The role of sexual attitudes in sexual functioning: Are general or specific attitudes more relevant?

Sexual attitudes are beliefs about sexuality that are expressed with a high emotional charge, which predisposes one to respond more positively or negatively to sexual stimuli or behaviors. These attitudes can refer both to sexuality in general - for example, the case of erotophilia - and to specific sexual behaviors - such as, for example, towards sexual fantasies or masturbation. In the field of sex therapy, it is usual to assess and address sexual attitudes. However, there is little research that has jointly studied the relationship of these two types of attitudes (general vs. specific) with sexual functioning (desire, arousal, lubrication or erection, ability to reach orgasm, and satisfaction with orgasm) in order to determine their relevance.

Therefore, researchers Juan Carlos Sierra, Jennifer Gómez-Carranza, Ana Álvarez-Muelas, and Oscar Cervilla have recently published a study in the International Journal of Environmental Research and Public Health, which analyzes the explanatory power of general sexual attitude (erotophilia) and specific attitudes towards sexual fantasies and masturbation on the dimensions of sexual functioning (desire, arousal, lubrication/erection, ability to reach orgasm and satisfaction with orgasm). A sample of 2,000 Spanish adults with heterosexual orientation (52.2% women) and aged 18 to 83 years participated in the study. The results indicated that the explanatory models of sexual functioning were different for men and women, with a greater diversity of explanatory variables of sexual functioning in men. However, in both men and women, a positive attitude towards sexual fantasies stood out as the most relevant variable with the greatest explanatory capacity in all dimensions of sexual functioning. A more positive attitude towards sexual fantasies is associated with better sexual functioning, i.e., more sexual desire and arousal, better vaginal lubrication or erection, greater ability to reach orgasm, and more satisfaction with orgasm. On the other hand, the negative attitude towards masturbation was negatively associated with orgasm satisfaction, in both sexes, and erection in men, so that the greater the negative attitude, the greater the orgasmic dissatisfaction, and the worse the erection. As for erotophilia, as a general sexual attitude, it had no explanatory capacity in women, while in men it played a secondary role, facilitating erection and the ability to have an orgasm.

In conclusion, these results indicate that specific sexual attitudes would be more sensitive variables than the general attitude towards sexuality (i.e., erotophilia) in examining sexual health, with the positive attitude towards sexual fantasies being especially relevant, constituting a fundamental element in the understanding of sexual functioning.

Sierra, J. C., Gómez-Carranza, J., Álvarez-Muelas, A., & Cervilla, O. (2021). Association of Sexual Attitudes with Sexual Function: General vs. Specific AttitudesInternational Journal of Environmental Research and Public Health, 18, Article 10390.   

The recent theory of "Relational and Bodily Experiences Theory" by Cherkasskaya and Rosario (2019) indicates that women's sexual desire a multifaceted phenomenon. These dimensions comprehend aspects such as how women feel about their own body and the sensations they experience through it in the sexual context. Shortly, experiencing positive feelings about one's body and its ability to feel pleasure activates sexual desire, while experiencing negative feelings can reduce desire as well as interfere with various aspects of sexual functioning.

Researchers Nieves Moyano and María del Mar Sánchez-Fuentes have carried out a study published in Sexual and Relationship Therapy to analyze how different elements related to a woman's body and her feelings are related not only to sexual desire but also with other aspects of sexuality, in order to contemplate a more complete and integrating model of these elements.

In a sample of 278 women, they found that a woman's ability to obtain pleasure from her partner (expressed in statements such as "I would not hesitate to ask my partner for what I want sexually") is crucial to favor her dyadic desire, that is, her desire to maintain relationships with the partner. On the other hand, women who report a high capacity to satisfy their own sexual needs by themselves are the ones who carry out masturbation behaviors to a greater extent, that is, their solitary sexual desire.

This research also presents a main finding to guide the intervention in sex therapy, since two specific patterns of female sexuality are distinguished, that is, a dyadic context (with their couple) and a solitary context. In relation to the dyadic context, it is found that the ability to obtain pleasure from the partner, as well as greater body sexual self-esteem related to the body, are important for women to enjoy their relationships, feel more sexually satisfied, as well as favor their sexual desire to maintain relationships as a couple. In addition, these "empowered" women would be less likely to suffer pain during penetration and easier to reach orgasm. In this sense, therapeutic interventions should encourage greater awareness of bodily sensations and the eroticization of the woman's own body.

Moyano, N., & Sánchez-Fuentes, M. M. (2021). Sexual body self-representations, desire, and functioning in women. Sexual and Relationship Therapy. Advance online publication.

Sexual response in young people with psychopathological symptoms

The relationship between psychiatric disorders (schizophrenia, depression, bipolar disorders, anxiety disorders, personality disorders, etc.) and alterations in sexual functioning (loss of sexual interest and difficulties in sexual arousal or orgasmic capacity) is well known. However, few studies have been carried out in non-clinical samples, especially in young people, even though they may also suffer from sexual dysfunctions.

For this reason, researchers from the Laboratory of Human Sexuality LabSex UGR (Reina Granados, Ana I. Arcos-Romero, Cristóbal Calvillo, Ana Álvarez-Muelas, María del Mar Sánchez-Fuentes, Nieves Moyano, and Juan Carlos Sierra), in collaboration with researcher Franklin Soler from the Universidad del Rosario in Colombia, have published an article in the International Journal of Environmental Research and Public Health in which they present the results of the association between psychopathological dimensions and sexual functioning in young adults aged 18 to 35 years old.

