Sexes, Volume 6, Issue 4 (December 2025) – 7 articles

Sexual consent, although more extensively studied in recent decades, remains a complex and nuanced concept that is often difficult to define and investigate. This study aimed to analyze the relationships between beliefs, attitudes, and behaviors related to sexual consent, and the ability to interpret complex sexual scenarios with varying characteristics. A voluntary sample of 738 individuals over 18 years of age was recruited, mainly through social networks. Data analysis was conducted using descriptive statistics and mean comparison tests. Participants with higher scores for continuous consent, communicative sexuality, and positive attitudes toward consent, as well as lower scores for subtle coercion and (lack of) perceived control, showed more accurate interpretations of sexual assault situations. These findings may contribute to the development and implementation of programs aimed at reducing the use of coercive and violent strategies in sexual relationships. Full article

Background: Sexual and reproductive health promotion is a political and social process that involves not only individual actions but also strategies to change social, environmental and economic factors. It is necessary to know the characteristics of effective interventions in order to design new evidence-based programmes. However, programmes need to follow a holistic approach, hence the importance of Comprehensive Sexuality Education. Methods: An extensive bibliographic search was carried out. Twenty systematic reviews between 2015 and 2025 were selected following PRISMA 2020. Results: This review shows that interventions to promote SRH are effective and have significant results in increasing SRH knowledge, attitudes and skills, the competencies of professionals and improving access to SRH services. It has been possible to extract that it is necessary to promote SRH with the inclusion of young people, the adaptation of interventions according to the needs of each person, the coordination between different areas, the application of the intersectional and gender perspective, the application of a rights-based approach, the use of comprehensive and inclusive education models, the training of professionals and the carrying out of evaluations to disseminate the results. Furthermore, there are shortcomings in the evidence, such as the lack of an intersectional perspective, the lack of inclusion of certain groups and the lack of rigorous evaluations following quality standards. Conclusion: Programmes based on Comprehensive Sexuality Education are effective and have certain common characteristics. Full article

Gender dysphoria stems from incongruence between gender identity and assigned sex, often causing significant distress related to breast anatomy in transmasculine individuals. Gender-affirming hormone therapy typically precedes mastectomy, which is a fundamental intervention in transgender healthcare. Surgical challenges arise in patients with large breasts on lean frames, requiring customized techniques to achieve a natural, proportional, androgynous chest. This case report describes a 23-year-old transmasculine patient with macromastia and a tall, lean build who underwent gender-affirming mastectomy with free nipple grafts and muscular sculpture aimed at an androgynous esthetic. Pre- and postoperative evaluations showed marked improvements in body image, physical strength performance, and emotional well-being. Psychological assessments revealed significant reductions in body uneasiness and gender dysphoria, while human figure drawings demonstrated increasing bodily integration and identity congruence. A general improvement in physical performance over time was reported, particularly in upper body strength, with minor fluctuations potentially related to the surgical intervention and recovery phase. The narrative literature review supports these outcomes, highlighting satisfaction rates above 90%, minimal regret, and consistent gains in psychosocial functioning and sexual and mental health, including reduced anxiety and depression. This evidence reinforces that gender-affirming mastectomy is medically necessary, particularly when tailored to individual anatomical and esthetic needs, affirming identity and alleviating distress. Full article

Despite notable progress in HIV prevention and treatment, men who have sex with men (MSM) continue to bear a disproportionate burden of HIV, particularly in sub-Saharan Africa, where systemic barriers restrict access to HIV testing. This study draws on data from the 2017 Ghana Men’s Study II (GMS II), to examine the socio-demographic, behavioural, and structural factors influencing HIV testing among MSM. The Ghana Men’s Study II dataset, involving 4095 MSM, was de-identified and analysed using STATA (software version 17). Before the analysis, missing information for categorical variables were treated using the mode imputation technique. Chi-square test was done to describe relevant characteristics of the study population, such as socio-demographic/socio-economic variables and behavioural practices. Multivariable logistic regression analysis was performed for variables with p < 0.05 to determine significant predictors of HIV testing among MSM. All the statistical analyses were performed at a 95% confidence interval, with significant differences at p < 0.05. In multivariable logistic regression analysis, age 25–34 (AOR: 1.43; 95% CI: 1.18–1.74, p < 0.001), having a senior high school education (AOR: 1.69; 95% CI: 1.02–2.80, p = 0.040), tertiary education (AOR: 2.03; 95% CI: 1.17–3.55, p = 0.012), being a light drinker of alcohol (AOR: 1.28; 95% CI: 1.04–1.58, p = 0.020), and having a comprehensive knowledge of HIV (AOR: 1.50; 95% CI: 1.26–1.78, p < 0.001) had higher odds for HIV testing. Other factors such as being a Muslim (AOR: 0.69; 95% CI: 0.54–0.90, p = 0.005) and sold sex to other males (AOR: 0.67; 95% CI: 0.50–0.90, p = 0.007) were also positively associated with HIV testing among Ghanaian MSM. The findings revealed a number of socio-demographic and behavioural factors associated with HIV testing among the MSM population in Ghana. Full article

