{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T04:52:44Z","timestamp":1771476764766,"version":"3.50.1"},"reference-count":87,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T00:00:00Z","timestamp":1698624000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FCT\u2014Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","award":["UIDB\/05380\/2020"],"award-info":[{"award-number":["UIDB\/05380\/2020"]}]},{"name":"FCT\u2014Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","award":["2022.09087.PTDC"],"award-info":[{"award-number":["2022.09087.PTDC"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Healthcare"],"abstract":"<jats:p>Introduction: Sexual pleasure is a human right and a central aspect of human sexuality that contributes significantly to people\u2019s overall well-being, making it an essential element to consider in clinical settings. This study aims to expand the understanding of sexual pleasure by examining how LGB+ people (lesbian, gay, bisexual, and other minority sexual orientations)-who perceived having a sexual problem-define solitary and partnered sexual pleasure. Methods: A cross-sectional exploratory qualitative study was conducted online. The current study included 85 people who self-identified as LGB+ and reported experiencing a sexual problem. Data analysis was performed using summative content analysis. Results: The results for solitary sexual pleasure comprised the creation of 5 categories (Enhancing the relationship with oneself, Specification of solitary pleasure, Negative experience, Unrestrained experience and A goal). For partnered sexual pleasure, 9 categories were created (The perks of being with another, Openness to experience, A result of sexual techniques, Psychophysiological experience, Misconceptions about sexual pleasure, Absence of intrapersonal constraints, Undesirable feelings, Explicit consent, and Absence of interpersonal constraints). Discussion: Despite reporting sexual problems, most participants reported having experienced sexual pleasure, and were able to define it. This study provided a deeper understanding of the perspectives on and experiences of sexuality among LGB+ people who experience sexual problems. Our findings highlight that current diagnostic criteria (e.g., DSM-5) do not seem to align with the problems reported by this sample population (the problems presented are beyond their sexual function). This reinforces the importance of viewing sexual problems from a perspective that goes beyond the categorial psychopathology model. Our study\u2019s findings may offer valuable insights for the evaluation and treatment of sexual problems, where sexual pleasure is considered a crucial aspect of sexual well-being.<\/jats:p>","DOI":"10.3390\/healthcare11212856","type":"journal-article","created":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T13:00:49Z","timestamp":1698670849000},"page":"2856","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["What Sexual Problems Does a Sample of LGB+ People Report Having, and How Do They Define Sexual Pleasure: A Qualitative Study to Inform Clinical Practice"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9376-6336","authenticated-orcid":false,"given":"Andreia A.","family":"Man\u00e3o","sequence":"first","affiliation":[{"name":"HEI-Lab: Digital Human-Environment Interaction Labs, Lus\u00f3fona University, Campo Grande 376, 1749-024 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4741-1985","authenticated-orcid":false,"given":"Edna","family":"Martins","sequence":"additional","affiliation":[{"name":"HEI-Lab: Digital Human-Environment Interaction Labs, Lus\u00f3fona University, Campo Grande 376, 1749-024 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2810-4034","authenticated-orcid":false,"given":"Patr\u00edcia M.","family":"Pascoal","sequence":"additional","affiliation":[{"name":"HEI-Lab: Digital Human-Environment Interaction Labs, Lus\u00f3fona University, Campo Grande 376, 1749-024 Lisboa, Portugal"},{"name":"Sociedade Portuguesa de Sexologia Cl\u00ednica, Rua 1\u00b0 de Maio No. 2, 5300-236 Bragan\u00e7a, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1007\/s10508-007-9175-2","article-title":"Why Humans Have Sex","volume":"36","author":"Meston","year":"2007","journal-title":"Arch. Sex. Behav."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1007\/BF02853934","article-title":"The pursuit of sexual pleasure","volume":"11","author":"Rye","year":"2007","journal-title":"Sex. Cult."