Eli Coleman's research while affiliated with University of Minnesota Twin Cities and other places
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Publications (124)
Emotion dysregulation is an associated feature of compulsive sexual behavior disorder (CSBD), now recognized by the World Health Organization. Previous studies have identified associations between trait emotion dysregulation and CSBD. Given that difficulties with emotion regulation (DERS) is comprised of several facets (e.g., difficulty with impuls...
Compulsive sexual behavior (CSB) is a clinical syndrome in which repetitive sexual behaviors, urges, or thoughts cause significant distress and impairment. Moral incongruence (MI), or conflict between an individual’s sexual behaviors and moral beliefs, is highly associated with self-reported problematic pornography use, a common behavioral manifest...
The aim of with this brief report is to examine how the COVID-19 pandemic differentially impacted solitary sexual behaviors in those with and without clinically significant compulsive sexual behavior (CSB). A total of 944 individuals in the United States completed an online cross-sectional survey in October 2020. Participants were asked to retrospe...
Background and aims:
The World Health Organization's International Classification of Diseases (ICD-11) includes Compulsive Sexual Behavior Disorder (CSBD), a new diagnosis that is both controversial and groundbreaking, as it is the first diagnosis to codify a disorder related to excessive, compulsive, and out-of-control sexual behavior. The inclus...
Introduction
Today, we are facing increased and continued adverse sexual health outcomes in the United States, including high post-COVID-19 pandemic rates of sexually transmitted infections (STIs). For the past 20 years, there have been calls for a national health strategy and a more comprehensive sexual health approach to address the myriad of per...
Men who have sex with men (MSM) are disproportionately impacted by HIV in the United States, and substance use and compulsive sexual behavior (CSB) are contributors to HIV risk behavior. This study sought to examine the direct and interactive effects of concurrent substance use and CSB on condomless anal sex (CAS) in a community sample of MSM (N =...
Despite well-documented individual, relational, and health benefits, masturbation has been stigmatized and is understudied compared to partnered sex. In a US nationally representative survey of adults, we aimed to: (1) assess the prevalence and frequency of participants’ prior-year masturbation, (2) describe reasons people give for not masturbating...
Compulsive sexual behavior (CSB) is associated with poor affect regulation and difficulties in interpersonal relationships. People experiencing CSB may engage in ineffective coping and have poor social support. The current study tested relationships between several coping orientations and sources of perceived social support (from significant others...
Compulsive sexual behavior (CSB) is associated with religiosity and moral disapproval for sexual behaviors, and religiosity and moral disapproval are often used interchangeably in understanding moral incongruence. The present study expands prior research by examining relationships between several religious orientations and CSB and testing how moral...
Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this are...
After introduction of compulsive sexual behavior disorder (CSBD) in the ICD-11, many questions regarding etiology, classification and diagnostic criteria remain unanswered, providing rationale for further research. In this commentary, we critically review the ongoing discussion reflected in some relevant articles, and try to point out the risks of...
Affect regulation is associated with compulsive sexual behavior (CSB) despite ongoing debate about its inclusion in diagnostic criteria. Previous studies on two specific affect regulation constructs - boredom proneness and attachment styles - suggest that affect regulation is associated with CSB. We tested a moderation model of the effects of attac...
The purpose of this study is to assess how the COVID-19 pandemic impacted various sexual behaviors and levels of sexual and relationship satisfaction by performing a content analysis of participants’ (N = 1051 American adults) responses to open-ended survey questions. Results revealed a variety of impacts that increased, decreased, or otherwise qua...
Introduction
It has been hypothesized that compulsive sexual behavior (CSB) may be a result of a biological vulnerability for affective dysregulation and impulsive control, which may emerge as a result of underlying neurobiological disruptions, childhood adversity, or attachment instability. Boredom proneness and attachment style have been shown to...
This article provides technical guidance on the content, meaning, and application of the World Association of Sexual Health (WAS) Declaration on Sexual Pleasure to various stakeholders and practitioners working in the area of sexuality, sexual health, and sexual rights. A growing body of work shows that sexual pleasure is integral to broader health...
Background and aims:
In recent years, increasing attention has been given to the relationship between compulsive sexual behavior (CSB), religiosity, and spirituality. This review summarizes research examining the relationship CSB has with religiosity and spirituality, clarifying how these constructs inform the assessment and treatment of this synd...
