A Grounded Theory Exploration of the Stages of Relationship Development in Marriages of Convenience in China.

A marriage of convenience has been defined as a reciprocal relationship between a gay man and a lesbian that provides a way to cope with social, cultural, family, and political stress, but this definition may be oversimplified in explaining this type of reciprocal relationship in a guanxi (the system of social networks and influential relationships that facilitate business and other dealings) society such as China. Such relationships are undergoing a process of development and change rather than remaining stable in Chinese guanxi society. This paper explores the nature and process of the development of marriages of convenience between gay men and lesbians in China. The data were collected and analyzed according to the grounded theory method. A theoretical sampling strategy was employed, and a sample of 15 people involved in so-called marriages of convenience was recruited from gay and lesbian communities in China. In our research, we found that the marriage relationships documented in this study included four stages: (1) men dang hu dui (being matched for marriage), (2) partnership, (3) friendship, and (4) kinship. Building a suitable relationship in a marriage of convenience can help gay men and lesbians meet social expectations while simultaneously retaining a degree of autonomy for their own homosexual identities. Maintaining and developing guanxi is a basic method of conflict resolution in Chinese society. Meanwhile, the ambiguity of the relationship within a marriage of convenience may cause conflict in these marriages. Treatment modalities are recommended to reorganize the system structuring these marriages and clarify ambiguous family boundaries by redefining who is in the family unit and his and her associated roles and responsibilities in the marriage of convenience. We conclude that more research is warranted to investigate how family therapy can be adapted for Chinese gay and lesbian individuals.

Un matrimonio de conveniencia se ha definido como una relación recíproca entre un hombre homosexual y una lesbiana que ofrece una manera de afrontar el estrés social, cultural, familiar y político. Sin embargo, esta definición puede ser demasiado simple para explicar este tipo de relación recíproca en una sociedad guanxi (el sistema de redes de contactos y de relaciones influyentes que facilitan los negocios y otros acuerdos), como la de China. Dichas relaciones están sufriendo un proceso de desarrollo y cambio en lugar de mantenerse estables en la sociedad guanxi de China. Este artículo analiza la índole y el proceso de desarrollo de los matrimonios de conveniencia entre gais y lesbianas en China. Los datos se recopilaron y se analizaron de acuerdo con el método de la teoría fundamentada. Se empleó una estrategia de muestreo teórico y se reunió una muestra de 15 personas implicadas en matrimonios denominados de conveniencia pertenecientes a comunidades gais y lesbianas de China. En nuestra investigación descubrimos que las relaciones conyugales documentadas en este estudio constaban de cuatro etapas: 1) men dang hu dui (búsqueda de pareja para casarse), 2) sociedad, 3) amistad, y 4) parentesco. La construcción de una relación adecuada en un matrimonio de conveniencia puede ayudar a los gais y a las lesbianas a satisfacer expectativas sociales y, a su vez, a conservar un grado de autonomía para sus propias identidades homosexuales. El mantenimiento y el desarrollo del sistema guanxi es una manera básica de resolver conflictos en la sociedad china. Mientras tanto, la ambigüedad de la relación dentro de un matrimonio de conveniencia puede causar conflicto en estos matrimonios. Se recomiendan modalidades de tratamiento para reorganizar el sistema que estructura estos matrimonios y para aclarar los límites familiares ambiguos mediante la redefinición de quiénes integran el grupo familiar y de los roles y las responsabilidades asociados a cada uno en el matrimonio de conveniencia. Llegamos a la conclusión de que se requiere más investigación con el fin de investigar cómo la terapia familiar puede adaptarse para las personas gais y lesbianas de China.

Missing Piece of the Puzzle: Evaluating a General Meaning of Sex Measure.

The presence of and search for meaning has divergent and salient outcomes for individuals' physical, mental, and emotional well-being. Although numerous domains of meaning have been examined, the literature on the meaning of sex is sparse and lacks a quantitative measure. In this study, we evaluated a new general Meaning of Sex (MOS) Measure that captured the presence of (MOS-P) and search for (MOS-S) the meaning of sex by analyzing how these subscales were associated with important relational and sexual outcomes (i.e., relationship stability and satisfaction and sexual satisfaction) in two samples. For Sample 1, all participants (N = 865) reported engaging in what they considered to be sexual intercourse and were either single or in a relationship. For Sample 2, all participants (N = 884) reported being in a committed relationship for at least two years. With both samples, confirmatory factor analyses showed good construct validity as the two subscales were distinct from one another and had good reliability. The analyses also demonstrated divergent validity between both scales and meaning in life, sexual motivations, sexual beliefs, and religiosity. The MOS-S had a strong (and negative) association with relationship stability in both samples. The MOS-P had a strong (and positive) association with relationship satisfaction in both samples.

