Background Individuals with narcissistic traits, specifically vulnerable ones, are more prone to experiencing concerns related to self-worth and physical appearance and to showing heightened sensitivity to appearance evaluation. Negative body image and body image self-consciousness may, in turn, undermine sexual functioning, especially when apprehension is related to body appearance in sexual contexts. Methods We aimed to evaluate the associations between self-reported pathological narcissistic traits, both grandiose and vulnerable, and sexual functioning in a large sample of nonclinical women (N = 656). Furthermore, we tested the mediating role of body image self-consciousness in these associations. Outcomes Sexual functioning was measured through the Female Sexual Function Index. Results The results highlight that vulnerable narcissistic traits are associated with lower sexual functioning, this association being mediated by higher levels of body image self-consciousness. Conversely, grandiose narcissistic traits are linked to lower body image self-consciousness and, consequently, higher levels of sexual functioning. Clinical Implications Considering the link between body image self-consciousness and sexuality is of utmost importance in clinical practice with women, as well as in promoting positive body appreciation. Clinicians working with individuals presenting with pathological personality traits should consider including an assessment of their sexual functioning. S Pavanello Decaro, M Di Sarno, A Anzani, et al. Narcissistic Personality Traits and Sexual Dysfunction in Women: The Role of Body Image Self-Consciousness. J Sex Med 2021;18:1891–1898.

Transgender or non-binary (TGNB) people are often present as protagonists of pornographic material. This study is the first to consider TGNB people as critical consumers of sexually explicit material. The sample included 212 self-identified TGNB individuals: 47.2% trans man/transmasculine, 15.6% trans woman/transfeminine and 37.3% non-binary. The online questionnaire consisted of a sociodemographic data collection, multiple-choice questions about preferences and habits concerning pornography, and open-ended questions about the sensations experienced when watching pornography, opinions on the representation of TGNB people in pornography, and their experience in watching pornographic videos with cisgender or TGNB protagonists. The answers were analyzed using the qualitative method of thematic analysis. We identified four themes that appeared across the responses: 1) heteronormativity and cisnormativity in pornography: the need for deconstructing the current cis-het-patriarchial normative and binary system, which dominates pornography except for the ethical porn industry, 2) cisgender pornography compared to TGNB pornography, 3) pleasurable sensations (e.g., identification and empowerment) associated with TGNB pornography, and 4) negative sensations (e.g., objectification and dysphoria) associated with TGNB pornography. Results are discussed in light of the objectification framework and the minority stress model.

Background: Sexuality research on the sexual practices of women who have sex with women (WSW) has thus far mostly centered on risk factors and addressed a limited number of practices, with a focus on oral sex and insertive vaginal sex. Aim: This study arises from the need to fill such a significant gap, which prevents researchers, clinicians, and policy makers from being adequately up-to-date on the sexual habits and tendencies of this population. Methods: A multiple-choice questionnaire was completed by 723 WSW with a mean (SD) age of 29.14 (6.94) years. Outcomes: The survey included closed questions on sexual practices, including genital and oral sex, but also nongenital sexual contact (petting and intercrural sex), anal sex, and kinky practices. Results: The most common sexual practices were self-masturbation (99.03%), oral sex (performed or received, 98.20%), and insertive genital sex (performed or received, 89.07%). Half of our sample had tried kinky practices at least once in a lifetime (51.31%). Respondents tended to experiment sexually more with stable partners rather than with casual ones. Comparisons among practices in the lesbian and bisexual population are presented. Clinical Implications: Providers should be aware that sexual orientations have their own specificities, including sexuality and practices, which should increase their knowledge and comfort in working with sexual minorities. Strengths and Limitations: The novel topic of the study addresses the gap in sexuality research among WSW. Strengths include the sex-positive approach, the inclusion of an array of sexual practices, and the consideration of the specificities of the group. Limitations in the generalization of the results are the cross-sectional design and the explicit topic, which may have kept some persons from responding. Conclusion: We propose the framing of sex as going beyond genital contact, and we invite clinicians and researchers who come into contact with WSW to be aware that sexual orientation can be associated with specificities regarding sexuality and sexual practices.

Chemsex, the use of psychoactive substances during sexual activity, is prevalent among men who have sex with men (MSM) and is associated with various health risks. Despite increasing global attention, research on chemsex in Italy remains scarce. This cross-sectional study explored the prevalence and characteristics of chemsex among Italian MSM, its associations with psycho-sexual health, and it sought to identify psychological, social, and health-related factors linked to the perception of chemsex as problematic. A total of 841 participants (mean age = 35.1, SD = 9.6) completed an anonymous online questionnaire assessing chemsex practices, mental health, sexual health, and minority stress. Chemsex prevalence was found to be 18.2%, with an additional 10% expressing interest in the practice. The most used substances were inhalants (83.7%) and cocaine (45.8%). Chemsex participants had higher rates of sexually transmitted infections (STIs) (χ²(1) = 27.78, p < 0.001) but also reported greater use of preventive measures, such as PrEP (χ²(1) = 95.2, p < 0.001). No significant differences in anxiety, substance use severity, or intraminority stress were found between chemsex and non-chemsex users. Chemsex participants displayed higher levels of sexual dysfunction (t(696) = 3.37, p < 0.001), particularly in receptive and insertive anal sex and erectile function, but no differences in sexual satisfaction were observed. These findings challenge the applicability of the “identity process theory” (IPT) to the Italian MSM context, suggesting that chemsex motivations may extend beyond marginalization within the community. Participants perceiving their chemsex practice as problematic reported more negative consequences from this sexual practice (χ²(1) = 14.41, p < 0.001) and lower satisfaction with sexual life (t(69) = 2.03, p = 0.046). This subgroup also sought professional help for substance use more frequently, highlighting the need for integrated mental health and substance use interventions (χ²(2) = 6.4, p = 0.041). These findings emphasize the importance of public policies and harm reduction programs to promote the well-being of MSM engaged in chemsex, with a focus on community-based interventions and peer support.

This study investigates the relationship between sexual quality of life (SQoL) and internalized homonegativity among Italian lesbian and bisexual cisgender women, drawing on the minority stress model. The aim of this study is to compare levels of internalized homonegativity and SQoL between the two groups, exploring the association between these variables. We used a quantitative methodology based on a questionnaire. The data were collected through an online questionnaire from 686 women, including 217 lesbians and 469 bisexuals, using the Lesbian Internalized Homophobia Scale and the Female-Sexual Quality of Life Questionnaire. Statistical analyses, including t-tests and linear regression, were performed to assess group differences and predictors of SQoL. The findings support the hypothesis that bisexual women may experience higher levels of internalized homonegativity. Additionally, the study reveals disparities in SQoL, with lesbian women reporting better outcomes. The linear regression model confirmed a significant negative association between internalized homonegativity and SQoL. The results highlight the need for further research on factors influencing sexual well-being in sexual minority women, and the need to give thorough attention to specific sexual identities in clinical and research practice.