For this purpose, a research composed of two studies was carried out. In the first study, sexual functioning and psychopathological dimensions were assessed in 700 women and 516 men. Results indicated that, in both men and women, depression and anxiety-related symptoms had a negative effect on dimensions of sexual functioning (desire, arousal, and orgasm). In the second study, 143 men and 123 women of the same sample participated to determine whether psychopathological symptoms explained subjective sexual arousal which was assessed by an experimental task conducted in a laboratory setting. The task consisted of watching clips of explicit sexual content for the assessment of subjective sexual arousal and genital sensations. The results of this second study showed that anxiety was positively associated with subjective sexual arousal in men and women, also with the intensity of genital sensations in men. The differences in the results on the role of anxiety between the two studies could be explained by the fact that sexual arousal was assessed in general terms in Study 1, while in Study 2 arousal was assessed as a state when watching clips of sexual content This confirms the need to assess anxiety in depth by relating it to dimensions of sexual response.

Overall, the findings confirm that the presence of psychopathological symptoms affects the sexual functioning of young people, and it is necessary to strengthen mental disorder prevention programs that include sexual health content.

Soler, F., Granados, R., Arcos-Romero, A. I., Calvillo, C., Álvarez-Muelas, A., Sánchez-Fuentes, M. M., Moyano, N., & Sierra, J. C. (2021). Association between psychopathological dimensions and sexual functioning/sexual arousal in young adults. International Journal of Environmental Research and Public Health, 18, Article 3584.   

Masturbation is a behavior present from childhood to adulthood, however, throughout history, it has been stigmatized from traditional and orthodox positions that have tried to instill a negative view about its practice. The impact of this behavior on sexual health has been extensively studied. Masturbation promotes sexual health, positive intimacy experiences, and self-knowledge and self-exploration, among other benefits. Despite this, recent studies still show that a negative attitude towards this behavior may persist in a minority of Spanish society. Despite the importance of masturbation in sexual health, to date, there have been no adapted and validated instruments to assess the attitude towards this behavior in the Spanish population. Therefore, Óscar Cervilla, Pablo Vallejo-Medina, Carmen Gómez-Berrocal and Juan Carlos Sierra carried out a study published in the International Journal of Clinical and Health Psychology to develop an instrument in Spanish to assess negative attitudes towards masturbation. The Negative Attitudes Towards Masturbation Inventory (NATMI) is an instrument originally composed of 30 items distributed in three dimensions (positive attitudes towards masturbation, false beliefs about the harmful nature of masturbation, and personally experienced negative affects associated with masturbation) that quantify the negative attitude towards this behavior. After a rigorous process of linguistic adaptation to Spanish, a version was obtained and administered to 1,867 men and 2,249 women, aged between 18 and 83 years. Psychometric analyses led to a reduced version of ten items (e.g., " Masturbation in an adult is juvenile and immature" or "I feel guilty about masturbating"). People with a more negative attitude toward masturbation indicated that they prayed more often and masturbated less. Besides, they had a more negative attitude toward sexuality in general and toward sexual fantasies in particular. They also showed greater sexual inhibition due to the threat of performance failure, probably because of a lack of self-exploration and self-knowledge as a consequence of masturbating less. Along the same lines, these people with a negative attitude toward masturbation, compared to those with a more positive attitude, reported having worse sexual functioning, i.e., lower sexual desire, greater difficulty with erection in the case of men or vaginal lubrication problems in the case of women, more difficulties in reaching orgasm, and lower satisfaction associated with orgasm. Also, its scores have allowed us to observe the impact of negative attitudes towards masturbation on important variables for sexual health. Finally, considering the therapeutic relevance of masturbation for the treatment of problems associated with sexual desire or orgasm, it is worth highlighting the usefulness of this scale to assess attitudes towards this behavior.

Cervilla, O., Vallejo-Medina, P., Gómez-Berrocal, C., & Sierra, J. C. (2021). Development of the Spanish short version of Negative Attitudes Toward Masturbation Inventory. International Journal of Clinical and Health Psychology, 21, Article 100222. 

Adolescence is a stage of growth and development of great relevance. According to the World Health Organization, at the onset of adolescence, adolescents are not fully capable of understanding the relationship between a behavior and its consequences, or of perceiving their ability to judge when making decisions related to their health, in particular with their sexual health. Thus, adolescents frequently perform risky sexual behaviors, that is, behaviors that increase the probability unplanned pregnancies. Unplanned teenage pregnancies can be considered a global public health problem due to the high impact on the present and future of these young people, as well as their possible offspring. With the goal to provide a greater knowledge about the factors associated with unplanned pregnancies among adolescents, Nieves Moyano, Reina Granados, Christian Durán and Carlos Galarza conducted a recently paper published in the International Journal of Environmental Research and Public Health among adolescents in Ecuador. The aim of their study was to analyze the relationship between self-esteem, attitudes toward love, and sexual assertiveness among pregnant and non-pregnant teenagers. We also considered whether their pregnancy was planned or not. The study was conducted with 225 women from Ecuador. We administered self-reported measures such as the Rosenberg Self-Esteem Scale, the Love Attitudes Scale, and the Sexual Assertiveness Scale. Self-esteem was higher in adolescents with a planned pregnancy than in those women whose pregnancy was not planned. Pregnant women reported greater acceptance and endorsement of beliefs related to the myth of "soulmate" in comparison to non-pregnant women. Sexual assertiveness related to the negotiation of the use of contraceptive methods was greater in non-pregnant adolescents than in pregnant girls. We discuss the implications of our findings in terms of sexual education and prevention in the sex education field. This study shows differences in self-esteem, attitudes toward love, and sexual assertiveness between pregnant and non-pregnant adolescents. In summary, self-esteem, beliefs about love, and sexual assertiveness are factors that play a relevant role in the risk of teenage pregnancy. Specifically, women who did not plan their pregnancies have lower levels of self-esteem than those who did. Likewise, pregnant adolescents have greater beliefs in romantic myths, especially those where women idealize their male partners, and the role of the latter becomes predominant. Finally, sexual assertiveness was lower in pregnant women than in women who had not had sexual intercourse, and in others who were sexually active. These findings highlight the relevance of adequate sexual and mental health education in adolescents to avoid unwanted and/or unplanned pregnancies, as well as other consequences derived from risky sexual behaviors. Therefore, health education, and more specifically sexual health education, must take into account the reinforcement of self-esteem and sexual assertiveness in this age group. In the same way, it is necessary to apply holistic interventions (i.e., informative, educational, psychological, health, etc.) that help to demystify love based on a romantic and unreal perspective, which is still culturally preserved. Furthermore, it is necessary to study other individual psychological factors that, together with those studied herein, can provide more information about the reasons that favor the increasing number of teenage pregnancies.