La presencia y la búsqueda de significado tiene consecuencias divergentes y prominentes para el bienestar físico, mental y emocional de las personas. Aunque se han analizado varios componentes de significado, la bibliografía sobre el significado del sexo es escasa y carece de un instrumento de medición cuantitativo. En este estudio, evaluamos un nuevo instrumento general de medición del significado del sexo que captó la presencia y la búsqueda del significado del sexo analizando cómo estas subescalas estuvieron asociadas con resultados sexuales y relacionales importantes (p. ej.: la estabilidad y la satisfacción en la relación y la satisfacción sexual) en dos muestras. En la muestra 1, todos los participantes (N = 865) informaron participar en lo que consideraron relaciones sexuales y estaban solteros o en una relación. En la muestra 2, todos los participantes (N = 884) informaron estar en una relación de pareja estable durante al menos dos años. Con ambas muestras, los análisis factoriales confirmatorios indicaron una buena validez de constructo, ya que las dos subescalas eran distintas entre sí y tenían buena fiabilidad. Los análisis también indicaron una validez divergente entre ambas escalas y el significado en la vida, las motivaciones sexuales, las creencias sexuales y la religiosidad. La búsqueda del significado del sexo tuvo una asociación fuerte (y negativa) con la estabilidad de la relación en ambas muestras. La presencia del significado del sexo tuvo una asociación fuerte (y positiva) con la satisfacción en la relación en ambas muestras.

The Long-Term Effects of Cancer Treatment on Sexuality and Couple Relationships.

Breast cancer and its pharmacological treatment often induce an impairment in women's sexual functioning and couple relationships, as a consequence of physiological changes and psychosocial issues that may arise and persist long after treatment. This study aims to evaluate the sexual functioning, the quality of the couple relationship, and the overall health status of breast cancer survivors. A further objective is to determine the predictive role of specific clinical and sociodemographic variables for sexual functioning and the couple relationship. Sixty-four breast cancer survivors completed the following questionnaires: the Female Sexual Function Index (FSFI), the Dyadic Adjustment Scale (DAS), the Short Form Health Survey-12 (SF-12), and a self-report questionnaire to collect sociodemographic characteristics. Clinical information was retrieved from medical records. Compared to normative data, our sample reported significantly (p < .01) lower mean scores in the FSFI, DAS, and Physical Component (PCS) and Mental Component Summary (MCS) of the SF-12. Multiple regression analyses show a significant effect of age, hormonal therapy, and psychological well-being on sexual functioning and a significant effect of physical and mental well-being on the quality of the couple relationship. Additionally, 75% of patients qualified for sexual dysfunction as measured by the FSFI global scale, and 71.9% declared they were not adequately informed about the side effects of treatments on sexuality. The high prevalence of sexual dysfunction in breast cancer survivors underlines the need for specific attention to this problem, starting from a complete and targeted communication between patients and health providers regarding these side effects.

El cáncer de mama y su tratamiento farmacológico frecuentemente producen un deterioro del funcionamiento sexual de las mujeres y de las relaciones de pareja como consecuencia de los cambios fisiológicos y los problemas psicosociales que pueden surgir y continuar mucho después del tratamiento. Este estudio tiene como finalidad evaluar el funcionamiento sexual, la calidad de la relación de pareja y el estado de salud general de las sobrevivientes de cáncer de mama. Otro objetivo es determinar el papel predictivo que desempeñan las variables clínicas y sociodemográficas específicas para el funcionamiento sexual y la relación de pareja. Sesenta y cuatro sobrevivientes de cáncer de mama contestaron los siguientes cuestionarios: el Índice de la Función Sexual Femenina (Female Sexual Function Index, FSFI), la Escala de Ajuste Diádico (Dyadic Adjustment Scale, DAS), la Encuesta Breve sobre la Salud-12 (Short Form Health Survey-12, SF-12) y un cuestionario de autoinforme para recopilar características sociodemográficas. Se obtuvo información clínica de expedientes médicos. En comparación con los datos normativos, nuestra muestra informó puntajes de la media significativamente más bajos (p<0.01) en el FSFI, en la DAS y en el Resumen del Componente Físico (PCS) y del Componente Mental (MCS) de la SF-12. Los análisis de regresión múltiple indican un efecto significativo de la edad, la terapia hormonal y el bienestar psicológico en el funcionamiento sexual, y un efecto significativo del bienestar físico y mental en la calidad de la relación de pareja. Además, el 75 % de las pacientes reunió los requisitos de disfunción sexual según la medición de la escala global del FSFI, y el 71.9 % declaró que no estaba adecuadamente informado acerca de los efectos secundarios de los tratamientos en la sexualidad. La alta prevalencia de disfunción sexual en las sobrevivientes de cáncer de mama subraya la necesidad de atender este problema de manera específica, partiendo de una comunicación completa y dirigida entre pacientes y profesionales de la salud con respecto a estos efectos secundarios.

Sexual health educational intervention in medical students.

INTRODUCTION: The National Autonomous University of Mexico Faculty of Medicine created the Adolescent Pregnancy Prevention Program, which is aimed at students. OBJECTIVE: To determine the sexual-reproductive health profile of medical students through a diagnostic questionnaire and of those who participated in an educational intervention on sexuality (three modules). METHOD: First-year undergraduate students, schoolyear 2017-2018, participated. Students were considered to be trained when they took at least one module. RESULTS: The questionnaire was answered by 1157 students, 21.9 % participated in at least one module, 43.1% had initiated sexual activity and 25 % received the educational intervention. Not having used a condom in their last intercourse was identified in 20 %, and a high prevalence of intercourse under the influence of alcohol was observed. CONCLUSIONS: It is important for specific sexuality competences to be promoted among those who will be doctors in the future.

