Introduction: Psychological, interpersonal, and sociocultural factors play a significant role in making one vulnerable to developing a sexual concern, in triggering the onset of a sexual difficulty, and in maintaining sexual dysfunction in the long term.Aim: To focus on psychological and interpersonal aspects of sexual functioning in women and men after a critical review of the literature from 2010 to the present.Methods: This report is part 1 of 2 of our collaborative work during the 2015 International Consultation on Sexual Medicine for Committee 2.Main Outcome Measures: Systematic review of the literature with a focus on publications since 2010.Results: Our work as sexual medicine clinicians is essentially transdisciplinary, which involves not only the collaboration of multidisciplinary professionals but also the integration and application of new knowledge and evaluation and subsequent revision of our practices to ensure the highest level of care provided. There is scant literature on gender non-conforming children and adolescents to clarify specific developmental factors that shape the development of gender identity, orientation, and sexuality. Conversely, studies consistently have demonstrated the interdependence of sexual function between partners, with dysfunction in one partner often contributing to problems in sexual functioning and/or sexual satisfaction for the other. We recommend that clinicians explore attachment styles of patients, childhood experiences (including sexual abuse), onset of sexual activity, personality, cognitive schemas, infertility concerns, and sexual expectations. Assessment of depression, anxiety, stress, substance use and post-traumatic stress (and their medical treatments) should be carried out as part of the initial evaluation. Clinicians should attempt to ascertain whether the anxiety and/or depression is a consequence or a cause of the sexual complaint, and treatment should be administered accordingly. Cognitive distraction is a significant contributor to sexual response problems in men and women and is observed more consistently for genital arousal than for subjective arousal. Assessment of physical and mental illnesses that commonly occur in later life should be included as part of the initial evaluation in middle-aged and older persons presenting with sexual complaints. Menopausal status has an independent effect on reported changes in sex life and difficulties with intercourse. There is strong support for the use of psychological treatment for sexual desire and orgasm difficulties in women (but not in men). Combination therapies should be provided to men, whenever possible.Conclusion: Overall, research strongly supports the routine clinical investigation of psychological factors, partner-related factors, context, and life stressors. A biopsychosocial model to understand how these factors predispose to sexual dysfunction is recommended.

We investigated the differences in sexual beliefs presented by men and women with sexual dysfunction and their sexually functional counterparts. A total of 488 participants (160 females and 232 males without sexual problems; 47 females and 49 males with a DSM‐IV diagnosis of sexual dysfunction) answered the Sexual Dysfunctional Beliefs Questionnaire. Findings showed that, although effects have only reached statistical significance for the female group, both dysfunctional men and women endorsed more sexually dysfunctional beliefs than functional beliefs. Women presented significantly more age‐related beliefs (e.g., after menopause women lose their sexual desire; as women age, the pleasure they get from sex decreases) and body image beliefs (women who are not physically attractive can't be sexually satisfied). Additionally, sexually dysfunctional males presented higher scores (not statistically significant) on “macho” belief (a real man has sexual intercourse very often) and beliefs about women's satisfaction (the quality of the erection is what most satisfies women). Overall, findings supported the idea that sexual beliefs play a role as vulnerability factors for sexual dysfunction.

Aims: This study aimed to highlight the salient sociocultural factors contributing to sexual health and dysfunction and to offer recommendations for culturally sensitive clinical management and research as well for an ethically sound sexual health care, counseling and medical decision-making. Background: There are limited data on the impact of sociocultural factors on male and female sexual function as well as on ethical principles to follow when clinical care falls outside of traditional realms of medically indicated interventions. Methods: This study reviewed the current literature on sociocultural and ethical considerations with regard to male and female sexual dysfunction as well as cultural and cosmetic female and male genital modification procedures. Results: It is recommended that clinicians evaluate their patients and their partners in the context of culture and assess distressing sexual symptoms regardless of whether they are a recognized dysfunction. Both clinicians and researchers should develop culturally sensitive assessment skills and instruments. There are a number of practices with complex ethical issues (eg, female genital cutting, female and male cosmetic genital surgery). Future International Committee of Sexual Medicine meetings should seek to develop guidelines and associated recommendations for a separate, broader chapter on ethics.

The aim of the present article is to present a new instrument, specially developed to assess beliefs about sexuality that are supposed to be closely related with the development of sexual disorders. Using a cognitive theory perspective we hypothesized that sexual behaviour and its problems are in someway related to the way we think about sexuality, our beliefs and our expectations. Although some questionnaires of sexual attitude, information and beliefs already exist, there is, until now, no specific measure oriented to assess both male and female sexual dysfunctional beliefs related to aetiology. The Sexual Dysfunctional Beliefs Questionnaire is a 40-item self-reported measure constituted by two versions (female and male) rated on a five point likert scale. Both male and female versions present satisfactory test-retest reliability (r=0.73 and r=0.80 respectively), and internal consistency (Cronbach's alpha=0.93 for male and 0.81 for the female version). Studies of convergent validity show a relationship with other measures of sexual and more general beliefs, as well as with measures of sexual functioning. Discriminant validity studies support its capacity to discriminate functional from sexual dysfunctional subjects. It is expected that these measures could be useful in both clinical practice and educational programmes serving as an indicator of vulnerability to sexual dysfunction.