Gender dysphoria and sexual euphoria - A Bayesian perspective on the influence of gender-affirming hormone therapy on sexual arousal

While the concept of sexual orientation is more clearly defined in cisgender, this is less so in transgender individuals. Both experienced gender and sex hormones have a relation to sexual preferences, arousal in response to erotic stimuli, and thus sexual orientation. In transgender individuals sexual orientation occasionally changes before or during transition, which may involve gender-affirming hormone therapy. Using functional magnetic resonance imaging, we investigated whether the neuronal and behavioral patterns of sexual arousal in transgender individuals moved from the given (before) to their chosen gender after 4.5 months of hormone therapy. To this aim, trans women and men as well as age-matched cisgender controls rated visual stimuli showing heterosexual, lesbian or gay intercourse for subjective sexual arousal. Utilizing a Bayesian framework allowed us to incorporate behavioral findings in cisgender individuals of different sexual orientations. The hypothesized changes in response patterns could indeed be observed in the behavioral responses to the single but not the differentiation between stimulus categories with the strongest results for trans men and lesbian scenes. Activation of the ventral striatum supported our hypothesis only for lesbian scenes in trans women. This prominent role of lesbian stimuli might be explained by their differential responses in cis women and men. We show that correlates of sexual arousal in transgender individuals might change in direction of the chosen gender. Future investigations longer into transition might resolve the discrepancy on behavioral and neuronal levels.

Gender-specific genital and subjective sexual arousal to prepotent sexual stimuli in androphilic men and gynephilic women

Marked differences have been found in men’s and women’s sexual response patterns, contingent upon their sexual orientation; androphilic (attracted to men) and gynephilic (attracted to women) men demonstrate greatest genital and self-reported arousal to their preferred stimulus type (a “gender-specific” response), whereas androphilic women do not, and findings for gynephilic women have been mixed. While there have been many investigations into gynephilic men’s and androphilic women’s (i.e., heterosexual men/women) sexual response, there has been less investigation into the specificity of sexual response of androphilic men and gynephilic women. Given the complex nature of sexual stimuli that are used in sexual response research, it is often unclear to what extent contextual cues (e.g., cues other than the sexual actor’s primary and secondary sex characteristics, such as physical attractiveness, sexual activity, etc.) influence participants’ sexual response patterns. As such, the current study examined genital, discrete self-reported, and continuous self-reported responses of androphilic men ( n = 22) and gynephilic women ( n = 10) to prepotent sexual features (stimuli thought to elicit automatic sexual arousal: erect penises and exposed vulvas), non-prepotent sexual features (flaccid penises and pubic triangles) and neutral stimuli (clothed men and women). Both samples exhibited a gender-specific pattern of genital, self-reported, and continuous self-reported sexual arousal. Similarly, all measures of sexual arousal were generally found to be greatest to “prepotent” sexual cues. Implications for understanding gender specificity of sexual response are discussed.

The Perceived Need To Be Hot: An Investigation Of The Relationship Between Belief In Sexual Stereotypes And Erectile Dysfunction In Gay Men Using Thermal Imaging

Erectile dysfunction (ED) has been associated with considerable mental health and interpersonal problems, an increase in risky sex, and is particularly prevalent among gay and bisexual men. Psychological treatment protocols for sexual dysfunctions often aim at challenging beliefs and cognitions about the importance of a “perfect sexual performance,” known as sexual stereotypes. However, to date, little empirical evidence exists for the relationship between ED and belief in sexual stereotypes (BSS). To address this gap, 70 gay men were recruited; 30 with ED and 40 healthy controls. Participants completed a battery of questionnaires, including a measure of BSS, followed by having their genital temperature measured using a thermal imaging camera, while viewing a sexually explicit film. The study had four main objectives: (1) to evaluate between group differences in subjective sexual arousal and physiological arousal; (2) to examine within group differences in the effects of BSS on physiological and self-reported sexual arousal; (3) to evaluate the relationship between BSS, negative automatic thoughts during sex, and ED; and (4) to evaluate the relationship between ED and risky sex among gay men. Results revealed significant between-group differences in physiological arousal, but not in subjective sexual arousal. While between-group differences were found in BSS, no within-group differences were found in the relation of BSS on physiological and self-reported sexual arousal. No significant relationships were found between BSS, negative automatic thoughts, and ED. Participants with ED were found to be significantly more likely to use erectile enhancing drugs, but no significant differences in condom removal were found between groups; however, substantially more individuals with ED (23.3%) reported removing condoms prior to the completion of sexual activity, as compared to healthy controls (5%). Findings of this study contribute to improving psychological treatments for gay men with ED, as well as better understanding pathways leading to risky sex in gay men.

