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Figuring It Out: How Late Adolescent and Young Adult Men and Women Perceive and Address Problems in Sexual Functioning

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Abstract

Although there are high rates of sexual problems and sexual dysfunction in adulthood (Mitchell et al., 2013), little is known about the circumstances under which problems are first experienced. A growing body of research addresses prevalence of problems in sexual functioning among adolescents and young adults, yet little is known about the meanings that young people give to these experiences or how they deal with them. We used content analysis of qualitative interviews with 53 heterosexual, sexually active Canadian adolescents (ages 18 to 21) to explore their perceptions of the sexual problems in functioning they had experienced and the strategies (if any) they used to address them over time. Problems among most young people originated early in their partnered sexual life. Figuring it out emerged as an intentional process directed toward improving sexual experiences, although certainly not all young people were successful. Strategies for figuring it out included informational or material help seeking, experimentation to inform future actions, mutual sharing and problem solving, and building emotional connection to improve sexual functioning. Implications for understanding the development of sexual dysfunctions in adulthood are discussed.
... It also is likely that more religious adolescents and young adults experience greater anxiety or guilt over engaging in sexual activity (Tan & Yarhouse, 2010), resulting in poorer sexual functioning. Individuals with less sexual experience would be expected to have poorer sexual functioning because they would have had fewer opportunities to learn about their sexual likes and dislikes and sexual responses with a partner (O'Sullivan et al., 2018). A history of adverse sexual experiences may result in both negative affective appraisals and conditioned responses that adversely affect sexual functioning. ...
... Indeed, Byers and Rehman (2013) concluded from their review of factors associated with sexual well-being in adults that dyadic contextual factors, especially the overall cognitive-affective evaluation of the relationship, sexual frequency, and sexual communication, play a key role. In addition, adolescents and young adults who have been with their partner longer and who report greater sexual communication with their partner will have had more opportunity to develop a mutually pleasurable sexual script (O'Sullivan et al., 2018). Sexual communication refers to the verbal and nonverbal means by which people develop and maintain sexual interactions (Byers & Rehman, 2013;MacNeil & Byers, 2009;Santos-Iglesias & Byers, 2018). ...
... Sexual communication refers to the verbal and nonverbal means by which people develop and maintain sexual interactions (Byers & Rehman, 2013;MacNeil & Byers, 2009;Santos-Iglesias & Byers, 2018). Of importance, young men and women identify emotionally connectedness and developing skills in sexual communication as essential to enhancing their sexual functioning, with these skills more likely to evolve in established, longer-term relationships as compared to shorter, casual forms (O'Sullivan et al., 2018). None of these associations have been investigated among late adolescents and young adults specifically. ...
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The research provides few insights regarding the sexual functioning of late adolescents and young adults who are currently in a committed romantic relationship, a context that likely affects their sexual functioning. We sought to identify individual and relationship factors associated with their sexual functioning. Participants were 409 individuals (172 men, 237 women; 18–24 years) who completed an online survey assessing their sexual functioning, individual characteristics, cognitive-affective appraisals of their romantic relationship, sexual frequency, and sexual communication. Significantly more women (22.8%) than men (4.7%) reported a sexual problem. These rates are lower than typically found in this age group. In addition, substantial numbers of men and women reported less than optimal sexual functioning in one or more sexual response domain that did not reach the level of a sexual problem. A hierarchical multiple regression analysis revealed that being male and reporting greater partner caring, relationship satisfaction, sexual frequency, and verbal sexual communication were unique predictors of more positive sexual functioning. One explanation for these findings is that being in a committed relationship may counter poor sexual functioning for young people because global positive feelings about the partner provide a safe context to figure out then communicate their sexual wants and needs.
... Physicians' lack of awareness about problems of sexual functioning has been identified as a major obstacle in treatment (Shivananda & Rao, 2016). Youth have limited knowledge about services for sexual problems or how to access them (O'Sullivan, Wuest, & Byers, 2018), and often appear to think that these problems are part of a typical sexual life (e.g., pain, lack of sexual interest or desire, problems getting or maintaining an erection), even though they would be cause for considerable concern among adults. Little is known about health-care provider (HCP) perspectives on youth sexual dysfunction. ...
... In the second study in our program of research, we conducted a descriptive qualitative study with 53 heterosexual youth to explore their perceptions of their experiences with sexual problems. We identified that youth engaged in an intentional process of 'figuring it out' directed toward improving their sexual experiences (O'Sullivan et al., 2018). Although help seeking was one strategy used by youth, they rarely mentioned seeking help from HCPs for issues requiring medical solutions, such as STIs, pain, or oral contraceptives. ...
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A body of work emerging in the last few years has expanded the focus of youth sexual health to include problems in sexual functioning. Recent surveys show that rates of youth sexual functioning problems are similar to those of adults. Physicians' lack of awareness about problems of sexual functioning has been identified as a major obstacle in treatment. Yet little is known about health-care provider (HCP) perspectives on youth sexual functioning. We conducted a descriptive qualitative study with HCPs to learn about their perceptions of adolescent sexual problems and HCP roles in managing these issues including sexual functioning. Nineteen HCPs: Family physicians, nurse practitioners, and public health nurses working primarily with youth in universities, schools, or sexual health clinics were recruited to draw on their expert knowledge and experience. All completed in-depth individual interviews. Data were analyzed using directed qualitative content analysis. Our findings illuminate inconsistent views. Some HCPs, particularly those in youth-focused services, adopt a holistic role in promoting healthy sexual functioning, and others, commonly those in general practice, attend only to biomedical issues related to sexual dysfunction. All HCPs in our study were challenged by a paucity of sexual health preparation in their formal education. HCP interest in youth sexual health affected their efforts to acquire new information and training and, along with the structure of their practice setting, influenced whether they framed their role in youth sexual health holistically within a context of social determination or constrained their role to a medical model. These findings draw attention to the need for new approaches for strengthening knowledge, training, and resources to foster HCP promotion of healthy sexual functioning and prevention of lifelong sexual health problems.
