An Indirect Measure of Implicit Sexual Assertiveness: Reliability and Validity of the Sexual Assertiveness IAT in Young Adults in The Netherlands.

In the present study we investigated the reliability and validity of an Implicit Association Test of sexual assertiveness (the SA-IAT) in a sample of young adults (n = 159). The D600 algorithm was used to calculate implicit sexual assertiveness scores. Explicit sexual assertiveness was measured using a selection of items from the Hurlbert Index of Sexual Assertiveness. Personality traits were assessed using the revised, short version of the Eysenck Personality Questionnaire. The internal consistency of the SA-IAT was evaluated based on split-half reliability, and found acceptable with α = 0.61 for the practice trials, and α = 0.70 for the test trials, after correction for attenuation. Convergent and divergent validity were evaluated using correlation analysis. Correlation with explicit sexual assertiveness was found to be low, as expected. Divergent validity of the SA-IAT was evaluated against the personality traits of extraversion, neuroticism, and social desirability. Except for a significant correlation of implicit sexual assertiveness with extraversion in the full sample and the female subsample, implicit sexual assertiveness and personality traits were not found to share variance, as expected.

Sex Work Criminalization Is Barking Up the Wrong Tree.

There is a notable shift toward more repression and criminalization in sex work policies, in Europe and elsewhere. So-called neo-abolitionism reduces sex work to trafficking, with increased policing and persecution as a result. Punitive "demand reduction" strategies are progressively more popular. These developments call for a review of what we know about the effects of punishing and repressive regimes vis-à-vis sex work. From the evidence presented, sex work repression and criminalization are branded as "waterbed politics" that push and shove sex workers around with an overload of controls and regulations that in the end only make things worse. It is illustrated how criminalization and repression make it less likely that commercial sex is worker-controlled, non-abusive, and non-exploitative. Criminalization is seriously at odds with human rights and public health principles. It is concluded that sex work criminalization is barking up the wrong tree because it is fighting sex instead of crime and it is not offering any solution for the structural conditions that sex work (its ugly sides included) is rooted in. Sex work repression travels a dead-end street and holds no promises whatsoever for a better future. To fight poverty and gendered inequalities, the criminal justice system simply is not the right instrument. The reasons for the persistent stigma on sex work as well as for its present revival are considered.

A Scale for the Assessment of Sexual Standards Among Youth: Psychometric Properties.

The (hetero)sexual double standard (SDS), prescribing sexual modesty for girls and sexual prowess for boys, negatively affects sexual and mental health. Nevertheless, endorsement and enactment of the SDS is still common. In this study, we respond to recent calls for modernization in the field of sexual double standard research. We describe the development of the "Scale for the Assessment of Sexual Standards among Youth" (SASSY), as well as its psychometric properties. This instrument was designed to measure contemporary sexual double standard endorsement, defined as "the degree to which an individual's attitude reflects a divergent set of expectations for boys and girls, in that boys are expected to be relatively more sexually active, assertive, and knowledgeable and girls are expected to be relatively more sexually reserved, passive, and inexperienced" among adolescents and emerging adults. In Study 1, a pool of 35 items was administered in a Dutch sample (N = 465, 54.8% female, age 16-20). A 20-item set formed a one-dimensional and internally consistent scale and was subsequently administered in a second Dutch sample. Study 2 (N = 818, 58.4% female, age 16-25) again assessed the 20-item set. After dropping one item, the 19-item SASSY proved to be one-dimensional and internally consistent, exhibiting good test-retest reliability, construct validity, and convergent validity. Finally, the instrument showed configural and metric measurement invariance across gender, age, education level, and sexual experience level, and configural, metric, and scalar measurement invariance across time. These studies confirmed the 19-item SASSY to be a reliable and valid new tool for the assessment of contemporary sexual double standard endorsement among adolescents and emerging adults.

Reorienting adolescent sexual and reproductive health research: reflections from an international conference.

