No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Lifetime Lubricant Use among a Nationally Representative Sample of Lesbian- and Bisexual-Identified Women in the United States: Lesbian and Bisexual Women
Abstract
Introduction:
The diversity in self-identified lesbian and bisexual women's sexual interactions necessitates better understanding of how and when they integrate personal lubricant into different experiences. However, little is known about lesbian and bisexual women's lifetime lubricant use, particularly at the population level.
Aims:
The aim of this study was to examine the prevalence and characteristics of lubricant use among adult lesbian and bisexual women in the United States.
Methods:
Data were drawn from a subset of lesbian and bisexual participants who participated in the 2012 National Survey of Sexual Health and Behavior, an online questionnaire administered to a nationally representative probability sample of U.S. adults ages 18 and older.
Main outcome measures:
We examined socio-demographic characteristics, recent and lifetime lubricant use, lubricant use in associated with specific sexual behaviors and condom use, frequency of use, motivations for use, as well as perception of lubricant when used.
Results:
A majority of lesbian- (60.1%) and bisexual-identified (77.1%) women reported ever using lubricant; 25.7% of lesbian women and 32.7% of bisexual women used it in the last 30 days. Across most age groups, lubricant was commonly used during partnered sexual play, partnered sexual intercourse, or when a vibrator/dildo was used. Lesbian and bisexual women reported using lubricants to increase arousal/sexual pleasure/desire, to make sex more fun, or to increase physical comfort during sex.
Conclusions:
Lubricant use is identified as a part of lesbian and bisexual women's sexual experience across the life span, as a part of both solo and partnered experiences. As part of evolving sexual health assessments, clinicians and health educators may find value in integrating lubricant-focused conversation with their lesbian and bisexual patients and clients, particularly.
... In addition, accurate language is important because the words people use to describe an activity help shape the meaning they ascribe to it [32]. A woman having access to a wider stimulation and penetration vocabulary may increase her satisfaction with her sexual communication with partners [51,52], which in turn may have positive implications for both relationship satisfaction and sexual satisfaction [53][54][55]. ...
... Of those who opened the study link, 88.8% (3017/3398) completed the survey (49.7% [3017/6123] of the initial sampling frame) and represent the analytical sample in this study. This completion rate is similar to other Ipsos-conducted nationally representative studies of sexuality and sexual behavior (44% -51%) [32,50,51,62]. Ipsos operates a modest incentive program that includes raffles and sweepstakes with both cash rewards and other prizes for completing the survey. ...
The study purpose was to assess, in a U.S. probability sample of women, the specific ways women have discovered to make vaginal penetration more pleasurable. Through qualitative pilot research with women that informed the development of the survey instrument used in this study, we identified four previously unnamed, but distinct, techniques women use to make vaginal penetration more pleasurable: Angling, Rocking, Shallowing and Pairing. This study defines each technique and describes its prevalence among U.S. adult women. Weighted frequencies were drawn from the Second OMGYES Pleasure Report—a cross-sectional, online, national probability survey of 3017 American women’s (age 18–93) sexual experiences and discoveries. Participants were recruited via the Ipsos KnowledgePanel®. Data suggest that 87.5% of women make vaginal penetration more pleasurable using ‘Angling’: rotating, raising, or lowering the pelvis/hips during penetration to adjust where inside the vagina the toy or penis rubs and what it feels like. Approximately 76% of women make vaginal penetration more pleasurable using ‘Rocking’: the base of a penis or sex toy rubbing against the clitoris constantly during penetration, by staying all the way inside the vagina rather than thrusting in and out. About 84% of women make vaginal penetration more pleasurable using ‘Shallowing’: penetrative touch just inside of the entrance of the vagina—not on the outside, but also not deep inside—with a fingertip, sex toy, penis tip, tongue, or lips. Finally, 69.7% of women orgasm more often or make vaginal penetration more pleasurable using ‘Pairing’: when a woman herself (Solo Pairing) or her partner (Partner Pairing) reaches down to stimulate her clitoris with a finger or sex toy at the same time as her vagina is being penetrated. These data provide techniques that are at women’s disposal to make penetration more pleasurable—which can enable women to better identify their own preferences, communicate about them and advocate for their sexual pleasure.
... During partnered sex, queer women often experience higher levels of orgasm than heterosexual women, because they engage in diverse sexual activities, focus on clitoral stimulation, and utilize pleasure-enhancing, orgasm-inducing tools (e.g., vibrators, lube, etc.) [54]. Women tend to prefer when sex feels wetter and even report being more easily orgasmic when they use lubricant [55]. However, lubricant use differs between Black lesbian women and Black bisexual women. ...
Purpose of Review
Limited research addresses Black queer women’s experience of sexual pleasure through an intersectional and sex-positive lens. Thus, the purpose of the paper is to review research on Black queer women’s sexual pleasure using the Pleasure Mountain model’s facilitators of pleasure: partnered interactions, liberation, mind-body-soul awareness, and orgasms.
Recent Findings
Black queer women’s sexual pleasure has been well theorized, but not often studied empirically. In the few studies, it was found that Black queer women appreciate mutual pleasure and orgasm, fake orgasm at similar rates as heterosexual peers, and employ their sex lives as sites of liberation.
Summary
While studies are limited, there is available research that discusses the lived-sexual experiences of Black queer women while considering their intersectional identities. However, gaps remain in the current sexual pleasure research of Black queer women that will better explicate the context and mechanisms of their sexual pleasure and health. Future studies are needed to investigate the facilitators to sexual pleasure for Black queer women while incorporating Black queer women’s voices as the sex scientists.
... Of those who opened the study link, 88.8% (3017/3398) completed the survey (49.7% [3017/6123] of the initial sampling frame) and represent the analytical sample in this study. This completion rate is similar to other Ipsos-conducted nationally representative studies of sexuality and sexual behavior (44%-51%) [5,[26][27][28]. Post-stratification, study-specific weights adjusted for over-or under-sampling as well as non-response. ...
