This article was downloaded by: [The University of British Columbia]On: 06 January 2013, At: 12:16Publisher: RoutledgeInforma Ltd Registered in England and Wales Registered Number: 1072954 Registeredoffice: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK

Journal of Sex & Marital TherapyPublication details, including instructions for authors andsubscription information:http://www.tandfonline.com/loi/usmt20

Motivations and Sexual Attitudes,Experiences, and Behavior of SexualityProfessionalsMijal Luria a , E. Sandra Byers b , Susan D. Voyer b & Moshe Mock ca Hadassah University Hospital, Jerusalem, Israelb Department of Psychology, University of New Brunswick,Fredericton, New Brunswick, Canadac Meir Medical Center, Kfar Saba, IsraelAccepted author version posted online: 21 Dec 2011.Version ofrecord first published: 19 Dec 2012.

To cite this article: Mijal Luria , E. Sandra Byers , Susan D. Voyer & Moshe Mock (2013): Motivationsand Sexual Attitudes, Experiences, and Behavior of Sexuality Professionals, Journal of Sex & MaritalTherapy, 39:2, 112-131

To link to this article: http://dx.doi.org/10.1080/0092623X.2011.606882

PLEASE SCROLL DOWN FOR ARTICLE

Full terms and conditions of use: http://www.tandfonline.com/page/terms-and-conditions

This article may be used for research, teaching, and private study purposes. Anysubstantial or systematic reproduction, redistribution, reselling, loan, sub-licensing,systematic supply, or distribution in any form to anyone is expressly forbidden.

The publisher does not give any warranty express or implied or make any representationthat the contents will be complete or accurate or up to date. The accuracy of anyinstructions, formulae, and drug doses should be independently verified with primarysources. The publisher shall not be liable for any loss, actions, claims, proceedings,demand, or costs or damages whatsoever or howsoever caused arising directly orindirectly in connection with or arising out of the use of this material.

Journal of Sex & Marital Therapy, 39:112–131, 2013Copyright © Taylor & Francis Group, LLCISSN: 0092-623X print / 1521-0715 onlineDOI: 10.1080/0092623X.2011.606882

Motivations and Sexual Attitudes, Experiences,and Behavior of Sexuality Professionals

MIJAL LURIAHadassah University Hospital, Jerusalem, Israel

E. SANDRA BYERS and SUSAN D. VOYERDepartment of Psychology, University of New Brunswick, Fredericton, New Brunswick,

Canada

MOSHE MOCKMeir Medical Center, Kfar Saba, Israel

This study examined the motivations for entering the field andsexual attitudes, experiences, and behavior of an internationalgroup of sexuality professionals. Participants were 252 individu-als attending the XVII World Congress of Sexology who completeda questionnaire in English, Spanish or French. Most participants’reported professional rather than personal motivations for enteringthe field in addition to interest. On average, participants reportedlittle sexual communication with their parents as children. Aboutone-third had experienced unwanted sexual activity as a child.Participants were mostly accepting of a range of sexual activities,although they were less accepting of some behaviors than of oth-ers. Twelve of the participants who had engaged in sexual activitywith a casual or anonymous partner in the previous 2 years hadnot used a condom consistently. Participants reported high sexualsatisfaction and good sexual communication with their partner.

The authors thank Pierre Assalian, M.D., President, XVII World Congress of Sexology,Montreal, Canada, 2005, and Eusebio Rubio, M.D., President, International Scientific Com-mittee, XVII World Congress of Sexology, Montreal, Canada, 2005, for their support. Theyalso thank Ruthy Ben-Zion Shechter and Merav Sharon for their help during the conference.The authors also appreciate the input in questionnaire design of the Human Sexuality Re-search Group at the University of New Brunswick. This research was supported in part byunrestricted grants from Bayer Israel and CTS Israel.

Address correspondence to E. Sandra Byers, Department of Psychology, University ofNew Brunswick, P.O. Box 4400, Fredericton, New Brunswick, Canada, E3B 5A3. E-mail:byers@unb.ca

112

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 1

2:16

06

Janu

ary

2013

Sexuality Professionals 113

Nevertheless, 45% of the women and 35% of the men reported reg-ularly experiencing one or more sexual problems. Few participantsreported that their profession affected their sexual functioning neg-atively; in contrast most reported that it had positive effects on theirsexual functioning. These results suggest that there are few differ-ences between sexuality professionals and the general public.

In their work, sexuality professionals are involved in furthering the under-standing of human sexuality, promoting sexual health, and preventing andtreating sexual problems. As a group, sexuality professionals come from avariety of disciplines and have diverse training related to sexuality (Giami& de Colomby, 2006). Therefore, for this study, we broadly define sexualityprofessionals to include sex counselors, sex therapists, sex educators, andsex researchers. With the exception of anecdotal accounts of personal expe-riences largely of North American individuals (e.g., T. D. Fisher, 1989; Nijs,2006), little is known about the sexual attitudes, behaviors, and motivationsof sexuality professionals (Zamboni, 2009). Yet, on the basis of their in-terpretation of research findings and their professional experience, sexualityprofessionals are often called upon to inform public understanding of normaland typical behavior and attitudes as well as to weigh in on ideological de-bates (Gagnon, 1975). These interpretations may be influenced by personaland professional motivations for entering the field; by personal attitudes andexperiences; and by work with students, clients, and patients (Papaharitouet al., 2008; Poole, Giles & Moore, 2004; Stoler, 2002). Therefore, the firstgoal of this study was to broaden our understanding of aspects of the sexualattitudes, experiences, and functioning of an international group of sexualityprofessionals that might affect their work and to compare these findings todata from the general population. Specifically, we examined motivations forentering the field, childhood experiences, sexual attitudes, sexual communi-cation, sexual satisfaction, and sexual functioning.

Motivations for Entering the Field

The general public often assumes that sexuality professionals are motivatedto enter the field for personal reasons (Poole et al., 2004). If so, this could beproblematic as individuals who are primarily motivated by personal reasonsmay be less aware of and/or more affected (consciously or unconsciously) bytheir personal biases and motivations (Poole et al., 2004; Stoler, 2002). How-ever, research suggests that sexuality professionals enter the field for personaland professional reasons. For example, Dupras, Lafond, and Dionne (2001)investigated French-Canadian undergraduate students’ personal and profes-sional motivations for enrolling in a sexology program. They found that thestudents most frequently identified personal reasons such as the pleasure of

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 1

2:16

06

Janu

ary

2013

114 M. Luria et al.

learning new things about sexuality, the desire to understand sexual phenom-ena, and the possibility of having interesting employment as their reasons forchoosing the sexology program. However, the majority of students also iden-tified contributing to the well-being of others—a professional reason—as animportant motivation for entering the field. Relatively few students identifiedincreasing the quality of their sex life as a personal motivation. However,the extent to which these results are reflective of the motivations of sexualityprofessionals is not known. Zamboni (2009) found that personal interest wasthe strongest factor influencing sexuality professionals to enter the field, fol-lowed by work experience and personal experiences. However, other thaninterest, Zamboni (2009) did not assess specific personal and professionalreasons for entering the field. Therefore, we assessed the extent to which arange of personal and professional reasons motivate sexuality professionalsto enter the field.

