Sexes, Volume 4, Issue 4 (December 2023) – 14 articles

Youth and young adults (YYA) have been uniquely affected by COVID-19. Behavioral models have not yet been applied to understand YYA’s preventive behavior, though the Information–Motivation–Behavior (IMB) model may be appropriate. We used data from a national, diverse survey of COVID-19 effects and prevention behaviors in YYA ages 14–24 (n = 1026) and conducted an exploratory factor analysis and bivariate linear regressions to assess the association between demographics and IMB measures. Significant differences by sexual identity were identified, with bisexual/pansexual, gay/lesbian, and queer populations reporting significantly lower prevention stigma, in comparison to their straight respondents. Non-binary respondents (vs. women/girls) and transgender and gender diverse individuals (vs. cisgender) had significantly higher intentions to social distance. Racial/ethnicity differences were also found in lower prevention efficacy beliefs (Latinx and multiracial vs. white), and lower motivation norms (Black and Latinx vs. white). Our findings about critical disparities in IMB measures provide recommendations for future prevention research, practice, and policy development in response to the pandemic, particularly related to highly marginalized communities. Full article

The inaugural AIDS Program in Brazil was established in São Paulo in 1983, with the Instituto Adolfo Lutz appointed for laboratory assistance. Subsequently, research on HIV infections and HIV/HTLV (HIV/HTLV-1 and HIV/HTLV-2) co-infections was conducted. This narrative review focuses on studies from the Immunology Department (1983–2017) that significantly influenced AIDS diagnosis or provided epidemiological data such as prevalence rates, sex, age, and risk factors. Twelve studies, encompassing over 8000 individuals, are discussed. During 1983–1985, nearly all AIDS cases were attributed to homosexual/bisexual men aged 31 years old. Subsequently, heterosexual men and women emerged as risk groups owing to intravenous drug use (IDU) and/or unprotected sexual intercourse with AIDS patients or multiple partners per year. From 1985 onwards, vertical transmission led to child infections. HIV/HTLV co-infection rates decreased over time, initially associated with male IDU, and in the 2010s with female IDU, and individuals aged >40 years. Trends in HIV and HIV/HTLV co-infections among younger men and women (<30 years of age) were observed from 2015 to 2017. The changing characteristics and risk groups for HIV and HIV/HTLV co-infections over the years underscore the necessity for ongoing public policies to prevent retrovirus transmission, particularly among adolescents and young adults. Full article

Premature ejaculation and erectile dysfunction are common male sexual dysfunctions worldwide, causing substantial distress in men as well as their partners and decreasing the quality and stability of romantic relationships. We investigated the associations between the self-reported anatomical characteristics of penises and sexual dysfunctions in an urban sample of Chinese men. We recruited 1085 Chinese urban men aged from 18 to 50 (M = 31.37; SD = 5.52) to fill out an online questionnaire regarding the anatomical characteristics of their penis, as well as early ejaculation and erectile problems via two Chinese online survey platforms. The participants reported their age, height, weight, penile length, penile circumference, circumcision status, and foreskin characteristics as well as answered the International Index of Erectile Function-5 and Checklist for Early Ejaculation Symptoms. Both an increasing penile length (M = 14.49; SD = 2.22) and girth (M = 15.46; SD = 4.36) were associated with fewer early ejaculation problems, but only an increasing penile length was associated with fewer erectile problems. Less foreskin covering the glans of the penis was associated with fewer early ejaculation and erectile problems. Age was found to have a non-linear relationship with early ejaculation and erectile problems in this cross-sectional study. Specifically, early ejaculation problems decreased until a certain age (31), and then increased with further increases in age. The relationship between the anatomical characteristics of the penis and sexual function is complex. Also, the results suggest that there is a curvilinear non-monotonic relationship between age and sexual dysfunction. Full article

This study delves into heterosexual identity–behavior discordance, exploring the interaction between sexual identification and behavior in the UK. Analyzing representative 2010 data from the British population (N = 12,472), this research categorizes participants into different groups: nonheterosexual, concordant heterosexual, and three discordant heterosexual categories (closeted, experimenters, and desisters). These groups were compared in terms of sociodemographics, attitudes toward sexuality, risk behaviors, and health indicators. Discordance was associated with permissive social attitudes, including behaviors such as adultery and one-night stands, and with increased substance abuse and risky sexual behaviors, especially among the closeted. Surprisingly, the physical and mental health of discordant heterosexuals was similar to concordant heterosexuals, in contrast to the poorer health of nonheterosexuals. Due to the significant variations in lifestyles and health indicators among different groups, this study highlights the importance of providing targeted services and interventions. Full article