The study purpose was to assess, in a U.S. probability sample of women, the specific ways women have discovered to experience pleasure from anal touch. Through qualitative pilot research with women that informed the development of the survey instrument used in this study, we identified three previously unnamed, but distinct, anal touch techniques that many women find pleasurable and that expand the anal sexual repertoire beyond the more commonly studied anal intercourse behaviors: Anal Surfacing, Anal Shallowing, and Anal Pairing. This study defines each technique and describes its prevalence among U.S. adult women. Weighted frequencies were drawn from the Second OMGYES Pleasure Report—a cross-sectional, online, national probability survey of 3017 American women’s (age 18–93) sexual experiences and discoveries. Participants were recruited via the Ipsos KnowledgePanel®. Data suggest that 40% of women find ‘Anal Surfacing’ pleasurable: sexual touch by a finger, penis, or sex toy on and around the anus. Approximately 35% of women have experienced pleasure using ‘Anal Shallowing’: penetrative touch by a finger, penis, or sex toy just inside the anal opening, no deeper than a fingertip/knuckle. Finally, 40% of women make other forms of sexual touch more pleasurable using ‘Anal Pairing’: touch on or inside the anus that happens at the same time as other kinds of sexual touch such as vaginal penetration or clitoral touching. These data provide techniques that women can and do use to explore the anus as a pleasurable region for touch—which can enable women to better identify their own preferences, communicate about them and advocate for their sexual pleasure.
... The methods for the 2009 and 2018 NSSHB survey waves have been described in detail elsewhere (e.g., Fortenberry et al., 2010;Fu et al., 2019;Herbenick et al., 2010a;Reece et al., 2010). The NSSHB is a US nationally representative probability survey of adolescents and adults in the USA that was initiated in 2009, with six subsequent data collection waves occurring between 2012(Beckemeyer et al., 2019Carter et al., 2019;Guerra-Reyes et al., 2018;Hensel et al., 2015;Herbenick et al., 2019aHerbenick et al., , 2019b. ...
Solo and partnered sexual behaviors are relevant to health, well-being, and relationships. Recent research shows that sexual frequency has declined in the U.S. and in other countries; however, measurement has been imprecise. We used data from 14- to 49-year-old participants in the 2009 and 2018 waves of the National Survey of Sexual Health and Behavior (NSSHB), a confidential U.S. nationally representative survey that is conducted online. We aimed to: (1) assess changes in frequency of past-year penile-vaginal intercourse and (2) examine combinations of past-year sexual behaviors for each of the two waves. We hypothesized that we would observe lower frequency of penile-vaginal intercourse (PVI) from 2009 to 2018 and that we would observe greater engagement in sexual repertoires involving non-coital partnered behaviors (e.g., partnered masturbation, oral sex) in 2018 as compared to 2009. Participants were 4155 individuals from the 2009 NSSHB (Adolescents: 406 females, 414 males; Adults: 1591 women, 1744 men) and 4547 individuals from the 2018 NSSHB (Adolescents: 416 females, 411 males; Adults: 2007 women, 1713 men). Compared to adult participants in the 2009 NSSHB, adults in the 2018 NSSHB were significantly more likely to report no PVI in the prior year (28% in 2018 vs. 24% in 2009). A similar difference in proportions reporting no PVI in the prior year was observed among 14–17-year-old adolescents (89% in 2018 vs. 79% in 2009). Additionally, for both adolescents and adults, we observed decreases in all modes of partnered sex queried and, for adolescents, decreases in solo masturbation.
... Such research should also examine how sexual health is related to mental well-being in older LGB adults. This information is needed to better craft policy and programmatic responses to the needs of these populations (Brown & Grossman, 2014;Hensel et al., 2015;Hillman, 2017;Michaels et al., 2017;Wolff, Wells, Ventura-DiPersia, Renson, & Grov, 2017). ...
Objectives: A significant gap in our knowledge concerns sexual health among the older lesbian, gay, and bisexual (LGB) population.
Methods: We compared a community-based sample of self-identified LGB older adults (n = 128) with population-based samples of behaviorally-defined LGB older adults (i.e., reporting same-sex experiences) (n = 112) and behaviorally-defined older heterosexuals (i.e., reporting no same-sex experiences) (n = 2,893) from the National Social Life, Health and Aging Project (NSHAP). Differences in sexual activity and sexual problems were examined.
Results: Older LGB adults were as likely to remain sexually active as older heterosexuals. Gay and bisexual men were more likely than heterosexual men to report some sexual problems. Regardless of sexual orientation, older adults rarely had their sexual health needs addressed in healthcare settings.
Conclusions: Results highlight the need for more research on LGB older adult sexual health.
Clinical Implications: The lack of attention to LGB older adults’ sexual health in healthcare settings may be exacerbated by ageism and heterosexism, leading these individuals to avoid disclosing their sexual orientations and avoid conversations about sexuality. Mental health practitioners require education on associations between sexual health and mental health, and how sexual health problems may contribute to mental health concerns in vulnerable populations like older LGB adults.
... Data presented here are from the 2012 National Survey of Sexual Health Behavior (NSSHB); from which previous data have been published [26][27][28]. The NSSHB is a population-based cross-sectional survey of adult women and men in the United States collected during October and November 2012, via national probability research panel samples, established by the Knowledge Panel of GfK Research (GfK) (Menlo Park, California). ...
This study assessed the prevalence of sexual behaviors among a nationally representative sample of Latino men and women in the United States (US) (N = 432) including Spanish language data collection. Prior studies of sexual health among US Latinos have consisted of convenience samples, and focused mainly on assessing risk behaviors. We consider a broader range of sexual behaviors, subjective sexual experiences (e.g. pleasure and arousal), and STI testing behaviors. Analyses by language dominance and gender indicate a higher variability in sexual behaviors for English-dominant participants and a link between overall STI testing to regular medical examinations, especially women. Higher rates of pleasure, orgasms and arousal was reported by Spanish-dominant men and women, relative to the English-dominant group. Results represent a nuanced examination of internal differentiation among US Latinos and provides applicable data for reducing sexual health disparities in this population.
