Sexes, Volume 2, Issue 1 (March 2021) – 12 articles

Adolescence is the time during which the personal and sexual identity develops. The specific characteristics of adolescents and the lack of maturity facilitates the acquisition of sexual risk behaviors such as relaxation in the use of barrier contraceptives or the use of toxic substances, alcohol or drugs during sexual relations, increasing of sexually transmitted infections (STIs) and unwanted pregnancies. Health education in sexuality is one of the best ways to prevent risk behaviors and to promote healthy and responsible sexuality. While there have been different works in sex education in adolescents, there is still a lack of a comprehensive systematic literature review that including randomized and non-randomized clinical trials and quasi-experimental pre-post studies addressing education programs that provide information on healthy and responsible sexuality. Further, it is noted that a protocol drafted in consideration of the existing approaches is needed to present a basis for a systematic literature review in this area. This article, therefore, proposes a review protocol that will evaluate the impact of comprehensive sex education programs in the level of knowledge about STIs, behavioral level concerning the frequency of use of effective contraceptive methods and level of knowledge about sexual identity, diversity and/or responsible sexuality, after the intervention. Full article

Objective: To examine the associations between internet use and overweight/obesity in people aged 15–49 years in Nepal and the extent to which these associations differ by biological sex. Materials and methods: The study analyzed the nationally representative Nepal Demographic and Health Survey (NDHS) 2016 data. Multivariable ordinal logistic regression models were fitted to estimate the total effects of internet use (IU) in the last 12 months and frequency of internet use (FIU) in the last month on overweight/obesity adjusted for potential confounders. Results: Of the 10,380 participants, the prevalence of overweight/obesity by IU was 38% (95% confidence interval (CI): 35.9%, 40.1%) for males and 44.1% (95% CI: 41.6%, 46.6%) for female. The likelihood of overweight/obesity was significantly higher (adjusted odds ratio (aOR): 1.55; 95% CI: 1.40, 1.73; p < 0.001) among those participants who used the internet compared to the participants who did not use the internet in the last 12 months. Similar associations were observed when using the augmented measure of exposure-FIU in the last month. We observed the modification effect of sex in the associations of IU (p-difference < 0.001) and FIU (p-difference < 0.002) with overweight/obesity in Nepal. Conclusions: Our findings suggest that future overweight/obesity interventions in Nepal discourage unnecessary internet use, particularly among males. Full article

Central precocious puberty (CPP) is due to the premature activation of the hypothalamic–pituitary–gonadal axis, which is responsible for the appearance of secondary sexual characteristics. It occurs before the age of 8 and 9 in girls and boys, respectively. CPP shows higher incidence in females than in males. Causes of CPP are similar in both sexes, but the idiopathic form is more frequent in girls, while organic forms are more frequent in males. Recent studies demonstrated a role of some genetic variants in the pathogenesis of CPP. The diagnostic evaluation based on accurate physical examination, assessment of the pituitary–gonadal axis, pelvic sonography in girls, and determination of bone age. Magnetic resonance of the central nervous system should be done in all boys and selected girls. Since the 1980s, pharmacologic treatment involves the use of gonadotropin-releasing hormone (GnRH) analogs. These drugs are characterized by few side effects and long-term safety. Many data are available on the outcome of GnRH analog treated female patients, while poor data are reported in boys. Adult height is improved in both sexes. Full article

The attention to transgender medicine has changed over the last decade and the interest is most likely going to increase in the future due to the fact that gender-affirming treatments are now being requested by an increasing number of transgender people. Even if gender-affirming hormone therapy (GAHT) is based on a multidisciplinary approach, this review is going to focus on the procedures adopted by the endocrinologist in an out-clinic setting once an adult patient is referred by another specialist for ‘gender affirming’ therapy. Before commencing this latter treatment, several background information on unmet needs regarding medical and surgical outcomes should be investigated. We summarized our endocrinological clinical and therapeutic approaches to adult transgender individuals before and during GAHT based on a non-systematic review. Moreover, the possible relationships between GAHT, gender-related pharmacology, and COVID-19 are also reported. Full article

