Abstract
Many women born with disorders or differences of sex development (DSD) report sexual problems, in particular women who have undergone extensive genital reconstruction. Examining cognitions and emotions that hinder or promote sexuality may facilitate understanding these sexual problems and may contribute to the development of specific interventions. In this study, sexual self-concept, body image, and sexual functioning were investigated in relation to genital surgery. To conduct the study, the women's Sexual Self-Concept Scale was translated to Dutch. Evaluation of psychometric properties was conducted in a sample of healthy Belgian and Dutch women participating in an anonymous web-based survey (N = 589, Mdn age, 23 years). The resulting three-factor structure corresponded largely to that of the original version. Compared to control women, women born with a DSD who were included in the Dutch DSD study (N = 99, Mdn age, 26 years) described themselves as being less interested in sex and less sexually active. These women also harbored more negative emotions and cognitions regarding their sexuality and were less satisfied with their external genitalia. In women with a DSD, sexual self-concept was associated with compromised outcomes on sexual functioning and distress. Women who were in a steady relationship, and/or had been sexually active in the past 4 weeks had a more positive sexual self-concept, took a more active role in their sexual relationship, experienced more sexual desire and arousal and less sexual distress than women who were not involved in a partner relationship. Findings in this study indicate that cognitions and emotions related to sexual self-concept play a role in sexual functioning of women with a DSD. A cognitive behavioral counseling approach with focus on coping and exploration of their own sexual needs could prove useful in this group.
| Original language | English |
|---|---|
| Pages (from-to) | 2213-2229 |
| Number of pages | 17 |
| Journal | Archives of Sexual Behavior |
| Volume | 51 |
| Issue number | 4 |
| Early online date | 1 Apr 2022 |
| DOIs | |
| Publication status | Published - May 2022 |
Bibliographical note
© 2022. The Author(s).Funding Information:
This study was financially supported by Stichting Swart-van Essen Foundation (Nita de Neve-Enthoven), the Flanders Research Foundation—FWO Vlaanderen (Nina Callens), and Stichting Edli Foundation (Arianne Dessens). These foundations aim to provide stipends for research projects (FWO Vlaanderen) and small projects of social relevance (Stichting Swart-van Essen Foundation and Stichting Edli Foundation). These funding sources had no involvement in study design, data collection, data analyses, data interpretation, data report and in the decision to submit the article for publication.
Funding Information:
Nita G. M. de Neve-Enthoven and Nina Callens have contributed equally to this work. We thank all participating women who volunteered in this study for their carefulness and efforts. We thank Yvonne van der Zwan and Katja Wolffenbuttel for analyses of medical data and Erwin Birnie for statistical advices. We thank Conny Min for editing the manuscript. We are indebted to all cooperating members of the Dutch Study Group on DSD for recruitment of participants, and in particular to Ingrid van Slobbe, Joke Dunk, Karen Kwak, Jacqueline Knol, and Hanneke Kempes for logistic support. The Dutch Study Group on DSD includes the authors listed above and in addition Katja Wolffenbuttel, MD, Yvonne van der Zwan, MD, PhD, Marjan van den Berg, MD, Erwin Birnie, Ingrid van Slobbe, and Joke Dunk from Erasmus Medical Center Rotterdam; Catharina Beerendonk, MD, PhD, Barto Otten, MD, PhD, Barbara Kortmann, MD, PhD, Karen Kwak, and Jacqueline Knol from Radboud University Medical Center Nijmegen and Mick van Trotsenburg, MD, PhD and Hanneke Kempes Amsterdam UMC, Vrije Universiteit Amsterdam.
Publisher Copyright:
© 2022, The Author(s).