Vaginal squirting is a phenomenon in which women expel fluid during the sexual response process, but it remains poorly understood in the extant literature. The study purpose was to use nationally representative data to investigate adult women's experiences with vaginal squirting. We assessed the prevalence of women who have ever squirted in their lifetime, the level of pleasure and concurrency of orgasm women reported during squirting, the ways in which women discovered squirting, and the challenges and/or concerns women experience with squirting. Forty percent of U.S. adult women (M = 47.6 years, SD = 16.8; Md = 24 years) had ever squirted in their lifetime (Md frequency = three to five times). Two thirds of women reported unintentional discovery of squirting, and most (75%) used specific techniques to promote build up and release of squirting versus squirting spontaneously. About 60% of participants reported squirting to be very or somewhat pleasurable, but only 20% "always" experienced squirting and orgasm together. Women reported different challenges with squirting, such as the time required to reach squirting or the experience being too emotionally intense. Our findings contribute to the growth of much needed, detailed literature on the ways in which women discover and enjoy squirting as part of their sexual lives. Knowledge of these techniques can enable women to better identify their own preferences, communicate about them with their partners, and advocate for their sexual pleasure.
Sexual Enrichment Aids (SEAs), or “sex toys” like dildos or vibrators, are used to enrich sexual experiences, either alone or with sexual partners. Although SEA use has become increasingly prevalent in recent decades, there remain significant gaps in knowledge regarding sexual behaviors and hygiene surrounding their use. In this study, we use mixed methods approaches (cross-sectional survey of n = 800 women and qualitative semi-structured interviews of n = 24 women) to better understand sexual behavior, potential risks, and hygiene practices of women who self-identify as having sex with men, with women, or with women and men when using SEAs. We identified SEA use is common, with 79.9% of women using an SEA. Among these women, 31.8% of women indicated that they share SEAs with sexual partners. Further, condom use is rare while sharing SEAs, with only 14% of women utilizing condoms regularly. The majority (81.8%) of women wash their SEAs, primarily with soap and water. Yet, there is no consensus among women interviewed regarding the perceived risk associated with SEA use. Together, our findings support the need for increased evidence-based education for women to increase safety and hygiene of SEA use.
Today, the trend of advertising sex toys via YouTube’s videos is increasing, and most of such advertisement videos use English as the medium of communication. To help those with insufficient English competences, YouTube provides a closed caption (CC) feature that can instantly display subtitles of various languages. However, sexual discourses are culturally sensitive and even of taboos in Indonesian culture. In this regard, cultural adjustments of CC’s Indonesian subtitles are of paramount importance. Thus, the present study sought to unravel the forms, categories, and units of sexual expressions and identify the translation techniques of CC’s Indonesian subtitles of 26 YouTube’s sex toy advertisement videos. Observations, document analysis, and focus group discussion were conducted to collect the data, and raters and translation experts were involved as the informants to validate the data. This study revealed that the videos most dominantly used orthophemism (395 expressions), followed by dysphemism (30 expressions) and euphemism (21 expressions). 13 translation techniques were identified from the CC’s Indonesian subtitles. Of some translation results, conflicts of cultural perspectives might occur when sexual expressions were dysphemically translated into Indonesian due to a taboo benchmark affiliated with sexual discourses. In the end, implication and recommendations for an update on CC feature and for further studies are given.
Keywords: subtitling, audiovisual translation, translation techniques, sexual expressions, sex toy advertisements, closed caption subtitles
Purpose:
Sexual minority women (SMW; lesbian, bisexual, and other women who have sex with women) are at risk for cervical cancer but less likely than non-SMW to receive regular cervical cancer screening (Pap- and/or HPV-testing). We examined factors contributing to receipt of guideline-based cervical cancer screening among SMW.
Methods:
During October 2019, we conducted an online survey of self-identified SMW aged 21-45 years living in the United States (n = 435). We estimated risk differences (RD) in women's likelihood of being within current cervical cancer screening guidelines by sociodemographic and health-related characteristics.
Results:
Overall, 75% of respondents were within current screening guidelines. Adjusting for other factors, SMW were more likely to be within guidelines if they were insured (aRD 0.26, 95% CI 0.13, 0.39), had a partner (aRD 0.18, 95% CI 0.09, 0.28), and were older (aRD 0.12, 95% CI 0.04, 0.20). Overall, the most common reasons for not being screened recently were lack of insurance/cost (42%) and perceiving it was unnecessary (28%).
Conclusion:
Many SMW are not being screened for cervical cancer according to guidelines. Findings can inform efforts to improve screening among this population.
Background
Sexual minority women (lesbian, bisexual, and other women who have sex with women) are at risk for human papillomavirus (HPV) infection and HPV-related disease, demonstrating the importance of HPV vaccination for these women.
Methods
We conducted an online survey of sexual minority women ages 18–45 from the United States (n = 505) in October 2019, about two months after HPV vaccine recommendations were expanded to include ages 27–45. Multivariable Poisson regression identified correlates of HPV vaccine initiation (i.e., receipt of at least one HPV vaccine dose).
Results
Overall, 65% of participants ages 18–26 and 33% of participants ages 27–45 had initiated the HPV vaccine series. Among participants ages 18–26, initiation was more common among those who had received a healthcare provider recommendation (RR = 2.19, 95% CI: 1.64–2.93) or had disclosed their sexual orientation to their primary healthcare provider (RR = 1.33, 95% CI: 1.07–1.65). Among initiators ages 27–45, a large majority (89%) reported receiving their first dose before turning age 27. Initiation was more common among participants ages 27–45 who had received a healthcare provider recommendation (RR = 3.23, 95% CI: 2.31–4.53) or who reported greater perceived social support for HPV vaccination (RR = 1.22, 95% CI: 1.05–1.40). Several reasons for not yet getting HPV vaccine differed by age group (ages 18–26 vs. ages 27–45; all p < 0.05).
Conclusions
Many sexual minority women, particularly those ages 27–45, remain unvaccinated against HPV. Findings provide early insight into HPV vaccine coverage among adult women and highlight key leverage points for increasing vaccination among this population.
Studies from English-speaking countries show that sex toy use is common in various populations and often associated with sexual well-being. Empirical data on sex toy use and perceived effects in other countries is still missing. Based on the Positive Sexuality framework and the Positive Technology framework, this study documented the prevalence of sex toy use in solo and partnered sex among heterosexual-identified women and men in Germany, as well as perceived positive and/or negative effects of sex toy use on sexual well-being. A survey was conducted with a national online sample of 1,723 heterosexual-identified adults in Germany (Mage = 42.71, SD = 13.25, 49% women, 51% men). The majority (52%) reported sex toy use in partnered sex, and 45% reported sex toy use in solo sex. Stronger positive than negative perceived effects of sex toy use were reported by women and men alike. Findings indicate that professionals in sexual health/sexuality education should consider sex toy use as a common and beneficial sexual behavior. Future studies could explore specific effects of sex toy use and their predictors in more detail.