Childhood Experiences

Childhood experiences have been shown to be associated with sexual be-liefs, expectations, and function (Dennerstein, Alexander, & Kotz, 2003;Guthrie, Dennerstein, Taff, Lehert, & Burger, 2004; Laumann et al., 2005;Papaharitou et al., 2008). Therefore, we assessed the sexuality educationprofessionals had received from their parents as well as their history of un-wanted sexual experiences in childhood.

Most parents do not engage in frequent or high-quality parent–child sex-ual communication (Byers et al., 2003a, 2003b; Byers, Sears, & Weaver, 2008;Martino, Elliott, Corona, Kanouse, & Schuster, 2008; McKay & Holowaty,1997; McKay, Pietrusiak, & Holowaty, 1998; Mueller, Gavin, & Kulkarni,2008; Schouten, van den Putte, Pasmans, & Meeuwesen, 2007). For exam-ple, Schouten et al. (2007) found that, on average, in the previous year, highschool students in The Netherlands had talked to their parents about sexualtopics between never and sometimes. Similarly, only 36% of Canadian highschool students rated the quality of the sexual health education they hadreceived from their parents as excellent or very good; a similar percentagerated it as fair or poor (Byers et al., 2003a). This may be because, accord-ing to Canadian parents, on average they had discussed most sexual healthtopics with their child in general terms only and had discussed no topicsin a lot of detail (Weaver, Byers, Sears, Cohen, & Randall, 2002). In non-Western countries, parent–child sexual communication may be even poorer(e.g., Duyan & Duyan, 2005; Izugbara, 2008; Namisi et al., 2009). The ex-tent to which sexuality professionals grew up in families in which sexualitywas discussed in at least some detail has not been investigated. However,growing up in a family with open sexual communication likely increases anindividual’s comfort talking about sexuality. Thus, we expected that sexuality

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 1

2:16

06

Janu

ary

2013

Sexuality Professionals 115

professionals would report better quality sexual health education with theirparents than is true of the general population.

Estimates of the prevalence of child sexual abuse range depending onthe breadth of the definition used. Most research has found that between15% and 33% of women in the general population report a history of un-wanted sexual activity as a child (Polusny & Follette, 1995; Rind, Tromovitch,& Bauserman, 1998). The estimates for boys range from 4% to 16% (Dubeet al., 2005; Finkelhor, Hotaling, Lewis, & Smith, 1990; Holmes & Slap, 1998).For example, Dube et al. (2005) found that 16% of the men and 25% of thewomen in their sample had experienced some type of childhood sexualabuse involving physical contact such as fondling and/or any type of sex-ual intercourse. It might be that a history of unwanted childhood sexualexperiences makes individuals more likely to want to work in the sexual-ity field, perhaps as a result of working through their own sexual issues.If so, sexuality professionals would report high rates of unwanted sexualactivity as children. Alternatively, researchers have shown that a history ofchild sexual abuse is associated with a variety of negative outcomes includ-ing posttraumatic stress disorder, depression, poor academic performance,and poorer sexual well-being (Lemieux & Byers, 2008; Paolucci, Genuis, &Violato, 2001). Thus, it is also possible that individuals who have experi-enced unwanted sexual experiences in childhood are less likely to becomesexuality professionals.

Attitudes and Behavior

Health care professionals hold diverse attitudes toward human sexuality (W.A. Fisher et al., 1988; Papaharitou et al., 2008). For example, Papaharitouet al. (2008) found a broad range of sexual attitudes among Greek studentsin five different health care disciplines, ranging from conservative to liberal,with more than half scoring in the neutral range. However, researchers havenot investigated the attitudes of sexuality professionals toward different sex-ual behaviors. Yet, sexuality professionals play an important role in settingsexual discourses by providing scientific standpoints that may be translatedinto what is considered normal (Gagnon, 1975). There are reasons to thinkthat, as a group, sexuality professionals hold accepting attitudes. For ex-ample, sexuality professionals participate in courses, supervised practice,conferences, and workshops related to a range of sexual topics as part oftheir training and/or continuing education. Such training has been shown topromote, among medical students and clinical psychology graduate students,confidence in one’s ability to discuss sexual issues with clients as well as un-derstanding and acceptance of sexual diversity (Dixon-Woods et al., 2002;W. A. Fisher et al., 1988; Marcotte & Logan, 1977; Miller & Byers, 2008, 2009,2010). Thus, we expected that, on average, sexuality professionals would

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 1

2:16

06

Janu

ary

2013

116 M. Luria et al.

hold accepting sexual attitudes to a range of consensual sexual expression.We also expected that their level of acceptance would vary from behaviorto behavior such that they would be less accepting of more controversialbehaviors such as group sex or paying for sex.

Sexuality professionals’ decisions in their personal lives may affect theirwork, consciously or unconsciously, and the public’s perceptions of them.Therefore, we also examined the behavior of sexuality professionals withrespect to sexual activity with casual and anonymous partners. Research inthe United Kingdom has shown that 23% of heterosexual men and 11% ofheterosexual women had engaged in first sex within 24 hr of meeting aperson in the past year (Mercer et al., 2009). Further, 38% of the men and29% of the women in the 35–44-year age range reported having used acondom the first time they had sex with a new partner. Although it is likelythat sexuality professionals are accepting of casual sex in others, the extentto which they personally engage in casual sex is not known. However, giventheir work promoting sexual health, we expected that sexuality professionalswould have greater knowledge about and enhanced personal motivationto engage in safer sex and, therefore, to use condoms consistently withanonymous or casual partners.

Sexual Communication and Sexual Functioning

Couples develop and maintain sexual satisfaction in long-term relationships,at least in part, through sexual self-disclosure of their sexual likes and dislikes(Cupach & Comstock, 1990; Cupach & Metts, 1991; MacNeil & Byers, 1997,2005, 2009; Purnine & Carey, 1997). However, on average, individuals reportdisclosing only a moderate amount about their sexual likes and dislikeseven in highly satisfying relationships (MacNeil & Byers, 2005, 2009). In theirwork, many sexuality professionals emphasize the importance of sexual self-disclosure within relationships. We, therefore, expected that they would behighly motivated to engage in high mutual sexual self-disclosure in theirrelationships.

