Closeness Discrepancies and Relationship Quality in German Partnered Women and Men.

The construct of inclusion of other in the self has been established as one of the most influential measures for relationship closeness in romantic relationships. It is regularly associated with relational well-being, sexual satisfaction, as well as mental health. However, the degree of closeness one desires in the present relationship is person-specific and can differ from the closeness one actually experiences. Exploring these discrepancies, the present study focused on the association between not enough closeness and too much closeness and relationship characteristics, parenting, and extradyadic sexual activity. Data from a population-based sample of 3,161 men and women from the German Health and Sexuality Survey were analyzed using structural equation modeling. Our results confirm closeness discrepancies as prevalent relationship phenomena, while identifying feelings of not enough closeness as much more problematic for the relationship.

Research in brief: How prevalent is rough sex? Results from a national online sample of adults in Germany.

BACKGROUND: Rough sex refers to consensual sexual activities that incorporate playful aggression, such as hair pulling, spanking, or choking. It is relevant in the context of sexual health as it can enhance sexual arousal, pleasure, and intimacy among consenting partners. However, it can also be associated with consent violations, discomfort, and injuries ranging from mild to severe or even fatal. The prevalence of rough sex in Germany is widely unknown. Our study aims to establish, for the first time, the overall age-related and gender-related prevalence rates of active and passive rough sex involvement among adults in Germany. METHODS: A national online sample of 1101 adults from Germany, aged 18-69 years (50% men, 49% women, 1% gender-diverse individuals) gave informed consent and reported on their lifetime engagement in rough sex in active and passive roles. We recruited participants through a professional panel provider for a multi-themed sexual health survey. Data analysis was conducted using R, with 95% confidence intervals of prevalence rates computed to answer the research questions. RESULTS: Lifetime prevalence of rough sex involvement was 29%. Adults below the age of 40 reported higher rates of involvement (up to 43%) than people over 40 (up to 26%). Men reported predominantly active role involvement and women reported primarily passive role involvement. DISCUSSION: Results show that rough sex is common. Sexual health professionals, educators, and researchers should be prepared to guide current and aspiring practitioners of rough sex, helping them understand potential benefits, risks, and age- and gender-related differences.

A Pilot Study of Metacognitive Training in U.S. Republican Leaners: Reducing Polarization Toward LGBTIQ+ Persons.

Negative attitudes and stigmatization toward sexual minorities is a cause of minority stress of non-heterosexual persons on an individual level and has a negative impact on democratic coexistence in postmodern, plural society on a societal level. Derived from clinical research, we developed a short metacognitive training (MCT) intended to induce doubt toward inaccurate beliefs about LGBTIQ+ persons. We expected this MCT to reduce homonegativity, threat perceptions of LGBTIQ+ persons, and to foster extended outgroup tolerance compared to an education and a no-treatment control condition. We tested this hypothesis in U.S. Republican leaners who represent a social group that is likely to hold homonegative attitudes. We randomly assigned 490 U.S. Republican leaners to an MCT condition comprising 16 questions and respective answers (n = 166) vs. an education control condition (n = 164) vs. a no-treatment control condition (n = 160). We found that Republican leaners after receiving MCT (1) had a significant reduction of homonegativity (ds ≥ 0.28), (2) significantly perceived LGBTIQ+ persons as less threatening (ds ≥ 0.30), and (3) were significantly more tolerant of various outgroups such as LGBTIQ+ persons, feminists, liberals, and climate activists (ds ≥ 0.23) relative to both control conditions. The small effects of this short intervention and the possibility of systematically applying MCT in social discourse to reduce homonegativity with its potential significance for LGBTIQ+ individuals' mental health are discussed. Furthermore, we highlight this pilot study's significance toward intervention possibilities regarding political division and polarization in postmodern, democratic societies.

Living without Partnered Sex in Germany. Results From the First Representative, Population-based German Health and Sexuality Survey (GeSiD).