INTRODUCCIÓN: La Facultad de Medicina de la Universidad Nacional Autónoma de México creó el Programa de Prevención de Embarazo en Adolescentes, dirigido a estudiantes. OBJETIVO: Determinar el perfil de la salud sexual-reproductiva de estudiantes de medicina mediante un cuestionario diagnóstico y de quienes participaron en una intervención educativa de sexualidad (tres módulos). MÉTODO: Participaron estudiantes del primer año de la carrera, ciclo 2017-2018. Se consideró que el estudiante fue capacitado cuando cursó al menos un módulo. RESULTADOS: Contestaron el cuestionario 1157 estudiantes, 21.9 % participó en al menos un módulo, 43.1 % había iniciado vida sexual y 25 % recibió la intervención educativa. El 20 % no usó condón en su última relación y se observó alta prevalencia de relaciones sexuales bajo el influjo de alcohol. CONCLUSIONES: Es importante promover competencias específicas en sexualidad entre quienes serán los futuros médicos.

Sexual Passion in Committed Relationships: Measurement and Conceptual Issues.

The purpose of this study is to discuss the need for a new triadic model of sexual passion in relationships and to present the preliminary psychometric properties of a scale designed to measure these three approaches to passion (harmonious, obsessive, and inhibited) for use in clinical and scholarly work. Existing theory and measures of general passion are based on a dualistic model of passion that includes the harmonious and obsessive approaches to passion. We added the inhibited approach to passion from the sexuality research and develop measures for assessing sexual passion in relationships. We utilized an Amazon Mechanical Turk sample of 1,421 individuals in committed relationships to test this measure. Reliability analyses and confirmatory factory analyses evinced that these three approaches to sexual passion were unique constructs and distinct from sexual satisfaction. Sexual passion showed predictive validity above and beyond relationship length, sexual desire toward a partner, and a broader variable of sexual drive. Harmonious sexual passion robustly predicted higher sexual satisfaction and relationship satisfaction, and inhibited sexual passion moderately predicted lower sexual satisfaction and relationship satisfaction. Obsessive sexual passion had minimal associations with either outcome. These new constructs, especially harmonious and inhibited sexual passion, may help scholars and practitioners improve their understanding of sexual satisfaction and overall relationship satisfaction.

El propósito de este artículo es debatir la necesidad de un nuevo modelo triádico de pasión sexual en las relaciones y presentar las propiedades psicométricas preliminares de una escala diseñada para medir estos tres enfoques de la pasión (armonioso, obsesivo e inhibido) a fin de usarlos en trabajos clínicos y académicos. La teoría y las escalas actuales de la pasión en general se basan en un modelo dualista de la pasión que incluye los enfoques armonioso y obsesivo de la pasión. Nosotros agregamos el enfoque inhibido de la pasión a partir de la investigación sobre sexualidad y desarrollamos escalas para evaluar la pasión sexual en las relaciones. Utilizamos una muestra de Amazon Mechanical Turk de 1421 personas en relaciones de pareja estables para probar esta escala. Los análisis de fiabilidad y los análisis factoriales confirmatorios demostraron que estos tres enfoques de la pasión sexual eran constructos únicos y diferentes de la satisfacción sexual. La pasión sexual demostró validez predictiva más allá de la duración de la relación, el deseo sexual hacia una pareja y una variable más amplia de impulso sexual. La pasión sexual armoniosa predijo sólidamente mayor satisfaccion sexual y satisfacción con la relación, la pasión sexual inhibida predijo moderadamente menor satisfacción sexual y satisfacción con la relación. La pasión sexual obsesiva tuvo asociaciones mínimas con ambos criterios. Estos nuevos constructos, especialmente la pasión sexual armoniosa y la inhibida, pueden ayudar a los investigadores y a los profesionales a mejorar su comprensión de la la satisfacción sexual y de la satisfacción con la relación en general.

[Behaviour and attitudes towards the sexuality of the pregnant woman during the last trimester. Phenomenological study]. / Comportamiento y actitud frente a la sexualidad de la mujer embarazada durante el último trimestre. Estudio fenomenológico.

OBJECTIVE: To explore the life experiences on sexual relationships in the third trimester of pregnancy in primiparous women. DESIGN: Phenomenological qualitative study, SITE: Cáceres (Extremadura). PARTICIPANTS: Primiparous women in the third trimester of their pregnancy. METHODS: We use theoretical sampling, was conducted on pregnant primiparous. The study included 15 participants. The data was collected using in-depth interviews, that were voiced recorded and later transcribed. The analysis was made using Giorgi's proposal. RESULTS: The results show three main points. Fear of doing damage, mediated by the obstetric history and the desire to have the long-awaited child. Exploring new routes: forms of sexual expression are modified by the physical changes, the fears, and the mobility. Highlighting the importance of other displays of affection and love (kisses and caresses). The Sex Taboo: lack of information against sexuality during pregnancy is still common. CONCLUSIONS: Women in the third trimester of their pregnancy put aside their sexual appetite and that of their partners, and concentrate in the wellbeing of their new born baby. It highlights the role of the mother before the couple. The more desired and difficult the pregnancy has been, the more the sexual life is reduced. The Health Professionals must advise and inform the couples with an open-minded attitude.

Executive summary of the consensus statement on assistance to women with HIV infection in the health care sector. National AIDS Plan (PNS) and AIDS Study Group (GeSIDA).

