Heather L. Armstrong

Psychosexual well-being, encompassing positive experiences of intimacy, pleasure and mutual respect, is increasingly recognised as a key component of overall health (World Health Organization 2022)...

The internet has greatly increased the ease of access to pornography and the privacy of its use, accompanied by a notable rise in consumption among young people. This review aimed to systematically review and narratively synthesise quantitative evidence on the prevalence, motivations, and content types of internet pornography use – as well as its associations with multiple domains of psychosexual well-being, including attitudes and emotions towards use, sexual self-concept, sexual desire and functioning, and compulsive use – among individuals aged 16–25 years. Following a pre-registered protocol, we originally conducted a systematic search of PubMed, PsycINFO, and Web of Science on 20 May 2024 and updated on 24 April 2025 for studies published from 1 January 2000 to 24 April 2025 that reported associations. Study quality was assessed. Twenty-seven studies (30,023 participants) were included in the systematic review. Measurement details were reported for the pornography use variables and the psychosexual well-being variables. The results indicate that most young people have used internet pornography, with a higher prevalence reported in men than women. Additionally, gender differences related to internet pornography were found in reported motivation and content types, attitudes and emotions, sexual self-concept, sexual desire and functioning, and compulsive use.

With the increasing prevalence of sexual content in media and evolving sexual/social norms, young women are exposed to pornography more frequently. This study aims to explore the mechanisms linking young women's attitudes toward pornography and sexual well-being. Involving 306 women from the UK (mean age = 20.12 years), the study examined how attitudes toward pornography are associated with sexual satisfaction and comfort with sex, with potential mediating factors including emotion after porn use, frequency of use, and sexual communication. Results indicate that positive attitudes toward porn are associated with higher sexual satisfaction and comfort with sex, whereas no association was found between negative attitudes toward porn and these variables. Sexual communication mediated the relationship between positive attitudes and sexual well-being, but neither emotion after porn use nor frequency of use served as mediators. Findings suggest that women with positive attitudes may experience less internal conflict related to pornography use. Negative attitudes, while correlated with emotional discomfort, were not associated with broader sexual well-being, possibly reflecting adaptive strategies for managing personal ambivalence. These results emphasize the need for sex education that critically examines and constructively addresses the psychosexual impact of pornography use on young women's sexual development.

Non-binary is a term used by individuals to describe their gender identity, which is better conceptualized outside the man–woman binary. In recent years, research interest in the sexuality of gender minority individuals has grown, as shown by the increasing number of publications on this topic. Accordingly, a comprehensive systematic review which synthesizes the range of sex-related variables captured in research studies with non-binary people is needed. This analysis examined 12 years of quantitative sex research, aiming to (1) outline what is known about the sexuality, sexual health, and relationship satisfaction of non-binary people; and (2) appraise measures used in this literature for the inclusivity of non-binary identities (focusing on language and terminology). Searches were conducted on PsycINFO, Web of Science, and MEDLINE for papers in Italian or English between 2012 and 2024, and 44 articles were included for synthesis. Papers covered a wide range of topics, showing that non-binary people often report non-monosexual sexual identities (e.g., queer, pansexual), more attraction to and relationships with other non-binary individuals, and similar levels of sexual and relationship satisfaction as binary transgender people. However, the language and tools employed within the research were not always expansive or inclusive enough to adequately represent non-binary people’s experiences. For example, gender minority individuals were often grouped together for analysis, hiding likely within group differences. Future research should use gender-neutral language and measures and consider non-binary individuals separately, in order to better understand their specific sexual health, well-being, and relationship needs and outcomes.

Non-binary identities are often overlooked in quantitative sex research. This explorative study focused on the sexuality and partnerships of non-binary people. The analysis addressed three primary topics: the characteristics of non-binary people's sexual experiences, demographic factors linked to sexual well-being and relationship satisfaction, and differences between non-binary and binary trans/cisgender individuals. Eight hundred and twenty-two participants (462 non-binary, 129 binary trans and 231 cisgender individuals) took part. 60% of non-binary individuals identified as autistic and 40% reported chronic health conditions or physical disabilities. Regression analyses were performed with sexual wellbeing, sexual satisfaction, and relationship satisfaction as dependent variables and demographics, transition status and minoritised identities as independent variables. Among the non-binary subsample, being autistic, being asexual, being in a relationship and transition status were associated with higher sexual well-being, while sexual fluidity and living with chronic health conditions were linked to lower sexual well-being. Sexual fluidity was associated with lower sexual and relationship satisfaction. Non-binary and binary trans individuals reported lower sexual satisfaction and wellbeing than cisgender individuals. Results highlight the importance of examining overlapping minoritised identities in non-binary populations and call for further investigation into the connections between sexual fluidity, autism, asexuality, and sexual outcomes to improve understanding of non-binary people's sexual experiences.

Farahani M, Killian R., Reid GA, et al. Prevalence of syphilis among adults and adolescents in five sub-Saharan African countries: findings from Population-based HIV Impact Assessment surveys. Lancet Glob Health. 2024;12:e1413–23.

Background: Sexual health service engagement is important for the healthy sexual development of young people. Further, as later adolescence and early adulthood are critical periods for relationship development, sexual health needs may vary across this period and be associated with relationship status. Methods: A total of 468 participants, aged 16–25 years (mean age: 19.7 years) and living in the United Kingdom, completed an anonymous, online survey about their sexual health service use. To explore how relationship status is associated with engagement for five different sexual health services, we conducted chi-squared and multivariable logistic regression analyses. Results: In general, engagement with sexual health services was low: 28.2% reported accessing free condoms, 21.4% reported STI testing, and 9.4% had used relationship advice services. Among women only, 57.2% had accessed services to start the pill and 19.6% had done so for pregnancy testing. Among all participants, those in relationships were more likely to have accessed sexual health services for free condoms (aOR: 1.71, 95% CI: 1.13, 2.59). Among female participants, those in relationships were more likely to have accessed sexual health services to start the pill (aOR: 2.21, 95% CI: 1.45, 3.36) and for pregnancy testing (aOR: 3.86, 95% CI: 2.20, 6.78). There were no differences by relationship status for accessing sexual health services for STI testing or relationship advice. Conclusions: Health care providers and relationship and sexual education providers should encourage all young people to engage with sexual health services, while also recognising that sexual health needs are likely to vary depending on relationship status.

Attitudes among couples about women's solo masturbation are not well understood. The primary aim of this study was to assess (dis)similarities in attitudes between partners about women's solo masturbation and associations of each partner's attitudes with women's and their partners' sexual satisfaction. One hundred and four mixed-sex couples (M = 27.43 years), recruited through social networking websites and Prolific (an online research participant platform), completed an online survey about demographics, their experiences of solo masturbation, and validated measures of attitudes about women's masturbation and sexual satisfaction. Dyadic data were analyzed using correlational methods and the Actor-Partner Interdependence Model. Women and their partners reported similar and positive attitudes about women's solo masturbation. For women, reports of positive attitudes toward women's solo masturbation were associated with both their own and their partner's sexual satisfaction; there were no associations for men. The role of solo masturbation within romantic relationships is complex but our results support the idea that women's masturbation is now less stigmatized than commonly thought. Normalizing and including masturbation in the sexual script for individuals in relationships may help maximize their, and their partners,' sexual satisfaction.

Borgogna JLC, Grace SG, Holm JB, et al. Investigating the impact of condomless vaginal intercourse and lubricant use on the vaginal metabolome: a pre-post observational study. Sex Transm Infect. 2023;99:489–96.