Studies of the general population show that most couples report highsexual satisfaction (Byers & MacNeil, 2006; Lawrance & Byers, 1995). Forexample, Dunn, Croft, and Hackett (1998) found that 79% of female re-spondents and 70% of male respondents in Great Britain were extremely orquite satisfied with their current sex life. Nonetheless, internationally thereis a high incidence of sexual problems and concerns, with about 28% ofmen and 39% of women reporting that they experience one or more sex-ual problem sometimes or frequently (Nicolosi et al., 2006; Nicolosi et al.,2004). Because sexuality professionals are aware of the importance of sexualcommunication to sexual satisfaction and sexual functioning and of how toavoid and treat sexual problems, it is possible that they experience fewer

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 1

2:16

06

Janu

ary

2013

Sexuality Professionals 117

sexual problems than does the general population. In contrast, sexuality pro-fessionals often deal on a regular basis with stories of sexual and emotionalabuse and distress. Traumatic narratives may have a negative effect on thesexual life of therapists and researchers, on an emotional and a cognitivelevel (Nijs, 2006; Poole et al., 2004). This could result in lower sexual sat-isfaction and higher rates of sexual problems. Therefore, we examined thesexual satisfaction and sexual problems reported by sexuality professionalsas well as their perceptions of the effect of their work on various areas oftheir sexual functioning.

The Present Study

The aim of this study was to broaden our understanding of the motivationsfor entering the field, sexual attitudes, sexual experiences, and sexual func-tioning of an international group of sexuality professionals. We predictedthat, compared with the general population, sexuality professionals wouldreport better sexual communication with their parents, consistent condomuse with new partners, more extensive sexual communication with a partner,higher sexual satisfaction, and fewer sexual problems. We also examined thefollowing research questions for which we could not make specific predic-tions: motivations for entering the field, history of unwanted sexual experi-ences in childhood, range of sexual attitudes, frequency of engaging in casualsex, and the extent to which they perceive themselves to have been changedby their work in the field. Last, because men and younger individuals tendto hold more liberal sexual attitudes (Barrett, King, Levy, Maticka-Tyndale,& McKay, 1997; Baumeister, Catanese, & Vohs, 2001; Nagourney & Thee,2007; Oliver & Hyde, 1993), we examined the extent to which gender andage were associated with these characteristics.

METHOD

Participants and Procedure

The English version of the questionnaire was distributed in the registrationpackage to participants attending the XVII World Congress of Sexology heldin Montreal, Canada, in July 2005. The researchers gave a brief presentationat the opening plenary session explaining the purpose and rationale for thestudy and the availability of Spanish and French versions of the questionnairein the exhibition hall. Participants returned completed questionnaires to col-lection boxes that were available in several locations in the main hallway.Questionnaires were completed and returned by 252 of the 1,000 regis-trants (170 women and 82 men; 25%). Participants ranged in age from 22 to80 years (M = 45.4 years, SD = 12.8 years) and had an average of 13.0 years(SD = 10.0 years) of experience in the field. Most (64.8%) were married or

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 1

2:16

06

Janu

ary

2013

118 M. Luria et al.

living with a romantic partner. The sample consisted of 77 sexuality profes-sionals residing in Canada, 53 in the United States, 17 in Mexico, 17 in France,and 82 from 21 different countries covering all five continents. Question-naires were completed in all three available languages: 66% in English,20% in French, and 14% in Spanish. The majority of respondents identi-fied themselves as psychologists (31.3%), physicians (20.2%), or sexualityeducators (13.5%), although there were also social workers, anthropologists,sociologists, nurses, and other therapists among the participants. In addition,69% identified as clinicians, 39% as researchers, 40% as educators, and 12%checked other (participants could check more than one category). In termsof sexual orientation, 83% of the sample identified themselves as heterosex-ual; 17% as a sexual minority. In terms of religiosity, 3% indicated that theywere very religious, 23% moderately religious, 26% somewhat religious and47% not religious.

Questionnaire

The questionnaire consisted of 26 questions; only questions used in thisstudy are subsequently described. Participants first provided informationabout their demographic characteristics including their age, gender, relation-ship status, religiosity (4 = not at all religious to 1 = very religious), sexualorientation, discipline, self-identification within the discipline (clinician, re-searcher, educator, other), and years of experience in sexology. Participantsselected from a list of 10 reasons developed for this study (see Table 1),all the reasons why they chose to become a sexologist. Four of the reasonsreflected professional reasons (i.e., perceived needs in the field) and sixreflected personal reasons (e.g., finding a solution to my own problems.)

TABLE 1. Reasons for Becoming a Sexologist

Percentage ofRespondents

Topic Who Agreed

Professional reasonsA lot left to learn about sexuality 84Improve sexual health 79Field needs more professional attention 75Help clients/students with problems 74

Personal reasonsField is interesting 94Makes me unique 32Enjoy work that might be provocative 32Like to hear about sexual issues of others 30Gives me legitimacy to explore sex 21Find solution to my own problems 22

Note. Total number of respondents was 252 (82 men, 170 women).

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 1

2:16

06

Janu

ary

2013

Sexuality Professionals 119

Participants also had the option of writing in reasons they entered the fieldthat were not listed.

With respect to their childhood, participants indicated the extent towhich their parents had discussed each of six sexual topics (e.g., mastur-bation, intercourse, sexual decision making) with them on a 4-point scaleranging from 1 (not at all) to 4 (in a lot of detail). Ratings were summedsuch that possible scores ranged from 6 to 24, with higher scores indicatingmore detailed discussion with their parents. These items were adapted fromWeaver et al. (2002). Byers et al. (2009) demonstrated good internal consis-tency for a longer version of this scale used with parents (α = .88 in thepresent study). Respondents also evaluated the sexual education providedby their parents on a 5-point scale ranging from 1 (very bad) to 5 (very good)using a question developed by Byers et al. (2003a). Because the middle pointon the Byers et al. scale, good, was positive rather than neutral, we changedthe response scale in order to provide a more continuous measure with aneutral point (i.e., neither good nor bad). Last, participants indicated whetherthey had experienced, as a child, each of eight types of unwanted sexualexperiences involving physical contact, ranging from kissing and hugging ina sexual way to touching to performing a sexual activity. In keeping withDube et al. (2005) and Lemieux and Byers (2008), respondents were consid-ered to have experienced unwanted sexual experiences in childhood if theyindicated that they had experienced any of these contact activities.

