Many studies focus on the differences in mental health between lesbian, gay, bisexual (LGB), and heterosexual individuals. Less attention has been paid to the differences in various aspects of sexual health and the potential explanations for these differences. Data from a Dutch population study on sexual health (aged 19-70 years; N = 4,333) were used to examine the potential differences in sexual satisfaction, sexual victimization, sexual dysfunction, and sexual health care need. At the same time, this study examined whether the differences could be attributed to differences in general factors influencing sexual health (sociodemographic variables and sexual behavior characteristics) or to LGB-specific factors (minority stress). The results showed that bisexual women and bi- and homosexual men had more often experienced sexual coercion and reported a higher need for sexual health care than their heterosexual counterparts. Both general determinants (e.g., a higher number of sexual partners or being single) and LGB-specific factors (e.g., internalized homonegativity or negative social reactions related to sexual orientation) were associated with different aspects of sexual health. Interventions aimed at improving the sexual health of LGB individuals should focus on general risk factors, as well as on LGB-specific stressors. Methodological limitations of the study and implications for further research are discussed.

Abstract A quasi-experimental study was conducted at a Dutch sexually transmitted infection (STI) clinic to compare the effects of educational counseling and motivational interviewing (MI)-based HIV/STI counseling on determinants of condom use and partner notification at 6-month follow-up. It also examined the feasibility of MI-based counseling in a busy real-life clinic. The counseling approaches were historically compared: respondents in the control condition were recruited between April and July 2005, those in the experimental condition between September and December 2005. The study involved 428 participants. These were all high-risk clients of the STI clinic. Their mean age was 33.7 years, and 39.6% were female. The study showed that MI-based counseling had a more positive effect on self-efficacy, intentions to use condoms with casual partners, and long-term condom use with steady partners. It had no adversarial outcomes on other social cognitions or behaviors compared to educational counseling. Furthermore, MI-based counseling is experienced as a more respectful and structured way of counseling. MI-based counseling was relatively easily implemented into the current clinic procedures. In addition to the implementation of the training, neither specialized staff nor additional or longer client visits were needed. However, some nurses indicated that the new method required more personal investment and effort. Limitations of the current study are the low response rates, the high educational level of most participants, and the small sample size regarding partner notification. Nonetheless, we conclude that MI-based counseling was a more effective approach to preventive counseling compared to educational counseling and feasible in the busy real-life setting.

This study investigated age- and gender-specific associations between parental support and parental knowledge of the child's whereabouts, on the one hand, and sexual experience and sexual health (the ability to have safe and pleasurable sexual experiences) on the other hand. A representative Dutch sample of 1,263 males and 1,353 females (aged 12-25 years), who had previously engaged in sexual intercourse, completed a questionnaire that included measures of these constructs. Both parental support and knowledge were positively associated with contraceptive use, social skills in sexual interactions, sexual satisfaction, and delay of sexual debut. Findings also revealed that the majority of correlations between parental support and sexual experience and sexual health are attributable to the relationship between a supportive family environment and parental knowledge of the child's whereabouts. Parental knowledge thus appeared to be more important for healthy sexual development than parental support.

Gender is central to sexuality, and vice versa, but there are a number of difficulties with the treatment of gender in sex research. Apparently, it is hard to find a balance between two conflicting needs. First, obviously, it is necessary to make distinctions between women and men, for political as well as research-technical and theoretical reasons. A second requirement, at odds with the first one, is the necessity to understand gender and its relation to sexuality and the body as much more complex than simplistically referring to two sets of individuals. This is all the more necessary when one realizes the possible drawbacks of exaggerating the differences between the sexes (in particular when they are biologically explained), because of stereotyping, stigmatizing, and expectancy confirmatory processes. This essay identifies and discusses 10 difficulties in the treatment of gender in sex research, reflects on their origins, and reviews theory and evidence with the aim to (1) consider the relative strength of gender/sex as an explanatory variable compared to other factors and processes explaining differences between men and women on a number of sexual aspects,(2) inform an understanding of gender and its relation to sexuality as an ongoing, open-ended, multi-determined, situated, interactional process, with the body as a third player, and (3) argue in favor of a nuanced, well-balanced treatment of gender in sex research.

This commentary wholeheartedly supports the critical observations by Kari Lerum and Shari L. Dworkin in this issue of the Journal of Sex Research with regard to the 2007 Report of the APA (American Psychological Association) Task Force on the Sexualization of Girls. The APA task force makes an overwhelmingly strong point for the dangers of the sexualization of women and girls and the self-objectification connected to it. However, their discussion of the evidence is noteworthy for being one-sided, generalizing, and negatively toned. Among the arguments presented in this commentary are notions about the rather diverse and often ambiguous nature of sexualized imagery and about the all too often ignored complexity of its presumed "effects." In addition, the issue of female sexual power and the case of sex workers are discussed. When sexualization is defined as only negative, both sex worker's rights and, more generally, women's rights to be sexual, get into a tight corner. The main contention is that sexualization is associated with risks, as well as with rights, and that any productive analysis will have to consider both.