Moyano, N., Granados, R., Durán, C. A., & Galarza, C. (2021). Self-esteem, attitudes toward love, and sexual assertiveness among pregnant adolescents. International Journal of Environmental Research and Public Health, 18, Article 1270. 

The violence that takes place in partner relationships causes physical and psychological harm. Its prevalence, especially high in women, has led the World Health Organization to consider this type of violence a global public health problem. Its consequences have been related to negative effects on sexual health. In order to provide greater knowledge about the association between intimate partner violence and sexuality, Juan Carlos Sierra, Ana I. Arcos-Romero, Ana Álvarez-Muelas, and Óscar Cervilla have carried out a study published in the International Journal of Environmental Research and Public Health in which how relevant aspects related to sexual health are different between people who have suffered abuse in the context of heterosexual partnership and people who have not experienced this type of violence. In this study participated 3,394 Spanish adults (1,628 men and 1,766 women) with ages between 18 and 81 years old. The evaluated variables related to sexual health were sexual attitudes (erotophilia and positive attitude towards sexual fantasies), sexual assertiveness, and sexual functioning dimensions (desire, excitation, erection, orgasm, and sexual satisfaction). Groups of men and women were examined based on whether they had experienced psychological or physical partner abuse.

Results indicated that men and women that had suffered abuse (psychological or physical) showed lower sexual assertiveness to initiate desired sexual activities or to refuse unwanted sexual contact. Men who had experienced physical abuse reported lower assertiveness to prevent STI. It was observed fewer positive attitudes towards sexual fantasies in women who had suffered abuse (psychological or physical) compared to those without abuse experience. An explanation for this fact occurred only in women could be because, generally, men tend to inform more positive attitudes towards sexual fantasies. Nevertheless, no association between abuse experience and erotophilia was found. This result seems to indicate that specific attitudes (e.g., attitudes towards sexual fantasies) could be more sensitive to examine sexual health than general attitudes (e.g., erotophilia). Regarding sexual functioning, partner-focused sexual desire was lower in men and women who had suffered abuse (psychological or physical). However, higher sexual desire for an attractive person was observed in men who had experienced physical abuse and in women who had experienced psychological and/or physical abuse. It suggests that having experience of partner abuse would not mean the loss of sexual desire, but the promotion of sexual interest in other people outside the relationship. The study also showed a higher solitary sexual desire in men who had experienced physical abuse compared to those who have not experienced abuse. These results support the differences between men and women in this type of desire, such as the greater frequency of masturbation by men and traditional gender roles. It was observed less sexual excitation and orgasmic capacity only in women with abuse experience (psychological or physical). It reflects that the abuse experience has a greater impact on sexual functioning dimensions in women than in men. Men who had suffered abuse showed to have affected the subjective components of sexual functioning (desire and sexual satisfaction), but not the objective ones, such as the erection or orgasm. Finally, men and women who had suffered abuse (psychological or physical) reported less sexual satisfaction than those who had not suffered abuse.

As a conclusion, the experience of abuse both psychological and physical are associated with a clear impact on variables related to sexual health, such as sexual attitudes and dimensions of sexual functioning.

Sierra, J. C., Arcos-Romero, A. I., Álvarez-Muelas, A., & Cervilla, O. (2021). The Impact of Intimate Partner Violence on Sexual Attitudes, Sexual Assertiveness, and Sexual Functioning in Men and Women. International Journal of Environmental Research and Public Health, 18, Article 594. 

Sexual satisfaction is the subjective assessment that people make of their sexual relationships, being considered one of the most relevant manifestations of sexual health. It does not depend only not only depends on one's own sexual relationships, but also on other personal, interpersonal, and socio-cultural factors. A personal factor that has been related to sexual satisfaction is the sexual double standard (SDS), which refers to the different evaluation of a sexual behavior depending on whether it is performed by a man or a woman. Therefore, this attitude can be man-favorable (greater sexual freedom and less sexual shyness for men than for women), woman-favorable (greater sexual freedom and less sexual shyness for women than for men), and egalitarian (the same sexual freedom and sexual shyness for men than for women). The study of the relationship between sexual satisfaction and SDS has not taken into account these three typologies. Following the need for further research, the study by Ana Álvarez-Muelas, Carmen Gómez-Berrocal, and Juan Carlos Sierra (2021), published in Frontiers in Psychology, analyzed the sexual satisfaction in 1,194 heterosexual adults of the Spanish population who had been in a relationship and presented different forms of adherence to SDS (man-favorable, woman-favorable, and egalitarian). To do this, sexual satisfaction was compared between the different SDS typologies and it was analyzed the predictive capacity of personal variables (age, social dominance orientation,  and propensity for sexual excitation/inhibition), interpersonal variables (relationship satisfaction), and social variables (gender norms about sexual behaviors) in sexual satisfaction in men and women, considering the SDS adherence type and sexual behavior area (sexual freedom or sexual shyness). Firstly, the results of this study indicated higher sexual satisfaction levels in in those people with the egalitarian SDS adherence type. Secondly, it was evidenced by the influence of the personal and interpersonal variables have on sexual satisfaction, with variability in their predictive capacity depending on the SDS adherence type. Generally, it was found more predictor variables of sexual satisfaction of women in comparison to men. Among the personal variables, the most common variable in most SDS adherence types in men and women was age that is negatively associated with sexual satisfaction. Also, sexual inhibition due to threat of performance was positively associated in both genders; and social dominance orientation was negatively associated only in women. These last two variables had predictive capacity in shyness area, so it was in this area where more variables are predicting sexual satisfaction. On the other hand, relationship satisfaction, as an interpersonal variable, was the main predictor of sexual satisfaction positively, in all SDS adherence type. Social variables did not show the predictive capacity of sexual satisfaction. This study concludes by highlighting the importance of considering the attitude to the SDS that is, how the person internalizes gender roles in the sexuality area, as a variable to be taken into account in programs that promote sexuality healthily and pleasantly, as well as in therapy focused on sexual satisfaction in the couple context.

