High Emotional and Sexual Satisfaction Among Partnered Midlife Canadians: Associations with Relationship Characteristics, Sexual Activity and Communication, and Health.

Despite midlife adults accounting for a substantial and growing segment of the population, few large-scale studies have investigated factors which distinguish highly satisfying relationships from less satisfying ones in midlife. In a subsample of partnered 40-59-year-old Canadians (705 men, 743 women), relationship characteristics, sexual activity and communication, and health were investigated individually and simultaneously as predictors of high emotional and sexual satisfaction. Though the vast majority of participants reported being at least somewhat satisfied in their current relationship, less than half reported high satisfaction. For men and women, high emotional and sexual satisfactions were strongly linked. Logistic regressions indicated that longer relationships, dating relationships, and greater subjective overall health predicted high emotional satisfaction for men, whereas older age, married or cohabiting relationships, and frequent sexual communication predicted high emotional satisfaction for women. All types of sexual activities (minus penile-anal intercourse) were bivariately related to high emotional and sexual satisfaction. More frequent partnered sexual activity predicted high emotional and sexual satisfaction for men and women in regression analyses. More frequent sexual communication predicted high emotional satisfaction for women and high sexual satisfaction for both men and women. Newer relationships were more sexually satisfying for men. Postmenopausal women were less likely to be highly sexually satisfied. Findings suggest that physical health conditions are not generally related to high levels of satisfaction in midlife couples and that frequently discussing sex and engaging in (any) sexual activity with a partner are key components of highly satisfying relationships.

Genital Self-Image: Associations with Other Domains of Body Image and Sexual Response.

Genital self-image is an emerging aspect of body image relevant to sexual functioning and sexual satisfaction. The aims of the present study were to (1) examine the association between body image and genital self-image with a broad range of sexuality-related outcomes; (2) explore whether genital self-image is a more salient influence on sexual satisfaction and functioning than body image and (3) determine whether this would hold true for both men and women. The analytic sample (6,228 cis-gendered, heterosexual men and women between the ages of 18 and 40) was recruited from reddit.com online communities. Participants completed a survey that assessed genital self-image, body image, sexual satisfaction, and sexual functioning. Among women and men, positive genital self-image was associated with positive feelings about one's body overall and reduced body-related concerns specific to sexual encounters (e.g., sexual performance). In female respondents, as genital self-image increased, so did sexual satisfaction. Although genital self-image did not significantly predict sexual satisfaction among men, exploratory analysis indicated a mediating relationship with body image concerns. Findings from the current study may inform interventions to facilitate the development of a healthy sexual self-concept as well as a more positive outlook on genital appearance among men and women.

Corrigendum to: Decision making over condom use during menses to avert sexually transmissible infections.

Background:The aim of this study was to test the hypothesis that receptive partners in penile-vaginal intercourse (PVI) who exercise independent decision making over condom use during menses do so to avert sexually transmissible infection (STI) transmission or acquisition. Methods: Data were collected through a partnership with Clue, the industry-leading female health app. A brief web-based questionnaire was developed, translated into 10 languages, and made accessible via a URL link sent to Clue users and posted on social media. Inclusion criteria were: age ≥14 years, not being currently pregnant and engaging in PVI and condom use during menses in the past 3 months. The analytical subsample comprised 12889 respondents residing in 146 countries. Results: Twenty per cent indicated independent decision making about condom use during menses. Independent decision making was associated with lower odds of reporting that condoms were used for contraception (adjusted odds ratio (aOR) 0.65; 99% confidence interval (CI) 0.57-0.73) and higher odds that they were used for the prevention of STIs (aOR 1.44; 99% CI 1.28-1.61). A third significant finding pertained to always using condoms during menses; this was less likely among those indicating independent (female only) decision making (aOR 0.69; 99% CI 0.62-0.78). Non-significant associations with another two outcomes were found: protecting the partner against menstrual blood and protecting themselves against semen. Conclusions: Findings from people in 146 countries strongly support the hypothesis that those exercising independent decision making over condom use during menses do so to avert STI transmission or acquisition. That only one-fifth of this global sample reported this type of independent decision making suggests that empowerment-oriented (structural-level) interventions may be advantageous for individuals who are the receptive partner in PVI that occurs during menses.

Decision making over condom use during menses to avert sexually transmissible infections.