On December 4th 2014, the International Centre for Reproductive Health (ICRH) at Ghent University organized an international conference on adolescent sexual and reproductive health (ASRH) and well-being. This viewpoint highlights two key messages of the conference--(1) ASRH promotion is broadening on different levels and (2) this broadening has important implications for research and interventions--that can guide this research field into the next decade. Adolescent sexuality has long been equated with risk and danger. However, throughout the presentations, it became clear that ASRH and related promotion efforts are broadening on different levels: from risk to well-being, from targeted and individual to comprehensive and structural, from knowledge transfer to innovative tools. However, indicators to measure adolescent sexuality that should accompany this broadening trend, are lacking. While public health related indicators (HIV/STIs, pregnancies) and their behavioral proxies (e.g., condom use, number of partners) are well developed and documented, there is a lack of consensus on indicators for the broader construct of adolescent sexuality, including sexual well-being and aspects of positive sexuality. Furthermore, the debate during the conference clearly indicated that experimental designs may not be the only appropriate study design to measure effectiveness of comprehensive, context-specific and long-term ASRH programmes, and that alternatives need to be identified and applied. Presenters at the conference clearly expressed the need to develop validated tools to measure different sub-constructs of adolescent sexuality and environmental factors. There was a plea to combine (quasi-)experimental effectiveness studies with evaluations of the development and implementation of ASRH promotion initiatives.

Lower Psychological Well-Being and Excessive Sexual Interest Predict Symptoms of Compulsive Use of Sexually Explicit Internet Material Among Adolescent Boys.

Although a growing body of literature addresses the effects of young people's use of sexually explicit Internet material, research on the compulsive use of this type of online content among adolescents and its associated factors is largely lacking. This study investigated whether factors from three distinct psychosocial domains (i.e., psychological well-being, sexual interests/behaviors, and impulsive-psychopathic personality) predicted symptoms of compulsive use of sexually explicit Internet material among adolescent boys. Links between psychosocial factors and boys' compulsive use symptoms were analyzed both cross-sectionally and longitudinally with compulsive use symptoms measured 6 months later (T2). Data were used from 331 Dutch boys (M age = 15.16 years, range 11-17) who indicated that they used sexually explicit Internet material. The results from negative binomial regression analyses indicated that lower levels of global self-esteem and higher levels of excessive sexual interest concurrently predicted boys' symptoms of compulsive use of sexually explicit Internet material. Longitudinally, higher levels of depressive feelings and, again, excessive sexual interest predicted relative increases in compulsive use symptoms 6 months later. Impulsive and psychopathic personality traits were not uniquely related to boys' symptoms of compulsive use of sexually explicit Internet material. Our findings, while preliminary, suggest that both psychological well-being factors and sexual interests/behaviors are involved in the development of compulsive use of sexually explicit Internet material among adolescent boys. Such knowledge is important for prevention and intervention efforts that target the needs of specific problematic users of sexually explicit Internet material.

Prevalence and correlates of young people's sexual aggression perpetration and victimisation in 10 European countries: a multi-level analysis.

Data are presented on young people's sexual victimisation and perpetration from 10 European countries (Austria, Belgium, Cyprus, Greece, Lithuania, the Netherlands, Poland, Portugal, Slovakia and Spain) using a shared measurement tool (N = 3480 participants, aged between 18 and 27 years). Between 19.7 and 52.2% of female and between 10.1 and 55.8% of male respondents reported having experienced at least one incident of sexual victimisation since the age of consent. In two countries, victimisation rates were significantly higher for men than for women. Between 5.5 and 48.7% of male and 2.6 and 14.8% of female participants reported having engaged in a least one act of sexual aggression perpetration, with higher rates for men than for women in all countries. Victimisation rates correlated negatively with sexual assertiveness and positively with alcohol use in sexual encounters. Perpetration rates correlated positively with attitudes condoning physical dating violence and with alcohol use in men, and negatively with sexual assertiveness in women. At the country level, lower gender equality in economic power and in the work domain was related to higher male perpetration rates. Lower gender equality in political power and higher sexual assertiveness in women relative to men were linked to higher male victimisation rates.

Associations between common mental disorders and sexual dissatisfaction in the general population.