Prevalence rates indicate that receptive anal sex is increasingly part of heterosexual women’s sexual repertoire. However, there is a body of literature linking this behavior to risk for adverse sexual health outcomes. Women’s anal sexual health knowledge and awareness of behaviors associated with elevated risk have received less attention in the research literature. The aim of the current study was to examine anal sexual health knowledge and product use among heterosexual women aged 18 to 30 years. A total of 33 self-identified heterosexual women recruited from the general population participated in one of six focus groups. The results suggest that knowledge was variable. Salient sexual health themes centered on risks of human immunodeficiency virus/sexually transmitted infections (HIV/STIs), other infections, and physical harm/damage. Product-use themes included cleanliness/hygiene, comfort, and product safety. Participants expressed the desire for anal sexual health education. The results have implications for sexual health research, education, and clinical practice.
In the shadows of the cultural obsession with male erections, women’s vaginal lubrication and experiences of wetness have received surprisingly little academic attention. Framed largely as a biological or normative behavioral “sexual function” issue and not as a subjective experience, no previous qualitative studies have asked women to discuss their feelings about their vaginal lubrication and wetness. This study analyzed semi-structured interviews with 20 women from a diverse 2014 community sample collected in a large Southwestern U.S. city in order to examine American women’s subjective feelings about their own vaginal lubrication and wetness, particularly the sensations they experience and the meanings they make around wetness. Results revealed four themes in how women described vaginal lubrication: (1) wetness as pleasure, joy, and connection; (2) wetness as physical and biological phenomenon; (3) anxiety about insufficient wetness; and (4) having excessive or “too much” wetness. Tensions surrounding women’s sexual anxieties and where they place responsibility for “too little” wetness is discussed in tandem with analyses of how pleasure and arousal may (or may not) overlap with feelings about sexual normality and health. Ultimately, renewed attention to the complexities of women’s sexual arousal and function, particularly in stark contrast with pharmaceutical efforts to medicate women’s sexual arousal and reduce it to “brain chemistry,” are examined.
Abstract The literature on genital and pelvic pain has largely focused on heterosexual women. An online study examined characteristics of vulvar pain in 839 lesbian, bisexual, and heterosexual women aged 18-45 and investigates associations between relationship qualities such as love and communication with participants' perceptions of pain's influence on relationships. Characteristics of vulvar pain were similar across groups. Groups differed in how they perceived pain to impact their relationships, such that better communication for same-sex couples and more love for mixed-sex couples was associated with the perception of their pain as having less of an impact on their relationship functioning.
http://www.tandfonline.com/doi/abs/10.1080/0092623X.2014.931315#.U6BEQf2ERVc
Sampling has been the single most influential component of conducting research with lesbian, gay, and bisexual (LGB) populations. Poor sampling designs can result in biased results that will mislead other researchers, policymakers, and practitioners. Investigators wishing to study LGB populations must therefore devote significant energy and resources to choosing a sampling approach and executing the sampling plan. The authors describe probability and nonprobability sampling methods used in LGB populations and critically discuss the advantages and disadvantages of the sampling methods they review. The authors conclude that no single sampling methodology is correct or incorrect for use in LGB populations; rather, researchers must evaluate advantages and disadvantages of each sampling methodology in the context of the specific research question and the research design. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Lesbian and bisexual women have specific sexual health needs, including the need for information about transmission and prevention of sexually transmissible infections (STIs) between women, contraceptive and conception advice, and support regarding any abuse experiences. These needs can be easily accommodated in general practice. However, there are a number of barriers to general practitioners meeting these needs, including lack of experience in facilitating disclosure of sexual orientation, fears of being intrusive, and lack of specific knowledge and skills in the area of minority sexual orientation.
This article presents the current evidence related to lesbian and bisexual women's sexual health, describes practical skills to conduct a sensitive sexual history, and discusses sexual health advice that GPs could provide to this group of women.
Improved GP knowledge in this area will increase GPs' perceived need to inquire about sexual orientation. Sensitive inquiry can be facilitated by creating a welcoming practice environment, using appropriate terminology, assuring confidentiality, establishing relevance, and by using focused and normalising questions.
Sexually transmitted infections (STIs) are a significant health issue for lesbian and bisexual women. Older age and having a history of sexual intercourse with males are primary risk factors for STIs among this population. However, little research has been conducted to assess sexual risk among lesbian and bisexual college women exclusively. A cross-sectional Internet survey was conducted with 230 self-identified lesbian and bisexual female college students to examine their sexual risk and to determine with which, if any, STIs they had ever been diagnosed. Eight percent of lesbian and bisexual college women reported ever being diagnosed with an STI; the human papillomavirus, bacterial vaginosis, and genital herpes accounted for 84% of STI cases. Number of lifetime sex partners was significantly associated with an STI diagnosis among this population. Older age, engaging in penile-vaginal intercourse with a male (lifetime), and younger age at first same-sex experience were significantly associated with a greater number of lifetime sex partners. Results may be useful to sexual health programs targeting lesbian and bisexual college women and/or their providers.
To assess the prevalence of sexually transmitted infections (STIs) and blood borne viruses, risk behaviours, and demographics in women who have sex with women (WSW).
Retrospective cross sectional study using a multivariate model. Demographic, behavioural, and morbidity data were analysed from standardised medical records of patients attending a public STI and HIV service in Sydney between March 1991 and December 1998. All women with any history of sex with a woman were compared with women who denied ever having sex with another woman (controls).
1408 WSW and 1423 controls were included in the study. Bacterial vaginosis (BV) was significantly more common among WSW (OR 1.7, p < 0.001). Abnormalities on cervical cytology were equally prevalent in both groups, except for the higher cytological BV detection rate in WSW (OR 5.3, p = 0.003). Genital herpes and genital warts were common in both groups, although warts were significantly less common in WSW (OR 0.7, p = 0.001). Prevalence of gonorrhoea and chlamydia were low and there were no differences between the groups. The prevalence of hepatitis C was significantly greater in WSW (OR 7.7, p < 0.001), consistent with the more frequent history of injecting drug use in this group (OR 8.0, p < 0.001). WSW were more likely to report previous sexual contact with a homo/bisexual man (OR 3.4, p < 0.001), or with an injecting drug user (OR 4.2, p < 0.001). Only 7% of the WSW reported never having had sexual contact with a male.
