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.

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.

The Relationship Between Endorsement of the Sexual Double Standard and Sexual Cognitions and Emotions.

Sexual gender norms promoting sexual prowess for men, but sexual modesty for women have been shown to negatively affect sexual and mental health in both men and women. Knowledge about the relationship between gender norms and sexual cognitions and emotions might further the understanding of continued gender-norm conformity. In the present study, we investigated whether and how gendered sexual attitudes are related to (positive and negative) sex-related emotions, via sexual cognitions (autonomy, body esteem, and approach/avoidance motives for sex). A survey was submitted to 293 heterosexually identified, sexually active, Dutch (central and southern regions) 18-25 year-olds. Results from a moderated mediation model (using structural equation modeling) revealed that women, but not men, who more strongly endorsed traditional gender-related sexual attitudes experienced significantly less positive and more negative emotions, as a result of decreased sexual autonomy and sexual body esteem as well as increased avoidance motives for sex. We conclude that, as a result of negative cognitions associated with the endorsement of traditional gender norms, women in particular are at risk of experiencing negative emotional outcomes in the sexual context. We argue that sexual cognitions and emotions deserve explicit attention in sex-positive and gender-transformative sexuality education, which has been proven to be a vital resource for achieving increased gender-equity in sexual and romantic relationships.

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.

Psychosexual Correlates of Sexual Double Standard Endorsement in Adolescent Sexuality.

Endorsement and enactment of the (hetero)sexual double standard (SDS), prescribing sexual modesty for girls and sexual prowess for boys, has been shown to be negatively related to sexual and mental health. To be able to challenge the SDS, more insight is needed into the conditions that shape gendered sexual attitudes. A survey was conducted among 465 heterosexual adolescents (aged 16-20 years), examining the relationship between a number of relevant demographic and psychosexual variables and SDS endorsement. SDS endorsement was assessed using a newly developed instrument, the Scale for the Assessment of Sexual Standards Among Youth (SASSY). Gender (being male) and religiousness were significantly associated with increased SDS endorsement. For both boys and girls, increased feelings of entitlement to self-induced sexual pleasure (e.g., masturbation) were significantly associated with reduced SDS endorsement, whereas higher gender investment was significantly associated with increased SDS endorsement. Furthermore, increased feelings of entitlement to partner-induced sexual pleasure and more frequent talking about sexuality with peers were associated with increased SDS endorsement among boys but not among girls. We conclude that future research should explore peer influence processes through peer communication about sex, gender investment, and feelings of entitlement to both self and partner-induced sexual pleasure.

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.

Educational Differences in Adolescents' Sexual Health: A Pervasive Phenomenon in a National Dutch Sample.

Educational level is strongly associated with age of first intercourse and risk of unintended pregnancies. This study examined these associations in a large representative sample of Dutch adolescents and also included associations of educational level with other sexual health aspects. Adolescents aged 12 to 25 (3,926 boys and 3,915 girls) completed an online questionnaire that included measures of romantic and sexual experience; the evaluation of their sexual debut; the risk of sexually transmitted infections (STIs) and pregnancy; and sexual attitudes, satisfaction, self-efficacy, knowledge, victimization, and functioning. The results showed that adolescents on a vocational track or who completed fewer years of education were more at risk of several adverse sexual health outcomes than adolescents on an academic track. They had their first sexual experiences at an earlier age; evaluated these experiences less favorably; had less sexual health knowledge and fewer refusal skills; and had a higher risk of unintended pregnancy, STIs, and victimization. Possible explanations for these consistent differences are discussed. Sex education and services should pay specific and targeted attention to less educated young people and tailor their efforts specifically to the needs, characteristics, and realities of this group.

Sexuality in adolescent boys with autism spectrum disorder: self-reported behaviours and attitudes.

Differences in sexual functioning of adolescents with and without autism spectrum disorder (ASD) are understudied. In the current study, self-reported sexual behaviours, interests and attitudes of 50 adolescent boys, aged 15-18, with at least average intelligence and diagnosed with ASD, were compared with a matched general population control group of 90 boys. Results demonstrated substantial similarity between the groups in terms of sexual behaviours. The only significant difference was that boys with ASD reacted more tolerant towards homosexuality compared to the control group. Results reveal that sexuality is a normative part of adolescent development in high-functioning boys with ASD. Hence, attention should be given to this topic in education and mental health care.