Feminist scholars have suggested that male ejaculations in pornographic videos, particularly ejaculations on a sexual partner’s face or in their mouth, are often used to symbolically debase and humiliate women. However, no previous study has asked pornography viewers about their perceptions and preferences regarding male ejaculation. In this article, I investigate these perceptions and preferences using a large sample of more than 300 pornography viewers representing diverse demographics and cultural backgrounds. I find that most viewers either did not care about the male ejaculation or its placement or preferred for it to be in the female partner’s vagina. In contrast to common assumptions found in the literature, very few viewers expressed a preference for ejaculation on a woman’s face or in her mouth and many of them found such practices disturbing. Full article

Homosexuality is a sensitive issue in Africa that inspires a great deal of public contention and controversy and attracts much social science research interest. Due to the sensitivity of the issue, conducting empirical research on homosexuality in Africa or within African population groups could be subject to several challenges. This article presents an autoethnographic account of my experiences conducting empirical research on attitudes towards homosexuality among Cameroonians based at home and those living in Switzerland. The paper highlights the key challenges, surprises, and lessons learned experienced in the different stages of the research process, from design to data collection, analysis, and publication of findings. Drawing on these experiences, the article calls attention to some aspects that young researchers embarking on research in sensitive topics should be aware of and should plan for upfront. It proposes practical coping approaches that can support young researchers to navigate the difficult waters of researching homosexuality in challenging settings so they can achieve their research goals within the timeframe and resources available to them. Full article

Sexual dysfunction, a globally widespread concern, is associated with numerous negative outcomes. While some evidence indicates the potential of ginger supplementation to enhance sexual function, comprehensive research in this area remains scarce and the potential mechanism behind is unclear. The current study aimed to explore if and how consumption of ginger as part of a daily diet is associated with sexual desire, frequency of sexual behavior, as well as sexual arousal and disgust experienced during these behaviors. Chinese participants (N = 499; 250 women) from an online sample service (Credamo) answered a cross-sectional survey regarding their consumption of ginger, sexual behavior, and sexual desire. Ginger consumption was associated with higher sexual desire, and more frequent sexual behaviors, as well as feelings of sexual arousal during them. Sexual desire and feelings of sexual arousal during specific sexual activities mediated the association between the ginger consumption and the frequency of sexual behaviors, indicating potential pathways of the effects of ginger on sexual behavior. Interestingly, while ginger consumption showed no direct relationship with feelings of disgust during sexual behavior, sexual arousal during these behaviors did positively mediate the association between ginger consumption and feelings of disgust. The findings imply that ginger shows potential as an intervention for enhancing sexual behavior, but further experimental and longitudinal research is needed to fully understand the causal mechanisms underlying the effects of ginger on sexual health. Full article

Although several lines of evidence from different studies highlight sex differences in cardiovascular diseases, to date, most studies have been focused on males, with the idea that males and females are similar, differing only in the magnitude of the response. However, the principles learned in male models cannot and should not be extrapolated to women and, therefore, it is important to study in greater detail not only the differences between the sexes but also the physiological intertwining of the underlying genetic and hormonal mechanisms of sexual dimorphism. This review explores the sex disparities in the autonomic nervous system regulation of blood pressure (particularly baroreceptor function), with special emphasis on sex hormones and sex chromosome complement factors involved in sexually dimorphic autonomic blood pressure regulation. A more detailed understanding of the sources of physiological disparities between the sexes may also help in understanding the differences between the sexes in rates of cardiovascular disease and may also aid in designing future improvements for sex-tailored therapeutic treatments. Full article

Comprehensive sexuality education (CSE) is an important framework utilized worldwide to provide students and young people with accurate, affirming, and socially conscious sexuality education. However, there is still a lack of CSE curricula in school contexts that is relevant for students with various disabilities. This article takes the Ontario, Canada, context as an example of where and how CSE can improve to be more inclusive for students with disabilities. This article reviews the current context of CSE in Ontario, Canada, including its controversies, while providing recommendations for meeting the needs of students with various disabilities, including psychological, intellectual, and physical disabilities. This article aims to provide practical recommendations, such as pertinent curricular content and pedagogical recommendations for scholars, researchers, and policymakers for improving CSE for students with disabilities in schooling. Full article