The aim of this paper was to develop a consensus on clinical recommendations for health care assistance for women with HIV infection. To this end, a panel of experts, appointed by the Secretariat of the National AIDS Plan and GeSIDA was assembled, that included internal medicine physicians with expertise in the field of HIV infection, gynecologists, pediatricians and psychologists, with two members of the panel acting as coordinators. Scientific information was reviewed in publications and conference reports up to October 2012. In keeping with the criteria of the Infectious Disease Society of America, two levels of evidence were applied to support the proposed recommendations: the strength of the recommendation according to expert opinion (A, B, C) and the level of empirical evidence (I, II, III), already used in previous documents from SPNS/GESIDA. Multiple recommendations are provided for the clinical management of women with HIV infection, considering both the diagnostic and possible therapeutic strategies. This document presents recommendations for the treatment of women with HIV infection. This must be multidisciplinary, taking into account the differences that can be found in the diagnosis, development of disease and treatment between men and women.

[Consensus statement on assistance to women with human immunodeficiency virus infection in the health care sector. National AIDS Plan (PNS) and AIDS Study Group (GeSIDA)]. / Documento de consenso sobre la asistencia en el ámbito sanitario a las mujeres con infección por el virus de la inmunodeficiencia humana.

OBJECTIVE: To develop a consensus document on clinical recommendations for the health care of women with human immunodeficiency virus (HIV) infection. METHODS: We assembled a panel of experts appointed by the Secretariat of the National AIDS Plan and GeSIDA that included internal medicine physicians with expertise in the field of HIV infection, gynecologists, pediatricians and psychologists, and two panel members acting as coordinators. Scientific information was reviewed in publications and conference reports up to October 2012. In keeping with the criteria of the Infectious Disease Society of America, two levels of evidence were applied to support the proposed recommendations: the strength of the recommendation according to expert opinion (A, B, C), and the level of empirical evidence (i, ii, iii), already used in previous documents from SPNS/GeSIDA. RESULTS: We provide multiple recommendations for the clinical management of women with HIV infection, considering both the diagnostic and possible therapeutic strategies. The consensus recommends gender mainstreaming in health care, and promoting training for healthcare professionals in order to avoid gender bias. With currently available data it seems that the effectiveness of the treatment is the same in both men and women, there being no limitation as to the use of any antiretroviral for this reason. Women have more treatments suspended for reasons other than virological failure, thus they require better monitoring. CONCLUSIONS: This document presents recommendations for addressing women with HIV infection. This must be multidisciplinary, taking into account the differences that can be found in the diagnosis, disease development, and treatment between men and women.

Sexual dysfunction in women with chronic obstructive lung disease.

OBJECTIVE: To determine the prevalence of sexual dysfunction in women with COPD and the factors related to its presence. METHODS: Cross-sectional observational study during 2021, including women with COPD diagnosed by spirometry through convenience sampling. Data on age, smoking status, spirometric data, comorbidities and medications used were collected. A sexual health questionnaire was administered. RESULTS: The study included 101 women with a mean age of 59.7 (11.3) years. All had experienced a change in sexual activity, with 44% attributing it to COPD. Among them, 51.5% experienced dyspnea during coitus. The prevalence of sexual dysfunction was 52.5%. Women with sexual dysfunction were older and had a lower Tiffeneau index. Furthermore, they consumed alcohol more frequently and had hypertension and cerebrovascular disease, and less often, they had diabetes and heart failure. However, they scored lower on the Charlson index corrected for age. Patients with sexual dysfunction used inhaled triple therapy less frequently. CONCLUSIONS: Sexual dysfunction is common in women with COPD. Further studies are needed to investigate its causes, mechanisms, and potential treatments.

Knowledge of professionals about sexuality of the ostomyzed.

BACKGROUND: An ostomy significantly influences a person's life, altering their biopsychosocial and sexual sphere and affecting their interpersonal relationships. MATERIALS AND METHODS: Through an observational, descriptive, and cross-sectional study, with a questionnaire aimed at professionals from a health area in Madrid, we analyzed: sociodemographic variables, knowledge of the professionals on the subject, referral of the patient according to the professional's assessment and feelings that the subject under study produces in the patient and in professionals. RESULTS: 49% claimed to have no knowledge about sexuality of the ostomyzed patients. 55.9% of those surveyed consider that the healthcare provider is the one who should introduce the topic of sexuality during the clinical interview. 48.5 and 85.2% are unaware of treatments for male and female sexual dysfunction, respectively. CONCLUSIONS: The data show that the training provided in the university centers is insufficient to deal effectively with this issue in the medical consultation. The participants manifest null or minimal knowledge about the sexual sphere in ostomized patients. Knowledge deficiencies are detected in relation to the sexuality of the ostomized patient, difficulty in talking about sex with these patients, and the importance that sanitary professionals give to the patient's sexual sphere, among others.

ANTECEDENTES: Una ostomía influye significativamente en la vida de la persona, alterando su esfera biopsicosocial y sexual, y afectando a sus relaciones interpersonales. MATERIAL Y MÉTODO: Estudio observacional, descriptivo y transversal. Mediante un cuestionario dirigido a profesionales de un área sanitaria de Madrid, se analizan variables sociodemográficas, conocimientos de los profesionales, derivación del paciente a un especialista según la valoración del profesional encuestado y sentimientos que produce en ellos el tema de estudio. RESULTADOS: El 49% afirma tener conocimientos nulos sobre la sexualidad del paciente ostomizado. El 55.9% de los encuestados considera que el sanitario es quien debe introducir el tema de la sexualidad durante la entrevista clínica. El 48.5 y el 85.2% desconocen tratamientos para la disfunción sexual, masculina y femenina, respectivamente. CONCLUSIÓN: Los datos demuestran que la formación impartida en los centros universitarios es insuficiente para tratar de forma efectiva este tema en la consulta. Los participantes en el estudio muestran nulo o mínimo conocimiento sobre la esfera sexualidad en el paciente ostomizado Se detectan deficiencias de conocimiento en relación con la sexualidad del ostomizado, dificultad para hablar de sexo con el paciente y valor que da el profesional a la esfera sexual en su paciente, entre otras.

