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Sex and Sexual Orientation

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The Textbook of Clinical Sexual Medicine

Abstract

Sexual orientation can be defined as a romantic and/or sexual attraction to same sex, opposite sex, or both, usually conceptualized as homosexual, heterosexual, and bisexual, respectively. More recently, asexuality has been proposed as a new category of sexual orientation, characterized by the absence of sexual attraction to the same sex, the opposite sex, or both sexes. Research on same-sex sexuality has been characterized by a heterosexual bias, due to heterosexual scripts in sexual behavior conceptualization. Additionally, homophobia, defined by the prejudice and discrimination against homosexuals, and internalized homophobia, are key concepts to consider in same-sex sexuality research. This field of research can focus on same-sex relationships, namely non-monogamous and extra-dyadic relationships, and on sexual difficulties. Assessing sexual difficulties among gays, lesbians, and bisexuals requires being aware of common sexual behaviors in same-sex relationships. Regarding sexual difficulties prevalence, empirical evidence suggests that anodyspareunia is the most frequent sexual complaint among gay men, and lack of sexual desire is the most common sexual difficulty among lesbian women. Sexual dysfunction comprehension can be addressed through psychological approaches, namely cognitive-behavioral conception of sexual difficulties. Sexual beliefs are identified as vulnerability factors, predisposing gays and lesbians to developing sexual problems, while negative sexual cognitions are described as maintenance factors for sexual problems. Although no studies have been found about psychological intervention efficacy for sexual problems in same-sex couples, suggestions are made according to specificities found among same-sex couples, namely, sex roles, sex labels, sexual behaviors, or relationship types.

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  1. Psychotherapy and Psychopathology Research Unit from Research Center on Psychology (CIPsi), School of Psychology, University of Minho, Campus de Gualtar, Braga, 4710-057, Portugal

    Maria Manuela Peixoto

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  1. Cedars-Sinai Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California, USA

    Waguih William IsHak

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Peixoto, M.M. (2017). Sex and Sexual Orientation. In: IsHak, W. (eds) The Textbook of Clinical Sexual Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-52539-6_28

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