Broader insights into the life situations of sexually inactive adults in Germany are widely unexplored. Within the nationally-representative survey GeSiD (German Health and Sexuality Survey), undertaken 2018-2019, data of 4,758 participants with lifetime interpersonal sexual experience aged 18-75 years (men: n = 2234; women: n = 2524) were analyzed in regards to partnered sexual inactivity in the past 12 months (PSI; no genital-involving sexual contact with another person). Overall, advanced age, being single and impaired health conditions were associated with PSI. Data showed gender-specific associations with PSI, such as less alcohol, smoking and drug use in women. PSI was associated with lower general life satisfaction throughout different age groups.

Factors associated with non-use of condoms among heterosexually-active single people in Germany: Results from the first representative, population-based German health and sexuality survey (GeSiD).

Background: Against the backdrop of rising STI incidence among the heterosexual population, sexually active single people are at particularly high STI transmission risk. Gaining insight into circumstances related to condoms non-use in this population is therefore important for developing effective health interventions. Methods: The nationally-representative survey, GeSiD (German Health and Sexuality Survey) undertaken 2018-2019, interviewed 4,955 people aged 18-75 years. A total of 343 heterosexually-active single participants answered a question about condom use at last sex. Data on sociodemographic characteristics, sexual behaviours and circumstances of last sex were analysed to identify independently associated factors. Results: Condom non-use at last sex was reported more commonly by participants aged >35 years than by younger participants (48.5 vs 33.7%, respectively) and more likely among longer relationships (adjusted odds ratio [AOR]: 2.43) or early loving relationships (AOR: 3.59) than in one-night-stands. It was also associated with not discussing using condoms before sex (AOR: 6.50) and with reporting non-use of condoms at sexual debut (AOR: 4.75). Conclusions: Non-use of condoms is a common STI risk behaviour among heterosexually-active single people in Germany and so needs promoting from sexual debut throughout the life course, regardless of relationship type and age, but particularly among middle-aged and older people.

Religiosity, Perceived Effects of Pornography Use on Personal Sex Life, and Moral Incongruence: Insights from the German Health and Sexuality Survey (GeSiD).

Although online pornography use appears to be a mainstream activity, there is little information, particularly outside of the USA, about how consumers perceive its impact on their sexuality. Considering increasing concerns about pornography use, this lack of evidence has sociocultural and clinical ramifications - especially because the recently proposed Moral Incongruence model (MI) suggests that some individuals may see their pornography use as problematic independently of the frequency of use. Using data from 4,177 adults from the 2018-2019 national probability-based German Health and Sexuality Survey, we explored self-perceived impact of pornography use on personal sex life and the role of MI. Most participants (61.7%) reported no impact of pornography. Women were characterized by significantly higher odds of reporting positive relative to no impact, while men had higher odds of reporting mixed/negative compared to no impact. Participants in both the positive and the mixed impact group reported a significantly higher frequency of pornography use than participants in the no impact group. In line with the MI model, we observed a significant relationship between participants' religious upbringing and self-perceived negative (relative to mixed) impact of pornography use. Social relevance and clinical implications of the findings are discussed.

How Inclusion of Other in the Self Relates to Couple's Sexuality and Functioning - Results from the German Health and Sexuality Survey (GeSiD).

Closeness, in the sense of inclusion of other in the self, has been found to be an important factor for relationship well-being, satisfaction and pair-bonding. In the past ten years, the self-expansion theory has also been incorporated into sex research, although studies are still very scarce and not without limitations. The present research aimed at further elucidating the relevance of relational factors for couple's sexuality, and to clarify the role inclusion of other in the self plays for sexual satisfaction and sexual distress. A broadly representative sample of 3,046 men and women aged 18 to 75 was taken from the German Health and Sexuality Survey (GeSiD). Throughout analyses, inclusion of other in the self and love were positively related to sexual satisfaction. Furthermore, inclusion of other in the self was negatively related to how strongly someone was distressed by experiencing sexual problems. Closeness seems to have a compensatory role especially for women with sexual problems, protecting them from experiencing sexual distress. In future research, couple's sexual satisfaction should not be compartmentalized from relational aspects. Results clearly promote the Inclusion of Other in the Self Scale as an interesting tool for both research and treatment.

[The German health and sexuality survey (GeSiD)-a brief introduction to the study]. / Die GeSiD-Studie "Gesundheit und Sexualität in Deutschland" ­ eine kurze Einführung.