We demonstrated a higher prevalence of BV, hepatitis C, and HIV risk behaviours in WSW compared with controls. A similar prevalence of cervical cytology abnormalities was found in both groups. Measures are required to improve our understanding of STI/HIV transmission dynamics in WSW, to facilitate better health service provision and targeted education initiatives.
Men who have sex with men (MSM) and women who have sex with women (WSW) are purportedly neutral terms commonly used in public health discourse. However, they are problematic because they obscure social dimensions of sexuality; undermine the self-labeling of lesbian, gay, and bisexual people; and do not sufficiently describe variations in sexual behavior.
MSM and WSW often imply a lack of lesbian or gay identity and an absence of community, networks, and relationships in which same-gender pairings mean more than merely sexual behavior. Overuse of the terms MSM and WSW adds to a history of scientific labeling of sexual minorities that reflects, and inadvertently advances, heterosexist notions.
Public health professionals should adopt more nuanced and culturally relevant language in discussing members of sexual-minority groups.
To provide data about the sexual histories of a large sample of lesbians and bisexual women, to inform those who provide health care or carry out research with women who may be sexually active with other women.
Cross sectional survey. Setting/subjects: 803 lesbians and bisexual women attending, as new patients, lesbian sexual health clinics, and 415 lesbians and bisexual women from a community sample.
Self reported sexual history and sexual practice with both male and female partners.
98% of the whole sample gave a history of sexual activity with women, 83% within the past year, with a median of one female partner in that year. 85% of the sample reported sexual activity with men; for most (70%) this was 4 or more years ago. First sexual experience tended to be with a man (median 18 years old), with first sexual experience with a woman a few years later (median 21 years). Oral sex, vaginal penetration with fingers, and mutual masturbation were the most commonly reported sexual practices between women. Vaginal penetration with penis or fingers and mutual masturbation were the most commonly reported sexual activities with men.
These data from the largest UK survey of sexual behaviour between women to date demonstrate that lesbians and bisexual women may have varied sexual histories with both male and female partners. A non-judgmental manner and careful sexual history taking without making assumptions should help clinicians to avoid misunderstandings, and to offer appropriate sexual health advice to lesbians and bisexual women.
We estimated the prevalence of same-sex experience among women and compared women reporting sex with women and men and women reporting sex exclusively with women with women reporting sex exclusively with men, in terms of sociodemographics and sexual, reproductive, and general health risk behaviors and outcomes.
We used a British probability survey (n=6399 women, aged 16 to 44 years) conducted from 1999 to 2001 with face-to-face interviewing and computer-assisted self-interviewing.
We found that 4.9% of the women reported same-sex partner(s) ever; 2.8% reported sex with women in the past 5 years (n=178); 85.0% of these women also reported male partner(s) in this time. Compared with women who reported sex exclusively with men, women who reported sex with women and men reported significantly greater male partner numbers, unsafe sex, smoking, alcohol consumption, and intravenous drug use and had an increased likelihood of induced abortion and sexually transmitted infection diagnoses (age-adjusted odds ratios=3.07 and 4.41, respectively).
For women, a history of sex with women may be a marker for increased risk of adverse sexual, reproductive, and general health outcomes compared with women who reported sex exclusively with men. A nonjudgmental review of female patients' sexual history should help practitioners discuss risks that women may face.
Updated with findings from the latest research, this contributed work on the psychology of women covers global initiatives, theories, and practical applications in various settings. It also addresses best practices of feminist methodologies and teaching psychology of women courses. As societal gender standards continue to shift and the capabilities, strengths, and needs of women become more widely acknowledged and prioritized—even as myths regarding women's leadership, health, and work behavior persist—it becomes increasingly important to understand the psychology of women. This third edition of Psychology of Women provides updated and expanded coverage of this highly significant and relevant subject through diverse perspectives of internationally known scholars in their disciplines, offering synopses of recent research and examinations of key theoretical issues, global initiatives, and practical applications in the workplace, therapy, and educational settings.
A resource ideally suited to students in women's studies and the psychology of women as well as for use as a handbook for scholars, faculty members, and specialists in fields relating to the psychology of women, the book covers specific topics such as women in middle age, women's career development and challenges in integrating work and family roles, and the ongoing problem of violence against women. This latest edition also includes best practices of feminist methodologies and information regarding teaching psychology of women courses, and it emphasizes placing value on all women, including women of color, women with disabilities, and lesbian, bisexual, and transgender women.
Introduction:
Most research on men's use of commercial lubricants during sexual activities is in the context of condom use and often specifically among men who have sex with men. Less is known about men's use of lubricants associated with a broader range of sexual experiences.
Aims:
The aims of this study are to document the prevalence of commercial lubricant use among adult U.S. men (age 18+), to document men's use of lubricants across solo and partnered sexual behaviors, and to assess men's perceptions of the contributions lubricants have to the sexual experience.
Methods:
Data are from the 2012 National Survey of Sexual Health and Behavior, which involved the administration of an online questionnaire to a nationally representative probability sample of U.S. adults ages 18 and older.
Main outcome measures:
Sociodemographic characteristics, recent and lifetime commercial lubricant use, lubricant use during specific sexual behaviors, frequency of lubricant use, and reasons for lubricant use.
Results:
Most men in the United States (70%, N = 1,014) reported having used a commercial lubricant, with men older than 24 and those in a relationship more likely to report lubricant use. About one in four men had used a lubricant in the past 30 days. Intercourse was the most common behavior during which men used lubricant, though solo masturbation and partnered sexual play were also frequently linked to lubricant use. The most common reasons for lubricant use included "to make sex more comfortable," "for fun," "curiosity," and "my partner wanted to."
Conclusions:
Most American men have used a lubricant; lubricant use is common across all age groups, and some of the most common reasons why men report using lubricants have to do with sexual enhancement, comfort, and pleasure. Clinicians may find these data helpful to their efforts to educate patients about lubricant use, comfort during sex, and sexual enhancement.
