economical,
efficient, reliable, and precise manner. Taken together, these findings are consistent with the Kin
Selection Hypothesis, which suggests that androphilic males have been selected over
evolutionary time to act as “helper-in-the-nest,” caring for nieces and nephews and thereby,
increasing their indirect fitness.
Sexuality and Limb Amputation: A Systematic Review
Jesse Verschuren, Jan Geertzen, Corine van Es, and Pieter Dijkstra, Rijksuniveristeit Groningen,
the Netherlands, Center for Rehabilitation, University Medical Centre Groningen, PO Box
30.001, 9700 RB Groningen, the Netherlands, j.e.a.verschuren@rev.umcg.nl
In the Netherlands, 3000 major limb amputations are performed annually (1.9 per 10.0000). A
limb amputation induces several limitations in performing professional, leisure, social and
marital activities, including sexual activities. A total of five publication databases were searched:
Pubmed, Cinahl, Embase, Psychinfo and Recall. Papers were included in this review if they
described research in which the sexual (dys) functioning of a cohort of limb amputees was
investigated. Excluded were reviews, expert opinions, case studies (n < 10) as well as papers not
dealing with limb amputees. A total of 11 cross-sectional studies were found. The studies were
published between 1945 and 2002. The studies were characterized by a diversity of study
populations, sampling methods, gender and age distributions, assessment methods, and outcome
measures. The mean age ranged from 26 years to 57 years. The time interval between amputation
and research ranged from 6 months to more than 20 years. All studies found an impact of a limb
amputation on some part of sexual functioning (or concerns about sexual functioning) to some
degree. In general, single amputees experienced more impact of the amputation on (concerns
about) sexual functioning compared to married amputees. Additionally elder amputees
experienced a larger impact of the amputation on sexual functioning compared to younger
amputees.
For male amputees the impact on sexual functioning was larger than for female amputees. A
transfemoral amputation has a larger impact on sexual functioning than a transtibial amputation.
Amputees who suffered from amputation related pain experienced a larger impact on sexual
functioning compared to those who did not experience this pain. The finding that amputation had
a higher impact on sexual functioning in elderly compared to younger amputees might also be an
age effect unrelated to the amputation. Also adaptation in sexual behaviour or, for example,
obtaining other positions during coitus may be more difficult for elderly. Being married or
having a steady partner as an amputee give fewer problems in sexual functioning than being
single. Perhaps it is more difficult to start a new sexual relationship as an amputee. Male
amputees appear to have more sexual problems than female amputees, possibly due to the
traditional position of the man “on top”. Another problem is that recall bias may have occurred
when the amputees were asked to compare the current state with the state prior to amputation,
especially when the time interval between amputation and study was large. In the last 60 years,
only 11 studies concerning sexuality and amputations of extremities could be identified. Factors
influencing impact of an amputation on sexual functioning in limb amputees were higher being
single, higher age, being male, a larger amputation, and pain. However these results should be
regarded with caution because of the great clinical diversity in the studies, the cross-sectional
design and recall bias.
Darwin’s Legacy: An Evolutionary View of Reproduction
Virginia Vitzthum, Anthropology Dept & Kinsey Institute, Indiana University, Morrison Hall
302, 1165 E. Third St.,Bloomington, IN 47405 USA, vitzthum@indiana.edu
This year marks the bicentenary of Charles Darwin’s birth (February 12, 1809) and the 150th
anniversary of the publication of On the Origin of Species (November 24, 1859). Although, as
noted by Dobzhansky, “Nothing makes sense in biology except in the light of evolution,” the
application of evolutionary theory to explain women’s reproductive functioning is a relatively
recent development in the study of human biological variation. This delay reflected both the
limited technology available for studying neuroendocrino-logical mechanisms in humans and the
influence of Malthusian conceptualizations of human reproductive functioning, first expounded
in “Essay on the Principle of Population” (1798). Malthus saw the reproductive system much
like an unflagging machine without any internal controls or capacity to respond to changing
conditions. Human population growth was held in check only by external factors (famine,
disease, war, homicide), old age, and conscious restraint. This view was reinforced by the
metaphor of man as machine, traceable to the 17th century French philosopher, Descartes, but
still a powerful image today, particularly in biomedicine. A normal healthy body is expected to
approximate an ideal in form and function. Hence, for example, most women “should have” 28day menstrual cycles. Because the fundamental concern of physicians and epidemiologists is
with detecting and eliminating disease, medical paradigms often equate variation from an ideal
with pathologies in need of correction. Hence, if a woman’s reproductive machinery deviates
from the relentless productivity envisioned by Malthus, she must be malfunctioning. This
“pathology framework” underpins the medicalization of women’s normal, if variable,
reproductive functioning. In contrast, an evolutionary approach to human reproduction evaluates
the hypothesis that variability is both normal and potentially adaptive. More specifically, life
history theory, an evolutionary framework that has developed rapidly since the late 1960s, posits
that natural selection leads to the evolution of mechanisms that tend to allocate resources to the
competing demands of growth, reproduction, and survival such that fitness is locally maximized.
