Ageism and sexuality

Sexuality remains important throughout a person’s life, but sexual behavior does not receive the same levels of acceptance at all ages. Older people are challenged by ageist attitudes and perceptions that hinder their sexual expression. They are stereotyped as non-sexual beings who should not, cannot, and do not want to have sexual relationships. Expressing sexuality or engaging in sexual activity in later life is considered by many in society as immoral or perverted. False expectations for older people also stem from ideals of beauty, centralization of the biomedical perspective on sexuality of older adults, and the association of sex with reproduction. Unfortunately, older people internalize many ageist attitudes towards sexuality in later life and become less interested in sex and less sexually active. The following chapter explores attitudes towards sexuality in later life among the media, young people, older people themselves, and care providers. In order to enable older people to express their sexuality and sexual identity freely and fully, awareness of ageist perceptions must be raised and defeated

Psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT) across cross-cultural subgroups, genders, and sexual orientations: Findings from the International Sex Survey (ISS)

© 2023 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/).INTRODUCTION: Despite being a widely used screening questionnaire, there is no consensus on the most appropriate measurement model for the Alcohol Use Disorders Identification Test (AUDIT). Furthermore, there have been limited studies on its measurement invariance across cross-cultural subgroups, genders, and sexual orientations. AIMS: The present study aimed to examine the fit of different measurement models for the AUDIT and its measurement invariance across a wide range of subgroups by country, language, gender, and sexual orientation. METHODS: Responses concerning past-year alcohol use from the participants of the cross-sectional International Sex Survey were considered (N = 62,943; M age: 32.73; SD = 12.59). Confirmatory factor analysis, as well as measurement invariance tests were performed for 21 countries, 14 languages, three genders, and four sexual-orientation subgroups that met the minimum sample size requirement for inclusion in these analyses. RESULTS: A two-factor model with factors describing 'alcohol use' (items 1-3) and 'alcohol problems' (items 4-10) showed the best model fit across countries, languages, genders, and sexual orientations. For the former two, scalar and latent mean levels of invariance were reached considering different criteria. For gender and sexual orientation, a latent mean level of invariance was reached. CONCLUSIONS: In line with the two-factor model, the calculation of separate alcohol-use and alcohol-problem scores is recommended when using the AUDIT. The high levels of measurement invariance achieved for the AUDIT support its use in cross-cultural research, capable also of meaningful comparisons among genders and sexual orientations.Peer reviewe

Psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT) across cross-cultural subgroups, genders, and sexual orientations: Findings from the International Sex Survey (ISS)

Introduction. Despite being a widely used screening questionnaire, there is no consensus on the most appropriate measurement model for the Alcohol Use Disorders Identification Test (AUDIT). Furthermore, there have been limited studies on its measurement invariance across cross-cultural subgroups, genders, and sexual orientations. Aims. The present study aimed to examine the fit of different measurement models for the AUDIT and its measurement invariance across a wide range of subgroups by country, language, gender, and sexual orientation. Methods. Responses concerning past-year alcohol use from the participants of the cross-sectional International Sex Survey were considered (N = 62,943; Mage: 32.73; SD = 12.59). Confirmatory factor analysis, as well as measurement invariance tests were performed for 21 countries, 14 languages, three genders, and four sexual-orientation subgroups that met the minimum sample size requirement for inclusion in these analyses. Results. A two-factor model with factors describing ‘alcohol use’ (items 1–3) and ‘alcohol problems’ (items 4–10) showed the best model fit across countries, languages, genders, and sexual orientations. For the former two, scalar and latent mean levels of invariance were reached considering different criteria. For gender and sexual orientation, a latent mean level of invariance was reached. Conclusions. In line with the two-factor model, the calculation of separate alcohol-use and alcohol-problem scores is recommended when using the AUDIT. The high levels of measurement invariance achieved for the AUDIT support its use in cross-cultural research, capable also of meaningful comparisons among genders and sexual orientations

The short version of the Sexual Distress Scale (SDS-3): Measurement invariance across countries, gender identities, and sexual orientations

© 2024 The Author(s). Published by Elsevier B.V. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International License (CC BY-NC), https://creativecommons.org/licenses/by-nc/4.0/Background The three-item Sexual Distress Scale (SDS-3) has been frequently used to assess distress related to sexuality in public health surveys and research on sexual wellbeing. However, its psychometric properties and measurement invariance across cultural, gender and sexual subgroups have not yet been examined. This multinational study aimed to validate the SDS-3 and test its psychometric properties, including measurement invariance across language, country, gender identity, and sexual orientation groups. Methods We used global survey data from 82,243 individuals (Mean age=32.39 years; 40.3 % men, 57.0 % women, 2.8 % non-binary, and 0.6 % other genders) participating in the International Sexual Survey (ISS; https://internationalsexsurvey.org/) across 42 countries and 26 languages. Participants completed the SDS-3, as well as questions regarding sociodemographic characteristics, including gender identity and sexual orientation. Results Confirmatory factor analysis (CFA) supported a unidimensional factor structure for the SDS-3, and multi-group CFA (MGCFA) suggested that this factor structure was invariant across countries, languages, gender identities, and sexual orientations. Cronbach's α for the unidimensional score was 0.83 (range between 0.76 and 0.89), and McDonald's ω was 0.84 (range between 0.76 and 0.90). Participants who did not experience sexual problems had significantly lower SDS-3 total scores (M = 2.99; SD=2.54) compared to those who reported sexual problems (M = 5.60; SD=3.00), with a large effect size (Cohen's d = 1.01 [95 % CI=-1.03, -0.98]; p < 0.001). Conclusion The SDS-3 has a unidimensional factor structure and appears to be valid and reliable for measuring sexual distress among individuals from different countries, gender identities, and sexual orientations.Peer reviewe

