Purpose: The Institute of Medicine has suggested that teaching health care providers to inquire about and document the sexual orientation and gender identity (SOGI) of their patients will provide more accurate epidemiological data and allow for more patient-centered care, thus improving sexual and gender minority health. The purpose of this study was to determine whether medical students are asking about SOGI and to identify reasons why students were opting not to ask. Methods: In July 2020, an online survey was made available to second-, third-, and fourth-year medical students at a Midwestern medical school. Respondents were asked whether they consistently inquired about the SOGI of their patients, and the reasons they do not ask. The number of students asking about SOGI and reasons for not asking were analyzed using chi-square analyses as a function of year in training. Results: Of 1089 eligible participants, 364 completed the survey (33.4%). The number of students asking about sexual orientation significantly decreased with every year of training (92.8%, 82.2%, and 52.7%). The number of students asking about gender identity significantly decreased after the second year of training (69.9%, 40.6%, and 26.4%). Reasons that significantly increased across training included believing SOGI is irrelevant to encounters, limiting inquiries to patients with sexual health complaints only, and negative influence from their attendings. Conclusion: As medical students progressed into the clinical years of their training, they were less likely to ask their patients about SOGI and more likely to cite negative influence from their attendings and question the relevance of obtaining SOGI.

Purpose: Within the LGBTQ+ community, the transgender and nonbinary (TGNB) population experience a disproportionate amount of discrimination when seeking health care. Such disparities may arise from lack of proper medical training and resources for providers or biases. In this study, we examine the health care experiences of TGNB individuals living in Southern Indiana. Methods: We analyzed responses from TGNB respondents to an LGBTQ+ health care needs assessment survey in Southern Indiana. Respondents were asked about demographic data, their self-assessed health status, quality of health care received, whether they have a provider with whom they feel comfortable sharing their gender identity with, and if they have to commute to see their provider. Finally, respondents were asked an open-ended question about their health care experiences while living in Southern Indiana. Responses were coded and several themes emerged and were analyzed. Results: Eighty-five TGNB individuals completed our survey. Less than half of respondents indicated that they had an LGBTQ+-welcoming provider (44.7%). Individuals with an LGBTQ+-welcoming provider were more likely to report their self-assessed health as excellent/good (p=0.02) and quality of health as excellent/very good (p=0.03) compared to individuals without an LGBTQ+-welcoming provider. Five themes emerged from the write-in responses (n=64): discrimination (34.4%), invalidation (32.8%), distrust (28.1%), logistic concerns (35.9%), and positive experiences (35.9%). Conclusion: The TGNB community living in Southern Indiana reports numerous barriers related to provider attitudes when obtaining health care. Additional training is needed to address provider biases and improve LGBTQ+ community health disparities.

While the past two decades have seen an increase in research into both asexuality and polyamory, little is known about their intersection, that is, people who identify as asexual and engage in polyamorous relationships. Using an online survey, we explored the experiences of participants who identify as asexual or on the ace spectrum (e.g., demisexual, gray-asexual) and were in a polyamorous relationship at the time of the survey (N = 321). The majority of our participants identified as White (79.02%), a plurality identified as women (27.1%), and ages ranged from 18 to 53 years old (M = 29.55, SD = 6.77). Two qualitative questions related to motivations for engaging in polyamory were analyzed for this study (N = 224). The first question asked about personal motivations, and the second asked about partner(s)’s influence. Eight codes emerged across the two questions: Needs fulfillment, Exploration/contemplation, Solution to relationship conflict/personal insecurity, a Desire to connect with multiple people, Personal/relationship growth, Rejecting monogamy, Introduced by partner, and Other/no additional context. One additional code was found in Q2: Reluctance/jealousy/distrust. The most common code overall was Exploration/contemplation. Our findings indicate that fulfilling a partner’s sexual needs was not a primary motivating factor for ace individuals engaged in polyamory. Ace individuals were more likely to describe experiences as exploring their identity and fulfilling personal needs for connection and intimacy. These findings indicate that motivations for engaging in polyamory are not solely centered in fulfilling sexual desires, and they may have larger implications for the what the scope of romantic and sexual relationships can look at outside of a monogamous and heteronormative context.

Sex education research has focused largely on youth and adolescents, rather than adults. The current study explores single adults’ attitudes about the potential impact of their sex education, including a lack of sex education, on their current sexual and romantic relationships. Data were collected in 2023 from a demographically representative U.S. sample of single adults (ages 18 to 98 years). Participants (n = 3,895) reported whether they had learned about 16 different topics typically included in comprehensive sex education programs and their perceptions of how additional sex education beyond what they had received would impact their adult lives. When asked about sources of sex education/information, the majority of participants (54.6%) reported learning only about reproduction or pregnancy in school. Further, more than one in three participants reported receiving no education or information—from school or any other source—about healthy relationships (33.6%), gender identity (37.3%), or how to decide if they wanted to have sex (34.1%), among other topics. Participants believed that had they received additional sex education, they would currently have a better understanding of how to have a positive/healthy relationship, how to date more effectively, and how to talk about sex with partners. Participants also reported that additional sex education would have led to more sexual confidence now (40%) and healthier romantic relationships now (44%). Implications for supporting healthy and satisfying sexual and romantic relationships by providing evidence-based informal (i.e. non-school-based) sources of sex education for adults, including online education programs, are discussed.

Objectives: While there has been increasing interest in older adults’ sexuality, the literature to date has largely ignored sex toy use. This study investigated sex toy use in partnered sex and masturbation among older adult women. Methods: A survey was fielded in October 2023 among a national demographically representative sample (N = 3,001). Participants had to be at least 60 years old, identify as a woman, and be living in the United States. Results: Most of the survey participants were 60-69 years old (67.1%). Participants reported much greater use of sex toys during masturbation than during sex with a partner. Of the women who reported masturbating at least once in the last year, 46.4% used toys almost always or always during masturbation, compared with 5.1% who used sex toys almost always or always during partnered sex. Those who reported almost always or always using sex toys during masturbation were significantly more likely to report always or almost always having an orgasm compared with the lower frequency sex toy users. Of those who had partnered sex, 38.7% reported using sex toys during partnered sex at least rarely. Those who reported almost always or always using sex toys during partnered sex were more likely to report always or almost always having an orgasm compared with the lower frequency sex toy users. Conclusions: Given the prevalence of masturbation and sex toy use as well as their relationships to orgasm, older women could benefit from information from health care professionals on these topics.