On September 11, 2021, the World Association for Sexual Health ratified a Declaration on Sexual Pleasure in its General Assembly. This declaration was a bold attempt by WAS to urge all spheres of influence in society to recognize the critical importance of sexual pleasure as a key component of sexual health and sexual rights. This special issue of...
Sexual pleasure is best attained through facilitating access to the highest standard of health. Today global data show a persistent high burden of sexual health issues. Yet, pleasure remains a sensitive, stigmatized, and unspoken topic in healthcare services. This article examines how to incorporate a value for pleasure into healthcare services, gr...
Background
Compulsive sexual behavior (CSB) is a clinical syndrome that causes significant distress and impairment for many individuals in the United States. Gay men are thought to have a higher prevalence of CSB, and it is associated with many relevant health outcomes including HIV risk behavior.
Aim
To estimate the prevalence and examine demogra...
Background: Studies from the first months of the COVID-19 pandemic and the resulting lockdown and social distancing measures have shown that there have been decreases in sexual frequency and relationship satisfaction.
Aim. To evaluate the ongoing impact of the COVID-19 pandemic on sexual behavior, relationship satisfaction, and intimate partner vio...
Although most lesbian, gay, bisexual, transgender, and questioning youths are quite resilient and emerge from adolescence as healthy adults, the effects of stigma and heterosexism can contribute to health disparities. Part 2 of this first-of-its-kind 3-part series can help pediatric primary care providers become stronger allies for TGD patients and...
Background
Sexual health is generally considered an integral part of medical and allied healthcare professional training. However, many medical schools do not offer this as a mandatory curriculum, or minimize it. Sexual health as an academic area was introduced in the 1970s, but there have been few cohort evaluations of its impact. This was limited...
Introduction
Cancellation of university classes during the COVID-19 pandemic challenges teaching in-person sexual history taking skills to medical, physician assistant and nursing students. We used commercial online electronic services for medical students to learn sexual history taking skills.
Methods
174 medical students viewed a lecture on sexu...
Gender Dysphoria in Adults: An Overview and Primer for Psychiatrists
William Byne 1 2, Dan H Karasic 3, Eli Coleman 4, A Evan Eyler 5, Jeremy D Kidd 6, Heino F L Meyer-Bahlburg 7, Richard R Pleak 8, Jack Pula 9
PMID: 29756044 PMCID: PMC5944396 DOI: 10.1089/trgh.2017.0053
Free PMC article
Abstract
Regardless of their area of specialization, adult...
Background
A number of studies have found that hypersexuality is associated with a high propensity for sexual excitation. In comparison, less is known about the relationship between hypersexuality and sexual arousal at the state level. Also, previous research has revealed a relationship between hypersexuality and negative mood. However, the possibi...
Background: High quality data pertaining to the size of the transgender and gender diverse (TGD) population are scant, however, several recently published studies may provide more reliable contemporary estimates.
Aims: To summarize the estimated number and proportion of TGD individuals overall and across age groups, based on most accurate data.
Met...
Research has identified discrimination and a lack of knowledgeable providers as major barriers for transgender and gender diverse (TGD) individuals seeking care, which contributes to greater stress and significant health disparities affecting this population. However, research involving TGD youth is limited. The aim of this study, therefore, was to...
Purpose:
We describe the development of a measure of internalized transphobia, defined as discomfort with one's transgender identity as a result of internalizing society's normative gender expectations.
Methods:
An item pool was created based on responses from a small clinical sample (N = 12) to an open-ended questionnaire. Expert judges reviewed...
Much work on sexual health has emphasized adverse outcomes such as sexually transmitted infections/HIV, unintended pregnancy, and sexual violence. Although these objectives are of continued importance, they reflect a global tendency to focus on negative sexual health outcomes. Far less prominent in health promotion, policy, and programing is a sust...
Accurate estimates of the number and proportion of transgender and gender nonconforming people in a population are necessary for developing data-based policy and for planning and funding of health care delivery and research. The wide range of estimates reported in the literature is attributable primarily to differences in definitions. Other sources...
Most gambling research utilizes general youth samples and focuses on binary gender categories; few studies examine and compare gambling behaviors between transgender and gender diverse (TGD) youth and their cisgender peers. The current study used population-based data from the 2016 Minnesota Student Survey to compare the prevalence of gambling beha...
