The association between sexual subjectivity and sexual health outcomes both negative and positive in a sample of women

BACKGROUND

The role of psychosocial constructs such as assertiveness and self-efficacy has increasingly been acknowledged as an important component of research and interventions directed at young women’s sexual health. The female sexual subjectivity inventory (FSSI) was developed to measure five distinct factors of young women’s experiences of sexual pleasure and empowerment as agentic sexual beings: 1) sexual body esteem, 2) entitlement to sexual pleasure from a partner 3) entitlement to sexual pleasure from the self, 4) self-efficacy in achieving sexual pleasure from a partner, and 5) sexual self-reflection. Though previous research has found positive associations between higher scores on the FSSI and other constructs such as sexual well-being and condom use self-efficacy, no studies have explicitly evaluated the association between FSSI scores and adverse sexual health outcomes.

METHODS

We conducted a cross-sectional survey of women affiliated with the University of Washington to assess the association between FSSI factors and the occurrence of three adverse sexual health outcomes in the prior 12 months: acquisition of an sexually transmitted infection, unwanted pregnancy, or taking emergency contraception (Plan B). We used multivariate logistic regression models to evaluate the association between each FSSI factor while controlling for age and estimated frequency of sexual activity. We also assessed the association between FSSI scores and self-reported orgasm frequency during partnered sexual activity. We did not find any statistically significant associations between mean score on any of the FSSI factors and adverse sexual health outcomes in the prior year.

RESULTS

We found that all FSSI factors except for sexual self-reflection were positively associated with increased orgasm frequency. We further used the FSSI scale in a novel way to identify a population of women who are discordant on their levels of entitlement to pleasure from partner and self-efficacy in achieving sexual pleasure.

CONCLUSIONS

Though our primary analysis did not show statistically significant results, our study underscores the validity of the FSSI as a measure to assess psychosocial constructs relevant to young women’s ability to experience sexual pleasure with a partner. Our research also indicates that different FSSI factors may interact with each other to inform women’s sexual behavior, and implications for future research using this scale are discussed.