},{"key":"ref_3","unstructured":"Abramson, P.R., and Pinkerton, S.D. (1995). Sexual Nature\/Sexual Culture, University of Chicago Press."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, American Psychological Association. [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1552","DOI":"10.1111\/j.1743-6109.2008.00846.x","article-title":"Two challenges for the classification of sexual dysfunction","volume":"5","author":"Mitchell","year":"2008","journal-title":"J. Sex. Med."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Lafortune, D., Girard, M., Dussault, \u00c9., Philibert, M., H\u00e9bert, M., Boislard, M.-A., Goyette, M., and Godbout, N. (2023). Who seeks sex therapy? Sexual dysfunction prevalence and correlates, and help-seeking among clinical and community samples. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0282618"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Velten, J., and Margraf, J. (2023). Exploring barriers and facilitators to women\u2019s intention and behavior to seek treatment for distressing sexual problems. PLoS ONE, 18.","DOI":"10.31219\/osf.io\/eu64x"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1037\/0033-2909.129.5.674","article-title":"Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence","volume":"129","author":"Meyer","year":"2003","journal-title":"Psychol. Bull."},{"key":"ref_9","unstructured":"World Association for Sexual Health (2023, October 15). Was Declaration on Sexual Pleasure. Available online: https:\/\/worldsexualhealth.net\/wp-content\/uploads\/2021\/09\/WAS-DECLARATION-ON-SEXUAL-PLEASURE-2021-.pdf."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1080\/19317611.2023.2212663","article-title":"Sexual Pleasure Matters\u2014And How to Define and Assess It Too. A Conceptual Framework of Sexual Pleasure and the Sexual Response","volume":"35","author":"Werner","year":"2023","journal-title":"Int. J. Sex. Health"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.1016\/j.jsxm.2016.06.010","article-title":"Initial validation of the sexual pleasure scale in clinical and non-clinical samples of partnered heterosexual people","volume":"13","author":"Pascoal","year":"2016","journal-title":"J. Sex. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1007\/s10508-015-0490-8","article-title":"Beyond sexual orientation: Integrating gender\/sex and diverse sexualities via sexual configurations theory","volume":"44","year":"2015","journal-title":"Arch. Sex. Behav."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2137","DOI":"10.1007\/s10508-016-0704-8","article-title":"Defining pleasure: A focus group study of solitary and partnered sexual pleasure in queer and heterosexual women","volume":"45","author":"Goldey","year":"2022","journal-title":"Arch. Sex. Behav."},{"key":"ref_14","unstructured":"Masters, E.H., and Johnson, V.E. (1966). Human Sexual Response, Little, Brown and Company. [1st ed.]."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1080\/00224499.2013.815149","article-title":"What is sexual satisfaction? Thematic analysis of lay people\u2019s definitions","volume":"51","author":"Pascoal","year":"2014","journal-title":"J. Sex Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.1016\/j.sbspro.2011.10.318","article-title":"Masturbation: Prevention & treatment","volume":"30","author":"Shekarey","year":"2011","journal-title":"Procedia-Socand Behav. Sci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1007\/s10508-022-02505-2","article-title":"Masturbation prevalence, frequency, reasons, and associations with partnered sex in the midst of the COVID-19 pandemic: Findings from a US nationally representative survey","volume":"52","author":"Herbenick","year":"2023","journal-title":"Arch. Sex. Behav."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1080\/0092623X.2020.1717700","article-title":"Why and how women masturbate, and the relationship to orgasmic response","volume":"46","author":"Rowland","year":"2020","journal-title":"J. Sex Marital Ther."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1080\/0092623X.2023.2204088","article-title":"Why Men Masturbate: Reasons and Correlates in Men with and without Sexual Dysfunction","volume":"49","author":"Hevesi","year":"2023","journal-title":"J. Sex Marital Ther."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2271","DOI":"10.1007\/s10508-019-1397-6","article-title":"Porn Is for Masturbation","volume":"48","author":"Prause","year":"2019","journal-title":"Arch. Sex. Behav."