Álvarez-Muelas, A., Gómez-Berrocal, C., & Sierra, J. C. (2021). Study of sexual satisfaction in different typologies of adherence to the sexual double standard. Frontiers in Psychology, 11, Article 609571. 

Sexual desire and orgasm are both components of the sexual response cycle. The latter is the final result of this cycle, it is a product of sexual stimulation. It is assumed that sexual desire constitutes a potential element of the orgasm experience. Precisely, the study by Ana I. Arcos-Romero, Dharelys Guerra-Expósito, and Juan Carlos Sierra aimed to determine the role that sexual desire has on the subjective orgasm experience. This study has been published in the International Journal of Impotence Research. First, the authors examined the effect that sex and age, and the interaction of both factors, has on the subjective orgasm experience. Second, they analyzed the relationship of this experience with the sexual desire, in order to know the predictive ability of the different types of sexual desire (partner-focused dyadic sexual desire, for an attractive person, and in solitary) on the subjective orgasm experience in the context of sexual relationship. To carried out these objectives, 1,161 heterosexual Spanish adults who had been involved in a partner relationship were assessed. They were distributed into three age range (18-34, 35-49, and 50 years old or older). The participants completed the Orgasm Rating Scale (to assess the intensity of the subjective orgasm experience in the sexual relationship) and the Sexual Desire Inventory (to assess the intensity of the three types of the sexual desire). The obtained results indicated no significant differences between women and men regarding the intensity of their orgasm experience, and that this experience decrease as age increases. Even though there are differential nuances between men and women, both live orgasm experiences with their partners in a similar manner and feel it less intense as they get older. About the association between sexual desire and orgasm experience, only the partner-focused sexual desire predicted the subjective orgasm experience in the context of sexual relationship, this type of sexual desire explained the 21% of the subjective orgasm experience. It was striking that neither the dyadic sexual desire for an attractive person nor the solitary sexual desire have any relevance in explaining the subjective experience of orgasm in relationships. These results have implications in the field of sexual health, specifically, they should be considered within the context of sexual therapy.

Arcos-Romero, I., Guerra-Expósito, D., & Sierra, J. C. (2020). Sexual desire and its relationship with subjective orgasm experience. International Journal of Impotence Research. Advance online publication.

The concept of sexual double standard is used to refer to the assessment, positive or negative, that people make of men and women when they engage in certain sexual behavior. Research in psychology has shown that women and men are differently evaluated when they engage in the same sexual behavior. For example, we use the term traditional sexual double standard to refer to the fact that people positively assess men more than women for engaging in sexual behaviors such as taking the initiative in relationships, having sex in casual encounters, or engaging in frequent sexual activity. When many people agree on how to assess men and women for their sexual behavior, then that evaluation becomes a social norm. Recent years have shown that there are different norms for assessing men and women when they engage in sexual. Traditionally, most people supported a sexual double standard that favors men. That is, most people agreed in evaluating men more positively than women when they freely expressed their sexuality or are not sexually demure. It has been shown, for example, that when a person supports a sexual double standard that favors men, behaviors related to aggression, sexual coercion of men towards women, and sexual victimization of women can increase. In recent decades, in modern societies, women are increasingly claiming their right to express and live their sexuality freely. For this reason, the number of people who support a sexual double standard that favors women is increasing; in this case, sectors of the population coincide in valuing women more positively than men when they freely and unreservedly express their sexuality. In democratic and developed societies, a single criterion, which is a sexual equal standard, for assessing men and women when they express their sexuality is desirable. Knowing the percentage of the population that supports one sexual standard or sexual double standard, i.e. egalitarian or man-favorable and woman-favorable, is important not only to promote education policies that favor gender equality in the area of sexuality but also to develop intervention programs that help people to be more egalitarian in their heterosexual relationships Given the absence of research of this type, the study by Ana Álvarez-Muelas, Carmen Gómez-Berrocal, and Juan Carlos Sierra, published in The European Journal of Psychology Applied to Legal Context, examined how the percentage of support for the various forms of sexual double standards (man-favorable, woman-favorable, and egalitarian) is distributed in a sample of 2,002 heterosexual Spanish. The main results showed that the overall sample supports the sexual equal standard. However, differences were found between men and women, according to the age of the person. While most men support a sexual double standard than favors men, among women there is a higher prevalence of egalitarian and woman-favorable sexual norms. The differences between the age groups show that most men which are between 26 and 55 years old support the sexual double standard that favors men, while young men, which are between 18 and 25 years old, and over 55-year-olds support the sexual equal standard. For women, in all age groups, the egalitarian norm is most prevalent.

Álvarez-Muelas, A., Gómez-Berrocal, C., & Sierra, J. C. (2020). Typologies of Sexual Double Standard Adherence in Spanish Population. European Journal of Psychology Applied to Legal Context, 13, 1-7. 