Objective Compare sexual orientation groups on: numbers of male and female sexual partners and total numbers of partners in lifetime and the past year; propensity for casual sex; frequency of condom use in the past year; erotophilia-erotophobia; sexual sensation seeking; propensity for sexual excitation and sexual inhibition. Design and methods A volunteer sample of 545 women from the USA and Canada completed anonymous questionnaires. Analyses were conducted based on two groupings: 1) self-identity [heterosexual n=450, bisexual n=46, lesbian n=49] and 2) lifetime partner type [women who had sex with men only (WSMO) n=396, women who had sex with men and women (WSMW) n=136, women who had sex with women only (WSWO) n=13]. Comparison of the scores across sexual orientation groups included age as a covariate in a series of univariate GLM analyses. Results Statistically significant sexual orientation group differences (based on both self-identity and lifetime partner type) were found for almost all variables. These were not explained by other demographic differences. Specifically, bisexuals showed a different pattern of responding than both heterosexual and lesbian women, and WSMW scored differently than WSMO. WSWO did not differ from WSMW or WSMO. Conclusions Research merging bisexuals with lesbians (or with heterosexuals) OR merging WSMW with WSMO as WSM may obscure important differences relevant to sexuality and sexual health. Care should be exercised in conceptualizing bisexuality as “in-between” heterosexuality and homosexuality. Attention should be given to discordant findings across multiple dimensions of sexual orientation and various aspects of sexuality.
Introduction:
Although most Americans have used condoms and/or lubricant during sex, little is known about the context of sexual events that involve the use of such products outside of experimentally manipulated studies.
Aims:
To assess, in a nationally representative study of men and women in the United States ages 18-59, the characteristics of condom and lubricant use during participants' most recent sexual event and the relationship of their condom and lubricant use to event-level ratings of sexual quality.
Methods:
Data are from the National Survey of Sexual Health and Behavior, which involved the administration of an online questionnaire to a nationally representative probability sample of the U.S. adults.
Main outcome measures:
Sociodemographic items: event-level items related to sexual behavior, condom use, lubricant use, and participants' perceptions of their arousal, pleasure, ease of erection or lubrication, and pain associated with sex.
Results:
During their most recent sexual experience, 27.5% of men (N = 237) and 22.3% of women (N = 175) reported using a condom. More than twice as many women as men were unsure whether the condom was lubricated (26.6% vs. 11.4%) and the material it was made of (23.6% vs. 8.9%). Participants consistently rated sex to be arousing and pleasurable whether or not they used condoms or lubricant. No significant differences were found in regard to men's ratings of the ease of their erections based on condom and lubricant use.
Conclusions:
Although some have concerns about how condoms or lubricants may impact their enjoyment of sex, in a nationally representative sample of men and women ages 18-59, ratings of sex were largely quite high, with few differences based on condom and lubricant use. Women, more often than men, reported being unsure about the type of condom and lubricant used, which has implications for patient education.
Introduction. Exogenous lubricant use in the United States is common among women; however, there is little empirical research describing women's perceptions of lubricants, lubricant use, and vaginal wetness or dryness during penile-vaginal intercourse or other sexual behaviors.
Aims. To assess women's perceptions about lubricant use, women's perceptions about vaginal wetness during sexual activities, lubricant purchasing and application patterns, and the relationship of age to women's perceptions of lubricants and vaginal wetness.
Methods. Cross-sectional baseline data from an online daily diary study of 2,451 women enrolled in a study of lubricant use were analyzed.
Main Outcome Measures. Demographic items, women's lubricant purchasing patterns, lubrication use, perceptions about lubrication, and perceptions about vaginal wetness.
Results. Overall, women felt positively about lubricant and lubricant use, preferred sex to feel more wet, felt that they were more easily orgasmic when sex was more wet, and thought their partner preferred sex to feel more wet than dry. Perceptions varied by age group with women in their forties reporting more positive perceptions of lubricants than women under the age of 30.
Conclusions. Findings suggest that women generally feel positively about lubricants and lubricant use and prefer vaginal-penile intercourse to feel more wet. Such insights into women's perceptions of lubricants and lubricant use can be helpful to medical and other health professionals as well as sexual health educators, who routinely make recommendations to women about ways to incorporate products, such as lubricants, into their sexual activities. Jozkowski KN, Herbenick D, Schick V, Reece M, Sanders SA, and Fortenberry JD. Women's perceptions about lubricant use and vaginal wetness during sexual activities. J Sex Med **;**:**–**.
Research on the sexual lives of bisexually-identified women tends to focus on their heightened risk for sexually transmitted infection acquisition. The development of effective, tailored interventions would benefit from detailed behavior estimates from a large sample of bisexual women. Thus, this study collected sexual behavior data from 710 bisexually-identified women. When possible, items were adapted from the National Survey of Sexual Health and Behavior. Approximately equal proportions of participants reported no recent (past 30 days) sexual partners, male sexual partners only, female sexual partners only and male and female sexual partners. The majority of participants reported a diverse sexual repertoire.
Introduction. Although lubricant use is commonly recommended to women for solo and partnered sexual activities, little is known about women's use of lubricant or their relationship to sexual pleasure and satisfaction.
Aim. The aim of this study was to assess: (i) how adult women used lubricant during partnered and solo sexual activities; (ii) relations between women's reports of sexual pleasure and satisfaction and their use of a lubricant during a particular sexual event; and (iii) to what extent lubricant use was associated with subsequent genital symptoms.
Methods. A total of 2,453 women completed a 5-week internet-based, double-blind prospective daily diary study in which they were assigned to use one of six water- or silicone-based lubricants.
Main Outcome Measures. Baseline data included demographics, contraceptive use, and sexual behavior during the 4 weeks prior to study enrollment. Daily diary data included reports of penile–vaginal sex, penile–anal sex, solo sex, lubricant use, lubricant application, ratings of sexual pleasure and satisfaction, and genital symptoms.
Results. Water-based lubricants were associated with fewer genital symptoms compared with silicone-based lubricants. In addition, the use of a water-based or silicone-based lubricant was associated with higher ratings of sexual pleasure and satisfaction for solo sex and penile–vaginal sex. Water-based lubricant use was associated with higher ratings of sexual pleasure and satisfaction for penile–anal sex as compared with no lubricant use.