Pulse (beans, lentils, chickpeas, peas) consumption is low in developed countries. Pulses have the potential to benefit the management of polycystic ovary syndrome (PCOS) because they improve aspects of metabolic derangements (dyslipidaemia, insulin resistance), which contribute to reproductive disturbances (oligo-amenorrhea, hyperandrogenism). We compared changes in knowledge, attitudes, and barriers towards pulse consumption in PCOS cohorts who participated in a pulse-based or a Therapeutic Lifestyle Changes (TLC) dietary intervention. Thirty women (18–35 years old) randomised to a pulse-based diet (supplied with pulse-based meals) and 31 women in a TLC group completed pulse consumption questionnaires before and after a 16-week intervention. The pulse-diet group demonstrated increased knowledge of pulses per Canada’s Food Guide recommendations versus the TLC group post-intervention (p < 0.05). In both groups, increased scores were evident in the domain of attitude about pulses (p < 0.01). The top-ranked barrier to pulse consumption in no-/low-consumers was lack of knowledge about cooking pulses pre- and post-intervention. We attributed increased knowledge about pulse consumption in the pulse group to greater awareness through education and consuming pulse foods during the intervention. Our observations highlight the importance of multi-dimensional behavioural counselling and education to integrate healthy dietary practices for improving reproductive and sexual health in this under-studied high-risk population (ClinicalTrials.gov identifier: NCT01288638). Full article

(1) Background: Media play a significant role in forming audience perceptions about physical external appearance and food consumption patterns. It has been reported that children’s cartoons project slimness, and concomitantly consumption of poor nutritional quality food. However, data on the role of gender in this respect are lacking; thus, this was the aim of the present study. (2) Methods: 100 episodes of the 10 most popular cartoon series were analyzed. Characters’ body weight status was classified into underweight, normal weight and overweight, and foods consumed as core (e.g., fruit, vegetables) and non-core (e.g., sweets, snacks). Messages about characters’ attractiveness were recorded and classified according to their body weight status and gender. (3) Results: Out of 37 protagonists, 12 were female figures (32%), while out of the 10 thin protagonists, 7 were females (70%) and only 3 males (30%). Thin heroines were the recipients of the majority of the messages connotative to physical attractiveness (36 out of 58 messages). However, consumption of core and non-core foods did not differ within genders (core: z = −1.526, p = 0.127, non-core: z = −0.417, p = 0.667). (4) Conclusions: Females seem to be underrepresented in cartoon series but receive the majority of the comments related to physical appearance, with most of them addressing the attractiveness of a thin figure. Full article

Introduction: Considering a growing number of female sex workers (FSWs) in Bangladesh, there remains a greater need to reduce sexually transmitted infection (STI) rates, as lower social and cultural status cause FSWs to have less access to education, employment opportunities, and health care, including opportunities for HIV tests, counseling, and medical care. Methods: A cross-sectional study was conducted among 546 street, hotel, and residence-based FSWs. This current study aimed to identify the prevalence and to ascertain the associated risk factors among the FSW populations in Dhaka. Results: We found a majority of the participants were in the working age of more than 26 years for the FSW profession, with a mean age of 28 years. While the majority were unemployed (42.5%), alcohol abuse (p = 0.01) and drug dependency (p = 0.01) had an association, and inconsistency of condom use had a higher risk factor (AOR = 3.54) for a new STI case. Conclusions: FSW-oriented service platform should be integrated with health literacy interventions in urban and rural locations in Bangladesh. Understanding the differences in risk patterns and tailoring intervention will increase contraception use and lower STI cases and improve overall FSW quality of life. Full article

The purpose of this study was to examine possible sex differences in high-intensity exercise performance, fatigue, and motivational responses to exercise while listening to music. Physically active males and females (ages 18–24) were recruited to participate. Participants completed two separate repeated sprint exercise trials each with a different condition: (1) no music (NM) (2) self-selected music (SSM). During each trial, participants completed 3 × 15 s Wingate anaerobic tests (WAnTs) while listening to NM or SSM separated by 2 min of active recovery. Following each WAnT, rate of perceived exertion (RPE) and motivation to exercise were assessed. Relative power output, fatigue index, RPE, and motivation were analyzed. There were no significant sex differences for relative power between music conditions (p = 0.228). Fatigue index was significantly lower in females while listening to SSM (p = 0.032) versus NM while no differences were observed for males (p = 0.246). RPE was lower while listening to SSM versus NM in females (p = 0.020), but not for males (p = 0.277). Lastly, motivation to exercise increased in the SSM condition versus NM in females (p = 0.006) but not in males (p = 0.090). Results indicate that listening to SSM music did not result in superior anaerobic performance in either sex, but females responded more favorably to subjective outcomes (i.e., RPE and motivation) while listening to SSM, which may have in turn influenced indices of fatigue during the tests. These results suggest that females may respond more positively than males to exercise-induced fatigue while listening to SSM music during repeated bouts of high-intensity exercise. Full article