An attitude scale consisting of 12 sexual behaviors that varied in theextent to which they might be seen as controversial (see Table 2) was de-veloped for the present study. Participants rated their attitude toward eachbehavior on a 4-point scale ranging from 1 (never acceptable) to 4 (alwaysacceptable). This scale had high internal consistency (α = .89). Participants

TABLE 2. Level of Acceptance of 12 Sexual Activities

Behavior M SD

Heterosexual sexual activity 3.9 0.4Masturbation 3.9 0.4Oral sex 3.8 0.5Same-sex sexual activity 3.5 0.8Anal sex 3.3 0.9Casual sex 2.9 1.0Cross-dressing 2.8 1.2Internet sex 2.6 0.9Whipping/spanking as a part of sexual activity 2.6 1.1Group sex 2.4 1.1Paying for sex 2.3 1.0Extramarital/extradyadic sex 2.2 0.8Overall 3.0 0.6

Note. Total number of respondents was 252 (82 men, 170 women). Participants reported responses on a4-point Likert-type scale ranging from 1 (never acceptable) to 4 (always acceptable).

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 1

2:16

06

Janu

ary

2013

120 M. Luria et al.

also indicated whether they had engaged in penetrative sex with a casualand/or anonymous partner within the past 2 years and, if so, whether theyhad used condoms never, sometimes, or every time.

Participants who were in a steady relationship indicated their overallrelationship satisfaction and sexual satisfaction with their partner on 5-pointscales ranging from 1 (very unsatisfying) to 5 (very satisfying). They alsoindicated the extent to which they had discussed each of 10 topics withtheir partner on a 4-point scale ranging from 1 (not at all) to 4 (in a lot ofdetail). Five items assessed the extent of discussions of their own experiencesand preferences: past experiences, sexual fantasies, things that arouse me,masturbation patterns, and sexual difficulties. Five parallel items assessedthe extent of discussions of their partner’s experiences and preferences withrespect to these same topics. Possible scores ranged from 10 to 40 withhigher scores indicating more detailed discussion. Internal consistency forthis scale was high (α = .91).

Participants indicated the frequency with which they had experienceda range of sexual problems within the previous 6 months on a 5-point scaleranging from 1 (almost never or never) to 5 (almost always or always). Themen were asked about lack of interest, trouble getting or keeping an erection,lack of subjective arousal, rapid ejaculation, and delayed ejaculation. Thewomen were asked about lack of interest, difficulty with lubrication, lack ofsubjective arousal, difficulty reaching orgasm, and genital pain. In keepingwith Nicolosi and colleagues (Nicolosi et al. 2006; Nicolosi et al., 2004),participants who indicated sometimes, most times, or almost always or alwaysto any item were considered to have experienced a sexual problem.

Using items developed for the present study, respondents indicated theextent to which becoming a sexologist had affected nine aspects of theirsexual functioning (see Table 4). Responses were made on a 5-point scaleranging from 1 (significant deterioration) to 5 (significant improvement).For each item, responses of mild or significant deterioration were combinedas indicating a negative effect; responses of mild or significant improvementwere combined as indicating a positive effect.

Data Analysis

First, we conducted preliminary analyses to determine whether there weresignificant differences between individuals who completed the survey inEnglish, French, and Spanish on any of the variables examined in the study.Next, we examined gender differences using t tests; we used zero-ordercorrelations to examine relations with age. Because of the large number ofanalyses, alpha was set at p < .01. Because there were no differences on thebasis of the language of the survey and few gender or age differences, onlysignificant findings are subsequently reported.

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 1

2:16

06

Janu

ary

2013

Sexuality Professionals 121

RESULTS

The most frequent reason given for going into the field of sexology, endorsedby almost all participants, was interest (see Table 1). Between one fifth andone third of participants also endorsed the five other personal reasons forentering the field. However, a majority of respondents endorsed all fourof the professional reasons provided for becoming a sexuality professional.Of respondents, 68 (27%) provided written responses to the question aboutwhether there were additional reasons they had entered the field. Most ofthese responses elaborated on motivations already listed—for example, whythey felt that the field needs more professional attention or the reasons theyfound the field interesting. Other participants gave idiosyncratic responsesthat were not well represented on the list. The most frequent of these (givenby 4% of respondents) was wanting to educate or change society. For ex-ample, one participant wrote about wanting to help in a small way to altersociety’s norms in a more tolerant direction. Another participant wanted toraise awareness about sexual minorities/practices.

Childhood Experiences

On average, participants rated the quality of the sexual education providedto them by their parents as between bad and neither good nor bad (M =2.6, SD = 1.1). Only 15.3% rated the quality as good or very good and 43%rated it as bad or very bad. On average, they indicated that their parentshad discussed the six sexuality topics with them between not at all andin general terms only. The women (M = 2.7, SD = 1.1) tended to reporthigher quality parent–child sexual communication than did the men (M =2.3, SD = .9), t(193) = 2.98, p = .003. Younger respondents tended to reportbetter quality parent–child sexual communication as well as more detaileddiscussions with their parents, r(246) = –.22, p < .001 and r(249) = –.28,p < .001, respectively. Of participants, 86 (32% of the women and 38% ofthe men) reported that they had experienced one or more unwanted contactsexual experience as a child.

Attitudes and Behaviors

Participants’ opinions on the acceptability of various sexual activities are sum-marized in Table 2. On average, participants rated heterosexual activity, mas-turbation, oral sex, and same-sex activity as always acceptable. They ratedanal sex, casual sex, cross-dressing, Internet sex, and whipping/spanking aspart of sexual activity as mostly acceptable. They rated group sex, paying forsex, and extramarital/extradyadic sex as sometimes acceptable. Overall, their

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 1

2:16

06

Janu

ary

2013

122 M. Luria et al.

responses corresponded to mostly acceptable. Younger respondents tendedto hold more accepting attitudes, r = −.21, p = .002.

About one quarter of participants (23%) had engaged in penetrativesex with a casual or anonymous partner within the previous 2 years. Ofthese individuals, 79% reported that they had used a condom on all of theseoccasions. That is, 12 individuals indicated that they had not consistentlyused a condom with casual and/or anonymous partners.

Sexual Communication and Relationship Satisfaction

On average, respondents who were in a steady relationship rated their overallrelationship (M = 4.26, SD = 0.95) and their sexual relationship (M = 4.03,SD = 1.05) as satisfying. On average, participants reported that their sexualdiscussions with their partner were in some detail. Younger participantstended to have discussed the sexual topics in more detail, r = –.26, p <

.001.