The Perceived Need To Be Hot: An Investigation Of The Relationship Between Belief In Sexual Stereotypes And Erectile Dysfunction In Gay Men Using Thermal Imaging

Erectile dysfunction (ED) has been associated with considerable mental health and interpersonal problems, an increase in risky sex, and is particularly prevalent among gay and bisexual men. Psychological treatment protocols for sexual dysfunctions often aim at challenging beliefs and cognitions about the importance of a “perfect sexual performance,” known as sexual stereotypes. However, to date, little empirical evidence exists for the relationship between ED and belief in sexual stereotypes (BSS). To address this gap, 70 gay men were recruited; 30 with ED and 40 healthy controls. Participants completed a battery of questionnaires, including a measure of BSS, followed by having their genital temperature measured using a thermal imaging camera, while viewing a sexually explicit film. The study had four main objectives: (1) to evaluate between group differences in subjective sexual arousal and physiological arousal; (2) to examine within group differences in the effects of BSS on physiological and self-reported sexual arousal; (3) to evaluate the relationship between BSS, negative automatic thoughts during sex, and ED; and (4) to evaluate the relationship between ED and risky sex among gay men. Results revealed significant between-group differences in physiological arousal, but not in subjective sexual arousal. While between-group differences were found in BSS, no within-group differences were found in the relation of BSS on physiological and self-reported sexual arousal. No significant relationships were found between BSS, negative automatic thoughts, and ED. Participants with ED were found to be significantly more likely to use erectile enhancing drugs, but no significant differences in condom removal were found between groups; however, substantially more individuals with ED (23.3%) reported removing condoms prior to the completion of sexual activity, as compared to healthy controls (5%). Findings of this study contribute to improving psychological treatments for gay men with ED, as well as better understanding pathways leading to risky sex in gay men.

Association between Psychopathological Dimensions and Sexual Functioning/Sexual Arousal in Young Adults

Psychological-psychiatric factors have a different effect on sexual functioning in men and women. This research aimed to examine the association between psychopathological dimensions and dimensions of sexual functioning in Spanish young adults in two studies. Study 1 examined sexual functioning and psychopathological dimensions in 700 women and 516 men. Study 2 conducted an experimental laboratory task to evaluate subjective sexual arousal and genital sensations when watching visual sexual stimuli in a subsample of participants from Study 1 (143 women and 123 men). As a result, the first study showed that depression and anxiety-related symptoms had a negative effect, both in men and women, and having a partner had a positive influence on the dimensions of sexual functioning. The second study showed that anxiety symptoms were positively associated with subjective sexual arousal in both men and women, and anxiety was associated with the assessment of genital sensations in men. The differences between the results of anxiety may be explained because sexual arousal was evaluated in general terms in Study 1, whereas it was evaluated as a state in Study 2. These findings confirm that the presence of psychopathological symptoms contributes to sexual functioning, as well as the necessity of strengthening mental illness prevention programs that include sexual health components.

