Journal of Health Psychology

This study examined the ways in which the meaning of ‘sexual problems’ is constructed and defined in undergraduate human sexuality textbooks. Drawing on feminist and critical discourse frameworks, the dominant as well as the absent/marginalized discourses were identified using critical discourse analysis. Sexual difficulties were largely framed by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. Thus, medical discourse was privileged. Alternative conceptualizations and frameworks, such as the New View of Women’s Sexual Problems, were included marginally and peripherally. We argue that current constructions of sexuality knowledge reinforce, rather than challenge, existing hegemonic discourses of sexuality.

Critical approaches may benefit epidemiological studies of sexual health. This article proposes a critical approach, reconcilable with social epidemiological enquiry. Key aims of critical epidemiology for sexual health are identified, from which three criticisms of practice emerge: (1) lack of attention to socio-cultural contexts, (2) construction of ‘risk’ as residing in the individual and (3) enactment of public health agendas which privilege and pathologise certain behaviours. These reflect and construct an apolitical understanding of population health. This article proposes features of a critical epidemiology that represent a morally driven re-envisioning of the focus, analysis and interpretation of epidemiological studies of sexual health.

Indigenous (Māori) psychologies of sexual health occur at the cultural nexus of Indigenous and Western knowledge, colonising influence and intervention. Formal school-based sexuality education holds potential to intervene in this psychological space by decolonising notions of Māori sexuality, relationships and reproduction. This research utilises an Indigenous feminist (Mana Wāhine) methodology and interviews with 43 Māori participants (26 women and 17 men). We explore how Māori knowledges (mātauranga Māori), responsive to the surrounding colonising context, were interwoven through four themes: relationships, reproductive responsibility, open conversations about sexuality and contraceptive education. Indigenous knowledges can contribute to good sexual health psychologies for all.

A lack of research exists around the most common forms of sexual risk behaviors among adolescents, including their underlying factors, in Sub-Saharan Africa. Using an Ecological Model of Adolescent Behavior, we explore the perceptions of 85 young people and 10 stakeholders on sexual risk behavior of adolescents in Kilifi County on the coast of Kenya. Our findings show that transactional sex, early sexual debut, coerced sex, and multiple sexual partnerships are prevalent. An urgent need exists to develop measures to counter sexual risk behaviors. The results contribute to understanding the range of risks and protective factors in differing contexts, tackling underlying issues at individual, family, local institutional, wider socio-economic, and political levels.

Significant challenges remain in tackling the global HIV/AIDS epidemic. Effective action requires both appropriate policy at a global level and informed practice on the local level. Here, we report how workers in a project in Johannesburg, South Africa, make sense of HIV transmission. Discourse analysis of data from interviews with 63 participants shows that project workers routinely attribute transmission to men’s sexual relationships with multiple female partners. This explanation is so pervasive that it renders invisible other routes to transmission. Absence of consideration of other routes to infection potentially restricts front-line practice, so hindering local attempts to tackle HIV/AIDS.

This qualitative study examined the acceptability of female condoms in urban India, with a focus on sexual pleasure. We conducted focus group discussions with 50 women and 19 men, as well as a small number of individual interviews with women (n = 3), in Chennai and New Delhi. Perceived benefits of female condoms included protection against unintended pregnancy and sexually transmitted infections, increased sense of empowerment for women, and simple clean up. The most common drawback was reduced sensation. Participants suggested structural changes to the female condom to ease insertion and use. Consent and privacy were discussed as increasing sexual pleasure. Pleasure should be acknowledged in design and education efforts to increase female condom use.

We present a thematic discourse analysis of 94 Australian women’s written comments about women’s presumed dissatisfaction with their genital appearance. Two themes emerged: ‘from natural to normal’ and ‘the difficulty of resistance’. In the first theme, participants discuss genital dissatisfaction with reference to hegemonic constructions of femininity and to postfeminist, neoliberal discourses that position the natural female body as inadequate, with beauty practices necessary to achieve acceptability. The second theme addresses the difficulty of challenging this positioning, referencing discourses that position the vagina as unpleasant and discussion of it as taboo. We consider implications of these constructions for women’s well-being.

We take a dialogical approach to exploring fertility regulation practices and show how they can maintain or express social identity. We identify three themes in educated Ghanaian women’s accounts of how they navigate conflicting social demands on their identity when trying to regulate fertility: secrecy and silence – hiding contraception use and avoiding talking about it; tolerating uncertainty – such as using unreliable but more socially acceptable contraception; and wanting to be fertile and protecting menses. Family planning programmes that fail to tackle such social-psychological obstacles to regulating fertility will risk reproducing social spaces where women struggle to claim their reproductive rights.