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1080\/0092623X.2012.751072","article-title":"Couple communication, emotional and sexual intimacy, and relationship satisfaction","volume":"40","author":"Yoo","year":"2014","journal-title":"J. Sex Marital Ther."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1007\/s12119-021-09934-6","article-title":"The Peak of Pleasure: US Southern Black Women\u2019s Definitions of and Feelings Toward Sexual Pleasure","volume":"26","author":"Thorpe","year":"2022","journal-title":"Sex. Cult."},{"key":"ref_23","unstructured":"Tolman, D.L. (2014). A New View of Women\u2019s Sexual Problems, Routledge."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Chen, L., Shi, G.R., Huang, D.D., Li, Y., Ma, C.C., Shi, M., Su, B.-X., and Shi, G.J. (2019). Male sexual dysfunction: A review of literature on its pathological mechanisms, potential risk factors, and herbal drug intervention. Biomed. Pharmacother., 112.","DOI":"10.1016\/j.biopha.2019.01.046"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1016\/j.jsxm.2019.02.014","article-title":"Erectile dysfunction and premature ejaculation in homosexual and heterosexual men: A systematic review and meta-analysis of comparative studies","volume":"16","author":"Barbonetti","year":"2019","journal-title":"J. Sex. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1111\/bju.14813","article-title":"The global prevalence of erectile dysfunction: A review","volume":"124","author":"Kessler","year":"2019","journal-title":"BJU Int."},{"key":"ref_27","first-page":"653","article-title":"Estimating the Prevalence of Sexual Dysfunction Using the New ICD-11 Guidelines","volume":"117","author":"Briken","year":"2020","journal-title":"Dtsch. Arztebl. Int."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1016\/j.jsxm.2016.05.014","article-title":"Understanding orgasmic difficulty in women","volume":"13","author":"Reinhart","year":"2016","journal-title":"J. Sex. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1080\/0167482X.2019.1599857","article-title":"Self-reported reasons for having difficulty reaching orgasm during partnered sex: Relation to orgasmic pleasure","volume":"41","author":"Hevesi","year":"2020","journal-title":"J. Psychosom. Obstet. Gynaecol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2951","DOI":"10.1007\/s10508-020-01742-7","article-title":"Prevalence and predictors of sexual difficulties and associated distress among partnered, sexually active older women in Norway, Denmark, Belgium, and Portugal","volume":"49","author":"Graham","year":"2020","journal-title":"Arch. Sex. Behav."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1953","DOI":"10.1016\/j.jsxm.2019.08.016","article-title":"\u201cFulfilling His Needs, Not Mine\u201d: Reasons for Not Talking About Painful Sex and Associations with Lack of Pleasure in a Nationally Representative Sample of Women in the United States","volume":"16","author":"Carter","year":"2019","journal-title":"J. Sex. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1080\/0092623X.2022.2077271","article-title":"Solitary and dyadic sexual desire and sexual satisfaction in women with and without sexual concerns","volume":"49","author":"Peixoto","year":"2023","journal-title":"J. Sex Marital Ther."},{"key":"ref_33","first-page":"288","article-title":"La masculinidad de los otros: Narraciones sobre el placer y relaciones de clase en hombres gay de la Ciudad de M\u00e9xico","volume":"13","author":"Parrini","year":"2014","journal-title":"Prism. Soc."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.rhm.2015.11.016","article-title":"\u201cI provide the pleasure, I control it\u201d: Sexual pleasure and \u201cbottom\u201d identity constructs amongst gay youth in a Stepping Stones workshop","volume":"23","author":"Kiguwa","year":"2015","journal-title":"Reprod. Health Matters"},{"key":"ref_35","first-page":"101","article-title":"A thematic analysis of a sample of partnered lesbian, gay, and bisexual people\u2019s concepts of sexual satisfaction","volume":"10","author":"Pascoal","year":"2019","journal-title":"Psychol. Sex."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1080\/26895269.2022.2028693","article-title":"Pleasure please! Sexual pleasure and influencing factors in transgender persons: An ENIGI follow-up study","volume":"24","author":"Gieles","year":"2023","journal-title":"Int. J. Transgend. Health"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1007\/s10508-023-02558-x","article-title":"The Relational Nature of Gender, the Pervasiveness of Heteronormative Sexual Scripts, and the Impact on Sexual Pleasure","volume":"52","author":"Harvey","year":"2023","journal-title":"Arch. Sex. Behav."