Sexual Functioning

Overall, 45% of the women and 35% of the men indicated that they hadexperienced at least one sexual problem sometimes or more often in thepast 6 months (see Table 3). These included 27% of the women and 21%of the men who reported a sexual problem that occurred sometimes; and,18% of the women and 15% of the men who reported that the problemoccurred most of the time or always. Lack of desire or interest was the mostfrequent sexual problem reported by the women. Lack of desire and erectiledifficulties were the most frequent sexual problem reported by the men.We used a 2 (gender) × 2 (no sexual problem/sexual problem) analysis

TABLE 3. Percentage of Men and Women Reporting Each Sexual Problem

Women Men

No sexual Sexual No sexual Sexualproblem problem problem problem

Lack of sexual desire or interest 73.0 27.0 85.9 14.1Lack of feeling of arousal during sexual activity 88.3 11.7 93.5 6.5Difficulty with vaginal lubrication 79.1 20.9 — —Difficulty reaching orgasm/delayed ejaculation 83.4 16.6 88.7 11.3Genital pain during sexual activity 89.5 10.5 — —Trouble getting or keeping an erection — — 85.9 14.1Rapid ejaculation — — 88.6 11.4One or more of the listed problems 54.7 45.3 64.6 35.4

Note. Total number of respondents was 252 (82 men, 170 women). Having a sexual problem wasoperationally defined as responding sometimes, most of the time, almost always, or always.

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 1

2:16

06

Janu

ary

2013

Sexuality Professionals 123

TABLE 4. Perceptions of the Effect of Becoming a Sexologist

Negative No change PositiveDimension effect (%) (%) effect (%)

Sexual desire 6.3 44.6 49.2Physiological arousal 2.5 64.7 32.8Subjective arousal 3.0 49.6 47.5Frequency of orgasm 1.3 69.1 29.7Quality of orgasm 0.8 53.6 45.6Ejaculatory control (men only) 1.2 50.0 48.8Sexual satisfaction 4.6 30.4 64.9Sexual frequency 6.7 61.1 32.2Relationship satisfaction 3.3 36.4 60.3

Note. Total number of respondents was 252 (82 men, 170 women). Negative effect refers to significantdeterioration or mild deterioration, and positive effect refers to significant or mild improvement.

of variance with age as the dependent variable to examine possible groupdifferences in age. The main effect for gender was significant, F(1, 246) =34.64, p < .001. However, this was qualified by a significant interaction, F(1,246) = 9.01, p = .003. Whereas age was not associated with whether thewomen reported a sexual problem, the men who reported a sexual problemwere significantly older (M = 56.7) than the men who did not (M = 48.3).

Perceived Effect of Being a Sexologist

Participants indicated how being a sexologist had affected nine differentareas of their sexual functioning (see Table 4). Only 12% of participants in-dicated that one or more area had been adversely affected; most commonlythis was deterioration in sexual desire or sexual frequency. In contrast, 79%of participants reported an improvement in at least one of the areas; mostfrequently this was improved sexual satisfaction and relationship satisfaction.Overall, only 2% of respondents reported that they had experienced a neg-ative effect but no positive effect. On the other hand, 69% reported only apositive effect and no negative effect.

DISCUSSION

The main purpose of this study was to broaden our understanding of themotivations for entering the profession, sexual attitudes, sexual experiences,and sexual functioning of an international group of sexuality professionals.As such, our participants came from a number of different disciplines andidentified as clinicians, researchers, and educators. We found that our par-ticipants entered the field for diverse reasons—personal and professional.Consistent with past research (Dupras et al., 2001; Zamboni, 2009), the most

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 1

2:16

06

Janu

ary

2013

124 M. Luria et al.

common reason for entering the field was personal interest. We extendedpast research by showing that most sexuality professionals also were moti-vated by professional reasons aimed at contributing to the field and betteringthe human condition. These reasons included the perception that the field isin need of professional attention as well as a desire to help clients/studentswith their problems, contribute to knowledge, and improve sexual health. Incontrast, a minority of participants endorsed personal reasons for enteringthe field that would be more likely to result in personal bias such as want-ing to feel unique, learn about their own sexuality, and/or solve their ownpersonal problems.

As subsequently discussed in more detail, we found few differencesfrom the general population in sexuality professionals’ sexual attitudes, ex-periences, and functioning. For example, childhood sexual experiences donot appear to account for why these professionals entered the field in thatthe quality of parent–child sexual communication and rates of unwantedsexual experience in childhood were similar to the general population (By-ers et al., 2003a; Dube et al., 2005; Finkelhor et al., 1990; Holmes & Slap,1998). Conversely, being a sexuality professional does not appear to protectindividuals from experiencing sexual problems; the rates of sexual problemswere similar to those found in community samples (Nicolosi et al., 2004).For the most part, our results did not differ for English, French, and Spanishspeakers, men and women, and/or older and younger participants. How-ever, younger participants reported more liberal attitudes and better sexualcommunication with their partner.

Childhood Experiences

We predicted that sexuality professionals would, on average, report growingup in families with more open sexual communication than is true of thegeneral population. However, few of the participants in this study gave theirparents high marks for sexual communication. Only 15% rated the quality ofthe sexual education provided by their parents as good or very good and 43%rated it as bad or very bad. Similarly, using a different rating scale, 37% ofCanadian high school students rated the quality of sexual education providedby parents as fair or poor (Byers et al., 2003a). Although the rating scales arenot directly comparable, these results suggest that, contrary to predictions,sexuality professionals have not received better quality sexual education fromtheir parents than individuals who are not sexuality professionals, at leastthan Canadian individuals, and may indeed have received worse sexualityeducation. This may be less true for younger sexuality professionals becausewe found that younger individuals tend to report better parent–child sexualcommunication than did older individuals. However, the magnitude of thisrelationship was small. It may also be that the quality of parent–child sexual

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 1

2:16

06

Janu

ary

2013

Sexuality Professionals 125

communication actually was better for sexuality professionals than for otherindividuals but that they evaluate it more negatively because they have higherstandards for what they now see as expected sexual communication betweenparents and children. This interpretation is made less likely by the fact thatour participants reported very little sexual communication with their parents.That is, consistent with previous research (Weaver et al., 2002), on average,they indicated that their parents had discussed each of the six sexuality topicsbetween not at all and in general terms only. Apparently, for most sexualityprofessionals open discussion in their family of origin is not a prerequisitefor entering the field.