[Attitudes, knowledge and perceptions of care staff in long-term care homes about residents' sexual expressions. Systematic review]. / Actitudes, conocimiento y percepción del personal asistencial de centros geriátricos de larga duración sobre las expresiones sexuales de los residentes. Revisión sistemática.

The sexual manifestations of residents in long-term care facilities are often overlooked and even discouraged by care staff. The aim of this study was to conduct a systematic review of caregivers' attitudes, knowledge and perceptions of sexual expression. After consulting different databases, ten scientific articles published between 2012 and 2022 met the inclusion criteria to form part of this review. This work has made it possible to identify and structure the insufficient scientific literature on this specific area of sexuality in older adults. It is concluded that there is scarce scientific literature and that the areas reviewed are determinant in the daily care of institutionalised older adults. Expanding in this field of study will allow the creation of training programmes and the creation of programmes for the care staff to deal with the sexual behaviour of institutionalised older adults.

Evaluation of the sexual sphere in patients with psoriatic arthritis.

INTRODUCTION: Psoriatic arthritis (PsA) is a chronic inflammatory disorder that primarily affects the joints and entheses. In addition, it is associated with depressive syndrome (DS), cardiovascular disease, hypertension (HT), diabetes mellitus (DM), obesity and psoriasis (Pso). There are few studies aimed to analyze the association of the involvement of the musculoskeletal system with sexual function (SF). METHODS: A cross-sectional observational study was proposed in patients diagnosed with PsA, to whom self-administered validated questionnaires were applied to determine alterations in SF: MGH-SFQ and CSFQ-14, which assess the 4 domains of sexual function; Qualisex and DLQI designed for joint and dermatological pathology respectively, which explore sexual aspects. The objective was to describe the existence of altered sexual function in patients with PsA; analyze the association between sociodemographic characteristics, comorbidities (Pso, DS, cardiovascular risk factors) and the treatments of patients on SF; and describe differences of SF according to gender. RESULTS: 72 patients were evaluated. It was observed that the variables of patients with PsA that were associated with lower scores in SF were gender and age in the CSFQ-14 and MGH-SFQ; annual incomes, treatment with NSAIDs, DL and depression were associated with worse results in some domains of the sexual sphere. CONCLUSIONS: Patients with PsA had impaired SF, especially women, elder patiens, those with low annual incomes, DL and emotional disorders. Anti-inflammatory treatments were associated with better SF. Globally, the chronic disease and the psychological burden behaved as factors associated with sexual dysfunction.

Mythological Underpinnings of Feminine Development.

In the manner of Oedipus Rex, the myth of Myrrha-a story about a daughter's initiation of sex with her father-promises to divulge insights about feminine development. Given parallels between these two myths, the author asks why Jung identified Electra rather than Myrrha as the feminine counterpart to Oedipus, and revisits Freud's and Jung's differing interpretations of the incest theme in personality development. To break open the metaphor of Myrrha's incest, the author analyzes a similar account of incest in the Old Testament story of Lot and his wife and finds that they share a theme of female bitterness related to wounding of the mother and its arresting effect on the daughter's maturation. The article then considers the Demeter-Persephone myth, a tale not of incest but rape in Persephone's initiation into womanhood. In contrast to Myrrha, Persephone's development unfolds with strong maternal support tempered by the opposing claims on her by the masculine. The article draws these stories together to illuminate the archetypal forces that drive feminine development as well as the human affairs that resist and complicate them. The article concludes with a case study of a client whose developmental "stuckness" follows the contours of the Myrrha myth.

À la manière d'Oedipe Roi, le mythe de Myrrha, une histoire sur l'initiation sexuelle d'une fille avec son père promet de divulguer des éclairages concernant le développement féminin. Compte tenu des parallèles entre ces deux mythes, l'auteur se demande pourquoi Jung a identifié Électre plutôt que Myrrha comme la contrepartie féminine d'Œdipe. Il revisite les interprétations différentes de Freud et Jung sur le thème de l'inceste dans le développement de la personnalité. Pour ouvrir la métaphore de l'inceste de Myrrha, l'auteur analyse un récit similaire d'inceste dans l'histoire de Lot et de sa femme dans l'Ancien Testament et constate qu'ils ont en commun le thème de l'amertume féminine lié à la blessure de la mère et à son effet saisissant sur la maturation de la fille. L'article examine ensuite le mythe de Déméter-Perséphone, qui est non pas une histoire d'inceste mais de viol dans l'initiation de Perséphone à la féminité. Contrairement à Myrrha, le développement de Perséphone se déroule avec un fort soutien maternel tempéré par les revendications que le masculin lui oppose. L'article rassemble ces histoires pour éclairer les forces archétypales qui animent le développement féminin ainsi que les affaires humaines qui y résistent et les compliquent. L'article se termine par l'étude d'un cas clinique dont le « blocage ¼ développemental suit les contours du mythe de Myrrha.

