Introduction
The Biopsychosocial model (BPS) represents a comprehensive paradigm of consolidated practices. Although it has been outlined as the gold standard in sexology, its implementation is often challenging. The sex-positive approach is a ground-breaking movement that is gaining popularity all over and is focused on the recognition of different sexual expressions as valid, consensual, healthy, and meaningful. However, a pragmatic implementation of this approach is still missing.
Methods
A critical review was conducted based on bibliographic research on Medline, PubMed, EBSCO, Cochrane Library, Scopus and Web of Science on relevant articles published from January 2011 to July 2021.
Results
A total of 116 papers were included in the following review, indicating an increasing body of research about BPS and sex-positive frameworks during the last 10 years. One of the main limitations in the BPS is the scarce attention paid to socio-cultural factors involved in sexual expressions, such as the role of negative attitudes towards sexuality that may affect health care professionals’ work. An application of the sex-positive approach to the BPS model may bring greater attention to the needs, values and desires of the individual, as well as allow a new knowledge and understanding of sexuality within a broader spectrum, including diversities and pleasures.
Conclusions
The sex-positive approach represents a viable path that entails the willingness of health care professionals to get involved actively; criticize their personal attitudes, beliefs, and knowledge about sex and work hard to improve their practice in sexology.
Policy Implications
A discussion of the possible fruitful integration between the BPS and the sex-positive approach is presented, highlighting practical applications in research, clinical practice, training and sex education and giving possible directions for future studies and policies.
Women with endometriosis often suffer from genito-pelvic pain. The objective of the present study was to analyze the relationship between cognitive and psycho-emotional factors and sexual functioning of women with endometriosis, comparing women with and without endometriosis. A total of 87 women with endometriosis (EG) and 100 women without endometriosis (CG) completed a socio-demographic questionnaire; the short-form of McGill Pain Questionnaire (SF-MPQ); the Female Sexual Functioning Index (FSFI); the Sexual Distress Scale (SDS); the Symptoms Checklist (SCL-90-R); the Toronto Alexithymia Scale (TAS-20); the Positive and Negative Affects Scale (PANAS); the Sexual Dysfunctional Belief Questionnaire (SDBQ); the Sexual Modes Questionnaire (SMQ); and the Questionnaire of Cognitive Schema Activation in Sexual Context (QCSASC). EG obtained worse scores than CG in SF-MPQ, Pain subscale of FSFI, and SDS. EG reached higher scores than CG on almost all scales of SCL-90-R and lower scores in the “Identifying Feelings” scale of TAS-20. Furthermore, EG reported more negative emotions toward sexuality than CG (PANAS) higher scores on the “Affection Primacy” scale of SDBQ and the “Helpless” sexual cognitive schema of QCSASC than CG. No significant differences were found in SMQ. Sexual health professionals should address psychological, emotional, and cognitive factors since they seem involved in patients’ sexual experiences.
Background: Erotic fantasies are the most common sexual experiences and provide valuable clinical material for understanding individual and relational emotional dynamics. The primary objective of this study is to validate the Sexual Desire and Erotic Fantasies questionnaire (SDEF) Part 3–Inventory of Erotic Fantasies. This questionnaire was designed to be a sex-positive and inclusive measure of the content of erotic fantasies, accessible to individuals of all gender identities, sexual orientations, relationship/romantic status, and sexual behaviors. Methods: The SDEF3 was completed by 1773 Italian participants (1105 women, 645 men, and 23 participants identifying as other genders). Two factorial structures were presented and discussed: a 20-dimension structure for clinical and explorative use and a 6-dimension structure for research purposes. Results: The six-factor version was preferred due to its robust statistical properties and its ability to differentiate between sexually clinical and functional men and women, based on cut-off scores from the Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF). Differences in the frequency of themes in fantasies between gender and sexual orientation were reported and discussed. Conclusions: The current study indicates that the SDEF3 is a valuable and comprehensive measure for assessing various scenarios related to fantasizing activity. It has potential applications in both clinical practice and scientific research.
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