Between 15% and 33% of women and 4% and 16% of men in the generalpopulation report a history of unwanted sexual activity as a child (Dube etal., 2005; Finkelhor et al., 1990; Holmes & Slap, 1998; Polusny & Folette, 1995;Rind et al., 1998). Although at the high end, the percentage of our femaleparticipants who reported one or more experience of unwanted sexualityactivity (33%) is similar to these results. However, we found that substan-tially more of the men in our sample, 38%, reported having experiencedunwanted sexual activity as a child than has been reported in surveys of thegeneral population. This may be because male sexuality professionals aremore willing to disclose childhood sexual experiences, even anonymously.Alternatively, this finding may indicate that a history of unwanted sexualexperiences in childhood motivates some individuals, particularly men, towork in the sexuality field. These explanations are made less likely by thefact that, in participants’ written responses, only 1 identified sexual traumain childhood as a motivation for entering the field. Given the diversity ofoperational definitions of unwanted sexual activity/child sexual abuse in theliterature, the extent to which individuals’ personal sexual history motivatesthem to become sexuality professionals merits further research.

Attitudes and Behaviors

The sexuality professionals we surveyed were diverse in their attitudes to-ward a range of sexual behaviors, with attitudes ranging from not acceptingto very accepting. Nonetheless, as expected, on average the participants wereaccepting of these behaviors, with the level of acceptance varying from onebehavior to another. Heterosexual activity, same-sex sexual activity, mastur-bation, and oral sex were rated, on average, as always acceptable. There was,however, somewhat less acceptance of anal sex, casual sex, cross-dressing,and whipping/spanking as part of sexual activity that were rated, on average,as mostly acceptable. The topics that were rated as least acceptable and seenas only sometimes acceptable were group sex, paying for sex, and extramar-ital/extradyadic sex. It may be that some participants found these behaviorsless acceptable not because of the behaviors themselves but because they

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 1

2:16

06

Janu

ary

2013

126 M. Luria et al.

believe that there is exploitation involved in the activity (e.g., of sex workersor spouses). It should be noted, however, that some individuals (10% to26%) rated even these more controversial behaviors as always acceptable.

We did not assess the extent to which less accepting attitudes affectedparticipants’ work as professionals. It is possible that individuals who havemore conservative views about these more controversial behaviors have dif-ficulty taking a nonjudgmental stance in their professional work, whetherin therapy, education, or research. If so, training and continuing educationmay need to place more emphasis on ensuring that individuals are nonjudg-mental in their interaction with clients, patients, and students as well as intheir framing of research questions. This might be particularly true for olderindividuals in the field; we found that attitudes have become more permis-sive, with younger individuals finding the 12 behaviors more acceptable thandid older participants. However, it is possible that, through training, sexual-ity professionals with more conservative attitudes are able to separate theirpersonal opinions from their work.

Participants were generally accepting of casual sex. However, less thanone quarter of participants had engaged in penetrative sex with a casual oranonymous partner within the past 2 years. This is consistent with findingsthat professionals tend to hold accepting attitudes toward the behavior ofothers but may not want to engage in the behavior themselves (Duyan &Duyan, 2005; Marcotte & Logan, 1977). Nonetheless, the percent of sexualityprofessionals who have engaged in casual sex was somewhat higher thanreported by Mercer et al. (2009) in their research in the United Kingdomusing a community sample of heterosexual individuals (23% of men and11% of women). This may be because of the different time frames used inthe present research (2 years) and by Mercer et al. (2009; 1 year). Whatis perhaps most surprising is that 12 of these individuals (20%) reportedthat they had not used a condom on all of these occasions. That is, despiteknowledge of the risks of unprotected sex and their role in promoting safersex behaviors, some professionals (although not a large number) had notconsistently used condoms with casual and anonymous partners. Althoughthe rate of condom use with new partners (80%) among professionals washigher than that found among community samples (30–40%; Mercer et al.,2009), it is not consistent with the stated target in sexual health campaignsof condom use 100% of the time.

Sexual Communication and Sexual Functioning

Most of the participants with partners reported being satisfied with theiroverall relationship and their sexual relationship. Further, they tended tohave open communication with their partner about a range of sexual top-ics. That is, on average they had discussed their own and their partner’s

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 1

2:16

06

Janu

ary

2013

Sexuality Professionals 127

past experiences, sexual likes, sexual difficulties, masturbation patterns, andsexual fantasies in some detail. This suggests that sexuality professionalsare able to apply their understanding about the importance of open sexualcommunication with a partner in their own relationships.

Lack of desire was the most frequent problem reported by the women;lack of desire and erectile difficulties were the most frequent problems re-ported by the men. These also tend to be the most frequently reportedproblems in community samples, using the same criterion of experiencingsexual problems sometimes or more often (Laumann et al., 2005; Nicolosiet al., 2004). In addition, the rates of reported sexual problems (45% ofwomen, 35% of men) were similar to those reported in community sam-ples (e.g., Nicolosi et al., 2004). This suggests that knowledge about sexualfunctioning, high sexual and relationship satisfaction, and good sexual com-munication do not protect sexuality professionals from experiencing sexualproblems. We did not assess the extent to which participants were distressedby their sexual problems. For many individuals, sexual problems are not as-sociated with distress (Shifren, Monz, Russo, Segreti, & Johannes, 2008). Itmay be that although the rates of sexual problems are similar to those in thegeneral population, as a result of their greater knowledge, sexuality profes-sionals find their sexual problems less distressing.

On the other hand, the results suggest that being a sexuality professionaldoes not have a detrimental effect on most individual’s personal sexual lives.This conclusion is consistent with the self-reports of our participants. Indeed,79% of the sexuality professionals indicated that their profession had a posi-tive effect on one or more aspects of their sexual functioning, most frequentlytheir sexual satisfaction and relationship satisfaction. In contrast, only 12%of participants (30 individuals) reported a negative effect on any aspect oftheir sexual lives; this was most frequently a negative effect on sexual desireand/or sexual frequency. Nonetheless, research is needed to assess what as-pects of work as a sexuality clinician, researcher and/or educator adverselyaffect at least some people who work in the field—for example, hearing thedetails of clients’ students’ and research participants’ sexual lives, traumaticnarratives, and/or history of sexually transmitted infections; encounteringnegative attitudes, stereotyping and prejudice, and resistance to factual sex-ual information. This information is vital to developing programs to inoculatesexuality professionals against any negative outcomes from their work.