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1080\/19317611.2021.1965689","article-title":"In pursuit of pleasure: A biopsychosocial perspective on sexual pleasure and gender","volume":"33","author":"Laan","year":"2021","journal-title":"Int. J. Sex. Health"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1080\/00224499.2021.1918050","article-title":"How WEIRD and androcentric is sex research? Global inequities in study populations","volume":"59","author":"Klein","year":"2022","journal-title":"J. Sex Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1080\/19317611.2021.1910890","article-title":"Psychosocial and behavioral aspects of women\u2019s sexual pleasure: A scoping review","volume":"33","author":"Reis","year":"2021","journal-title":"Int. J. Sex. Health"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Patterson, C.J., and D\u2019Augelli, A.R. (2013). Handbook of Psychology and Sexual Orientation, Oxford University. [2nd ed.].","DOI":"10.1093\/acprof:oso\/9780199765218.003.0016"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"247","DOI":"10.3109\/09540269509028333","article-title":"Sexual Dysfunction in Gay Men\u2014Diagnosis and Management","volume":"7","author":"Bhugra","year":"1995","journal-title":"Int. Rev. Psychiatry"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1111\/j.1743-6109.2011.02538.x","article-title":"The relationship between same-sex sexual experience, sexual distress, and female sexual dysfunction","volume":"9","author":"Burri","year":"2012","journal-title":"J. Sex. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1037\/cou0000657","article-title":"Beyond the individual: Sexual minority help-seeking and the consequences of structural barriers","volume":"70","author":"Spengler","year":"2023","journal-title":"J. Couns. Psychol."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"World Medical Association (2013). Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA, 310, 2191\u20132194.","DOI":"10.1001\/jama.2013.281053"},{"key":"ref_46","unstructured":"European Commission (2023, August 31). European Textbook on Ethics in Research. Available online: https:\/\/op.europa.eu\/pt\/publication-detail\/-\/publication\/12567a07-6beb-4998-95cd-8bca103fcf43."},{"key":"ref_47","unstructured":"American Psychological Association (2020). Publication Manual of the American Psychological Association, American Psychological Association. [7th ed.]."},{"key":"ref_48","unstructured":"Wildemuth, B. (2009). Qualitative Analysis of Content, Libraries Unlimited."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1080\/009262300278650","article-title":"Cognitive distraction and women\u2019s sexual functioning","volume":"26","author":"Dove","year":"2000","journal-title":"J. Sex. Marital. Ther"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1177\/1049732305276687","article-title":"Three approaches to qualitative content analysis","volume":"15","author":"Hsieh","year":"2005","journal-title":"Qual. Health Res."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"George, D., and Mallery, P. (2019). IBM SPSS Statistics 26 Step by Step: A Simple Guide and Reference, Routledge. [16th ed.].","DOI":"10.4324\/9780429056765"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1007\/s40429-020-00298-9","article-title":"Child sexual abuse and compulsive sexual behavior: A systematic literature review","volume":"7","author":"Slavin","year":"2020","journal-title":"Curr. Addict. Rep."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.esxm.2020.02.008","article-title":"Sexual Desire Discrepancy: A Position Statement of the European Society for Sexual Medicine","volume":"8","author":"Marieke","year":"2020","journal-title":"Sex. Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1080\/00224499.2023.2219247","article-title":"The Dual Control Model of Sexual Response: A Scoping Review, 2009\u20132022","volume":"60","author":"Janssen","year":"2023","journal-title":"J. Sex Res."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1007\/s11930-017-0108-3","article-title":"The dual control model of sexual response: Relevance of sexual excitation and sexual inhibition for sexual function","volume":"9","author":"Velten","year":"2017","journal-title":"Curr. Sex. Health Rep."