Introduction:
Nurses and physicians receive minimal training about providing competent care to transgender and gender-diverse (TGD) patients, and training specific to TGD youth is particularly lacking. This qualitative study examined health care providers' experiences and attitudes about working with TGD youth to identify specific training needs....
This study examines the intersection of sexual and gender identities among adolescents, including the prevalence of these groups and rates of emotional distress and bullying victimization. Data come from a large population-based sample; two measures of sexual orientation and gender identity create eight identity groups. Youth who report identifying...
The association between positive and negative affect and sexual behavior in 39 MSM with and without hypersexuality (HS) was explored using ecological momentary assessment. Participants reported their current positive and negative affect three times per day and their sexual behavior each morning and evening. The relationship between affect and sexua...
Introduction:
Important mental and physical health disparities exist for transgender and gender diverse youth compared with cisgender youth (i.e., those whose birth-assigned sex and gender identity align), yet little is known about factors that protect transgender and gender diverse youth from health problems. The objective of this paper is to ide...
The diagnostic and conceptualization of obsessive, compulsive, impulsive, and driven sexual behavior is controversial, and its terminology has varied over time and across conceptualizations (out-of-control sexual behavior, compulsive sexual behavior, sexual addiction, etc.). This article articulates our Integrative Biopsychosocial and Sex Positive...
Importance
The veracity, nomenclature, and conceptualizations of sex addiction, out-of-control sexual behavior, hypersexual behavior, and impulsive or compulsive sexual behavior are widely debated. Despite such variation in conceptualization, all models concur on the prominent feature: failing to control one’s sexual feelings and behaviors in a way...
Purpose
Understanding the root causes of the substantial disparities in risk and protective factors among transgender and gender diverse (TGD) adolescents is essential to the development and expansion of resources and supports for this vulnerable population. This study examines differences in emotional distress, bullying victimization, and protecti...
Purpose:
As measures of birth-assigned sex, gender identity, and perceived gender presentation are increasingly included in large-scale research studies, data analysis approaches incorporating such measures are needed. Large samples capable of demonstrating variation within the transgender and gender diverse (TGD) community can inform intervention...
Gender Dysphoria and patient-initiated gender transition occur with increased frequency in individuals with somatic intersex conditions, a subset of disorders/differences of sex development (DSD). Providers need to be aware of assessment and treatment-relevant characteristics of these individuals that differ from gender-dysphoric individuals withou...
This article describes the gender identity, gender expression, and sexual orientation of male spirit mediums in Myanmar. Our analysis is based on ethnographic work, field observation, and 10 semi-structured interviews. These observations were conducted from 2010 to 2015, mostly in Mandalay, with some fieldwork in Yangon and Bagan. The focus of this...
Regardless of their area of specialization, adult psychiatrists are likely to encounter gender-variant patients; however , medical school curricula and psychiatric residency training programs devote little attention to their care. This article aims to assist adult psychiatrists who are not gender specialists in the delivery of respectful, clinicall...
Background:
Transgender and gender nonconforming (TGNC) adolescents have difficulty accessing and receiving health care compared with cisgender youth, yet research is limited by a reliance on small and nonrepresentative samples. This study's purpose was to examine mental and physical health characteristics and care utilization between youth who ar...
Purpose:
Research suggests that transgender and gender nonconforming (TGNC) youth may be at greatly increased risk of high-risk health behaviors compared with cisgender youth, but existing studies are limited by convenience samples and small numbers. This study uses a large school-based sample of adolescents to describe the prevalence of TGNC iden...
Sexual health is considered to be a state of wellness with physical, emotional, mental, and social dimensions. Sexual health can contribute to our overall well-being in each of these dimensions. However, despite the intrinsic importance and positive aspects of sexuality in our lives, the United States presently faces significant challenges related...
Introduction:
One of the major obstacles to conducting epidemiologic research and determining the incidence and prevalence of compulsive sexual behavior (CSB) has been the lack of relevant empirically derived cut points on the various instruments that have been used to measure the concept.
Aim:
To further develop the Compulsive Sexual Behavior I...
Introduction:
This review was designed to make recommendations on future educational needs, principles of curricular development, and how the International Society for Sexual Medicine (ISSM) should address the need to enhance and promote human sexuality education around the world.