Mindfulness in Sexual Activity, Sexual Satisfaction and Erotic Fantasies in a Non-Clinical Sample

The goal of this study is to better understand the relation between the practice of Mindfulness and the sexual activity, sexual satisfaction and erotic fantasies of Spanish-speaking participants. This research focuses on the comparison between people who practice Mindfulness versus naïve people, and explores the practice of Mindfulness and its relation with the following variables about sexuality: body awareness and bodily dissociation, personal sexual satisfaction, partner and relationship-related satisfaction, desire, subjective sexual arousal, genital arousal, orgasm, pain, attitudes towards sexual fantasies and types of sexual fantasies. The sample consisted of 106 selected adults, 32 men and 74 women, who completed six measures on an online survey platform: (a) Mindfulness Attention Awareness Scale (MAAS), (b) Scale of Body Connection (SBC), (c) New Sexual Satisfaction Scale (NSSS), (d) Scale of Sexual Activity in Women (SSA-W) and Men (SSA-M), (e) Hurlbert Index of Sexual Fantasy (HISF), (f) Wilson’s Sex Fantasy Questionnaire. In the MAAS, Body Awareness subscale (SBC), NSSS, SSA-W and SSA-M, HISF and intimate fantasies subscale (Wilson’s questionnaire), people in the Mindfulness condition showed higher scores and these differences were statistically significant. These results may have relevant implications in the sexuality of clinical and non-clinical samples.

Mindfulness in Sexual Activity, Sexual Satisfaction and Erotic Fantasies in a Non-Clinical Sample

The goal of this study is to better understand the relation between the practice of Mindfulness and the sexual activity, sexual satisfaction and erotic fantasies of Spanish-speaking participants. This research focuses on the comparison between people who practice Mindfulness versus naïve people, and explores the practice of Mindfulness and its relation with the following variables about sexuality: body awareness and bodily dissociation, personal sexual satisfaction, partner and relationship-related satisfaction, desire, subjective sexual arousal, genital arousal, orgasm, pain, attitudes towards sexual fantasies and types of sexual fantasies. The sample consisted of 106 selected adults, 32 men and 72 women, who completed six measures on an online survey platform: a) Mindfulness Attention Awareness Scale (MAAS), b) Scale of Body Connection (SBC), c) New Sexual Satisfaction Scale (NSSS), d) Scale of Sexual Activity in Women (SSA-W) and Men (SSA-M), e) Hurlbert Index of Sexual Fantasy (HISF), f) Wilson's Sex Fantasy Questionnaire. In the MAAS, Body Awareness subscale (SBC), NSSS, SSA-W and SSA-M, HISF and intimate fantasies subscale (Wilson’s questionnaire), people in the Mindfulness condition showed higher scores and these differences were statistically significant. These results may have relevant implications in the sexuality of clinical and non-clinical samples.

Preliminary Evidence on How the Dual Control Model Predicts Female Sexual Response to a Bogus Negative Feedback

The Dual Control Model of sexual response has been mostly tested with men. As such, there is a lack of evidence on how such model applies to women’s experience of sexual arousal, particularly when they face a threatening situation such as the threat of sexual performance failure. The aim of the current study was to test whether the Dual Control Model dimensions predict women’s sexual responses to a bogus negative feedback about their sexual performance. In addition, 22 women were exposed to a sexually explicit film clip, while their genital arousal was being measured. During this presentation, a bogus negative feedback, aimed at increasing women’s anxiety about their sexual performance, was provided. Vaginal photopletismography and self-report questions were used as means to evaluate women’s genital and subjective sexual arousal, respectively. The Sexual Excitation/Sexual Inhibition Inventory for Women was further used to capture women’s sexual dynamics. Regression analysis on the high-order factors revealed that sexual excitation proneness was the only predictor of the subjective sexual responses, while none of the factors has predicted genital arousal. “Arousability” and “Concerns about sexual function” dimensions predicted subjective sexual arousal. Sexual arousability may prevent women of lowering their subjective sexual responses in a sexually demanding situation, while “Concerns about sexual function” may have the opposite role, thus being a target of clinical interest. This work provides new data on the Dual Control Model of sexual response, and particularly on its role in women’s sexual functioning.