Background The aim of this study was to test the hypothesis that receptive partners in penile-vaginal intercourse (PVI) who exercise independent decision making over condom use during menses do so to avert sexually transmissible infection (STI) transmission or acquisition. METHODS: Data were collected through a partnership with Clue, the industry-leading female health app. A brief web-based questionnaire was developed, translated into 10 languages, and made accessible via a URL link sent to Clue users and posted on social media. Inclusion criteria were: age ≥14 years, not being currently pregnant and engaging in PVI and condom use during menses in the past 3 months. The analytical subsample comprised 12889 respondents residing in 146 countries. RESULTS: Twenty per cent indicated independent decision making about condom use during menses. Independent decision making was associated with lower odds of reporting that condoms were used for contraception (adjusted odds ratio (aOR) 0.65; 99% confidence interval (CI) 0.57-0.73) and higher odds that they were used for the prevention of STIs (aOR 1.44; 99% CI 1.28-1.61). A third significant finding pertained to always using condoms during menses; this was less likely among those indicating independent (female only) decision making (aOR 0.69; 99% CI 0.62-0.78). Non-significant associations with another two outcomes were found: protecting the partner against menstrual blood and protecting themselves against semen. CONCLUSIONS: Findings from people in 146 countries strongly support the hypothesis that those exercising independent decision making over condom use during menses do so to avert STI transmission or acquisition. That only one-fifth of this global sample reported this type of independent decision making suggests that empowerment-oriented (structural-level) interventions may be advantageous for individuals who are the receptive partner in PVI that occurs during menses.

Prevalence and Predictors of Sexual Problems Among Midlife Canadian Adults: Results from a National Survey.

BACKGROUND: Sexual problems are common among midlife men and women, and studies have identified a range of demographic, health, and relational correlates. Research on prevalence of these sexual problems within Canada is sparse and is warranted given the unique context related to provision of health care services in contrast to other countries. AIM: We investigated sexual problems (women's low desire, orgasm difficulties, and vaginal pain, as well as men's low desire, erection difficulties, and ejaculation difficulties) and their correlates among a large sample of Canadian men and women aged 40-59 years. METHODS: A national sample of Canadians was recruited (N = 2,400). Prevalence statistics for the sexual problems, and odds ratios for correlates were computed using logistic regression to identify demographic, health, and behavioral correlates of men' and women's sexual problems. OUTCOMES: Self-reported experiences in the last 6-months of low desire, vaginal dryness, vaginal pain, and orgasm difficulties for women, and low desire, erectile difficulties, and ejaculation problems for men. RESULTS: Sexual problems were relatively common; low desire was the most common sexual problem, particularly for women, with 40% reporting low sexual desire in the last 6 months. Women who were post-menopausal were much more likely to report low desire, vaginal pain, and vaginal dryness. Low desire and erectile difficulties for men, and low desire and orgasm difficulties for women were significant predictors of overall happiness with sexual life. CLINICAL TRANSLATION: Given the prevalence and impact of sexual problems indicated in our study, physicians are encouraged to routinely assess for and treat these concerns. CONCLUSIONS: Strengths include a national sample of an understudied demographic category, midlife adults, and items consistent with other national studies of sexual problems. Causal or directional associations cannot be determined with these cross-sectional data. Results are largely consistent with previous national samples in the United States and the United Kingdom. Sexual problems are common among Canadian men and women, with many being associated with self-reported sexual happiness. Quinn-Nilas C, Milhausen RR, McKay A, et al. Prevalence and Predictors of Sexual Problems Among Midlife Canadian Adults: Results from a National Survey. J Sex Med 2018;15:873-879.

Sexual Motives in Heterosexual Women With and Without Sexual Difficulties.

Previous research indicates that women with sexual problems may have different reasons for engaging in sex than women who are not experiencing sexual problems. The current study investigated whether reasons for sex differed by women reporting high versus low overall sexual functioning, as assessed by the Female Sexual Function Index (FSFI) (Rosen et al., 2000). As low desire and inability to achieve orgasm are the two most commonly reported sexual problems for women, the study also investigated whether women with and without problems specifically related to sexual desire or orgasm cited different reasons for sex. The sample consisted of 446 heterosexual women between the ages of 18 and 61 who completed an online questionnaire assessing reasons for sex and sexual functioning. Women with low sexual functioning overall were more likely to endorse insecurity reasons for sex, while women with high sexual functioning overall were more likely to endorse physical reasons for sex. Women experiencing low desire specifically were less likely to endorse emotional and physical reasons for sex than women without desire difficulties. Women experiencing orgasm difficulties specifically were more likely to endorse insecurity reasons for sex than women without orgasm difficulties. The variance accounted for was low in all cases. This research offers insights into the important but limited role sexual functioning may play in the broader context of women's sexual motivations.