A la manera de Edipo Rey, el mito de Mirra, una historia sobre la iniciación sexual de una hija con su padre, promete divulgar conocimientos sobre el desarrollo de lo femenino. Dados los paralelismos entre estos dos mitos, la autora se pregunta por qué Jung identificó a Electra en lugar de Mirra como la contrapartida femenina de Edipo y revisa las diferentes interpretaciones de Freud y Jung sobre el tema del incesto en el desarrollo de la personalidad. Para desentrañar la metáfora del incesto de Mirra, la autora analiza un relato similar de incesto en la historia de Lot y su esposa en el Antiguo Testamento y descubre que comparten el tema de la amargura femenina relacionada con la herida de la madre y su efecto paralizante en la maduración de la hija. A continuación, el artículo examina el mito de Deméter-Perséfone, una historia, no de incesto sino de violación, en la iniciación de Perséfone a la femineidad. A diferencia de Mirra, el desarrollo de Perséfone se desarrolla con un fuerte apoyo materno atenuado por las pretensiones opuestas de lo masculino sobre ella. El artículo reúne estas historias para iluminar las fuerzas arquetípicas que impulsan el desarrollo de lo femenino, así como los asuntos humanos que se resisten a ellas y las complican. El artículo concluye con un estudio de caso de una clienta cuyo "estancamiento" en su desarrollo sigue los devenires del mito de Mirra.

[Impact of isolation by Sars-CoV-2 on Sexuality. Results of an investigation in Argentina.] / Impacto del aislamiento por Sars CoV-2 en la Sexualidad. Resultados de una investigación en Argentina.

OBJECTIVE: To evaluate the impacton sexuality of the mandatory social isolation linked tothe pandemic by SARS-CoV-2 in an open population ofadults in ArgentinaMATERIAL AND METHOD: An anonymous andvoluntary self-response online questionnaire wasdistributed to an open population of adults who werein mandatory social isolation as consequence of theSARS-CoV-2 Pandemic, between March 31 and June1, 2020. A total of 2214 surveys were collected. At the time the survey was answered, 54.2% had been in isolationfor 6 weeks. RESULTS: We observed that the frequency ofintercourse had an impact in 62.7% of partners livingtogether, increasing by 27.8% and decreasingby 34.9%. Many couples decreased the frequencyof oral sex, anal sex, and mutual and simultaneousmasturbation. On the other hand, hugs, caresses andkisses increased. The presence of children at homeand the longest time in quarantine were closely relatedto the decrease in sexual intercourse frequency.In 50.3% of people who had no cohabitant partner,the frequency of weekly masturbation increased,while 23.7% increased the use of virtual sex. Transgenderpopulation showed that in those with a stablepartner, 68.7% experienced changes in their frequencyof intercourse, similarly to that observed incis population. We also found a higher frequency ofself-stimulation practices in this population. CONCLUSION: In most of the cohabiting couplesof the studied population, the frequency of sexualintercourse and the ways of interaction were affected,without relation to gender identity. An increasein masturbation and virtual sex was observed inpeople who had no cohabitant partner, in addition toa higher frequency of self-stimulation practices intrans individuals. More research and follow-up arerequired to understand the real impact of isolationon sexual health.

OBJETIVO: Evaluar el impacto en lasexualidad del aislamiento social obligatorio vinculadoa la Pandemia por SARS-CoV-2 en una poblaciónabierta de adultos de la Argentina.MATERIAL Y MÉTODO: Se empleo una encuestade auto respuesta, anónima y voluntaria, en unapoblación abierta de adultos que se encontraban enaislamiento social obligatorio como consecuenciade la Pandemia por SARS-CoV-2, durante el periodocomprendido entre el 31 de marzo y el 1 de junio de2020. Recogiendose un total de 2214 encuestas. En elmomento en que respondieron la encuesta el 54,2%llevaba 6 semanas de aislamiento. RESULTADOS: Observamos que en el 62,7% de lasparejas convivientes se modifico la frecuencia de relaciones,aumentando en el 27,8% y disminuyendo enel 34,9%. En general, se vio una disminución del sexooral, anal y de la masturbación mutua y simultánea, ypor otro lado, un aumento de abrazos, besos y caricias.La presencia de hijos en casa y el mayor tiempo decuarentena fueron directamente relacionados con ladisminución de la frecuencia de encuentros sexuales. En el 50,3% de los individuos sin pareja convivienteaumentó la frecuencia de masturbación semanal, y enel 23,7% aumento el uso de sexo virtual. En la poblacióntransgénero se encontró que el 68,7% de los queconvivían con una pareja estable experimentó un impactoen la frecuencia de relaciones sexuales, similara lo encontrado en la población cis. Por otro lado vimosen este subgrupo una mayor práctica de masturbaciónen relación a la población CIS. CONCLUSIÓN: En la mayoría de las parejas convivientesde la población estudiada se vio afectada lafrecuencia de encuentros sexuales y las formas de interacción,sin relación con la identidad de género. Seobservó además un aumento de la masturbación y elsexo virtual en las parejas no convivientes, además demayor frecuencia de prácticas de autoestimulación enlos individuos trans. Se requieren más investigación yseguimiento para comprender el real impacto del asilamientoen la salud sexual.