The concept of "female sexual subjectivity" has recently been considered as an indicator of female sexual empowerment. Shortly, sexual subjectivity is the pleasure and enjoyment that a woman obtains from her own body. This concept refers to various aspects related to sexual self-esteem and the ability to receive sexual pleasure (from oneself and / or from a sexual partner). Sexual subjectivity is related to other aspects of sexual functioning and well-being, since experiencing positive feelings towards one's own body favors a greater sexual desire in women, enhances arousal, as well as greater enjoyment and satisfaction of sexual relations. Therefore, the authors Nieves Moyano, Reina Granados, Melissa Vélez-Schemankewitz and Nicole Dib-Fayad, have carried out a study in 278 Ecuadorian adult women to have a validated version of the questionnaire that allows measuring female sexual subjectivity, the Female Sexual Subjectivity Inventory (FSSI). The study was published in Revista Latinoamericana de Psicología. The Female Sexual Subjectivity Inventory (ISSF) consists of 20 items distributed in five factors that assess: sexual self-esteem, self-pleasure, pleasure with a partner, self-efficacy and sexual self-reflection. Below, there is an example of an item for each of the dimensions evaluated by the questionnaire:

Sexual self-esteem: "I am confident that a romantic partner would find me sexually attractive".

  • Self-pleasure: "It is okay for me to meet my own sexual needs through self-masturbation".
  • Pleasure with a partner: "If a partner were to ignore my sexual needs and desires, I'd feel hurt".
  • Sexual self-efficacy: "I would not hesitate to ask for what I want sexually from a romantic partner".
  • Sexual self-reflection: "I spend time thinking and reflecting about my sexual experiences"

Our findings suggest that older women indicated a greater ability to ask their partner for what they want sexually, while women who were in a relationship indicated greater pleasure obtained from their partner. In general, women with greater sexual subjectivity feel more satisfied with their body. Finally, regarding the validation of the scale, it has adequate psychometric properties for its use in the Spanish-speaking population.

Moyano, N., Granados, R., Vélez-Schemankewitz, M., & Dib-Fayad, N. (2021). Are you sexually empowered? Validation of the Female Sexual Subjectivity Inventory for Spanish-speaking women. Revista Latinoamericana de Psicología, 52, 81-94.  

Since 2019, the World Health Organization has classified burnout as a recognized syndrome that is part of the International Classification of Diseases (ICD). This is characterized by being a occupational phenomenon defined by "emotional exhaustion, depersonalization and low personal accomplishment". To date, burnout has been studied in various professional fields, although few studies have analyzed the role of this syndrome among sex workers. The study of burnout is of relevance, given the negative consequences that sex workers suffer on many occasions due to stigma, criminalization and other forms of abuse. On the other hand, the legal aspect of the context and country in which sex work is carried out plays an important role, given sometimes the absence of protection and security in which this activity is performed. In the particular case of Colombia, there is still a legal gap in this regard, so there is no regulation for its proper development. Therefore, this activity is not illegal or prohibited, since it is approved by the Penal Code of the Republic of Colombia (2004) but it lacks mechanisms that ensure its safety or control its voluntary nature. For this reason, the researchers Maria del Mar Sánchez-Fuentes, Sandra Milena Parra-Barrera and Nieves Moyano have carried out a study, recently published in Sexuality Research and Social Policy, in which they have analyzed burnout syndrome in 98 sex workers. Among its findings, considerable levels of burnout stand out, despite the fact that 44% of them feel personally fulfilled with their work. Among the working conditions that are related to their higher level of burnout, it is worth mentioning having a low educational level and lower income. The importance of a legal framework that favors safety, protective working conditions and control of whether their work is done voluntarily or under pressure is discussed.

Sánchez-Fuentes, M. M., Parra-Barrera, S., & Moyano, N. (2020). Cisgender and Transgender Sex Workers from Colombia: The Relation Between Burnout Syndrome and Working Conditions in a Prohibitionist-Regulatory Law. Sexuality Research and Social Policy, 18, 507-515. 

Sexual fantasies are thoughts or mental images with sexual content, and they are experienced by most people, regardless of gender and sexual orientation. Both the ability to sexually fantasize and the frequency of the sexual fantasies depend on the attitude towards them. Juan Carlos Sierra, Ana I. Arcos Romero, and Crist bal Calvillo have published in the journal Psicothema a study about one of the few instruments that exist to assess the attitude towards sexual fantasies: the Hurlbert Index of Sexual Fantasy (HISF). The scale evaluates the positive attitude towards sexual fantasies. It is a short instrument, with excellent psychometric properties in the Spanish population, that include items about the frequency with which sexual fantasies are considered healthy and about the degree of enjoyment when listening to the sexual fantasies of the partner, among others. In a sample composed of 3,458 Spanish adults, (1,641 men, 1,817 women), distributed in three age range (18-34, 35-49, and 50 years old or older), the authors have concluded that the HISF is invariant across sex, age range, and education level, that is to say, its scores could be compared between men and women, people with different ages and different level education. Also, it was demonstrated that the positive attitude towards sexual fantasies is related to the positive attitude towards general sexuality, higher sexual assertiveness (higher ability to initiate/refuse sexual activities), and better sexual functioning. In this sense, the Spanish version of the HISF showed the ability to discriminate between individuals with and without sexual functioning difficulties. Apart from presenting a useful instrument for both clinical practice and research, this study has pointed out that having a positive attitude towards sexual fantasies is a clear indicator of good sexual health.

Sierra, J. C., Arcos-Romero, A. I., & Calvillo, C. (2020). Validity evidence and norms of the Spanish version of the Hurlbert Index of Sexual Fantasy. Psicothema, 32, 429-436. 