BACKGROUND: Little is known about the associations between common mental disorders and sexual dissatisfaction in the general population. AIMS: To assess the associations between the presence of 12-month and remitted (lifetime minus 12-month) mood, anxiety and substance use disorders and sexual dissatisfaction in the general population of The Netherlands. METHOD: A total of 6646 participants, aged 18-64, took part in a face-to-face survey using the Composite International Diagnostic Interview 3.0. Childhood trauma, somatic disorders and sexual dissatisfaction were also assessed in an additional questionnaire. Associations were assessed with multivariate regression analyses. RESULTS: In total, 29% reported some sexual dissatisfaction. Controlling for demography, somatic disorders and childhood trauma, significant associations with 12-month mood disorder (B = 0.31), substance use disorder (B = 0.23) and anxiety disorder (B = 0.16) were found. Specifically, relatively strong associations were found for alcohol dependence (B = 0.54), bipolar disorder (B = 0.45) and drug dependence (B = 0.44). The association between remitted disorders and sexual dissatisfaction showed significance for the category substance use disorder. CONCLUSIONS: People with mood, anxiety and substance use disorders show elevated scores on sexual dissatisfaction, even when relevant confounders are controlled for. Sexual satisfaction appears to be reduced most by alcohol and drug dependence and bipolar disorder. Once remitted, substance use disorder shows a persisting association with present sexual dissatisfaction.

Advocating for safe abortion in Rwanda: how young people and the personal stories of young women in prison brought about change.

In June 2012, a new abortion law came into effect in Rwanda as part of a larger review of Rwanda's penal code. This was a significant step in a country where it was previously taboo even to discuss abortion. This article describes some of the crucial elements in how this success was achieved in Rwanda, which began through a project launched by Rutgers WPF on "sensitive issues in young people's sexuality" in several countries. This paper describes how the Rwandan Youth Action Movement decided to work on unsafe abortion as part of this project. They gathered data on the extent of unsafe abortion and testimonies of young Rwandan women in prison for abortions; organized debates, values clarification exercises, interviews and a survey in four universities; launched a petition for law reform; produced awareness-raising materials; worked with the media; and met with representatives from government ministries, the national women's and youth councils, and parliamentarians - all of which played a significant role in the advocacy process for amendment of the law, which was revised when the penal code came up for review in June 2012. This history shows how important the role of young people can be in producing change and exposes, through personal stories, the need for a better abortion law, not only in Rwanda but also elsewhere.

Autism and normative sexual development: a narrative review.

AIMS AND OBJECTIVES: To explore the existing knowledge on sexuality and autism spectrum disorders. To this end, the concept of normative sexual development was used as an organising framework. BACKGROUND: Sexual health can be seen as a developmental task for all children, adolescents and adults. Core autism features are related with skills central to sexual development and functioning. More insight in sexual development in people with autism is relevant for education, support and interventions by parents and professionals in somatic and mental health care. METHODS: A comprehensive search of scientific online databases and reference lists was conducted. Publications based on qualitative and quantitative research, including case studies, were selected. RESULTS: Fifty-five articles and reports were selected and discussed. Information was grouped according to three domains: sexual behaviour, sexual selfhood and sexual socialisation. CONCLUSION: Sexual development is a part of life for people with autism of all developmental levels and is generally understudied in this population. Most information was available on behavioural aspects and experiences of socialising agents, such as parents and professionals. Developmental processes and the relation between sexual behaviour, selfhood and socialisation remained unclear. RELEVANCE TO CLINICAL PRACTICE: Nurses working in schools, institutions and general health care support children, adolescents and adults with autism and advice their families, teachers, other educators and caregivers on sexuality issues. They can have an important role in daily assessment and support of this developmental domain by actively enquiring about the different aspects of sexual development and by offering information. Our findings offer an overview on the existing knowledge and support the idea that sexual development is normative for people with autism just as for anybody else.

Sexual health problems and associated help-seeking behavior of people with physical disabilities and chronic diseases.

The aim of this study was to investigate help-seeking behavior in relation to sexual problems among people with a disease or an impairment, as well as determining factors that promote people to seek professional sexological help. A total of 341 respondents (224 men, 117 women) participated. Approximately 50% wanted professional help with finding a sexual partner and sexual adjustment problems. Further, approximately 40% wanted professional help for problems in their sexual relationship, practical sexual problems, and the inability to enjoy their sexuality. In total, two third considered contacting a health care professional of which 35% had indeed had contact with a health care professional. Only a third of those evaluated these contacts as positive. To identify factors associated with the respondent's participation in psychosexual therapy, we performed a logistic regression analyses with a participation in a psychosexual intervention as the dependent variable. Sexual dissatisfaction was the strongest predictor of participation in psychosexual therapy. Furthermore, people who indicated that they wanted professional help for their sexual problems and people who had already discussed sexuality issues with a health care professional were more likely to participate. Disease and demographic characteristics did not influence one's decision to participate.