We investigated the roles that suspicious jealousy and reactive jealousy might play in the associations between borderline personality features (BPF) and mate retention behaviors. Study 1 (N = 406) found that BPF had positive indirect associations with benefit-provisioning behaviors and cost-inflicting behaviors through suspicious jealousy but not through reactive jealousy. Study 2 (N = 334 (a dyadic sample of 167 romantic couples)) revealed actor effects such that BPF had positive indirect associations with benefit-provisioning behaviors and cost-inflicting behaviors through suspicious jealousy for both men and women. In addition, the positive association between BPF and benefit-provisioning behaviors was mediated by reactive jealousy in women but not in men. The only partner effect that emerged from these analyses showed that BPF in women were negatively associated with the benefit-provisioning behaviors reported by their male partners. Discussion focuses on the implications of these results for the function that jealousy might serve in the strategies used by individuals with BPF to maintain their romantic relationships. Full article

For sexual minority men (SMM), attachment anxiety and attachment avoidance are evidenced to predict poor mental health (e.g., depression and anxiety). While mindfulness is known to mediate this relationship among the general population, it has yet to be examined among SMM. This study examined the interaction of attachment anxiety and avoidance, and the mediating effect of mindfulness, in predicting symptoms of depression and anxiety among a sample of gay and bisexual men (GBM) in the U.S. We used regression-based path analyses to test the interaction of attachment anxiety and avoidance on symptoms of anxiety and depression. Attachment anxiety and avoidance were positively associated with mental health symptoms. In the model predicting anxiety, we found a significant interaction, indicating that individuals high in attachment anxiety and avoidance had the highest BSI scores. In model 2, direct effects for attachment anxiety and avoidance remained significant, and mindfulness was negatively associated with both mental health symptoms. Significant indirect effects from attachment anxiety and attachment avoidance, through mindfulness, to both depressive and anxiety symptoms were observed. No evidence of mediated moderation was found. Our findings show that attachment is an important predictor of mental health among GBM and support previous research on the mediating role of mindfulness in this association. Full article

In the face of ongoing interpersonal and structural violence towards sex workers in Canada, this research inquiry explores nine women and gender-diverse sex workers’ experiences of place identity within their workplaces. Employing multisensory and arts-based ethnographic fieldwork, the co-researchers storied their embodied place-based experiences of identity. The research findings illuminate place-identity processes within sex workplaces, suggesting that the context, materiality, and multisensory atmospheres of the co-researchers’ work environments were entwined with internal and external self-concepts. The co-researchers created personalized multisensory atmospheres in their workplaces through the use of colour, visual art, and music. Having workplaces that positively supported place identity fostered workplace comfort, control, and empowerment. Ultimately, this research suggests that place-identity processes in sex workplaces have the possibility to resist and shift sex work stigma. Full article

Congenital adrenal hyperplasia (CAH) is a heterogeneous group of autosomal recessive disorders due to defects in adrenal steroid biosynthesis. In about 90% of patients, CAH is caused by pathogenetic variants in CYP21A2 gene, impairing the function of 21-hydroxylase (21-OH) enzyme. CAH can present as classical form (simple virilizing or salt wasting) or as non-classical form (NC-CAH). NC-CAH is due to pathogenetic variants in the CYP21A2 gene that result in 20–70% residual activity of 21-hydroxylase. Early diagnosis may be missed, mainly in childhood, jeopardizing long-term outcome. This paper will review some information on clinical findings, symptoms, diagnostic approaches, and treatments of NC-CAH in childhood, allowing better management and long-term outcome. Full article

The Oxford English Dictionary (OED) lists 1571 as the year of the first recorded use of the English word ‘masculinity’; the Ancient Greek $\breve{\alpha }\nu \delta \rho ϵ\acute{\iota }\overline{\alpha }$ (andreia), usually translated as ‘courage’, was also used to refer to manliness. The notion of manliness or masculinity is undoubtedly older still. Yet, despite this seeming familiarity, not only is the notion proving to be highly elusive, its understanding by the society being in a constant flux, but is also one which is at the root of bitter division and confrontation, and which has tangible and far-reaching real-world effects. At the same time, while masculinity has been attracting an increasing amount of attention in academia, the large body of published work seldom goes to the very foundations of the issue, failing to explicitly and with clarity reach a consensus as to how masculinity ought to be understood. Herein, I critique the leading contemporary thought, showing it to be poorly conceived and confounded, and often lacking in substance which would raise it to the level of the actionable and constructive. Hence, I propose an alternative view which is void of the observed deficiencies, and discuss how its adoption would facilitate a conciliation between the currently warring factions, focusing everybody’s efforts on addressing the actual ethical, deconfounded of specious distractions. Full article