School bullying is a prevalent phenomenon worldwide. School is a relevant environment for children and adolescents' socialization. However, schools are sometimes a hostile place for students who are likely to suffer from school passivity. In a study published in Aggression and Violent Behavior, Nieves Moyano and María del Mar Sánchez-Fuentes have conducted a systematic review on homophobic bullying at schools. From the 90 documents that have been examined, most of them have used samples of adolescents. The results highlight as predictor factors being LGBTQ, in comparison to be heterosexual or cisgender, being male, school-related predictors or associated factors (e.g., peer group and social support, inclusive education, policies and supportive curricula), individual factors (e.g., self-compassion) and perpetrator-related variables (e.g., homophobic attitudes, sexual prejudice, legitimization of homophobic bullying, moral disengagement), or school-related consequences (e.g., negative academic outcomes, direct or indirect truancy (especially for females), negative effects on school belonging (especially for males) and negative emotions. Finally, there are some strategies to manage bullying. From a teacher´s perspective (e.g., awareness and self-efficacy), from a student´s perspective (e.g., more likely to intervene when they see others intervene). In addition, there are some barriers in tackling homophobic bullying, such as students' perceived discomfort about discussing their sexuality with teachers, teachers' discomfort about discussing issues (including associated lack of training), lack of priority given to these bullying types, and parental views on homosexuality. The findings from this systematic review provide information about useful strategies, as well as perceived barriers and facilitators. This review may better guide prevention in the education field.

Moyano, N., & Sánchez-Fuentes, M. M. (2020). Homophobic bullying at schools: A systematic review of research, prevalence, school-related predictors and consequences. Aggression and Violent Behavior, 53, Article 101441. 

One of the most important theoretical models of sexual satisfaction in the field of romantic relationships is the Interpersonal Exchange Model of Sexual Satisfaction, which explains it from four components: (1) balance between sexual rewards and costs, (2 ) comparative level or balance between real sexual rewards/costs and expected sexual rewards/costs, (3) level of perceived equality of sexual rewards and costs between the members of the couple, and (4) relationship satisfaction. To evaluate these components and thus assess the sexual satisfaction of people with a romantic relationship, the Interpersonal Model of Sexual Satisfaction Exchange Questionnaire (IEMSSQ) was developed. This assessment instrument had been validated years ago in Spain in the heterosexual population, but it lacked adequate validation in the Hispanic LGBT population. The version of the IEMSSQ for people with a same-sex couple has been published in the International Journal of Clinical and Health Psychology by Cristóbal Calvillo, María del Mar Sánchez-Fuentes, Tesifón Parrón-Carreño, and Juan Carlos Sierra. The validation was carried out on a large sample made up of 1,820 Spanish-speaking adults between 18 and 74 years of age (55.49% men and 44.51% women), of whom 50% were gay and 50% were heterosexual. All of them had a romantic relationship of at least three months' duration. This study confirms that the IEMSSQ is a reliable and valid instrument for assessing sexual satisfaction in gays and lesbians, and it is also invariant by sexual orientation, that is, it allows the sexual satisfaction of gay and heterosexual people to be compared without measurement error. The results obtained showed that relationship satisfaction is the most important component of sexual satisfaction in people with a same-sex partner, just as it happens in heterosexual couples. When examining sexual satisfaction and relationship satisfaction in men and women with a partner of the same and different sex, through the IEMSSQ, the results showed that it is lesbians who obtain the highest levels of both sexual satisfaction and relationship satisfaction. In short, based on this study, researchers and sexual health professionals have a brief instrument that allows them to reliably and validly assess sexual satisfaction in the Hispanic LGBT population.

Calvillo, C., Sánchez-Fuentes, M. M., Parrón-Carreño, T., & Sierra, J. C. (2020). Validation of the Interpersonal Exchange Model of Sexual Satisfaction Questionnaire in adults with a same-sex partner. International Journal of Clinical and Health Psychology, 20, 140-150. 

The Sexual Double Standard (SDS) is an attitude that involves different assessments of the same sexual behavior according to it is performed by a man or a woman. Traditionally, SDS supports greater sexual freedom for men than for women, so that certain sexual behaviors are better values by men and worse by women (e.g., more than one sexual relationship at the same time or having a lot of sexual experience). If we consider sexual health as the capacity that men and women have to freely express their sexuality, it is possible to think that the SDS gender inequality implies can have negative effects on it, specifically on sexual functioning (desire, arousal, orgasm, and sexual satisfaction) and risk sexual behaviors. Few studies have addressed these issues, and they have sometimes shown conflicting results. Hence, Ana Àlvarez-Muelas, Carmen Gómez-Berrocal, and Juan Carlos Sierra carried out a systematic review of 22 studies that studied this relationship, which was published in the Revista Iberoamericana de Psicología y Salud. The most relevant conclusions set out in this review of the literature are that SDS adversely affects sexual functioning and favors risk sexual behavior, with its effects being more harmful to women. In terms of sexual functioning, SDS was negatively related to sexual desire, orgasmic experience, and sexual satisfaction, highlighting the fact that both men and women with attitudes that favor SDS are affected in their sexual satisfaction. In terms of risk sexual behaviors, SDS predicted less use of protective methods during sex, the greater likelihood of contracting sexually transmitted infections, and more difficulty making decisions during relationships. It concludes by highlighting the importance of studying SDS for a better understanding of sexual health.

Álvarez-Muelas, A., Gómez-Berrocal, C., & Sierra, J. C. (2020). Relación del doble estándar sexual con el funcionamiento sexual y las conductas sexuales de riesgo: revisión sistemática. Revista Iberoamericana de Psicología y Salud, 11, 103-116.  