Prevalence and characteristics of sexual violence in the Netherlands, the risk of revictimization and pregnancy: results from a national population survey.

Prevalence figures on sexual violence among a representative sample of both men and women were not yet available for the Netherlands. The aim of this study, therefore, was to investigate the prevalence of sexual violence in the Netherlands and to add these figures to the international body of knowledge. Experiences of sexual violence during lifetime, before the age of 16 and in the year before the start of the study were measured. In addition, types of sexual violence were examined, as were the characteristics of the perpetrators. Lastly, revictimization and pregnancy as a result of rape experiences among the victims were investigated. Data were generated from a population survey on sexual health. The sample consisted of more than 6,000 men and women between the age of 15 and 70 years old. Prevalence rates as high as 21% for men and 56% for women were found. Fifty percent of the female victims and 30% of the male victims of child sexual abuse had experienced adult victimization. Of the female rape victims, 7% became pregnant as a consequence of rape. In the Netherlands, as elsewhere, the prevention of sexual violence should be prioritized.

Parental support and knowledge and adolescents' sexual health: testing two mediational models in a national Dutch sample.

This study investigated age- and gender-specific associations between parental support and parental knowledge of the child's whereabouts, on the one hand, and sexual experience and sexual health (the ability to have safe and pleasurable sexual experiences) on the other hand. A representative Dutch sample of 1,263 males and 1,353 females (aged 12-25 years), who had previously engaged in sexual intercourse, completed a questionnaire that included measures of these constructs. Both parental support and knowledge were positively associated with contraceptive use, social skills in sexual interactions, sexual satisfaction, and delay of sexual debut. Findings also revealed that the majority of correlations between parental support and sexual experience and sexual health are attributable to the relationship between a supportive family environment and parental knowledge of the child's whereabouts. Parental knowledge thus appeared to be more important for healthy sexual development than parental support.

Doing gender in sex and sex research.

Gender is central to sexuality, and vice versa, but there are a number of difficulties with the treatment of gender in sex research. Apparently, it is hard to find a balance between two conflicting needs. First, obviously, it is necessary to make distinctions between women and men, for political as well as research-technical and theoretical reasons. A second requirement, at odds with the first one, is the necessity to understand gender and its relation to sexuality and the body as much more complex than simplistically referring to two sets of individuals. This is all the more necessary when one realizes the possible drawbacks of exaggerating the differences between the sexes (in particular when they are biologically explained), because of stereotyping, stigmatizing, and expectancy confirmatory processes. This essay identifies and discusses 10 difficulties in the treatment of gender in sex research, reflects on their origins, and reviews theory and evidence with the aim to (1) consider the relative strength of gender/sex as an explanatory variable compared to other factors and processes explaining differences between men and women on a number of sexual aspects, (2) inform an understanding of gender and its relation to sexuality as an ongoing, open-ended, multi-determined, situated, interactional process, with the body as a third player, and (3) argue in favor of a nuanced, well-balanced treatment of gender in sex research.

Coping styles as mediator of sexual orientation-related health differences.

The higher prevalence of health problems in homosexual compared to heterosexual populations is usually understood as a consequence of minority stress. We hypothesized that differential rates of health problems also could result from sexual orientation-related differences in coping styles. We explored this using data collected in a general population-based study (N = 9684) via face-to-face interviews. A higher prevalence of both mental and physical health problems, as assessed with individual questions, the GHQ-12, and checklists, was observed in homosexual compared to heterosexual men and women. Coping style was related to sexual orientation in men, but not in women. Compared to heterosexual men, homosexual men more strongly applied emotion-oriented and avoidance coping strategies. Emotion-oriented coping mediated the differences in mental and physical health between heterosexual and homosexual men. Findings suggest the importance of further exploration of the development and use of emotion-oriented and avoidance coping by homosexual men.

Sexual trajectories during adolescence: relation to demographic characteristics and sexual risk.