Conclusion

There are some limitations to this study. First, there is the possibility that theresults were affected by selection bias. We only assessed individuals attend-ing the meeting of the World Association of Sexual Health. This excludedsexuality professionals who attend other professional meetings as well as

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 1

2:16

06

Janu

ary

2013

128 M. Luria et al.

those who would have liked to but could not afford to or were unable totravel to attend the World Association of Sexual Health meeting. Further,in keeping with the location of the meeting, Canadians were overrepre-sented in the sample. In addition, only 25% of those attending the conferencecompleted the questionnaire. Second, although we compared responses topublished data from community samples, we were not able to include amatched control group. Last, it was not possible to analyze the results ac-cording to the country or cultural background of participants because of thesmall numbers of participants from many of the countries and/or culturalbackgrounds. However, we did not find any differences between individualswho completed the survey in English, French, and Spanish. Our sample sizealso precluded comparing individuals on the basis of sexual orientation orprofession.

Nonetheless, these results shed light on the sexual attitudes, experi-ences, and functioning of an international group of sexuality professionalsdemonstrating that, as a group, sexuality professionals tend to resemble thegeneral population. Further, they demonstrate that, for the most part, sexual-ity professionals are motivated to enter the field by their desire to contributeto the profession and to better the human condition, a finding that may makepeople feel more comfortable about seeking professional help for their sex-ual concerns and participating in sexuality research.

REFERENCES

Barrett, M., King, A., Levy, J., Maticka-Tyndale, E., & McKay, A. (1997). Canada. InR. T. Francoeur (Ed.), International enclyclopedia of sexuality (pp. 221–343).New York, NY: Continuum.

Baumeister, R., Catanese, K., & Vohs, K. (2001). Is there a gender difference instrength of sex drive? Theoretical views, conceptual distinctions, and a reviewof relevant evidence. Personality and Social Psychology Review, 5, 242–273.

Byers, E. S., & MacNeil, S. (2006). Further validation of the interpersonal exchangemodel of sexual satisfaction. Journal of Sex & Marital Therapy, 32, 53–69.

Byers, E. S., Sears, H. A., Voyer, S. D., Thurlow, J. L., Cohen, J. N., & Weaver, A. D.(2003a). An adolescent perspective on sexual health education at school andat home: I. High school students. Canadian Journal of Human Sexuality, 12,1–17.

Byers, E. S., Sears, H. A., Voyer, S. D., Thurlow, J. L., Cohen, J. N., & Weaver, A. D.(2003b). An adolescent perspective on sexual health education at school and athome: II. Middle school students. Canadian Journal of Human Sexuality, 12,19–33.

Byers, E. S., Sears, H. A., & Weaver, A. D. (2008). Parents’ reports of sexual com-munication with children in Kindergarten to Grade 8. Journal of Marriage andFamily, 70, 86–96.

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 1

2:16

06

Janu

ary

2013

Sexuality Professionals 129

Cupach, W. R., & Comstock, J. (1990). Satisfaction with sexual communication inmarriage: Links to sexual satisfaction and dyadic adjustment. Journal of Socialand Personal Relationships, 7, 179–186.

Cupach, W. R., & Metts, S. (1991). Sexuality and communication in close relation-ships. In K. McKinney & S. Sprecher (Eds.), Sexuality in close relationships(pp. 93–110). Hillsdale, NJ: Erlbaum.

Dennerstein, L., Alexander, J., & Kotz, K. (2003). The menopause and sexual func-tioning: A review of the population-based studies. Annual Review of Sex Re-search, 14, 64–82.

Dixon-Woods, M., Regan, J., Robertson, N., Young, B., Cordle, C., & Tobin, M.(2002). Teaching and learning about human sexuality in undergraduate medicaleducation. Medical Education, 36, 432–440.

Dube, S. R., Anda, R. F., Whitfield, C. L., Brown, D. W., Felitti, V. J., Dong, M.,& Giles, W. H. (2005). Long-term consequences of childhood sexual abuse bygender of victim. American Journal of Preventive Medicine, 28, 430–438.

Dunn, K. M., & Croft, P. R., & Hackett, G. I. (1998). Satisfaction in the sex life of ageneral population sample. Journal of Sex & Marital Therapy, 26, 141–151.

Dupras, A., Lafond, J. S., & Dionne, H. (2001). The motivation to become a humansexuality professional. Canadian Journal of Human Sexuality, 10, 101–109.

Duyan, V., & Duyan, G. (2005). Turkish social work students’ attitudes towardsexuality. Sex Roles, 52, 697–706.

Finkelhor, D., Hotaling, G., Lewis, I., & Smith, C. (1990). Sexual abuse in a nationalsurvey of adult men and women: Prevalence, characteristics, and risk factors.Child Abuse & Neglect, 14, 19–28.

Fisher, T. D. (1989). Confessions of a closet sex researcher. Journal of Sex Research,2, 144–147.

Fisher, W. A., Grenier, G., Watters, W. W., Lamont, J., Cohen, M., & Askwith, J.(1988). Students’ sexual knowledge, attitudes toward sex, and willingness totreat sexual concerns. Journal of Medical Education, 63, 379–385.

Gagnon, J. H. (1975). Sex research and social change. Archives of Sexual Behavior,4, 111–141.

Giami, A., & de Colomby, P. (2006). Sexology as a profession in Europe: Diversityand common perspectives. Sexologies, 15, 7–13.

Guthrie, J. R., Dennerstein, L., Taff, J. R., Lehert, P., & Burger, H. G. (2004). Themenopausal transition: A 9-year prospective population-based study. The Mel-bourne Women’s Midlife Health Project. Climacteric, 7, 375–389.

Holmes, W. C., & Slap, G. B. (1998). Sexual abuse of boys: Definition, prevalence,correlates, sequelae, and management. JAMA, 280, 1855–1862.

Izugbara, C. O. (2008). Home-based sexuality education: Nigerian parents discussingsex with their children. Youth & Society, 39, 575–600.

Laumann, E. O., Nicolosi, A., Glasser, D. B., Paik, A., Gingell, C., Moreira, E., et al.(2005). Sexual problems among women and men aged 40–80? Prevalence andcorrelates identified in the global study of sexual attitudes and behaviors. Inter-national Journal of Impotence Research, 17, 39–57.

Lawrance, K., & Byers, E. S. (1995). Sexual satisfaction in long-term heterosexualrelationships: The interpersonal exchange model of sexual satisfaction. PersonalRelationships, 2, 267–285.

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 1

2:16

06

Janu

ary

2013

130 M. Luria et al.

Lemieux, S. R., & Byers, E. S. (2008). The sexual well-being of women who haveexperienced child sexual abuse. Psychology of Women Quarterly, 32, 126–144.