Having risky sex can have various negative consequences, such as sexually transmitted infections as well as unwanted pregnancies, among others. This undoubtedly involves several negative effects, both psychologically and physically. The intention to have sex can be influenced by some factors. These include the components of the Dual Control Model, defined by these two systems: propensity for sexual excitation or inhibition. On the other hand, sexual assertiveness, defined as the ability to initiate sexual contacts when we want to, to say no, when we do not want to have relationships, as well as to openly talk with our partner about the use of contraceptive methods, has proven to be a variable of great relevance in predicting sexual behaviors, especially for risky sexual behaviors. The study published by Reina Granados, Nieves Moyano and Juan Carlos Sierra in Plos One, examined the components of the Dual Control Model, that is, propensity for sexual excitation/inhibition, in addition to genital and subjective arousal, and sexual assertiveness and intention to engage in casual sexual encounters in which sexual risk was implicitly or explicitly present. The study took part in the Laboratorio de Sexualidad Humana LabSex UGR from the University of Granada. Participants were 99 heterosexual young adults (55 men and 45 women). Participants performed an experiment in the laboratory, which involved them watching a sexual clip, which was a triggered for sexual excitation, and then being presented with two erotic excerpts (stories) depicting casual sexual encounters in which there was an existence of implicit and explicit sexual risks, related to the lack of contraceptive methods. In men, the propensity for sexual inhibition was the most determining variable in preventing them from sexual risk-taking. In women, intention to engage in risky sexual behaviors was better determined by their propensity for sexual excitation and sexual assertiveness in negotiating the use of contraceptive methods. This research highlights the relevance of these factors to predict behavioral intention to have risky sex and gender differences.

Granados, R., Moyano, N., & Sierra, J. C. (2020). Behavioral intention to have risky sex in young men and women: The role of sexual excitation and assertiveness. Plos One, 15, Article e0232889.  

Sexual satisfaction is the subjective assessment that people make of their sexual relationships. Recent studies have indicated that it depends not only on personal factors (e.g., sexual desire or arousal) but also on interpersonal factors (e.g., relationship satisfaction) and even sociocultural (e.g., religiosity). Many of these studies were conducted in a heterosexual population, with less attention being paid to gay people. For this reason, the aim of the study published by Cristóbal Calvillo, María del Mar Sánchez-Fuentes, and Juan Carlos Sierra in the International Journal of Environmental Research and Public Health was to develop an explanatory model of sexual satisfaction in gay people with a romantic partner, based on personal and interpersonal variables. The participants were 410 men and 410 women who had a romantic relationship with a same-sex partner. As a personal variable, internalized homophobia was considered, and as interpersonal variables, the dimensions of attachment (anxiety and avoidance), sexual functioning, dyadic adjustment, relationship satisfaction, the balance between sexual rewards and costs in the relationship, the comparative level between actual sexual rewards/costs and expected sexual rewards/costs, the number of sexual costs and the number of sexual rewards in the context of the couple were analyzed. Two independent models were obtained to explain sexual satisfaction in gays and lesbians, with differential nuances in the indirect effect of some variables. However, in general, and in both cases, the results indicated that sexual satisfaction is negatively associated with internalized homophobia, the number of sexual costs, anxiety and avoidance; and positively associated with sexual functioning, dyadic adjustment, relationship satisfaction, positive balance between sexual rewards and costs in the relationship, positive balance between actual sexual rewards/costs and expected sexual rewards/costs, and the number of sexual rewards. In both gays and lesbians, the relational variables were the most relevant in explaining their sexual satisfaction. These explanatory models are useful tools to improve sexual satisfaction and romantic relationships in gay people.

Calvillo, C., Sánche-Fuentes, M. M., & Sierra, J. C. (2020). An explanatory model of sexual satisfaction in adults with a same-sex partner: An analysis based on gender differences. International Journal of Environmental Research and Public Health, 17, Article 3393. 

There is a Theory that explains the mechanisms that lead a person to become sexually aroused and to inhibit that arousal: it is the Dual Control Model of sexual response. According to this model, if we were a vehicle, the excitation would be the acceleration pedal and the inhibition would be the brakes. This system proposed by Bancroft and Janssen has been mostly tested with men. Given this, Reina Granados, Joana Carvalho, and Juan Carlos Sierra applied the principles of this model to the experience of sexual arousal of women, particularly when they face a threatening situation such as the threat of sexual performance failure. In this research, published in the Psychological Reports, 22 women who attended the Human Sexuality Laboratory - LabSex UGR were studied. In lab they were exposed to a sexually explicit film, while their genital arousal was being measured (vaginal pulse amplitude). During this presentation, a bogus negative feedback, aimed at increasing women's anxiety about their sexual performance, was provided. Vaginal photopletismography, self-report questions, and the propensity to become sexually aroused and sexually inhibited were used as means to evaluate women's genital, subjective sexual arousal, and personality traits, respectively. Sexual arousability may prevent women of lowering their subjective sexual responses in a sexually demanding situation, while sexual inhibition may have the opposite role. This work provides new data on the Dual Control Model of sexual response, and specifically on its role in women's sexual functioning.

Granados, R., Carvalho, J., & Sierra, J. C. (2020). Preliminary evidence on how the Dual Control Model predicts female sexual response to a bogus negative feedback. Psychological Reports. Advance online publication. 

The Sexual Double Standard (SDS) consists in the judgment of sexual behaviors based on the gender who exhibit it. Traditionally, more sexual permissiveness has been granted for men in comparison to women, in which men are allowed to play a more active role in sexuality and more casual sex. In the last years, this sexist attitude has been transformed into a more modern and subtle form, such as the support of sexual shyness for women but not for men. Therefore, nowadays, SDS comprehends both sexual freedom and sexual shyness. Considering that SDS can be clearly influenced by culture, María del Mar Sánchez-Fuentes, Nieves Moyano, Carmen Gómez-Berrocal and Juan Carlos Sierra, in a study published in the International Journal of Environmental Research and Public Health, compared the SDS in two countries, that although they share the same language, they are different based on their individualism-collectivism conceptualization: Spain (individualist culture) and Colombia (collectivistic culture). For this reason, using the Sexual Double Standard Scale, we evaluated two dimensions from the SDS (sexual freedom and sexual shyness) in a sample of 1,832 heterosexual adults (46.3% men and 53.7% women), of whom 54.3% were Spanish and 45.7% Colombian. The results showed that men and women from both countries supported greater sexual freedom for themselves in comparison to the other gender. Moreover, Spanish women, in contrast to their Colombian counterparts, supported greater sexual shyness for men. These findings seem to indicate what some authors have labelled as "reverse sexual double standard". That is, we find a SDS with favors women, in contrast to the traditional SDS that used to favor men. Future studies should get deep into this issue and to evidence the need of egalitarian attitudes towards the assessment of sexual behaviors from men and women, instead of polarized positions.