The "sexual trajectory" is an age-graded set of various new sexual experiences, defined by three key dimensions: sequence, duration, and timing. A comprehensive description of sexual trajectories creates the possibility to investigate potential risks of certain trajectory types. The present study attempted to answer three questions: (1) Is it possible to identify a typology in (the early stages of) sexual trajectories? (2) Is sexual trajectory type related to demographic characteristics, such as sex, ethnic background, and educational level? (3) What are the associations between sexual trajectory type and recent sexual risk behavior? A representative Dutch sample of 1,263 males and 1,353 females (M = 20.46 years; range, 12-25) who had engaged in sexual intercourse completed a questionnaire about sexual (health) behavior. About three quarters of participants followed a progressive sexual trajectory from less intimate (e.g., kissing) to more intimate behavior (e.g., sexual intercourse). Immigrant groups and less educated youth were more likely to follow a nonlinear trajectory. A progressive trajectory was associated with a higher likelihood of consistent contraceptive use with the most recent partner and, for girls, with a lower likelihood of having unprotected anal intercourse with the last partner. It was hypothesized that the nonlinear trajectory could be ascribed to a lack of opportunities or skills to plan and steer early sexual experiences and that these limitations were fairly stable over time. Sexual education should aim at providing adolescents with sufficient (self) knowledge and skills to construct their sexual trajectories according to their own wishes or needs.

The risks and rights of sexualization: an appreciative commentary on Lerum and Dworkin's "bad girls rule".

This commentary wholeheartedly supports the critical observations by Kari Lerum and Shari L. Dworkin in this issue of the Journal of Sex Research with regard to the 2007 Report of the APA (American Psychological Association) Task Force on the Sexualization of Girls. The APA task force makes an overwhelmingly strong point for the dangers of the sexualization of women and girls and the self-objectification connected to it. However, their discussion of the evidence is noteworthy for being one-sided, generalizing, and negatively toned. Among the arguments presented in this commentary are notions about the rather diverse and often ambiguous nature of sexualized imagery and about the all too often ignored complexity of its presumed "effects." In addition, the issue of female sexual power and the case of sex workers are discussed. When sexualization is defined as only negative, both sex worker's rights and, more generally, women's rights to be sexual, get into a tight corner. The main contention is that sexualization is associated with risks, as well as with rights, and that any productive analysis will have to consider both.

The Impact of Personal Gender-Typicality and Partner Gender-Traditionality on Taking Sexual Initiative: Investigating a Social Tuning Hypothesis.

Sexual assertiveness is an issue of interest in the context of gender equality and sexual health. This study investigated the social tuning hypothesis that encountering a gender-traditional partner would lead to stronger gender-typical behavior, i.e., respectively, higher and lower levels of taking sexual initiative among men and women. Participants (N = 271) read a vignette describing a romantic partner, who was either presented as gender-traditional or not, followed by a sexual scenario. Subsequently, participants were asked about their expectations toward their own sexual initiative taking. Results showed a significant 'target gender-traditionality × participant gender × participant gender-typicality (masculinity/femininity)' interaction meaning that less gender-typical men were more likely to initiate sexual contact in the experimental, compared to the control condition. Men low in masculine characteristics showed higher initiative taking in response to a gender-traditional target female. We conclude that less gender-typical men seem to employ more social tuning toward their sexual partner, whereas more gender-typical men seem to adhere to their gender-typical behavior regardless of perceived partner characteristics. These results were not seen among the women in the sample. These findings are a starting point for the further development of experimental investigations regarding the gendered nature of both sexual initiative taking and sexual assertiveness in general.

Dutch Adolescents' Motives, Perceptions, and Reflections Toward Sex-Related Internet Use: Results of a Web-Based Focus-Group Study.

The Internet offers adolescents unique opportunities to actively shape their own sexual media environment. The aim of this study was to gain in-depth insight into Dutch adolescents' motives, perceptions, and reflections toward Internet use for (a) finding information or advice related to romance and sexuality; (b) searching for and viewing pornographic or erotic material; and (c) romantic and sexual communication (i.e., cybersex/sexting). Data were collected through 12 Web-based focus groups (36 adolescents aged 16 to 19 years, 72.2% girls) and analyzed through three stages of open, axial, and selective coding. The themes that emerged from the focus-group discussions suggest that sex-related Internet use is a complex and ambivalent experience for adolescents. Sex-related Internet use seems an increasingly normalized and common phenomenon. Participants perceived the Internet as a useful source of sexual information, stimulation, inspiration, and communication. Yet they discussed a range of negative consequences and risks related to sex-related online behaviors, particularly concerning pornography's potential to create unrealistic expectations about sex and sexual attractiveness. Participants generally believed they had the necessary skills to navigate through the online sexual landscape in a responsible way, although they believed other young people could be influenced inadvertently and adversely by sex-related online content.