Measures of Attitudes Toward and Communication about Condom Use: Their Relationships With Sexual Risk Behavior Among Young Black Men Who Have Sex With Men.

OBJECTIVE: The aim of this study was to construct and test measures of psychosocial mediators that could be used in intervention studies seeking to promote safer sex behavior among young black men who have sex with men (YBMSM). METHODS: A total of 400 YBMSM, ages 18 to 29 years, were recruited from a clinic for sexually transmitted infection in the southern United States. All men had engaged in penile-anal sex with a man as a "top" in the past 6 months. The men completed an audio-computer-assisted self-interview and provided specimens used for nucleic acid amplification testing to detect Chlamydia and gonorrhea. Four measures were constructed and tested for criterion validity (Safer Sex Communication, Condom Turn-Offs, Condom Pleasure Scale, and a single item assessing frequency of condom use discussions before sexual arousal). RESULTS: With the exception of Safer Sex Communication, all of the measures showed criterion validity for both unprotected anal insertive and unprotected anal receptive sex. With the exception of the Condom Turn-Offs, the 3 other measures were supported by criterion validity for oral sex. Both the Condom Turn-Offs and Condom Pleasure Scale were significantly related to whether or not the men reported multiple partners as a top, but only the Condom Pleasure Scale was associated with reports of multiple partners as a "bottom." Only the Condom Turn-Offs Scale was positively associated with having been diagnosed with either Chlamydia or gonorrhea. CONCLUSION: Findings provide 3 brief scales and a single item that can be used in intervention studies targeting YBMSM. Perceptions about condoms being a turnoff and about condoms enhancing pleasure showed strong association with sexual risk behaviors.

Circumcision Status is Not Associated with Condom Use and Prevalence of Sexually Transmitted Infections Among Young Black MSM.

This study investigated whether intact young Black MSM differed from their circumcised counterparts regarding condom use behaviors and perceptions and HIV/Chlamydia/gonorrhea. Young Black MSM completed a self-interview, including a pictorial item assessing circumcision status and measures of condom use. Twenty-seven percent of 388 participants reported not being circumcised. With one exception, no associations tested approached significance. The mean frequency of unprotected insertive anal sex for circumcised men was about twice as high compared to those intact (P = .04). Intact young Black MSM did not differ from circumcised men relative to prevalence of STIs (including HIV) or condom use behaviors as reported only by insertive partners.

Sexual Excitation/Sexual Inhibition Inventory (SESII-W/M): Adaptation and Validation Within a Portuguese Sample of Men and Women.

The SESII-W/M is a self-report measure assessing factors that inhibit and enhance sexual arousal in men and women. The goal of this study was to adapt and validate it in a sample of Portuguese men and women. A total of 1,723 heterosexual men and women participated through a web survey, with ages ranging from 18 to 72 years old (M  = 36.05, SD =  11.93). The levels of internal consistency were considered satisfactory in the first four factors, but not in Setting and Dyadic Elements of the Sexual Interaction. Confirmatory factor analysis partially supported the six-factor, 30-item model, as factor loadings and squared multiple correlations pointed to problems with items mainly loading on those two factors. General fit indices were lower than the ones estimated by Milhausen, Graham, Sanders, Yarber, and Maitland (2010). Psychometric sensitivity and construct validity were adequate and gender differences were consistent with the original study. The six-factor, 30-item model was retained, but changes to the factors Setting and Dyadic Elements of the Sexual Interaction, and their corresponding items, were recommended in order to strengthen the measure.

Condom Use Errors and Problems: A Comparative Study of HIV-Positive Versus HIV-Negative Young Black Men Who Have Sex With Men.