Compulsive Sexual Behavior Disorder in 42 Countries: Insights from the International Sex Survey and Introduction of Standardized Assessment Tools

Background and aims: Despite its inclusion in the 11th revision of the International Classification of Diseases, there is a virtual paucity of high-quality scientific evidence about compulsive sexual behavior disorder (CSBD), especially in underrepresented and underserved populations. Therefore, we comprehensively examined CSBD across 42 countries, genders, and sexual orientations, and validated the original (CSBD-19) and short (CSBD-7) versions of the Compulsive Sexual Behavior Disorder Scale to provide stan- dardized, state-of-the-art screening tools for research and clinical practice. Method: Using data from the International Sex Survey (N 5 82,243; Mage 5 32.39 years, SD 5 12.52), we evaluated the psychometric properties of the CSBD-19 and CSBD-7 and compared CSBD across 42 countries, three genders, eight sexual orientations, and individuals with low vs. high risk of experiencing CSBD. Results: A total of 4.8% of the participants were at high risk of experiencing CSBD. Country- and gender-based differences were observed, while no sexual-orientation-based differences were pre- sent in CSBD levels. Only 14% of individuals with CSBD have ever sought treatment for this disorder, with an additional 33% not having sought treatment because of various reasons. Both versions of the scale demonstrated excellent validity and reliability. Discus- sion and conclusions: This study contributes to a better under- standing of CSBD in underrepresented and underserved populations and facilitates its identification in diverse populations by providing freely accessible ICD-11-based screening tools in 26 languages. The findings may also serve as a crucial building block to stimulate research into evidence-based, culturally sensitive pre- vention and intervention strategies for CSBD that are currently missing from the literature

When sex meets age: Family physicians’ perspectives about sexual dysfunction among older men and women: A qualitative study from Israel

Background: Gender differences in relation to sexual functioning among older adults have received very little research attention, although the ageing process is likely to be characterized by difficulties in sexual functioning among both women and men. Objectives: The purpose of this qualitative research is to examine and understand the perceptions of family physicians, and the differences in their attitudes regarding male and female patients. Method: Qualitative interviews with family physicians were conducted between August 2017 and December 2017. Sixteen family physicians participated in the study, aged 36–64; most were born in Israel and half of them were women. Twelve physicians were Jewish, two were Christian and two were Muslim. Nine work in rural practices and seven work in urban practices. We used in-depth, semi-structured, face-to-face interviews. The interviews were recorded, transcribed and analysed by three researchers using content analysis. Results: The analysis of the interviews revealed two main themes: (1) Differences as perceived by family physicians: men are perceived as being interested in engaging in full sexual relations, including penetration, while among women, the main need is focused on the relationship and intimacy. (2) Gender differences regarding seeking a solution through the family physician. Family physicians reported that most of the patients who seek solutions regarding sexual dysfunction in old age are men with impotence problems. Family physicians perceived that women seek out solutions less frequently, some because they are afraid their relationship will suffer if they do not continue having sex with their partners. Conclusion: Men and women were seen as having different motivations for engaging in sex and different needs from physicians

Views of family physicians on heterosexual sexual function in older adults

Abstract Background Sexual functioning among older adults has received little attention in research and clinical practice, although it is an integral part of old age. As older adults tend to consume health services and to visit family physicians more frequently, these care-providers serve as gatekeepers in the case of sexual concerns. The present study evaluated the perceptions of family physicians regarding sexuality in older adults. Method Qualitative interviews with 16 family physicians were conducted. We used in-depth, semi-structured interviews. Results Three main themes emerged: 1. Family physicians described having difficulty in raising questions about sexuality to older patients. 2. Family physicians tended towards the biological side of the spectrum, focusing on the patient’s medical problem and asking physiological questions. 3. Family physicians mainly related to medication administered to their male patients, whereas a minority also described the guidance they provided to older individuals and couples. Conclusions The study shows that family physicians tend not to initiate discourse with older patients on sexuality, but rather discuss sexuality mostly in conjunction with other medical conditions. Implications for research and practice are discussed

COVID-19-Related Fear among Youth in Israel

The present study sought to expand the now expansive research on COVID-19 by examining COVID-19-related fear among adolescents in Israel, focusing on demographic variables, COVID-19-related variables (e.g., exposure and vaccination), psychosocial variables (e.g., adolescent wellbeing and perceived social support), and technology usage (e.g., amount of time spent on social media). Data from parents were also collected, reflecting parental attitudes toward the pandemic, anxiety and depression, and wellbeing. A total of 150 youth aged 12–18 and 150 parents participated in the study. Findings indicated that being a female, having a parent who knew someone who had died from COVID-19, and never having tested positive for COVID-19 were positively associated with increased fear of COVID-19. Increased fear of being infected with COVID-19 was also associated with high levels of anxiety and depressive symptomatology in both youth and parents and with low parent subjective wellbeing. Youth who used social media for sharing experiences and for politics also reported such fear. Youth whose parents reported that the media exaggerated COVID-19 risks were less likely to fear something bad would happen to them or to a loved one or fear another outbreak of the virus. Our findings call for paying further scholarly and professional attention to the role intrapsychological, interpersonal, and social aspects play in processes of increased fear and wellbeing in adolescents who constitute a particularly vulnerable group to the mental health consequences of the pandemic