(That is, among alternative allocation patterns exhibited in a population, those having the highest
inclusive fitness will become more common over generational time.) Strategic modulation of
reproductive effort is potentially adaptive because investment in a new conception may risk
one’s own survival, future reproductive opportunities, and/or current offspring survival. Several
physiological and behavioral mechanisms modulate reproductive effort in human females,
influenced by a vast array of cultural, sociopolitical, and environmental factors. I will focus on
the hormonal changes that vary the probability of ovulation, conception, and/or continuing
pregnancy, discuss the evolutionary models that predict how and why these hormonal changes
occur, and consider the implications of this research for understanding women’s sexuality. Much
remains to be learned about the evolutionary determinants, proximate mechanisms, and
significance of variation in women’s reproductive functioning.
Political System and Transsexuality: Changes in FtM/MtF Ratio after Velvet Revolution in
the Czech Republic
Petr Weiss, Hana Fifkova, & Ivo Prochazka, Institute of Sexology, Charles University,
Apolinarska 4, 128 00 Prague 2, Czech Republic, weisspetr@volny.cz
The data about transsexual patients of the Institute of Sexology in Prague (the central Czech
institution providing the treatment of transsexuals) were collected. The data indicate that the
number of TS patients are dependent on the political system - there is a peak in 1968 (so called
Prague Spring) and then especially after 1989 (so called Velvet Revolution, the transmission
from the totalitarian communistic to the democratic political system). Before the change of
political system the rate of FtM: MtF transsexual patients was approximately 3:1. After
revolution this rate is slowly changing to the opposite with the prevalence of MtF patients (see
attachment).
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male to female
female to male
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An Integrated Theoretical Approach to Substance Use and Risky Sexual Behavior among
Men who have Sex with Men
Wells, Brooke E., Golub, Sarit A., & Parsons, Jeffrey T., CHEST, Hunter College and National
Development and Research Institutes, Inc., 250 W. 26th St., Suite 300, New York, NY 10001,
bwells@chestnyc.org
Decades of research demonstrate a consistent association between substance use and sexual risk
behavior, particularly among men who have sex with men (MSM) (Shoptaw and Reback, 2007;
Spindler et al., 2007). MSM who use substances are more likely to engage in sexual risk
behavior (Shoptaw and Reback, 2007; Spindler et al., 2007) and more likely to be HIV+ or test
positive for a sexually transmitted infection (STI) (Drumright et al., 2007; Spindler et al., 2007).
Further, situational evidence demonstrates that the concurrency of sexual behavior and
substance use predicts risky sexual behavior (Celentano et al., 2006; Purcell et al., 2005) and
HIV/STI transmission (Carey et al., 2008; Koblin et al., 2006). Despite the evidence for a
causal link, there are certainly MSM who engage in sexual risk behavior without using
substances and there are men who engage in substance use but do not engage in sexual risk
behavior (Grov et al., 2008). Two primary theories have been utilized to understand the
variability in the association between substance use and sexual risk behavior: Expectancy Theory
(positing that one’s socially informed expectations of substance’s sexual effects drive this
association) and Alcohol Myopia Theory (positing that alcohol limits one’s cognitive abilities,
the effects of which are best seen under conditions of inhibition conflict). While there is
supporting evidence for each of these theories, researchers have called for a theoretical
integration (Cooper, 2002; Dermen and Cooper, 2000) so as to better predict and intervene upon
sexual risk at the nexus of substance use and sexual behavior. As such, the present study
examined the synergistic role of conflict (surrounding unsafe sex) and expectancies in sexual
behavior (see Figure 1) among 135 men who have sex with men who were enrolled in an
intervention trial. Men were eligible for the study if were HIV negative, reported at least one
recent incident of sexual risk behavior (unprotected anal sex with a casual partner or a
serodiscordant main partner), and at least five instances of substance use in the previous three
months. Using the baseline data, two conflicts were examined: (1) The conflict between
motivation to improve one’s safer sex practices and their temptation for unsafe sex; and (2) The
conflict between motivation to improve one’s safer sex practices and their perceived benefits of
unsafe sex. Factorial ANOVAS (2 X 2; high vs. low expectancies and conflict vs. no conflict)
revealed a significant interaction between each type of conflict and expectancies such that those
with both strong expectancies and strong conflict engaged in a higher percentage of their sexual
activity under the influence of substances and a higher percentage of their sexual risk behavior
under the influence of substances, when compared to all other groups (See Figures 2-5). Results
demonstrate the synergistic effects of conflict and expectancies and highlight the need to
integrate the existing theories. This paper makes suggestions for ways in which these theories
may be integrated to inform prevention and intervention efforts designed at reducing sexual risk
behavior, even in the face of substance use.