Sex-related online behaviors and adolescents' body and sexual self-perceptions.

BACKGROUND AND OBJECTIVE: This study investigated: (1) the prevalence and development of 2 receptive (sexually explicit Internet material [SEIM] use and sexual information seeking) and 2 interactive (cybersex and general social networking site [SNS] use) online behaviors in adolescence; (2) whether development of these behaviors predict adolescents' body and sexual self-perceptions; and (3) whether parental strategies regarding adolescents' Internet use reduce engagement in sex-related online behaviors. METHODS: Four-wave longitudinal data among 1132 seventh- to 10th-grade Dutch adolescents (mean age at wave 1: 13.95 years; 52.7% boys) were collected. Developmental trajectories of sex-related online behaviors were estimated by using latent growth curve modeling. Self-perception outcomes at wave 4 and parental strategies predicting online behaviors were investigated by adding regression paths to growth models. RESULTS: Boys occasionally and increasingly used SEIM. Patterns for girls' SEIM use and boys' and girls' sexual information seeking and cybersex were consistently low. SNS use, however, was a common, daily activity for both. Higher initial levels and/or faster increases in sex-related online behaviors generally predicted less physical self-esteem (girls' SNS use only), more body surveillance, and less satisfaction with sexual experience. Private Internet access and less parental rule setting regarding Internet use predicted greater engagement in sex-related online behaviors. CONCLUSIONS: Although most sex-related online behaviors are not widespread among youth, adolescents who engage in such behaviors are at increased risk for developing negative body and sexual self-perceptions. Particular attention should be paid to adolescents' SNS use because this behavior is most popular and may, through its interactive characteristics, elicit more critical self-evaluations. Prevention efforts should focus on parents' role in reducing risky sex-related online behaviors.

Young adolescents' sexual and romantic reference displays on Facebook.

PURPOSE: Social networking sites (SNSs) form increasingly popular venues for adolescents to express their developing identity, including their sexual self. This study investigated how and to what extent early and middle adolescents display sexuality and romance on SNSs and the demographic and psychosexual factors associated with their displays. METHODS: Dutch adolescents aged 11-18 years were recruited and Facebook friended. Participants' Facebook profiles were evaluated for sexual and romantic references and Facebook engagement. Participants completed a digital questionnaire measuring constructs related to romantic and sexual development. Analyses included chi-square and Student's t-tests. RESULTS: A total of 104 adolescents (M(age) = 15.01, 68.3% female) were Facebook friended. Of 104 profiles, 25 (24.0%) contained 67 sexual references, and 27 (26.0%) contained 204 romantic references. Sexual references were mostly posted by others and referring to others or to no one in particular, whereas romantic references were predominantly posted by and referring to the profile owner. Displayers of sexual and romantic references were, compared with nondisplayers, older, more engaged in Facebook, more sexually experienced, and perceived more of their peers as approving of sex and as sexually active. In addition, sexual displayers were more likely boys and more sexually interested. There were no differences with respect to sexual intention and sexual attitudes. CONCLUSIONS: A minority of young adolescents display sexual and romantic references on SNSs. References may reflect adolescents' offline sexual and romantic experiences. Yet, they may be powerful in creating behavioral norms; therefore, guidance on interpreting and displaying such messages should be promoted.

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.

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.

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.

Prostitution push and pull: male and female perspectives.

Smith, Grov, Seal, and McCall's (2012) analysis, focusing on how young men become, and stay, involved in male escorting, is a welcome contribution to the still relatively thin male sex worker literature. For this study group, notably supportive working surroundings, effective coping strategies, and a growing sense of "self-efficacy" eventually turn sex work into an increasingly comfortable experience and viable moneymaking option. In this commentary, I add some reflections from a broader perspective to these insights. I also consider some evidence on the numbers of men and women in sex work and make some observations on male versus female positions related to push and pull factors, stigma, and the experience of sex work.