Conclusion. The water- and silicone-based lubricants used in this study were associated with significantly higher reports of sexual pleasure and satisfaction and rarely associated with genital symptoms. Herbenick D, Reece M, Hensel D, Sanders S, Jozkowski K, and Fortenberry JD. Association of lubricant use with women's sexual pleasure, sexual satisfaction, and genital symptoms: A prospective daily diary study. J Sex Med 2011;8:202–212.
Objective: The assumption that self-identified lesbians are at low risk for sexually transmitted diseases (STDs) and other gynecological infections may be premised upon infrequent screening, ignorance of lesbian sexual practices, and the discomfort that lesbians may feel concerning the disclosure of their sexual identity and behavior. We hypothesize that transmission between women may occur, and actual risk may depend upon the sexual behaviors as well as the number and gender of partners. Methods: In 1994, the Family Planning Council of Western Massachusetts developed a Lesbian Health Needs Assessment Survey. The Fenway Community Health Center (FCHC) supplemented the survey with a one-page STD questionnaire aimed at evaluating STD testing, diagnoses, and sexual practices among self-identified lesbian and bisexual women. Circulated only in eastern Massachusetts, 421 of the 1523 surveys, including the one-page STD supplement, that were distributed were returned. The prevalence of specific STDs among women with and without recent male sexual partners was compared and analyzed in relation to self-reported sexual behavior. Results: Among lesbians who denied having prior male sexual partners, the following gynecological infections were reported: trichomoniasis, anogenital warts, and abnormal Pap smears. The most commonly reported sexual practices were digital–vaginal penetration, oral–oral, oral–genital, and genital–genital contact. Conclusions: Probable woman-to-woman transmission of STDs and vaginitis was frequently reported. Although the true incidence of specific infections among lesbians is unknown, routine screening should be offered to sexually active lesbians.
The development of safer sex recommendations for women who have sex with women (WSW) remains challenging given a limited understanding of sexual behaviour between women. The present study was conducted in order to investigate the sexual repertoires of WSW and the safer sex methods they use to reduce the likelihood of sexually transmitted infection acquisition.
An online survey targeted towards women with desire, attraction or previous sexual behaviour with women was distributed globally. Women (N=3116) who engaged in at least one sexual act with a woman in the previous year and were currently living in the USA, UK, Canada or Australia were included in the present study. Questions were based upon previously validated items in nationally representative studies.
Participants indicated a wide diversity of sexual behaviours with the majority of women reporting a history of genital rubbing (99.8%), vaginal fingering (99.2%), genital scissoring (90.8%), cunnilingus (98.8%) and vibrator use (74.1%). Barrier use was reported by a minority (<25%) of the participants.
The variety of sexual acts reported by the sample points to the need for the development of more contextually appropriate sexual health guidelines for WSW.
Women who have sex with women (WSW) comprise a diverse group of people who evidence a spectrum of sexual identity, sexual behaviors, sexual practices, and risk behaviors. WSW are at risk of acquiring a diversity of sexually transmitted infections (STIs) from current and prior partners, both male and female. Notably, human papillomavirus (HPV) is sexually transmitted between female partners, and Pap smear guidelines should be followed in this group. Bacterial vaginosis is common among WSW. WSW should not be presumed to be at low or no risk for STIs based on sexual orientation, and reporting of same sex behavior by women should not deter providers from considering and performing screening for STIs, including Chlamydia trachomatis, according to current guidelines. Effective delivery of sexual health services to WSW requires a comprehensive and open discussion of sexual and behavioral risks, beyond sexual identity, between care providers and their female clients.
There are few studies examining the relationship between lubricant use and sexual functioning, and no studies have examined this relationship in women with dyspareunia. Vaginal dryness is a prevalent complaint among women of all ages. There is an association between vaginal dryness and painful intercourse; therefore, women with dyspareunia represent a particularly relevant sample of women in which to investigate lubricant use.
The aim of this study was to examine differences between women with and without dyspareunia in self-reported natural lubrication and attitudes toward and use of personal lubricants.
Respondents completed an online survey including questions on demographics, gynecological/medical history, sexual functioning, and lubricant use and attitudes.
The main outcome measures used were the Female Sexual Function Index (FSFI) and questions regarding attitudes toward and use of lubricants.
Controls scored higher on the lubrication subscale of the FSFI than women with dyspareunia (P < 0.001). Women with dyspareunia reported greater frequency of lubricant use during sexual activity over the last year (P < 0.01). They were also more likely to use lubricant prior to penetration (P < 0.05). The most common use for controls was to enhance sexual experiences. This was also a common answer for women with dyspareunia; however, in this group, the most common reason was to reduce/alleviate pain. Lubricants were rated as less effective among women with dyspareunia vs. controls across all reported reasons for use. Nevertheless, lubricant use was still rated as being moderately effective in alleviating pain for women with dyspareunia.
Women with dyspareunia have more difficulty with natural lubrication; it is consequently not surprising that they reported using lubricant more frequently than control women. Women with dyspareunia reported using lubricants more often than controls to try to prevent or alleviate pain and reported this as being a moderately effective strategy, suggesting that it may be a useful tool for some women with dyspareunia.
Research suggests that vibrator use may be more prevalent among lesbian/bisexual-identified women. However, previous research has been limited by small samples of lesbian- and bisexual-identified women and has not focused specifically on the characteristics of vibrator use between women.
The present study was designed in order to develop a comprehensive understanding of women's use of vibrators with their female sexual partners and to understand the extent to which vibrator use is related to their sexual experiences.
Data were collected via a cross-sectional web-based survey from 2,192 women living in the United States and the United Kingdom. All participants reported engaging in sexual behavior with only women in the previous year.
Sociodemographic characteristics, vibrator use history, vibrator use perceptions, and the Female Sexual Function Index (FSFI).
Over three-quarters of women in the sample reported a history of vibrator use during solo masturbation/with a female partner and over a quarter of the sample reported use in the previous month. Participants who were older, white, and in a long-term relationship were the most likely to use a vibrator with a female partner in the previous year. Vibrator use lifetime history was unrelated to all FSFI subscales with the exception of pain for lesbian and queer-identified women. In contrast to lifetime use, participants who used a vibrator with a female sexual partner in the previous month scored higher on several of the FSFI domains than women who reported no vibrator use or vibrator use only during solo masturbation in the past month.