Until 2020, there was no representative sex survey for Germany with published data. The GeSiD study "Health and Sexuality in Germany" is the first nationwide, representative sex survey. The aim of this paper is to provide a brief introduction to the German health and sexuality (GeSiD) survey.A total of 4955 persons (2336 men, 2619 women) aged 18-75 years were interviewed between 2018 and 2019. The computer-assisted face-to-face interviews had an extensive self-completion section and asked about a wide range of sexual behaviour and sexual health topics. Data on sexual identity, relationships, sexual behaviour, and sexual health were assessed. Data show, among other things, that only a minority of respondents had ever talked to a healthcare provider about HIV/AIDS or other sexually transmitted infections (STIs).Data show a clear need for education, information dissemination, and training in the area of sexual health.

Single and Multiple Orgasm Experience Among Women in Heterosexual Partnerships. Results of the German Health and Sexuality Survey (GeSiD).

BACKGROUND: Orgasm occurrence plays an important role in general sexual satisfaction for women. Until now, only few studies have focused on examining a broad spectrum of sexuality- and relationship-specific factors associated with orgasm in heterosexual women currently in a long-term relationship or on differences between the overall experience of orgasm and multiple orgasms. AIM: The present study aims to understand how various sexuality- and relationship-associated factors are related to experiencing partnered orgasm among heterosexual women having stable relationships in Germany. Moreover, the study aims to differentiate between the overall experience of orgasm and the experience of multiple orgasms and shed light on their impact on general sexual satisfaction. METHODS: Within the nationwide representative survey GeSiD (German Health and Sexuality Survey), n = 1,641 sexually active women aged between 18 and 75 years in heterosexual relationships reported their experience of orgasm during the latest sexual encounter. Data on the type of sexual practices, frequency of sexual activity and of masturbation, relationship satisfaction, feelings of love, closeness, and general sexual satisfaction were analyzed. OUTCOMES: The overall experience of orgasm, the experience of multiple orgasms, and associations between experiencing orgasm and sexual satisfaction. RESULTS: Frequency of sexual activity, relationship satisfaction, feelings of love and closeness were moderately to strongly positively correlated with each other and each showed positive associations with the likelihood of orgasm. Greater number of sexual practices and frequency of sexual activity were associated with an increased likelihood of experiencing multiple orgasms, which in turn was correlated with higher sexual satisfaction. CLINICAL IMPLICATIONS: In clinical and therapeutic work with women who have difficulty achieving orgasm, central issues should be the perceived relationship quality as well as regular sexual activity with the partner. STRENGTHS & LIMITATIONS: The present population-representative study is the first in Germany to identify significant factors associated with the experience of orgasm among heterosexual women in relationships. Further studies ought to include the frequency of orgasms in partnered sex over a longer period of time as well as the experience of orgasm during masturbation. CONCLUSION: The experience of orgasm for women is related to a variety of complex interpersonal mechanisms and to be associated with sexual satisfaction. Cerwenka S, Dekker A, Pietras L, et al. Single and Multiple Orgasm Experience Among Women in Heterosexual Partnerships. Results of the German Health and Sexuality Survey (GeSiD). J Sex Med 2021;18:2028-2038.

Sexual aggression against males: Differences between acts by males and females - Results from the German Health and Sexuality Survey (GeSiD).

BACKGROUND: Current research examining sexual aggression against males is rare and representative studies often do not sufficiently differentiate between male and female affected persons, male and female offending person, as well as between different types of sexual aggression. OBJECTIVE: We investigated the prevalence of sexual aggression against males perpetrated by males and females distinguished by the type of sexual aggression and examined differences between sexual aggression against males committed by males and females in characteristics of the sexual aggression. PARTICIPANTS AND SETTING: We examined representative self-report data collected in the German Health and Sexuality Survey (GeSiD; n = 4,955). A total of 305 male participants (12.3 % of all male participants) experienced at least one incident of sexual aggression. METHOD: We investigated differences between characteristics of male- and female-perpetrated sexual aggression against males in cases of (1) sexual aggression against minors by adults, (2) sexual aggression among minors/peers, and (3) sexual aggression among adults. Characteristics of sexual aggression included were frequency, relation of accused person, disclosure, participant's age at first incident, and accused person's age at first incident. RESULTS: Our results revealed that the proportion of sexual aggression by females against males is rather low in cases of sexual aggression against minors by adults (9 %) compared with sexual aggression among minors/peers (56 %) and among adults (52 %). Although the majority of characteristics of sexual aggression were similar, some differences between male- and female-perpetrated sexual aggression were found. CONCLUSIONS: Sexual aggression against males appears to be an under-researched phenomenon, especially when it is perpetrated by a female person. More research on sexual aggression against males as well as on the differences between male- and female-perpetrated sexual aggression is therefore considered necessary.