Aim:
To explore the ways in which graduate and postgraduate medic...
The sexual health model is a conceptual framework that posits 10 key components of healthy human sexuality. An initial scale was developed to measure the sexual health as conceptualized by Robinson et al. Building on that research, this article describes the exploratory factor analysis examining the underlying structure of the sexual health model a...
This article explores the evolution and current delivery of undergraduate medical education in human sexuality.
To make recommendations regarding future educational needs, principles of curricular development, and how the International Society for Sexual Medicine (ISSM) should address the need to enhance and promote human sexuality education aroun...
Introduction
Hypersexuality has been conceptualized as sexual addiction, compulsivity, and impulsivity, among others, in the absence of strong empirical data in support of any specific conceptualization.
Aim
To investigate personality factors and behavioral mechanisms that are relevant to hypersexuality in men who have sex with men.
Methods
A sam...
Purpose of review:
Transgender persons suffer significant health disparities and may require medical intervention as part of their care. The purpose of this manuscript is to briefly review the literature characterizing barriers to healthcare for transgender individuals and to propose research priorities to understand mechanisms of those barriers a...
Purpose of review:
Research on the health of transgender and gender nonconforming people has been limited with most of the work focusing on transition-related care and HIV. The present review summarizes research to date on the overall development and quality of life of transgender and gender nonconforming adults, and makes recommendations for futu...
Reproductive and sexual health morbidity in the United States is much higher than that of other developed nations. It is estimated that in the United States, there are 50,000 new human immunodeficiency virus infections, 20 million sexually transmitted infections (STIs), 3 million unintended pregnancies, and 1 million rapes each year. The annual cos...
This Viewpoint discusses a framework for improving patient care and public sexual health.
Reproductive and sexual health morbidity in the United States continues to far exceed that of other developed nations. Calls for greater attention and new strategies to address this fact usually begin with a ceremonial nod to the numbers of associated adverse...
The Good Practice Guidelines for the Assessment and Treatment of Adults with Gender Dysphoria is a publication of the Intercollegiate Committee of the Royal College of Psychiatrists. The overall goal of the Good Practice Guidelines is to provide clinical guidance for health professionals to assist transsexual, transgender, and gender nonconforming...
At least eighteen countries allow transgender personnel to serve openly, but the United States is not among them. In this article, we assess whether US military policies that ban transgender service members are based on medically sound rationales. To do so, we analyze Defense Department regulations and consider a wide range of medical data. Our con...
Medical education in sexual health in the United States and Canada is lacking. Medical students and practicing physicians report being underprepared to adequately address their patients' sexual health needs. Recent studies have shown little instruction on sexual health in medical schools and little consensus around the type of material medical stud...
Scientific interest in the measurement of homophobia and internalized homophobia has grown over the past 30 years, and new instruments and terms have emerged. To help researchers with the challenging task of identifying appropriate measures for studies in sexual-minority health, we reviewed measures of homophobia published in the academic literatur...
Objectives:
We assessed the association between minority stress, mental health, and potential ameliorating factors in a large, community-based, geographically diverse sample of the US transgender population.
Methods:
In 2003, we recruited through the Internet a sample of 1093 male-to-female and female-to-male transgender persons, stratified by g...
The extant literature indicates a robust association between compulsive sexual behavior (CSB) and HIV sexual risk. Our research has found that CSB influences multiple measures of HIV sexual risk and that the association between CSB and HIV sexual risk behavior is consistent across multiple populations, including men who have sex with men and Africa...
Both the diagnosis and treatment of Gender Identity Disorder (GID) are controversial. Although linked, they are separate issues and the DSM does not evaluate treatments. The Board of Trustees (BOT) of the American Psychiatric Association (APA), therefore, formed a Task Force charged to perform a critical review of the literature on the treatment of...
The Standards of Care (SOC) for the Health of Transsexual, Transgender, and Gender Nonconforming People is a publication of the World Professional Association for Transgender Health (WPATH). The overall goal of the SOC is to provide clinical guidance for health professionals to assist transsexual, transgender, and gender nonconforming people with s...
Both the diagnosis and treatment of Gender Identity Disorder (GID) are controversial. Although linked, they are separate issues and the DSM does not evaluate treatments. The Board of Trustees (BOT) of the American Psychiatric Association (APA), therefore, formed a Task Force charged to perform a critical review of the literature on the treatment of...