MacNeil, S., & Byers, E. S. (1997). The relationships between sexual problems,communication, and sexual satisfaction. Canadian Journal of Human Sexuality,6, 277–283.

MacNeil, S., & Byers, E. S. (2005). Dyadic assessment of sexual self-disclosure andsexual satisfaction in heterosexual dating couples. Journal of Social and Per-sonal Relationships, 22, 169–181.

MacNeil, S., & Byers, E. S. (2009). Role of sexual self-disclosure in the sexual satis-faction of long-term heterosexual couples. Journal of Sex Research, 46, 1–12.

Marcotte, D. B., & Logan, C. (1977). Medical sex education: Allowing attitude alter-ation. Archives of Sexual Behavior, 6, 155–162.

Martino, S. C., Elliott, M. N., Corona, R., Kanouse, D. E., & Schuster, M. A. (2008).Beyond the “big talk”: The roles of breadth and repetition in parent–adolescentcommunication about sexual topics. Pediatrics, 121, e612–e618.

McKay, A., & Holowaty, P. (1997). Sexual health education: A study of adolescents’opinions, self-perceived needs, and current and preferred sources of informa-tion. The Canadian Journal of Human Sexuality, 6, 29–37.

McKay, A., Pietrusiak, M., & Holowaty, P. (1998). Parents’ opinions and attitudestowards sexuality education in the schools. Canadian Journal of Human Sexu-ality, 7, 139–145.

Mercer, C. H., Copas, A. J., Sonnenberg, P., Johnson, A. M., McManus, S., Erens, B.,& Cassell, J. A. (2009). Who has sex with whom? Characteristics of heterosexualpartnerships reported in a national probability survey and implications for STIrisk. International Journal of Epidemiology, 38, 206–214.

Miller, S. A., & Byers, E. S. (2008). An exploratory examination of the sexual in-tervention self-efficacy of clinical psychology graduate students. Training andEducation in Professional Psychology, 2, 137–144.

Miller, S. A., & Byers, E. S. (2009). Psychologists’ continuing education and trainingin sexuality. Journal of Sex & Marital Therapy, 35, 206–219.

Miller, S. A., & Byers, E. S. (2010). Psychologists’ sexual education and training ingraduate school. Canadian Journal of Behavioural Science, 42, 93–100.

Mueller, T. E., Gavin, L. E., & Kulkarni, A. (2008). The association between sexeducation and youth’s engagement in sexual intercourse, age at first intercourse,and birth control use at first sex. Journal of Adolescent Health, 42, 89–96.

Nagourney, A., & Thee, M. (2007, June 27). Young Americans are leaning left, newpolls finds. The New York Times. Retrieved from http://www.nytimes.com

Namisi, F. S., Flisher, A. J., Overland, S., Bastien, S., Onya, H., Kaaya, S., & Aarø,L. E. (2009). Sociodemographic variation in communication on sexuality andHIV/AIDS with parents, family members and teachers among in-school adoles-cents: A multi-site study in Tanzania and South Africa. Scandinavian Journal ofPublic Health, 37, 65–74.

Nicolosi, A., Laumann, E. O., Glasser, D. B., Brock, G., King, R., & Gingell, C.(2006). Sexual activity, sexual disorders and associated help-seeking behavioramong mature adults in five Anglophone countries from the Global Survey ofSexual Attitudes and Behaviors (GSSAB). Journal of Sex & Marital Therapy, 32,331–342.

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 1

2:16

06

Janu

ary

2013

Sexuality Professionals 131

Nicolosi, A., Laumann, E. O., Glasser, D. B., Moreira, E. D., Jr., Paik, A., & Gingell,C. (2004). Global Study of Sexual Attitudes and Behaviors Investigators’ Group.Sexual behavior and sexual dysfunctions after age 40: The global study of sexualattitudes and behaviors. Urology, 64, 991–997.

Nijs, P. (2006). Mental health of sex counsellors and of sex therapists: Some guide-lines. Sexual and Relationship Therapy, 21, 123–129.

Oliver, M. B., & Hyde, J. S. (1993). Gender differences in sexuality: A meta-analysis.Psychological Bulletin, 114, 29–51.

Papaharitou, S., Nakopoulou, E., Moraitou, M., Tsimtsiou, Z., Konstantinidou, E.,& Hatzichristou, D. (2008). Exploring sexual attitudes of students in healthprofessions. Journal of Sexual Medicine, 5, 1308–1316.

Paolucci, E. O., Genuis, M. L., & Violato, C. (2001). A meta-analysis of the publishedresearch on the effects of child sexual abuse. Journal of Psychology, 135, 17–36.

Polusny, M., & Follette, V. (1995). Long-term correlates of child sexual abuse: The-ory and review of the empirical literature. Applied & Preventive Psychology, 4,143–166.

Poole, H., Giles, D. C., & Moore, K. (2004). Researching sexuality and sexual issues:Implications for the researcher? Sexual and Relationship Therapy, 19, 79–86.

Purnine, D. M., & Carey, M. P. (1997). Interpersonal communication and sexualadjustment: The roles of understanding and agreement. Journal of Consultingand Clinical Psychology, 65, 1017–1025.

Rind, B., Tromovitch, P., & Bauserman, R. (1998). A meta-analytic examination ofassumed properties of child sexual abuse using college samples. PsychologicalBulletin, 124, 22–53.

Schouten, B. C., van den Putte, B., Pasmans, M., & Meeuwesen, L. (2007).Parent–adolescent communication about sexuality: The role of adolescents’ be-liefs, subjective norm and perceived behavioral control. Patient Education andCounseling, 66, 75–83.

Shifren, J. L., Monz, B. U., Russo, P. A., Segreti, A., & Johannes, C. B. (2008). Sexualproblems and distress in United States women. Obstetrics & Gynecology, 112,970–978.

Stoler, L. R. (2002). Researching childhood sexual abuse: Anticipating the effects onthe researcher. Feminism and Psychology, 12, 269–274.

Weaver, A. D., Byers, E. S., Sears, H. A., Cohen, J. N., & Randall, H. E. S. (2002).Sexual health education at school and at home: Attitudes and experiences ofNew Brunswick parents. Canadian Journal of Human Sexuality, 11, 19–31.

Zamboni, B. (2009). Identity, training, and expertise among sexual health profes-sionals. International Journal of Sexual Health, 21, 132–144.D

ownl

oade

d by

[T

he U

nive

rsity

of

Bri

tish

Col

umbi

a] a

t 12:

16 0

6 Ja

nuar

y 20

13