OBJECTIVES: To describe self-reported frequencies of selected condom use errors and problems among young (age, 15-29 years) black men who have sex with men (YBMSM) and to compare the observed prevalence of these errors/problems by HIV serostatus. METHODS: Between September 2012 October 2014, electronic interview data were collected from 369 YBMSM attending a federally supported sexually transmitted infection clinic located in the southern United States. Seventeen condom use errors and problems were assessed. χ(2) Tests were used to detect significant differences in the prevalence of these 17 errors and problems between HIV-negative and HIV-positive men. RESULTS: The recall period was the past 90 days. The overall mean (SD) number of errors/problems was 2.98 (2.29). The mean (SD) for HIV-negative men was 2.91 (2.15), and the mean (SD) for HIV-positive men was 3.18 (2.57). These means were not significantly different (t = 1.02, df = 367, P = 0.31). Only 2 significant differences were observed between HIV-negative and HIV-positive men. Breakage (P = 0.002) and slippage (P = 0.005) were about twice as likely among HIV-positive men. Breakage occurred for nearly 30% of the HIV-positive men compared with approximately 15% among HIV-negative men. Slippage occurred for approximately 16% of the HIV-positive men compared with approximately 9% among HIV-negative men. CONCLUSIONS: A need exists to help YBMSM acquire the skills needed to avert breakage and slippage issues that could lead to HIV transmission. Beyond these 2 exceptions, condom use errors and problems were ubiquitous in this population regardless of HIV serostatus. Clinic-based intervention is warranted for these young men, including education about correct condom use and provision of free condoms and long-lasting lubricants.

General Erectile Functioning among Young, Heterosexual Men Who Do and Do Not Report Condom-Associated Erection Problems (CAEP).

INTRODUCTION: Condom-associated erection problems (CAEP) are an underestimated factor related to inconsistent or incomplete male condom use. The underlying mechanisms of CAEP are not understood, and whether men who report these difficulties are also likely to experience erectile problems in situations when condoms are not used has not been studied. AIM: The aim of the study was to investigate, in a sample of condom-using young, heterosexual men (aged 18-24 years), whether men who report CAEP are more likely to (i) have erection problems when not using condoms and (ii) meet criteria for erectile dysfunction. METHODS: A total of 479 men recruited online completed the International Index of Erectile Function (IIEF-5) and answered questions about erection problems experienced when using and not using condoms during the last 90 days. Demographic, sexual experience, and health status variables were investigated as correlates. MAIN OUTCOME MEASURES: Self-reported frequency of erection loss during condom application or during penile-vaginal intercourse (PVI) in the past 90 days and IIEF-5 scores. RESULTS: Of the men, 38.4% were classified in the no CAEP group, 13.8% as having CAEP during condom application, 15.7% as having CAEP during PVI, and 32.2% as having CAEP during both condom application and PVI. Men reporting any form of CAEP were significantly more likely than men reporting no CAEP to also report erection difficulties during sexual activity when not using condoms. Men who reported CAEP during PVI only or during both application and PVI scored significantly lower on the IIEF-5 than men without CAEP. CONCLUSION: The findings suggest that men who report CAEP are also more likely to experience more generalized erection difficulties. Clinicians should assess whether men using condoms experience CAEP and where appropriate, refer for psychosexual therapy or provide condom skills education.

Relationships Between Body Image, Body Composition, Sexual Functioning, and Sexual Satisfaction Among Heterosexual Young Adults.

This study investigated the association between body image and body-image self-consciousness on sexual satisfaction, accounting for relationships between body fat and body image, and between sexual functioning and sexual satisfaction, while controlling for relationship satisfaction. Participants were 143, 18-25 year-old Caucasian men and women in heterosexual monogamous relationships, recruited from the University of Guelph and surrounding community in Ontario, Canada. Various domains of body image, body-image self-consciousness, sexual satisfaction and functioning, and relationship satisfaction data were collected by questionnaires. Body fat was measured using dual energy X-ray absorptiometry. Among men, body image was positively associated with sexual satisfaction, after controlling for relationship satisfaction. Men with greater body fat were more likely to have poorer behavioral and affective body image. Only body image specific to the sexual encounter influenced sexual functioning. Among women, no domain of body image was associated with sexual satisfaction, after controlling for relationship satisfaction. Women with greater body fat were more likely to have poorer affective and sexual-encounter-specific body image. As percent total fat increased, sexual functioning decreased. Our results suggest a complex pattern of relationships exists among body image and body composition constructs and sexual and relationship variable; and that these relationships are not the same for men and women.

Understanding problems with condom fit and feel: an important opportunity for improving clinic-based safer sex programs.