Past research has consistently found that aging lesbians, gay men, and bisexuals (LGBs) are more apt to suffer from loneliness than their heterosexual counterparts. Data from the 2002 Gay Autumn survey (N = 122) were used to find out whether minority stress relates to higher levels of loneliness among older LGB adults in the Netherlands. We examined five minority stress factors: external objective stressful events, expectations of those events, internalized homonegativity, hiding and concealment of one's LGB identity, and ameliorating processes. The results showed that greater insight into loneliness among older LGB adults was obtained when minority stress factors were considered. Older LGB adults who had experienced negative reactions, as well as aging LGBs who expected those reactions, had the highest levels of loneliness. Having an LGB social network buffered against the impact of minority stress. These minority stress processes added to the variance already explained by general factors that influenced levels of loneliness (partner relationships, general social network, physical health, and self-esteem). Interventions aimed at decreasing feelings of loneliness among older LGBs should be focused on decreasing societal homonegativity (to decrease the amount of negative and prejudiced reactions) and on the enhancement of social activities for LGB elderly.

The "sexual trajectory" is an age-graded set of various new sexual experiences, defined by three key dimensions: sequence, duration, and timing. A comprehensive description of sexual trajectories creates the possibility to investigate potential risks of certain trajectory types. The present study attempted to answer three questions:(1) Is it possible to identify a typology in (the early stages of) sexual trajectories?(2) Is sexual trajectory type related to demographic characteristics, such as sex, ethnic background, and educational level?(3) What are the associations between sexual trajectory type and recent sexual risk behavior? A representative Dutch sample of 1,263 males and 1,353 females (M = 20.46 years; range, 12-25) who had engaged in sexual intercourse completed a questionnaire about sexual (health) behavior. About three quarters of participants followed a progressive sexual trajectory from less intimate (e.g., kissing) to more intimate behavior (e.g., sexual intercourse). Immigrant groups and less educated youth were more likely to follow a nonlinear trajectory. A progressive trajectory was associated with a higher likelihood of consistent contraceptive use with the most recent partner and, for girls, with a lower likelihood of having unprotected anal intercourse with the last partner. It was hypothesized that the nonlinear trajectory could be ascribed to a lack of opportunities or skills to plan and steer early sexual experiences and that these limitations were fairly stable over time. Sexual education should aim at providing adolescents with sufficient (self) knowledge and skills to construct their sexual trajectories according to their own wishes or needs.

Research has shown that aging lesbians, gay men, and bisexuals (LGBs) often experience feelings of loneliness. The main aim of this study was to examine whether older LGB adults in the Netherlands are lonelier than their heterosexual counterparts and, if so, whether the higher levels of loneliness can be attributed to a lower degree of social embeddedness. Using data from the Gay Autumn project and the NESTOR survey on Living Arrangements and Social Networks of Older Adults, we found that LGB elders were significantly lonelier and less socially embedded than heterosexual elders. Compared with their heterosexual peers, older LGBs were more likely to have experienced divorce, to be childless or to have less intensive contact with their children. They also had less intensive contact with other members of their families and they were less frequent churchgoers. Their weaker level of social embeddedness, however, only partially explained the stronger feelings of loneliness among older LGB adults. Nor could their higher levels of loneliness be attributed to other, non-social embeddedness factors (health, living conditions, self-esteem, and socioeconomic status). Emphasis on other aspects of social embeddedness, such as the quality of social relationships in the private domain and minority stress, is an important challenge for future research.

The higher prevalence of health problems in homosexual compared to heterosexual populations is usually understood as a consequence of minority stress. We hypothesized that differential rates of health problems also could result from sexual orientation-related differences in coping styles. We explored this using data collected in a general population-based study (N = 9684) via face-to-face interviews. A higher prevalence of both mental and physical health problems, as assessed with individual questions, the GHQ-12, and checklists, was observed in homosexual compared to heterosexual men and women. Coping style was related to sexual orientation in men, but not in women. Compared to heterosexual men, homosexual men more strongly applied emotion-oriented and avoidance coping strategies. Emotion-oriented coping mediated the differences in mental and physical health between heterosexual and homosexual men. Findings suggest the importance of further exploration of the development and use of emotion-oriented and avoidance coping by homosexual men.

Most work on adolescents' contact with sexuality in mainstream media has been framed in terms of media effects upon the sexual self-concepts, attitudes, and behaviors of youth, even when such causality cannot be inferred. Rarely examined are the sexual characteristics of adolescents that may predict contact with sexual media. Using Steele's (1999) Media Practice Model as a foundation, the present study reports on these associations for 2184 Dutch adolescents. Sex differences in the characteristics that predict such contact, and the role of youths' critical evaluations of information about sex in the media, are emphasized. Correlation and regression analyses revealed several sex differences in the characteristics related to sexual media contact, with individual characteristics accounting for more variance in females and critical evaluations accounting for more variance in males. The report underscores the need for more comprehensive, longitudinal studies of adolescents' media consumption and its conections to sexual development in youth.