... Qualitative interviews with young people as well as with health care providers have revealed that young people also are reluctant to turn to primary care providers to help them address their concerns in sexual function (O'Sullivan et al., 2019a), and that providers typically do not inquire about sexual function at all (O'Sullivan et al., 2019b). For the most part, then, young adults are left to identify and attempt to resolve these issues on their own. ...
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There is a growing field of apps/websites designed to address user concerns about sex using valid information (e.g., OMGYes.com). Young people may turn to this educational sexuality-related technology ("sextech") to address perceived shortcomings of traditional sex education. The current study investigated the prevalence, motivations, and outcomes associated with educational sextech use and examined links between sextech use and self-reported sexual function in a sample of 1029 young adults (18-24 years; 57% women). Those who reported past sextech use (n = 236; 32%) completed an anonymous survey assessing patterns of sextech use, perceptions of associated outcomes, and current sexual function. They reported use of one site/app on average. Sextech users had worse sexual function than a comparison group of non-users (n = 440; 18-24 years, 58% women) but reported perceiving sextech as helpful. Most users reported approach (vs avoidance) motives. This study is the first to our knowledge to investigate sextech use among young people and has implications for better reaching this group for sexual education.
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Introduction: Provoked vestibulodynia (PVD) is a prevalent vulvovaginal pain condition that is associated with sexual and relational consequences for women and their partners. Greater perceived quality of sexual communication has been associated with women's lower pain during intercourse and with couples' better sexual and relational well-being. Whether couples' collaborative (eg, expressing feelings or problem solving) and negative (eg, withdrawing or criticizing) sexual communication patterns (SCPs) are differentially associated with couples' adjustment to PVD is unknown. Aim: To examine associations between collaborative and negative SCPs and women's pain and the sexual and relationship adjustment of women with PVD and their partners. Methods: Women diagnosed with PVD (N = 87) and their partners completed the Sexual Communication Patterns Questionnaire and measurements of pain (women only), sexual functioning, sexual satisfaction, sexual distress, and relationship satisfaction. Main outcome measures: (i) Numerical rating scale of pain during intercourse, (ii) Female Sexual Function Index and International Index of Erectile Function, (iii) Global Measure of Sexual Satisfaction, (iv) Female Sexual Distress Scale-Revised, and (v) Couple Satisfaction Index. Results: When women reported greater collaborative SCP, they also reported higher sexual and relationship satisfaction. When women reported greater negative SCP, they reported less relationship satisfaction and had partners who reported greater sexual distress. When partners reported greater collaborative SCP, they also reported higher relationship satisfaction and had female partners who were less sexually distressed. When partners reported higher negative SCP, they also reported less relationship satisfaction. There were no associations between SCP and women's or partners' sexual functioning or women's pain. Conclusion: Collaborative SCP may benefit couples' sexual and relational well-being, whereas negative SCP may impede sexual and relational adjustment to PVD. Findings provide preliminary support for the need to assess and target collaborative and negative SCPs in psychological interventions for couples affected by PVD. Rancourt KM, Flynn M, Bergeron S, Rosen NO. It Takes Two: Sexual Communication Patterns and the Sexual and Relational Adjustment of Couples Coping With Provoked Vestibulodynia. J Sex Med 2017;XX:XXX-XXX.
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Communication between parents and teens about sexuality can reduce early sexual behavior. However, little research investigates how parents who were adolescents when they had children (early parents) talk with their teens about sex. In-depth interviews were conducted with a racially/ethnically diverse sample of 29 parents of seventh graders. Salient themes of conversations with adolescents were risks of early parenthood, sexually transmitted infections, delaying sex, and using protection. Compared with parents who were older when they had children (later parents), early parents were more likely to report having had negative sexuality communications with their families of origin and to express a wish to communicate differently with their own children. Early parents were more likely than later parents to discuss risks of early parenthood and to rely on extended family involvement in sexuality communication. Findings suggest that early parents may bring unique perspectives that enable them to approach sexuality communication differently than do later parents.
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Purpose To assess the evolution of sexual dysfunctions among young males after an average of 15 months follow-up to determine the predictive factors for this evolution and the characteristics differentiating young males who continue reporting a sexual dysfunction from those who do not. Methods We conducted a prospective cohort study in two Swiss military recruitment centers mandatory for all Swiss national males aged 18–25 years. A total of 3,700 sexually active young males filled out a questionnaire at baseline (T0) and follow-up (T1: 15.5 months later). Main outcome measures were self-reported premature ejaculation (PE) and erectile dysfunction (ED). Results Overall, 43.9% of young males who reported (PE) and 51% of those reporting (ED) at T0 still reported it at T1. Moreover, 9.7% developed a PE problem and 14.4% developed an ED problem between T0 and T1. Poor mental health, depression, and consumption of medication without prescription were predictive factors for PE and ED. Poor physical health, alcohol consumption, and less sexual experience were predictive factors for PE. ED persistence was associated with having multiple sexual partners. Conclusions This is the first longitudinal study to examine sexual dysfunctions among young males. Our results show high prevalence rates among young males for maintaining or developing a sexual dysfunction over time. Consequently, when consulting with young males, health professionals should inquire about sexual dysfunctions as part of their routine psychosocial assessment and leave the subject open for discussion. Future research should examine in more detail the relationship between sexual dysfunctions and poor mental health.