Sexual health is an issue for the whole population, not just members of groups at risk for outcomes such as STD/HIV. Since sexuality is an intrinsic component of human physical, emotional, mental, social, and spiritual well-being, sexual health is important across the lifespan, and there are specific developmental challenges and opportunities at ea...
This article reviews the development of the construct of sexual health as well as how sexual health has become both part of the public health discourse and a key strategy in promoting overall health and human development. There are many lessons learned from international efforts which can be helpful in formulating a broad sexual health approach to...
The present study explored the relationship between compulsive sexual behavior (CSB) and unprotected anal intercourse (UAI)
for men who have sex with men (MSM) across a number of ethnic/racial groups and who used the Internet to seek sexual partners.
A sample of 2,716 MSM (512 Asian, 445 Black, 683 Latino, 348 Other, 728 White) completed on online...
Compulsive sexual behavior (CSB) is generally characterized by recurrent and intense sexually arousing fantasies, sexual urges, and behaviors, which cause individuals distress or impair daily functioning. Descriptive studies of individuals with paraphilic and nonparaphilic CSB indicate that they experience urges to engage in problematic sexual beha...
The World Professional Association for Transgender Health's (WPATH, formerly the Harry Benjamin International Gender Dysphoria Association) Standards of Care (SOC), Version 6, is in the process of revision. In considering the next revision of the SOC, a number of articles were commissioned to examine various parts of the current WPATH SOC and revie...
Standards of Care (SOC)—Sixth Version of the World Professional Association for Transgender Health (WPATH, formerly the Harry Benjamin International Gender Dysphoria Association) is in the process of revision. In considering the next revision of the SOC, a number of articles were commissioned to examine various parts of the current WPATH SOC and re...
This article reviews the history of the development of the World Professional Association for Transgender Health's (WPATH) Standards of Care (SOC) (formerly the Harry Benjamin International Gender Dysphoria Association). In considering the next revision of the SOC, a number of articles were commissioned to examine various parts of the current WPATH...
In the previous issue of the
International Journal of Transgenderism, I reviewed the history of the development of the
Standards of Care (SOC) of the World Professional Association for Transgender Health (WPATH), formerly the Harry Benjamin International Gender Dysphoria Association (Coleman, 2009). In considering the next revision of the
SOC, a...
We studied a North American sample of female-to-male (FtM) transsexuals sexually attracted to men, aiming to understand their identity and sexuality in the context of a culture of transgender empowerment. Sex-reassigned FtM transsexuals, 18 years or older and attracted to men, were recruited via an FtM community conference and listserv. Participant...
This special issue of the International Journal of Sexual Health is devoted to the issues of the United Nations Millennium Development Goals and the effort by the World Association for Sexual Health to argue that the promotion of sexual health is an essential strategy for attaining those goals. Recently, the World Association for Sexual Health has...
This study assessed the feasibility of online recruitment of high-risk Latino men who have sex with men (MSM) for HIV prevention
survey research and investigated the relationship between Internet use and unsafe sex. Participants (N=1,026) were Internet-using Latino MSM living in the U.S. recruited using online banner advertisements. Respondents com...
Whether homosexuality or internalized homo-negativity is the critical variable affecting the mental health of men who have sex with men has long been debated. As part of a larger study, 422 Midwestern homosexual men completed questionnaires examining degree of homosexuality, internalized homo-negativity, and depression. Logistic regression modeling...
This special issue of the International Journal of Sexual Health is devoted to the issues of sexual health and public policy. The special issue reviews the public health challenge regarding the plethora of sexual health problems we face around the world. It describes the process of developing effective public policy to promote sexual health and add...
Compulsive sexual behavior (CSB) is a putative clinical syndrome characterized by the experience of sexual urges, sexually arousing fantasies, and sexual behaviors that are recurrent, intense, and a distressful interference in one's daily life. Although the putative phenomenology of CSB has been described in the literature, the lack of a reliable,...
Medical charts of 85 patients diagnosed with Compulsive Sexual Behavior (CSB) were reviewed to assess for symptoms of Borderline Personality Disorder (BPD). One patient met criteria for BPD. Participants presented with a mean of one BPD symptom. The most commonly observed symptoms were “impulsivity in at least two areas,” “affective instability” an...