[Evaluation of the approach to sexuality in primary care consultations in Spain: A multicentre comparative study (2004-2017)]. / Evaluación del abordaje de la sexualidad en las consultas de atención primaria en España: estudio comparativo multicéntrico (2004-2017).

OBJECTIVE: To describe how sexuality is addressed in general practitioners' (GP) consultations, as well as to compare the results of a questionnaire carried out in 2017 that updated the data obtained from a 2004 survey. MATERIAL AND METHODS: Descriptive, analytical, multicentre study with 2cross-sections. Of the 3,500 GP who met the selection criteria (holding current accreditation as a resident tutor and being an active worker at the time of the study), 598 doctors participated in the survey in 2017 and 357 in 2004. RESULTS: In both studies, the majority (98.6% in 2017 and 96% in 2004) consider that the sexual sphere is an important component in people's health, but less than half (40, 6% in 2017 and 21.6% in 2004) systematically recorded it in their clinical history. The main source of training in sexuality in both studies were continuing education courses (50.6% in 2017 and 31.4% in 2004). The main barriers found in both studies were lack of time (85.5% in 2017 and 82.1% in 2004) and lack of training (75.2% in 2017 and 74.5% in 2004). CONCLUSIONS: GP are aware of the importance of sexuality in people's health, despite this, few professionals systematically record it in their medical records. The main source of training in sexuality is continuing education courses, which has increased in recent years. The main barriers in both studies are lack of time and poor training.

Assessment of sexual life in spina bifida patients: A survey among pediatric urologists.

OBJECTIVE: To assess the status of the sexual education approach with spina bifida (SB) patients. MATERIALS AND METHODS: An online survey was sent to 223 pediatric urologists from Latin countries, all contacted using email or mobile messaging software. There were 12 questions about participants' demographic characteristics and SB-specific care topics. Data was collected from January 2019 to January 2020. Checklist for reporting results of internet e-survey (CHERRIES) guidelines were followed to ensure the quality of this study. RESULTS: We received 101 valid answers from participants practicing in seven different countries. Among these, 98.4% confirmed that sexuality in the SB population is considered relevant, nevertheless it is only evaluated by 62.5%. Transitional urologists discuss sexuality more often than those whose practice consists solely of pediatric patients (70% vs. 50%). Basic surgeon training (urologist vs. pediatric surgeon), age, part or full-time pediatric urology practice and country of participants were of no statistically different influence inrates of approach to sexuality. CONCLUSION: Our study demonstrates that pediatric urologists are insufficiently addressing sexuality in SB patients. Those who practise transitional urology show higher rates of approach to sexuality with SB patients, which suggests this is an important model of care.

[On pornography and sexual education: Can "sex" legitimate humiliation and violence?] / Sobre la pornografía y la educación sexual: ¿puede «el sexo¼ legitimar la humillación y la violencia?

The aim of this article is to argue for the need and urgency to open an interdisciplinary debate on the goals of critical sexual education. From a philosophical and gender approach, the consequences of generalized online access to pornography, a profitable business, are analyzed as a school of sexuality for youth. The article deals with the violence and misogyny of many of the most visited contents and poses two hypothesis to debate. Firstly, pornography is subject to a process of erotizing violence, which may become a new space of legitimization of inequality between female and male teenagers. Secondly, a mismatch exists between the expectations of female and male teenagers regarding what a good sexual life is. Movements such as Me too and Cuéntalo as well as social polarization over trials like that of "the herd" would confirm such a mismatch. The conclusions reflect on the contradictions in societies, committed to equality, which increasingly tolerate less sexual abuse and aggression and at the same time are becoming more tolerant towards pornographic contents freely accessed by young people as a school of misogyny and violence. Some of the most serious consequences of those contradictions are dealt with by way of three current examples.

Attitudes and beliefs of nurses and physicians about managing sexual health in primary care: A multi-site cross-sectional comparative study.

Aim: To understand the attitudes and beliefs of nurses and physicians about managing the sexual health of patients during office visits in primary care centres. Design: A questionnaire-based, cross-sectional multi-centre study. Methods: The study was performed in 15 primary care centres in Barcelona (Spain), from December 2017-February 2018. Obtained data were analysed with descriptive and bivariate statistics. Results: Nearly half the participants believed they should manage sexual health in primary care, but a third of them disagreed this is a priority. Participants also believed patients are not comfortable speaking with them about sex. Statistically significant differences were observed between the professions as nurses more often reported receiving sexual health questions from patients and believed they had enough knowledge to appropriately respond. Most participants wanted additional education to speak with patients more comfortably and confidently about sex.

Sexual and Reproductive Health in Patients with Schizophrenia and Bipolar Disorder. / Salud sexual y reproductiva de los pacientes con esquizofrenia y trastorno afectivo bipolar.