The purpose of this study was to investigate gender differences and other demographic correlates of condom fit and feel problems among a diverse sample of adult condom users and to examine men's and women's perceptions and experiences with condom fit and feel problems. Participants were recruited from an electronic mailing list. The analytic sample (N = 949) included self-identified heterosexual men (n = 771) and women (n = 178) who reported using condoms for penile-vaginal or penile-anal intercourse in the past 3 months. Both quantitative and qualitative methods were applied. Of the sample, 38.3% reported experiencing at least one condom fit or feel problem. Problems with condom fit during sex did not differ significantly by gender (p = .73). Perceptions of specific condom use problems were organized into five themes: (1) decreased sensation, (2) lack of naturalness, (3) condom size complaints, (4) decreased pleasure, and (5) pain and discomfort. In this diverse sample, there was a high prevalence of condom fit and feel issues among women as well as men. These issues, mostly focused on loss of pleasure, represent a substantial public health problem and thus warrant attention in safer sex programs.

Motives between the Sheets: Understanding Obligation for Sex at Midlife and Associations with Sexual and Relationship Satisfaction.

Reasons for sex are associated with sexual and relational outcomes. This study investigated reasons for sex at last sex, with a focus on obligation (an avoidance motivation) and doing something nice for a partner (an approach motivation), and their associations with sexual and relationship satisfaction, while controlling for marital duration, age, and sexual desire. We investigated these reasons among married, midlife Canadian women (n = 324), men (n = 275), and 25 non-binary/gender queer participants 40 to 59 years of age. Participants were recruited from a Qualtrics analytics panel and completed an online questionnaire. Obligation was reported as a reason for having sex by 12.4% of women and 1.8% of men; "doing something nice" was reported by 10.2% of women and 9.5% of men. In regression analyses, women who reported having sex for obligation had significantly lower relationship satisfaction and sexual satisfaction than women who did not report this reason. In contrast, having sex to do something nice for one's partner was associated with higher sexual satisfaction among women. Findings indicate that having sex when feeling obligated may be associated with negative sexual and relational outcomes among midlife women.

Sexual desire and relationship duration in young men and women.

Sexual desire is often present at the beginning of a romantic relationship. However, research is divided regarding whether, and how, desire is experienced as a relationship progresses. The authors examined relationship duration and its effect on sexual desire in a sample of 170 undergraduate men and women between the ages of 18 and 25 years. Hierarchical multiple regression results indicated that women's sexual desire was significantly and negatively predicted by relationship duration after controlling for age, relationship satisfaction, and sexual satisfaction. Men's sexual desire, however, was not significantly affected by the duration of their romantic relationships. These findings suggest that men and women may have different experiences with sexual desire as relationships progress and that sexual desire might be affected by different factors depending on one's gender. Possible reasons for these results are suggested and therapeutic implications are discussed.

Body image, body mass index, and body composition in young adults.

PURPOSE: Associations were examined between body image and body mass index (BMI) in comparison with body composition in healthy weight, overweight, and obese young adults. METHODS: Weight and height were determined, and the percentage of fat mass (%FM) and percentage of fat-free mass (%FFM) were measured by dual energy X-ray absorptiometry in 75 male and 87 female young adults (21.1 ± 1.9 years; 25.2 ± 4.4 kg/m² [mean ± standard deviation]). Body image was measured using the three subscales Weight Esteem, Appearance Esteem, and External Attribution of the Body-Esteem Scale for Adolescents and Adults (BESAA). RESULTS: Body mass index and %FM were highly correlated (r for males = 0.74, r for females = 0.82; both p<0.001), and were inversely associated with body image, particularly Weight Esteem. After adjustment for physical activity, BMI and %FM (and %FFM, although in the opposite direction) were associated with each BESAA subscale: %FM, %FFM, and BMI explained 12% to 14% of the variance in Appearance Esteem for both sexes, 33% to 41% in Weight Esteem in women and 16% to 18% in men, and 8% to 10% in External Attribution in women (all p<0.05) and <5% for men (NS). CONCLUSIONS: Clinicians should be aware that as their clients' BMI and %FM increase, body image decreases, particularly in women.

Incomplete use of condoms: the importance of sexual arousal.