The present research assessed university student stakeholders’ perceptions of positive outcomes (i.e., appropriateness and benefits of conferencing) and negative outcomes (i.e., endangerment and revictimization of the complainant) associated with restorative justice-based direct conferencing in sexual misconduct cases. Stakeholders received random assignment to a 2 (allegation severity: more vs. less) × 2 (evidence strength: lower vs. higher) between-participant experimental design. More severe allegations and higher evidence strength were associated with lower ratings of appropriateness; allegation severity and evidence strength interacted to affect ratings of benefits; and more severe allegations, but not stronger evidence, were associated with higher ratings of endangerment and revictimization. Belief in the alleged perpetrator’s guilt explained the relationship between evidence strength and ratings of appropriateness, and desire to punish the alleged perpetrator explained the relationship between allegation severity and ratings of appropriateness. Researchers and Title IX coordinators should evaluate and respond to stakeholder sentiment toward direct conferencing. Full article

Masculinity norms and gender socialization play a critical role in shaping boys’ attitudes, behaviours, and interactions within society. In South Africa, historical legacies of colonialism and apartheid, coupled with deeply ingrained cultural and societal expectations, have contributed to rigid masculinity norms that emphasize dominance, emotional restraint, and aggression. These constructs not only influence boys’ development but also have significant implications for gender-based violence (GBV). This paper explores how norms of masculinity and processes of gender socialization among boys in South Africa shape attitudes and behaviours that contribute to gender-based violence (GBV). The central aim is to offer a critical theoretical synthesis and contextual analysis that informs the development of gender-equitable policies and interventions. Drawing on theoretical frameworks such as hegemonic masculinities, intersectionality, and social learning theory, this study examines how historical, cultural, and socio-economic factors shape gender socialization and influence boys’ developmental trajectories. Through an intersectional lens, this paper underscores the urgent need to challenge harmful masculinity norms and promote alternative models that encourage emotional expression, empathy, and equitable gender relations. Finally, it provides recommendations on how these harmful norms can be disrupted through educational, community, media, and policy-level reforms to foster healthier masculinity norms and reduce GBV in South Africa. Full article

Personal identity is a multidimensional, universal, and ever-developing construct that forms primarily during youth. One domain of identity—gender—manifests quite clearly in terms of developmental course and psychosocial components in the lives of transgender individuals. Members of this population often initiate various social and medical transitions to rework their gendered characteristics to align more authentically with their internal selves. Consequently, healthcare and social service professionals express growing interest in facilitating and fostering the psychological health of transgender youth. Rather than focus on adversity (e.g., depression, suicidality, mental illness), the current study addresses this concern by describing positive components of the gender identity of 120 transmasculine youth participants. To this end, we operationalized gender identity health through three overarching constructs: developmental process, psychological functioning, and the positive outcomes of being a transgender person. Further, we investigate how these components interrelate, plus compare responses by age and gender identity cohorts. For age, we compared adolescent responses to the identity measures to those of transgender emerging adults (n = 166; 20–29 years) and adults (n = 53; 30–39 years). For gender, we partitioned the adolescent participants into binary (n = 91) versus non-binary (n = 29) identities. The descriptive results demonstrated that identity is reasonably developed, functional, and positive in this adolescent sample. Moreover, the three hypothetical components of transgender identity demonstrated modest overlap with each other. The youth did not differ in identity development, functionality, or positivity compared to older cohorts. Binary transmen scored slightly higher on gender authenticity and commitment than their non-binary transmasculine counterparts, but the two gender groups were the same on the other identity components. We discuss some practical implications of these findings as focus areas for healthcare providers and support systems to continue to foster healthy identity development. Full article