Sánchez-Fuentes, M. M., Moyano, N., Gómez-Berrocal, C., & Sierra, J. C. (2020). Invariance of the Sexual Double Standard Scale: A cross-cultural study. International Journal of Environmental Research and Public Health, 17, Article 1569. 

Subjective orgasm experience refers to the psychological perception of orgasm intensity. In a study published by the Journal of Sex & Marital Therapy, Ana Isabel Arcos-Romero and Juan Carlos Sierra analyzed which personal, interpersonal (related to sexual partners), social and cultural factors are associated with the subjective orgasm experience in heterosexual relationships. 1,300 Spanish adults participated in this study by answering different questionnaires about sexual functioning. Although the results show differences between men and women, the most relevant factors related to orgasm intensity evaluation in both sexes were age, sensation seeking, sexual satisfaction inside a relationship and sexual desire towards the partner. As age increases, the intensity of the experience of subjective orgasm decreases. Furthermore, variables such as predisposition towards taking part in new sexual experiences, being satisfied in sexual relationships with a sentimental partner and high sexual desire towards said partner, facilitate more intense subjective orgasm experiences. 

Arcos-Romero, A. I., & Sierra, J. C. (2020). Factors associated with subjective orgasm experience in heterosexual relationships. Journal of Sex & Marital Therapy, 46, 314-329.  

Subjective orgasm experience refers to the evaluation of the sensations caused by an orgasm from a psychological point of view.  Juan Carlos Sierra, Ana Ortiz, Cristóbal Calvillo and Ana Isabel Arcos-Romero published an article in Revista Internacional de Andrología where they analyzed subjective orgasm experience in the context of solo masturbation according to sex and age, and they compared it with said perceived experience in the context of sexual relationships. In order to do so, they evaluated orgasmic intensity experienced by  874 heterosexual adults in the context of sexual relationships and solo masturbation. The results showed that sex and age affect subjective orgasmic experience in the context of masturbation, being women and young people the ones to report higher intensity. On the other hand, differences were found in subjective orgasm experience between solo masturbation context and sexual relationships context, being this last one the most intense.

Sierra, J. C., Ortiz, A., Calvillo, C., & Arcos-Romero, A. I. (2020). Experiencia subjetiva del orgasmo en el contexto de la masturbación en solitario. Revista Internacional de Andrología. Advance online publication. 

Erotophilia, as opposed to erotophobia, is the positive emotional response people have to different sexual stimuli. Thus, it is a general attitude towards sexuality. In a study published in the International Journal of Psychological Research, Ana Isabel Arcos-Romero, Cristóbal Calvillo, Reina Granados, Ana Álvarez-Muelas and Juan Carlos Sierra introduce a short scale that reliably evaluates erotophilia in a Spanish sample: SOS-6. With a large sample of 1500 heterosexual adults between 18 and 80 years old, they concluded that this scale isn't biased by comparing men and women, young and older people, single people and people who are in a relationship and people with different levels of education. This is a very important question, given that in the scientific literature we find that attitudes are usually compared without making sure first that the instrument used is valid. For the first time, Spain has an instrument that allows this comparison without response bias. On the other hand, in a second study conducted in LabSex UGR, the authors previously mentioned found that in men, erotophilia was related to subjective sexual arousal experienced by visual sexual stimuli while in women, it was related to the estimation of sexual arousal and genital sensations perceived during visual sexual stimuli. These results suggest the relevance of erotophilia in good sexual functioning.

Arcos-Romero, A. I., Calvillo, C., Granados, R., Álvarez-Muelas, A., & Sierra, J. C. (2020). The Spanish version of the Sexual Opinion Survey (SOS-6): Evidence of validity of a short version. International Journal of Psychological Research, 13, 40-49.  

Giving an answer to this question was the aim of the study published by Juan Carlos Sierra, Gara Díaz, Ana Álverez-Muelas, Cristóbal Calvillo, Reina Granados and Ana I. Arcos-Romero in Revista de Psicopatología y Psicología Clínica. While sexual desire refers to the interest in sexual relationships and activities, sexual arousal is an emotional and motivational state that causes physiological, cognitive-affective and behavioral changes. Specifically, this study examined the explanatory capacity of dyadic sexual desire towards a partner, towards an attractive person and solo sexual desire in objective and subjective sexual arousal. For this purpose, they evaluated these three types of sexual desire in 60 young heterosexual couples and quantified the sexual arousal these couples experienced when exposed to videos with neutral and sexually explicit content by recording their genital responses (erection diameter in men and vaginal pulse amplitude in women) to them. In men, dyadic sexual desire towards their partner explained 31% of the genital response, while dyadic sexual desire towards an attractive person (not their partner) explained 23% of the subjective sexual arousal experienced in the viewing of sexually explicit videos. In contrast, in women, only dyadic sexual desire towards their partner explained 17% of the objective sexual arousal. The authors of this study conclude the importance of differentiating between the three types of sexual desire when it comes to linking it to sexual arousal and the difference in this relationship between men and women.

Sierra, J. C., Díaz, G., Álvarez-Muelas, A., Calvillo, C., Granados, R., & Arcos-Romero, A. I. (2019). Relación del deseo sexual con la excitación sexual objetiva y subjetiva. Revista de Psicopatología y Psicología Clínica, 24, 173-180.