The purpose of this study was to identify associations between incomplete condom use (not using condoms from start to finish of sex) and sexual arousal variables. A convenience sample of heterosexual men (n = 761) completed a web-based questionnaire. Men who scored higher on sexual arousability were more likely to put a condom on after sex had begun (AOR = 1.58). Men who reported difficulty reaching orgasm were more likely to report removing condoms before sex was over (AOR = 2.08). These findings suggest that sexual arousal may be an important, and under-studied, factor associated with incomplete use of condoms.

Infidelity in heterosexual couples: demographic, interpersonal, and personality-related predictors of extradyadic sex.

This study aimed to assess the relative importance of demographic, interpersonal, and personality factors in predicting sexual infidelity in heterosexual couples. A total of 506 men (M age = 32.86 years, SD = 10.60) and 412 women (M age = 27.66 years, SD = 8.93), who indicated they were in a monogamous sexual relationship, completed a series of questionnaires, including the Sexual Excitation/Inhibition (SES/SIS) scales and the Mood and Sexuality Questionnaire, and answered questions about, among others, religiosity, education, income, relationship and sexual satisfaction, and sexual compatibility. Almost one-quarter of men (23.2%) and 19.2% of women indicated that they had "cheated" during their current relationship (i.e., engaged in sexual interactions with someone other than their partner that could jeopardize, or hurt, their relationship). Among men, a logistic regression analysis, explaining 17% of the variance, revealed that a higher propensity of sexual excitation (SES) and sexual inhibition due to "the threat of performance concerns" (SIS1), a lower propensity for sexual inhibition due to "the threat of performance consequences" (SIS2), and an increased tendency to engage in regretful sexual behavior during negative affective states were all significant predictors of infidelity. In women, a similar regression analysis explained 21% of the variance in engaging in infidelity. In addition to SIS1 and SIS2, for which the same patterns were found as for men, low relationship happiness and low compatibility in terms of sexual attitudes and values were predictive of infidelity. The findings of this study suggest that, for both men and women, sexual personality characteristics and, for women, relationship factors are more relevant to the prediction of sexual infidelity than demographic variables such as marital status and religiosity.

Sexual identity and sexual well-being in female heterosexual university students.

Sexual identity has generally been studied with a focus on sexual orientation and has not incorporated a general identity framework. Low levels of identity exploration and commitment have been shown to predict poor well-being in adolescents, but the relationship between sexual identity and sexual well-being has not been examined. The current cross-sectional survey was administered to 293 heterosexual female undergraduate students from a mid-sized university in Ontario, Canada. Participants completed the Measure of Sexual Identity Exploration and Commitment (Worthington, Navarro, Savoy, & Hampton, 2008), as well as several measures to assess sexual well-being. These included the Sexuality Scale (Snell & Papini, 1989), the Sexual Awareness Questionnaire (Snell, Fisher, & Miller, 1991), the Body Esteem Scale for Adolescents and Adults (Mendelson, Mendelson, & White, 2001; Mendelson, White, & Mendelson, 1997), and four individual items assessing sexual satisfaction (Laumann et al., 2006). Confirmatory factor analysis was used to test the measurement models of sexual identity and sexual well-being, and structural equation modeling was used to examine the relationship between sexual identity and sexual well-being. Results indicated that higher levels of sexual identity exploration and commitment predicted sexual well-being. However, other aspects of sexual identity, such as synthesis and sexual orientation identity, were not predictive of sexual well-being. The implications of using an identity framework for measuring sexual identity are discussed.

Validation of the sexual excitation/sexual inhibition inventory for women and men.

The purpose of the current investigation was to develop a scale that would assess propensity for sexual arousal in response to a broad range of stimuli and sexual situations in both men and women. In Study 1, data from a nonclinical sample of 481 male and female students (graduate and undergraduate) were submitted to exploratory and confirmatory factor analyses in order to develop the Sexual Excitation/Sexual Inhibition Inventory for Women and Men (SESII-W/M), and gender differences on the subscales were tested. In Study 2, construct validity and test-retest reliability of the SESII-W/M were assessed with a second sample of undergraduate students. The resultant measurement tool was comprised of six subscales: Inhibitory Cognitions, Relationship Importance, Arousability, Partner Characteristics and Behaviors, Setting (Unusual or Unconcealed), and Dyadic Elements of the Sexual Interaction. The measure demonstrated good test-retest reliability and discriminant and convergent validity. The SESII-W/M will likely be a useful measure in investigations in which sexual inhibition and sexual excitation must be assessed identically for men and women.