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1080\/00224490902747222","article-title":"The dual control model: Current status and future directions","volume":"46","author":"Bancroft","year":"2009","journal-title":"J. Sex Res."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1080\/00224499.2015.1066743","article-title":"Examining the psychometric properties of the Sexual Excitation\/Sexual Inhibition Inventory for Women (SESII-W) in a sample of lesbian and bisexual women","volume":"53","author":"Jozkowski","year":"2016","journal-title":"J. Sex Res."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1080\/00926237708405343","article-title":"Hypoactive sexual desire","volume":"3","author":"Kaplan","year":"1979","journal-title":"J. Sex Marital Ther."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1080\/00926230252851357","article-title":"Beyond dysfunction: A new view of women\u2019s sexual problems","volume":"28","author":"Tiefer","year":"2022","journal-title":"J. Sex Marital Ther."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1080\/00224490609552322","article-title":"Women\u2019s sexual desire: A feminist critique","volume":"43","author":"Wood","year":"2006","journal-title":"J. Sex Res."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Travis, C.B., and White, J.W. (2000). Sexuality, Society, and Feminism, American Psychological Association.","DOI":"10.1037\/10345-000"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1080\/00918369.2021.2004794","article-title":"Minority stress and mental health: A review of the literature","volume":"70","year":"2023","journal-title":"J. Homosex."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1080\/19317611.2021.1909684","article-title":"Minority stress and relationship well-being in sexual minorities: The varying role of outness on relationship and sexual satisfaction","volume":"33","author":"Vale","year":"2021","journal-title":"Int. J. Sex. Health"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"91","DOI":"10.22381\/AJMR5120189","article-title":"LGBT healthcare disparities, discrimination, and societal stigma: The mental and physical health risks related to sexual and\/or gender minority status","volume":"5","author":"Mccrone","year":"2018","journal-title":"Am. J. Med. Res."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/s11930-020-00263-7","article-title":"Sexual Desire and Fantasies in the LGBT+ Community: Focus on Lesbian Women and Gay Men","volume":"12","author":"Nimbi","year":"2020","journal-title":"Curr. Sex. Health Rep."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/j.sxmr.2019.10.003","article-title":"Compulsive sexual behavior and dysregulation of emotion","volume":"8","author":"Lewczuk","year":"2020","journal-title":"Sex. Med. Rev."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1037\/hea0000180","article-title":"A minority stress\u2014Emotion regulation model of sexual compulsivity among highly sexually active gay and bisexual men","volume":"34","author":"Pachankis","year":"2015","journal-title":"Health Psychol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1002\/wps.20748","article-title":"The unified protocol for transdiagnostic treatment of emotional disorders","volume":"19","author":"Barlow","year":"2020","journal-title":"World Psychiatry"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1016\/j.sxmr.2020.01.004","article-title":"Sex after prostate cancer in gay and bisexual men: A review of the literature","volume":"8","author":"McInnis","year":"2020","journal-title":"Sex. Med. Rev."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1007\/s10826-019-01551-0","article-title":"Coming out in family and sports-related contexts among young Italian gay and lesbian athletes: The mediation effect of the \u201cdon\u2019t ask, don\u2019t tell\u201d attitude","volume":"29","author":"Pistella","year":"2020","journal-title":"J. Child. Fam. Stud."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1080\/01612840802601382","article-title":"Mental illness stigma and disclosure: Consequences of coming out of the closet","volume":"30","author":"Bos","year":"2009","journal-title":"Issues Ment. Health Nurs."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"903361","DOI":"10.3389\/fpsyt.2022.903361","article-title":"Masturbation parameters related to orgasm satisfaction in sexual relationships: Differences between men and women","volume":"13","author":"Cervilla","year":"2022","journal-title":"Front. Psychiatry"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"3889","DOI":"10.1007\/s10508-022-02390-9","article-title":"Sexual Subjectivity in Solo and Partnered Masturbation Experiences Among Emerging Adult Women","volume":"51","author":"Foust","year":"2022","journal-title":"Arch. Sex. Behav."