Sentiment analysis (SA) is a technique aimed at extracting opinions and sentiments through the analysis of text, often used in healthcare research to understand patients’ needs and interests. Data from social networks, such as Twitter, can provide useful insights on sexual behavior. We aimed to assess the perception of Valentine’s Day by performing SA on tweets we collected between 28 January and 13 February 2019. Analysis was done using ad hoc software. A total of 883,615 unique tweets containing the word “valentine” in their text were collected. Geo-localization was available for 48,918 tweets; most the tweets came from the US (36,889, 75.41%), the UK (2605, 5.33%) and Canada (1661, 3.4%). The number of tweets increased approaching February 14. “Love” was the most recurring word, appearing in 111,981 tweets, followed by “gift” (55,136), “special” (34,518) and “happy” (33,913). Overall, 7318 tweets mentioned “sex”: among these tweets, the most recurring words were “sexy” (2317 tweets), “love” (1394) and “gift” (679); words pertaining to intimacy and sexual activity, such as “lingerie”, “porn”, and “date” were less common. In conclusion, tweets about Valentine’s Day mostly focus on the emotions, or on the material aspect of the celebration, and the sexual aspect of Valentine’s Day is rarely mentioned. Full article

Human Trafficking (HT) persists in the US, despite multi-level measures designed to mitigate its societal costs. HT instruction for healthcare providers is growing, but there is a dearth of resources and training presenting obstacles for victims accessing suitable healthcare services. Voices of survivors are also scant in the literature, despite the fact that their recommendations would appear essential when designing best practices. This study aimed to methodically gather recommendations from sex trafficking (ST) survivors who sought medical care during their victimization. An exploratory concurrent mixed-methods design was used, and semi-structured interviews (N = 22) were conducted between March 2016 and March 2017, in San Diego, CA, and Philadelphia, PA. Data were analyzed through a coding system to identify meaningful analytical themes. Study participants were recruited through survivor-centered organizations, and their identification was kept anonymous and confidential. Findings included three main themes: (A) Red Flags; (B) supportive healthcare practices; and (C) resources for ST-patient study participants’ recommendations aimed to improve healthcare practice in response to their medical needs in a compassionate and caring manner, with trust building, rapport, and an opportunity to instill hope among ST-patients. Implementing Compassionate Care approaches when caring for ST-patients could positively impact patient–provider interactions, while creating opportunities for intervention. Full article

Research on pathological narcissistic traits and sexuality are mainly focused on the dysfunctional aspects of sexuality. The present study aims to explore the relationship between narcissistic traits and sexual satisfaction in men, testing whether sexual self-esteem mediates this association. Participants included 212 men who completed measures of grandiose and vulnerable narcissistic traits, sexual self-esteem, and sexual satisfaction. Results highlight how vulnerable narcissistic traits are negatively associated with sexual satisfaction. This association is fully mediated by sexual self-esteem. On the contrary, grandiose narcissistic traits are not directly associated with sexual satisfaction, but with sexual self-esteem only, which explains the indirect effect of grandiose traits on sexual satisfaction. In conclusion, sexual self-esteem in personality configurations with high pathological narcissistic traits accounts for the relationship between narcissistic traits and sexual satisfaction. Full article

Talk with parents and extended family about sex and relationships can support adolescents’ sexual health. However, few studies explore how parent and extended family communication with adolescents intersect. This study used thematic analysis to assess family roles in talk with teens about sex and relationships among a sample of 39 adult extended family members (such as aunts and uncles, and older siblings and cousins) in the United States. Analyses identified four themes in sexuality communication that address: why adolescents talk to extended family about sex and relationships, family engagement in these conversations, consistency of family messages, and family communication about adolescents. Findings identify variation in how family members interact with adolescents and one another regarding talk about sex and relationships. For example, some participants described family coordination of sexual messages to the teen, while others reported no family communication about this topic. Results also showed similarities and differences in how sibling and non-sibling extended family describe these processes. These findings identify the need to examine family talk about sex and relationships in the context of a larger family system, rather than only within dyadic relationships, and suggests possibilities for family-based interventions to support adolescents’ sexual health. Full article