Vibrator use was common among this sample of women who have sex with women. Women who reported recent vibrator use with other women had higher mean sexual functioning scores than women who reported no vibrator use or vibrator use only during masturbation. Implications for health-care providers are discussed.
Past surveys of sexual behavior have demonstrated that female sexual behavior is influenced by medical and sociocultural changes. To be most attentive to women and their sexual lives, it is important to have an understanding of the continually evolving sexual behaviors of contemporary women in the United States.
The purpose of this study, the National Survey of Sexual Health and Behavior (NSSHB), was to, in a national probability survey of women ages 18-92, assess the proportion of women in various age cohorts who had engaged in solo and partnered sexual activities in the past 90 days and to explore associations with participants' sexual behavior and their relationship and perceived health status. Past year frequencies of masturbation, vaginal intercourse, and anal intercourse were also assessed.
A national probability sample of 2,523 women ages 18 to 92 completed a cross-sectional internet based survey about their sexual behavior.
Relationship status; perceived health status; experience of solo masturbation, partnered masturbation, giving oral sex, receiving oral sex, vaginal intercourse, anal intercourse, in the past 90 days; frequency of solo masturbation, vaginal intercourse, and anal intercourse in the past year.
Recent solo masturbation, oral sex, and vaginal intercourse were prevalent among women, decreased with age, and varied in their associations with relationship and perceived health status. Recent anal sex and same-sex oral sex were uncommonly reported. Solo masturbation was most frequent among women ages 18 to 39, vaginal intercourse was most frequent among women ages 18 to 29 and anal sex was infrequently reported.
Contemporary women in the United States engage in a diverse range of solo and partnered sexual activities, though sexual behavior is less common and more infrequent among older age cohorts.
Little is known about women's use of vibrators within sexual partnerships. Data were collected from a population-based, cross-sectional survey of 2056 women aged 18-60 years in the United States. Partnered vibrator use was common among heterosexual-, lesbian-, and bisexual-identified women. Most vibrator users indicated comfort using them with a partner and vibrator use was related to positive sexual function as measured by the Female Sexual Function Index (FSFI). In addition, partner knowledge and perceived liking of vibrator use was a significant predictor of sexual satisfaction for heterosexual women (p < .01). Clinical and research implications are discussed.
Sexually transmitted diseases (STDs) can be spread between female sex partners, probably through the exchange of cervicovaginal fluid and direct mucosal contact. Additionally, lesbians have a high prevalence of bacterial vaginosis, which may represent an STD in this population. However, few data on sexual practices or perceived STD risk among lesbians are available to guide development of interventions aimed at reducing the risk.
To inform the development of a safer-sex intervention for women who have sex with women, focus group discussions were conducted with 23 lesbian and bisexual women aged 18-29. Topics included sexual practices, STD transmission and prevention, and knowledge about bacterial vaginosis.
Although six participants had had bacterial vaginosis and three an STD, women reported little use of preventive measures with female partners (washing hands, using rubber gloves and cleaning sex toys). Participants said that vaginal penetrative practices using sex toys and fingers or hands are common, and that partners frequently share sex toys during a sexual encounter, generally without condoms. Knowledge of potential for STD transmission between women, and of bacterial vaginosis, was limited. Participants viewed use of barrier methods (gloves or condoms) as acceptable, provided that there is a reason (usually STD-focused) to use them and that they are promoted in the context of sexual health and pleasure.
Safer-sex messages aimed at lesbian and bisexual women should emphasize the plausibility of STD transmission between women, personal responsibility and care for partners' well-being; should target common sexual practices; and should promote healthy sexuality.
Research on vaginal microbicides for HIV prevention is progressing rapidly; the first large-scale effectiveness trials were launched in 2004. The majority of candidate microbicides are formulated as gels, which will act as lubricants when used during sex. Preferences and practices regarding lubrication during sex, therefore, likely influence microbicide acceptability and use. Researchers seek to maximize consistent and correct use of candidate microbicides during clinical trials to enable valid estimates of product effectiveness, and if proven effective, microbicides will be widely used only if acceptable.
We conducted a comprehensive literature review and interviewed 13 key informants from nine countries in Africa, Asia, Latin America, and North America.
We found that norms and practices regarding lubrication during sex exist in many different countries. Despite significant variation, common themes emerged. In the majority of countries, women's genital hygiene is highly valued, and women are expected to achieve a moderate amount of vaginal lubrication during sex that is neither excessive nor inadequate. Women may try to achieve this by engaging in a wide variety of vaginal practices.
Even though some informants expressed concerns about the acceptability of lubricating microbicides in some settings, they thought that microbicides should be developed, that women and men may be willing to accept a certain level of increased lubrication in exchange for protection from HIV, and that lubricating microbicides may be considered more acceptable when perceived as genital hygiene products. Recommendations are made on how to take vaginal practices into account during clinical testing of microbicides.
Bacterial vaginosis (BV) may increase women's susceptibility to HIV infection, but there are few prospective data.
During follow-up for up to 36 months, 86 new HIV seroconverters (case patients) were identified among 5110 women enrolled in a cervical cancer screening trial. Nonseroconverting control subjects (n=324) were frequency matched to case patients by age and duration of follow-up. At enrollment, case patients and control subjects were evaluated for clinical signs of BV, and Gram stains of vaginal fluid were scored using Nugent criteria.
BV was diagnosed on the basis of clinical criteria at enrollment in 20% of seroconverters and 16% of control subjects (summary odds ratio [OR], 1.31 [95% confidence interval {CI}, 0.71-2.41]). Nugent criteria for BV were met by 74% of seroconverters and 62% of control subjects. Diagnosis of BV on the basis of Nugent criteria was significantly associated with an increased risk of HIV seroconversion, after adjustment for demographic characteristics, other sexually transmitted infections, and sexual behaviors (adjusted OR, 2.01 [95% CI, 1.12-3.62]).
BV may account for a substantial fraction of new HIV infections in this setting. Treatment of BV and other interventions to promote normal vaginal flora warrant attention for HIV prevention.
Psychology of women: A handbook of issues and theories
- Fassinger RE
- Arseneau JR
Sexual practices, risk perception and knowledge of sexually transmitted disease risk among lesbian and bisexual women
- Marrazzo
Condom Fact Sheet in Brief
- Centers for Disease Control and Prevention
Methodological papers, presentations, and articles on KnowledgePanel
- Knowledge Networks