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1080\/10720162.2018.1495586","article-title":"Operationalization of excessive masturbation\u2014Development of the EMS","volume":"25","author":"Driemeyer","year":"2018","journal-title":"Sex. Addict. Compuls."},{"key":"ref_75","unstructured":"Hungrige, A. (2016). Women\u2019s Masturbation: An Exploration of the Influence of Shame, Guilt, and Religiosity. [Ph.D. Thesis, Texas Woman\u2019s University]."},{"key":"ref_76","unstructured":"Santos, D.L.R.A. (2021). Shame, Coping with Shame and Psychopathology: A Moderated-Mediation Analysis by Sexual Orientation. [Master\u2019s Thesis, Faculty of Psychology and Educational Sciences, University of Coimbra]."},{"key":"ref_77","unstructured":"Man\u00e3o, A.A., Seabra, D., and Salvador, M.C. (2023). Measuring Shame Related to Sexual Orientation: Validation of Sexual Minority\u2014External and Internal Shame (SM-EISS). Sex. Res. Soc. Policy, Manuscript in review."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"101594","DOI":"10.1016\/j.copsyc.2023.101594","article-title":"The enticement of feeling understood, validated, and cared for: How does perceiving a partner as responsive affect the sexual arena?","volume":"52","author":"Birnbaum","year":"2023","journal-title":"Curr. Opin. Psychol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1080\/00224499.2017.1283484","article-title":"Do Women\u2019s Orgasms Function as a Masculinity Achievement for Men?","volume":"54","author":"Chadwick","year":"2017","journal-title":"J. Sex Res."},{"key":"ref_80","first-page":"201","article-title":"Oral sex among teenagers: Research, discourse, and education","volume":"13","author":"McKay","year":"2004","journal-title":"Can. J. Hum. Sex."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1080\/00224499.2021.1991260","article-title":"Expectations and sexual desire in romantic relationships: An experimental investigation of pleasure and emotional closeness expectancies among young adults","volume":"59","author":"Blumenstock","year":"2022","journal-title":"J. Sex Res."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1080\/00224499.2016.1170101","article-title":"Sexually experienced adolescents\u2019 thoughts about sexual pleasure","volume":"54","author":"Saliares","year":"2017","journal-title":"J. Sex Res."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1111\/j.1471-6402.2008.00452.x","article-title":"Objectification theory and psychology of women: A decade of advances and future directions","volume":"32","author":"Moradi","year":"2008","journal-title":"Psychol. Women Q."},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Man\u00e3o, A.A., and Pascoal, P.M. (2023). Body Dissatisfaction, Cognitive Distraction and Sexual Satisfaction in LGB+ People: A mediation study framed by Cognitive Psychology models of sexual response. Healthcare, Manuscript in review.","DOI":"10.3390\/healthcare11222930"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1177\/1745691613497965","article-title":"Minority Stress and Physical Health Among Sexual Minorities","volume":"8","author":"Lick","year":"2013","journal-title":"Perspect. Psychol. Sci."},{"key":"ref_86","doi-asserted-by":"crossref","unstructured":"Ribeiro-Gon\u00e7alves, J.A., Costa, P.A., and Leal, I. (2023). Double Stigma in Portuguese Lesbian, Gay, and Bisexual Older Adults: A Study of Health Status. J. Sex Mar. Ther.","DOI":"10.1080\/0092623X.2023.2215258"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1038\/s44159-023-00218-4","article-title":"A review of approaches and models in psychopathology conceptualization research","volume":"2","author":"Eaton","year":"2023","journal-title":"Nat. Rev. Psychol."}],"container-title":["Healthcare"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9032\/11\/21\/2856\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:14:05Z","timestamp":1760130845000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9032\/11\/21\/2856"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,30]]},"references-count":87,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2023,11]]}},"alternative-id":["healthcare11212856"],"URL":"https:\/\/doi.org\/10.3390\/healthcare11212856","relation":{},"ISSN":["2227-9032"],"issn-type":[{"value":"2227-9032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,30]]}}}