INTRODUCTION: People with schizophrenia and bipolar disorder (BD) have a high risk of unwanted pregnancies and abortions, due to their condition of vulnerability or hypersexuality (common in BD). This is associated with difficulty in planning their actions and lack of sex education and counselling by medical personnel, and can lead to adverse obstetric outcomes and inability to care adequately for their children. OBJECTIVE: To describe the characteristics in terms of sexual and reproductive health, and the use of contraception and counselling in psychiatric consultations, in a sample of patients with BD and schizophrenia in Medellin, Colombia. METHODS: Observational cross-sectional study. We included the 160 participants from the clinical trial, "The effects of a multimodal intervention programme in patients with bipolar disorder and schizophrenia", who were recruited from the mood and psychosis disorders group clinic at Hospital Universitario de San Vicente Fundación in Medellin. They were contacted by phone by a third-year psychiatry resident, who applied a survey about the characteristics of their sex life, contraception and reproduction. RESULTS: Almost all of the patients with schizophrenia were single, had no undergraduate studies and were unemployed. No significant differences were found regarding the age of starting sexual relations when comparing by diagnosis and gender. Almost all patients with schizophrenia and almost half of the patients with BD reported not having an active sexual life. Almost all of those who admitted to having an active sexual life claimed to always use contraception; in the BD group, only 48.8% of single women admitted to using contraception and a little over half of men stated that they used a condom when having sex. A quarter of the pregnancies were unplanned. Although the majority of the patients stated that they had never received information about family planning in the consultations with their psychiatrist, 57.4% of the patients with BD and 78.8% of those who had schizophrenia, considered themselves to be well informed on the subject. CONCLUSIONS: Patients with mental illness have cognitive and behavioural alterations that affect their sexual and reproductive lives. Psychiatrists should therefore address this issue, to ensure education in areas such as contraception, family planning and sexually transmitted diseases and help safeguard the safety and quality of life of their patients.

Construcciones sociales de la salud sexual en mujeres adolescentes de una comunidad rural / Social constructions of sexual health in adolescent women from a rural community / Construções sociais da saúde sexual em mulheres adolescentes de uma comunidade rural

Objetivo: Descubrir cuáles son las construcciones sociales en la salud sexual de las mujeres adolescentes de una comunidad rural. Material y Métodos: Estudio cualitativo fenomenológico hermenéutico, donde participaron mujeres adolescentes de 14 a 19 años, pertenecientes a la comunidad, El Molino, Ojuelos Jalisco, México. A través de un muestreo por cadena de referencia, se realizaron entrevistas fenomenológicas, transcritas de manera artesanal y anal-izadas mediante el "círculo hermenéutico Heiderggeriano". Se obtuvo la autorización mediante el consentimiento informado, así como el asentimiento por parte de los tutores. Se cumple un rigor metodológico a través de la trasparencia, transferibilidad, credibilidad y autenticidad. Resultados: Se realizaron 10 entrevistas afines a 10 adolescentes y se determinaron 6 unidades de significado a partir del análisis hermenéutico, de los cuales tres son ónticas; una realidad palpable a la desinformación sobre vida sexual, ideologías paternales adiestradas y falo centrismo como base central en la dinámica social. Y tres son ontológicas; Sesgo educativo, Discurso del lenguaje culturizado, finalmente tabúes y estigmas familiares. Conclusión: Las mujeres adolescentes de una comunidad rural viven una doble moral social. Así se demuestra un ineficiente conocimiento sobre salud sexual hasta ser un tema intrascendente, los padres son quienes influyen y toman decisiones sobre la educación, autonomía y forma de pensar.

Objective: Discover what the social constructions in the sexual health of adolescent women in a rural community. Material and Methods: A qualitative hermeneutic phenomenological study, involving adolescent women from 14 to 19 years old, belonging to the community, El Molino Ojuelos Jalisco, México. Through a reference chain sampling, phenomenological inter-views were carried out, transcribed by hand and analyzed through the "Heiderggerian herme-neutic circle". Authorization was obtained through informed consent, as well as the assent of the tutors. Complying with methodological rigor through transparency, transferability, credibility and authenticity. Results: 10 related interviews were carried out with 10 adolescents, and 6 units of meaning were determined from the hermeneutic analysis, of which three are ontic; a palpable reality to the ignorance of contraceptive methods, trained paternal ideologies and phallocentrism as a central basis in social dynamics. And three are ontological; Educational bias, cultured language discourse, finally taboos and family stigmas. Conclusion: Adolescent women from a rural community experience a double social standard. Thus, demonstrating an inefficient knowledge about sexual health until it is an insignificant issue, parents are the ones who influence and make decisions about education, autonomy and way of thinking

Objetivo: Descubra quais são as construções sociais na saúde sexual de mulheres adolescentes de uma comunidade rural. Material e Métodos: Estudo hermenêutico fenomenológico quali-tativo, onde participaram mulheres adolescentes de 14 a 19 anos, pertencentes à comunidade El Molino, Ojuelos Jalisco, México. Por meio de amostragem por cadeia de referência, foram realizadas entrevistas fenomenológicas, transcritas à mão e analisadas por meio do "círculo her-menêutico heideggeriano". A autorização foi obtida mediante consentimento informado, bem como assentimento dos responsáveis. Cumprir o rigor metodológico através da transparência, transferibilidade, credibilidade e autenticidade. Resultados: foram realizadas 10 entrevistas relacionadas com 10 adolescentes e foram determinadas 6 unidades de significado a partir da análise hermenêutica, das quais três são ônticas; uma realidade palpável do desconhecimento dos métodos contraceptivos, das ideologias paternas treinadas e do falocentrismo como base central na dinâmica social. E três são ontológicos; Viés educacional, discurso de linguagem cul-turalizado, finalmente tabus e estigmas familiares. Conclusão: As mulheres adolescentes de uma comunidade rural vivenciam um duplo padrão social. Demonstrando assim um conhecimento ineficiente sobre saúde sexual a ponto de ser uma questão inconsequente, são os pais que influ-enciam e tomam decisões sobre educação, autonomia e modo de pensar