Methodology of the German National Sex Survey - GeSiD (German Health and Sexuality Survey).

The German Health and Sexuality Survey (GeSiD) was carried out in 2018/2019 to provide up-to-date measures of sexual behavior, sexual attitudes and sexual lifestyles of the adult population. We describe the methods used in GeSiD which surveyed the general population in Germany aged 18-75 years (with oversampling of younger adults aged 18-35 years). This article focuses on study design, recruitment, and response rate and discusses the strategies implemented to enhance the response rate compared to the pilot study. Overall, 4.955 interviews were completed with a response rate of 30.2%. The data were weighted by age, gender, education, nationality, and region to reduce possible bias. Compared to the German 2018 census, the weighted sample provides good representativeness for selected respondent characteristics. The computer-assisted interviews consisted of a combination of face-to-face and self-completion components. They covered a broad perspective on sexual health, which included topics such as online sexual activities, pleasure, sexual dysfunction, and sexual violence. Reliable data on sexual and reproductive health in Germany are urgently needed for evidence-based prevention and health promotion work, to inform sexual health policy and for cross-national comparisons of the development of sexual behavior in Europe.

Inclusion of Other in the Self and Couple's Sexuality: A Scoping Review.

To better understand the effect relationship closeness has on couple's sexuality a scoping review was conducted, that focused on the inclusion of other in the self scale (IOS). Authors reviewed quantitative journal articles published between 2000 and 2020 by searching PsychInfo, Medline, and PubMed, resulting in 24 studies. Results suggest positive associations between IOS and sexual well-being, functioning, desire, frequency and satisfaction, and negatively related to sexual distress. Also, the benefits of positive sexual experiences expand well beyond the sexual domain onto different personal and relational factors of health and well-being. Sampling designs considerably limit the generalizability of results.

Estimating the Prevalence of Sexual Dysfunction Using the New ICD-11 Guidelines.

BACKGROUND: The 11th edition of the International Statistical Classification of Diseases (ICD-11) is due to come into force in 2022. The goal of the present partial evaluation of the GeSiD study findings is to provide the first ever estimate of the prevalence of different types of sexual dysfunction in Germany as defined by the diagnostic guidelines that are soon to take effect. METHODS: The representative GeSiD study was carried out in 4955 men and women who belonged to a doubly stratified random sample of data from residence registration offices across Germany. The participation rate was 30.2%. Various types of sexual dysfunction were ascertained for the first time by means of a screening instrument based on the new ICD-11 guidelines. RESULTS: The reported prevalence of one or more sexual problems, including mild distress, in the previous 12 months was 33.4% in men (95% confidence interval [31.0; 35.9]) and 45.7% in women [43.0; 48.4]. Some 80.4% of men and 72.1% of women stated that they had had at least one sexual contact in the past year. Sexual dysfunction causing marked distress, as per the ICD-11 guidelines, was reported by 13.3% [11.6; 15.1] of the sexually active men (most commonly, erectile dysfunction in 6.6% and early ejaculation in 4.5%), and by 17.5% [15.6; 19.6] of the sexually active women (most commonly, hypoactive sexual desire in 6.9% and orgasmic dysfunction in 5.8%). Orgasmic dysfunction was approximately twice as common in women as delayed ejaculation was in men. The prevalence of erectile dysfunction increased with age, while that of early ejaculation decreased. Women felt particularly impaired by pain associated with sexual activity. CONCLUSION: The findings of this study indicate the importance of sexual dysfunction as an obstacle to sexual health. The study provides the first prevalence estimates for the new ICD-11 guidelines and simultaneously offers a screening instrument for sexual dysfunction that can be used economically in routine practice.