Abstract
Sex is integral to maintaining a satisfying long-term romantic relationship such as marriage. It is thus important to identify the factors that promote sexual satisfaction in these relationships. To this end, we examined the extent to which a crucial evolved individual difference—sexual disgust sensitivity—impacts people’s sexual satisfaction and relationship satisfaction. Using a two-year longitudinal study of 102 newlywed couples (204 individuals), we demonstrated that, rather than exerting main effects, the interaction of both couple members’ sexual disgust sensitivities was indirectly associated with marital satisfaction through sexual satisfaction. People whose partners’ sexual disgust sensitivities were relatively similar (versus dissimilar) to their own maintained higher levels of sexual satisfaction across the first two years of marriage, which was associated with similarly elevated marital satisfaction. Not only do these findings highlight the importance of integrating evolutionary perspectives and relationship science, they underscore the value of conducting dyadic research to examine the unique intersection of both couple members’ characteristics for people’s relationship outcomes.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Notes
Four previously published papers have drawn from this broader longitudinal study (Du et al., 2020; French et al., 2019; French & Meltzer, 2020; Hicks et al., 2021). Du et al. (2020) used one measure of marital satisfaction (the semantic differential) to illustrate and compare multiple Bayesian synthesis approaches. French et al. (2019) examined the associations between both couple members’ sociosexual orientations, marital satisfaction, and dissolution. French and Meltzer (2020) examined the extent to which a given woman’s changes in hormonal contraceptive use relative to her use at relationship formation is associated with her sexual satisfaction. Finally, Hicks et al. (2021) examined the extent to which people are able to explicitly report their implicitly assessed partner evaluations.
We provide all measures on the OSF: https://osf.io/bstf3/?view_only=355462d11c3748e2936cb272d5ac2d77.
We additionally calculated McDonald’s omega reliability coefficients for all multi-item scales; these coefficients were nearly identical to the Cronbach’s alpha coefficients.
It is worth noting that identical results emerged in our primary analyses when we used each individual measure of marital satisfaction separately.
The results remained unchanged in analyses using partners’ individual reports of relationship length prior to marriage.
We provide all syntax and outputs on the OSF: https://osf.io/bstf3/?view_only=355462d11c3748e2936cb272d5ac2d77.
Analyses using only the heterosexual couples (i.e., excluding the five same-sex couples) revealed no associations were moderated by participants’ biological sex, supporting our use of indistinguishable models.
Analyses demonstrated that a model including Time × Time fit the data better than a model not including Time × Time, χ2(1) = 4.16, p = .041.
Analyses demonstrated this model fit the data no better than a model that included the quadratic estimate of Time, χ2(1) = 0.004, p = .950; we thus excluded the quadratic estimate.
We additionally conducted a lagged analysis to examine whether participants’ sexual satisfaction at any given assessment was associated with their marital satisfaction at the next assessment (i.e., four months later), controlling for their marital satisfaction at the same assessment as well as both couple members’ sexual disgust sensitivities and their interaction; it was not (p = .239).
We had the data available to explore three possible mediators—people’s sexual need fulfillment, people’s sexual problems, and couples’ frequency of sex. Nevertheless, none of these potential mediators were associated with the interaction of couple members’ sexual disgust sensitivities. We provide these null results in Supplementary Materials. Additional analyses further revealed that these null associations did not differ across husbands and wives.
References
Al-Shawaf, L., Lewis, D. M., & Buss, D. M. (2015). Disgust and mating strategy. Evolution and Human Behavior, 36(3), 30–35. https://doi.org/10.1016/j.evolhumbehav.2014.11.003
Altgelt, E. E., & Meltzer, A. L. (2019). Mate-retention behaviors mediate the association between spouses’ attachment insecurity and subsequent partner satisfaction. Personality and Individual Differences, 151. https://doi.org/10.1016/j.paid.2019.109534
Altgelt, E. E., & Meltzer, A. L. (2021). Associations between premarital factors and first-married, heterosexual newlywed couples’ frequency of sex and sexual satisfaction trajectories. Journal of Sex Research, 58, 146–159. https://doi.org/10.1080/00224499.2019.1695722
Altgelt, E. E., Reyes, M. A., French, J. E., Meltzer, A. L., & McNulty, J. K. (2018). Who is sexually faithful? Own and partner personality traits as predictors of infidelity. Journal of Social and Personal Relationships, 35(4), 600–614. https://doi.org/10.1177/0265407517743085
Amato, P. R., & James, S. (2010). Divorce in Europe and the United States: Commonalities and differences across nations. Family Science, 1(1), 2–13. https://doi.org/10.1080/19424620903381583
Burleson, B. R., & Denton, W. H. (1992). A new look at similarity and attraction in marriage: Similarities in social–cognitive and communication skills as predictors of attraction and satisfaction. Communication Monographs, 59(3), 268–287. https://doi.org/10.1080/03637759209376269
Buss, D. M., & Shackelford, T. K. (1997). From vigilance to violence: Mate retention tactics in married couples. Journal of Personality and Social Psychology, 72(2), 346–361. https://doi.org/10.1037/0022-3514.72.2.346
Butzer, B., & Campbell, L. (2008). Adult attachment, sexual satisfaction, and relationship satisfaction: A study of married couples. Personal Relationships, 15, 141–154. https://doi.org/10.1111/j.1475-6811.2007.00189.x
Byers, E. S. (2005). Relationship satisfaction and sexual satisfaction: A longitudinal study of individuals in long-term relationships. Journal of Sex Research, 42(2), 113–118. https://doi.org/10.1080/00224490509552264
Cohen, J., Cohen, P., West, S. G., & Aiken, L. S. (2013). Applied multiple regression/correlation analysis for the behavioral sciences. Mahwah, NJ: Lawrence Erlbaum.
Cupach, W. R., & Metts, S. (1995). The role of sexual attitude similarity in romantic heterosexual relationships. Personal Relationships, 2(4), 287–300. https://doi.org/10.1111/j.1475-6811.1995.tb00093.x
Curtis, V., Aunger, R., & Rabie, T. (2004). Evidence that disgust evolved to protect from risk of disease. Proceedings of the Royal Society of London, Series B, 271(4), S131–S133. https://doi.org/10.1098/rsbl.2003.0144
Davis, D. (1981). Implications for interaction versus effectance as mediators of the similarity–attraction relationship. Journal of Experimental Social Psychology, 17(1), 96–117. https://doi.org/10.1016/0022-1031(81)90009-3
de Jong, P. J., van Overveld, M., & Borg, C. (2013). Giving in to arousal or staying stuck in disgust? Disgust-based mechanisms in sex and sexual dysfunction. Journal of Sex Research, 50(3–4), 247–262. https://doi.org/10.1080/00224499.2012.746280
Du, H., Bradbury, T. N., Lavner, J. A., Meltzer, A. L., McNulty, J. K., Neff, L. A., & Karney, B. R. (2020). A comparison of Bayesian synthesis approaches for comparing two means: A tutorial. Research Synthesis Methods, 11(1), 36–65. https://doi.org/10.1002/jrsm.1365
Durante, K. M., Eastwick, P. W., