Sexual function and satisfaction among heterosexual and sexual minority U.S. adults: A cross-sectional survey.

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BACKGROUND: Despite known health disparities for sexual minorities, few studies have described sexual function by sexual orientation using a robust approach to measurement of sexual function. We compared recent sexual function and satisfaction by sexual orientation among English-speaking US adults. METHODS AND FINDINGS: Cross-sectional surveys were administered by KnowledgePanel® (GfK), an online panel that uses address-based probability sampling and is representative of the civilian, noninstitutionalized US population. Data were collected in 2013 from the general population (n = 3314, 35% response rate) and in 2014 from self-identified lesbian, gay, and bisexual adults (n = 1011, 50% response rate). Sexual function and satisfaction were measured using the Patient-Reported Outcomes Measurement Information System® Sexual Function and Satisfaction measure version 2.0 (PROMIS SexFS v2). The PROMIS SexFS v2 is a comprehensive, customizable measurement system with evidence for validity in diverse populations. A score of 50 (SD 10) on each domain corresponds to the average for US adults sexually active in the past 30 days. We adjusted all statistics for the complex sample designs and report differences within each sex where the 95% CIs do not overlap, corresponding to p<0.01. Among US men who reported any sexual activity in the past 30 days, there were no differences in erectile function or orgasm-ability. Compared to heterosexual men, sexual minority men reported higher oral dryness and lower orgasm-pleasure and satisfaction. Compared to heterosexual men, gay men reported lower interest, higher anal discomfort and higher oral discomfort. Among sexually active women, there were no differences in the domains of vulvar discomfort-clitoral, orgasm-pleasure, or satisfaction. Compared to heterosexual women, sexual minority women reported higher oral dryness. Lesbian women reported lower vaginal discomfort than other women; lesbian women reported higher lubrication and orgasm-ability than heterosexual women. Bisexual women reported higher interest, higher vulvar discomfort-labial and higher anal discomfort than other women, as well as higher oral discomfort compared to heterosexual women. CONCLUSIONS: Recent sexual function and satisfaction differed by sexual orientation among US adults. Sexual minority men and women had decrements in domains of sexual function that have not traditionally been included in multi-dimensional self-report measures. Clinicians should make themselves aware of their patients' sexual concerns and recognize that sexual minority patients may be more vulnerable to certain sexual difficulties than heterosexual patients.






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Flynn, Kathryn E, Li Lin and Kevin P Weinfurt (2017). Sexual function and satisfaction among heterosexual and sexual minority U.S. adults: A cross-sectional survey. PLoS One, 12(4). p. e0174981. 10.1371/journal.pone.0174981 Retrieved from

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Kathryn Eve Flynn

Adjunct Professor in the Department of Population Health Sciences

Kathryn E. Flynn, PhD, is an adjunct assistant professor in psychiatry and behavioral sciences at the Duke University School of Medicine. She works primarily at the Duke Clinical Research Institute.

Dr. Flynn was trained in sociology and population health sciences at the University of Wisconsin, where she worked with Maureen Smith on the development and fielding of new survey instruments to assess health care access and utilization in the near elderly as part of the Wisconsin Longitudinal Study, a long-term cohort study with over 10,000 participants. In 2005, Dr. Flynn was awarded an R36 dissertation grant from the Agency for Healthcare Research and Quality to use the Wisconsin Longitudinal Study to examine preferences for health care decision making among older adults. Findings from this research have been published in Social Science and Medicine and the Journal of General Internal Medicine. As a postdoctoral fellow at the Duke Clinical Research Institute, Dr. Flynn trained under Kevin Weinfurt, gaining experience in the design and analysis of patient-reported outcomes in clinical trials.

Dr. Flynn's research interests include shared medical decision making; patient-provider relationships, including communication, trust, and technology; quality of medical care; patient-reported outcomes in clinical trials; and quantitative and qualitative methods in behavioral research.

Areas of Expertise: Health Measurement, Health Services Research, and Health Behavior


Kevin Phillip Weinfurt

James B. Duke Distinguished Professor of Population Health Sciences

Kevin P. Weinfurt, PhD, is Professor and Vice Chair of Research in the Department of Population Health Sciences at Duke University Medical Center and a faculty member of the Duke Clinical Research Institute. He holds secondary appointment as a Professor of Psychology and Neuroscience, Professor of  Psychiatry and Behavioral Sciences, Professor of Biostatistics and Bioinformatics, and a Faculty Associate of the Trent Center for Bioethics, Humanities & History of Medicine. Dr. Weinfurt also co-directs the Center for Health Measurement at Duke and is co-director of the Clinical Research Training Program (Masters degree offered through the School of Medicine). Dr. Weinfurt worked as a Special Governmental Employee for the U.S. Food and Drug Administration for four years, helping to create the Patient-Focused Drug Development guidance series. He is also a member of the Secretary's Advisory Committee for Human Research Protections. 

Dr. Weinfurt conducts research on measuring patient-reported outcomes, medical decision making, and bioethics. In addition to conducting research, Dr. Weinfurt has taught undergraduate courses in introductory psychology, judgment and decision making, and the psychology of medical decision making; and graduate courses in multivariate statistics, patient-reported outcomes, and research ethics.

Areas of Expertise: Bioethics, Health Measurement, Health Services Research, and Health Behavior

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