Few studies have investigated the role of disenfranchisement and denial of agency in women’s sexual health. To address this, a cross-sectional study of disenfranchisement, control (general and reproductive control) and health was conducted in Ireland, where abortion is severely restricted. Multiple mediation models (N = 513 women) indicated that general but not reproductive control mediates the association between disenfranchisement and psychological well-being. Additionally, serial mediation shows disenfranchisement is associated with lower sense of control, which is linked to poorer well-being and risky sexual behaviour. Disenfranchisement arising from socio-political contexts may have important implications for women’s sexual health.

Discourses of ‘choice’ are routinely involved in sexual and reproductive rights’ advocacy. In this article, we offer a discursive psychological examination of how ‘choice’ is oriented to, in online deliberations on the ongoing movement for abortion rights in Ireland. Comment posters treated ‘choice’ as involving outcomes of and motives for choosing, in negotiating legitimacy of women’s rights to choose. These accompanied alternative versions of women, either as independent or as intimately bound up with pregnancy/motherhood, which were flexibly used in negotiation legitimacy of women’s rights to ‘choice’ in abortion practices. Choice advocacy is then situated in particular discursive practices.

This proposal is an attempt to intervene in psychology’s violent past and troubling present by calling for notions of “care-ful” practice, compelling us to recognize and celebrate the permeable, porous, and flexible boundaries between bodies and selves. With this heuristic of care, this article hopes to trouble the separation between rigor and relational responsibility, to trouble objectivism, to oust the illusion of cool rationality, and to offer an affective understanding of consent that refuses to deny sexuality in bodies oppressed with the label of intellectually disabled.

There is a growing recognition of the sexual and reproductive rights of people with disabilities, and since the World Health Organisation’s World Report on Disability, increased international attention has been given to these issues. Past research, however, suggests that this group encounter barriers to sexual and reproductive rights, which are both physical and attitudinal. Against this backdrop, this article employs a sequential mixed qualitative methodology to explore the practical and subjective experiences of 13 people with physical disabilities in South Africa, with regard to their sexual lives and experiences of sexuality. These experiences were marked by concerns about their ‘fitness’ as sexual beings and indicated that social forces were key in shaping their expectations for their own sexual life.

Australian public health promotion positions safe sex as a biomedical, heteronormative concept. Consequently, there is a dearth of scholarly research examining queer young women’s sexual health. To fill this knowledge gap, this article considers how Australian bisexual and queer young women understand ‘safe sex’ and conceptualise ‘good’ sexual citizenship. Drawing on qualitative interviews with 15 participants in Tasmania, findings reveal that although queer women understand heterosexual safe sex, there is little awareness of safer sexual practices with female partners. We argue that gendered sexual scripts shape perceptions of sexual health risk whereby queer women adopt multiple situation-dependent approaches to safer sex.

The stigma related to HIV status, gender identity, and sexual orientation has negative implications for the quality of life of individuals. A qualitative study was conducted to explore the resources that these stigmatized groups recognize as tools to cope with stigma and maintain their psychological well-being. Four focus groups were conducted with gay men and transgender women divided by HIV status. A thematic analysis revealed that individual, interpersonal, and institutional resources are commonly recognized as coping resources. This article discusses the importance of enhancing self-acceptance, social support, and a legal framework that legitimizes these groups as right holders.

Constructions of masculinity have shifted and changed but the central role of the penis has remained firm. Yet, despite the implications for sexual health, there has been very little research on discourses around penises. The messages men receive about their manhood is apparent in articles in men’s magazines. We conducted a discursive analysis of the ways in which penises were discussed in four market leading UK titles: Loaded, Men’s Health, GQ and Attitude. Two broad discourses were identified, termed Laddish and Medicalised, both of which create fear-ridden spaces where men are bombarded with unachievable masculine ideals and traumatic examples of mutilated members. We discuss how health psychologists could use the findings to communicate with men about their sexual health needs using this channel.

Researchers have seldom compared how various psychological factors relate to men’s sexual health. We sought to identify whether and how psychological risk factors (i.e. anxiety sensitivity, emotion regulation, psychological distress) predict men’s sexual health (i.e. functioning, sexual quality of life, frequency of sexual activity). Men (N = 306) completed an online survey measuring emotional, psychological, and sexual outcomes. Comparisons of four path analysis models suggested that psychological risk factors are related to some but not all sexual health markers. We will highlight the factors that may place young men at risk for developing mental and sexual health difficulties.