Funding Source: The project on which this data is based is funded by the National Institutes on
Drug Abuse.
How Many Men with Erectile Dysfunction May Benefit From
Testosterone Screening?
Kevan Wylie, Porterbrook Clinic, Sexual Medicine, 75 Osborne Road, Sheffield. S11 9BF,
k.r.wylie@sheffield.ac.uk
Over a ten year period, men presenting to two sexual medicine services within a major UK city
with erectile difficulties have undergone a standard assessment programme. Partial
demographics of 7030 men are within the electronic data system of which 2409 have a full
record entered into the electronic database. 3538 men have at least one serum testosterone (T)
result entered onto the system. The clinic protocol is that all patients with a first T level of
12nmol/l and below should have a second measure between 0800 and 1000.
Using three different thresholds, there were 498 men with a first T of less than 12 nmol/l with
382 where the second T<12nmol/l; 416 men with a first T of less than or equal to 10.4 nmol/l
with 270 where the second T<10.4nmol/l; and 203 men with a first T of less than or equal to
8.4nmol/l with 111 where the second T<8.4 nmol/l. In addition 54 men had a T level<12nmol/l
with no second measure; 27 men had a T level<10.4nmol/l with no second measure; and 12 men
had a T level<8.4nmol/l with no second measure.
Whilst more accurate calculation of free and bio available testosterone is now routine with
concurrent measurement of SHBG and albumin, the figures identify the considerable number of
patients where testosterone may play an important part in the aetiology and maintenance of any
erectile dysfunction process. As T therapy alone is now recognised as helping to restore erectile
function in around half of men with late onset hypogonadism without recourse to prescription of
an erectogenic agent like sildenafil, it is important to identify potential patients requiring such
therapy. So for men presenting with ED, with a threshold of T</12nmol/l and assuming 77% of
the 54 men who only had one blood test would also fall below this threshold, then around 424
men (8.34%) should be offered a trial of T therapy.
Towards DSM-V: An Overview
Kenneth J. Zucker, Child, Youth, and Family Program, Centre for Addiction and Mental Health,
250 College St., Toronto, Ontario M5T 1R8, Canada, Ken_Zucker@camh.net
The Sexual and Gender Identity Disorders Work Group is one of 13 panels responsible for the
review of diagnoses that are currently in the fourth edition of the Diagnostic and Statistical
Manual of Mental Disorders (DSM-IV-TR) in preparation for the publication of DSM-V in 2012.
These Work Groups, which also have a number of nominated advisors, have been charged with
several tasks: (1) reviewing the diagnostic literature; (2) recommending changes to current
diagnostic criteria; (3) recommending deletion or addition of diagnoses; (4) proposing field trials
for diagnoses that require them; and (5) revising the text for each diagnosis. In addition to these
13 Work Groups, the DSM-V Task Force also has cross-cutting Work Groups that will consider
several issues, including (1) meta-structure of the manual; (2) dimensional diagnosis; (3)
measurement of distress and impairment; and (4) gender and cultural issues. This presentation
will provide an overview of the DSM-V charge and will introduce some of the issues that are
under consideration by the Sexual Dysfunctions subworkgroup of the Sexual and Gender Identity
Disorders Work Group.

International Academy of Sex Research

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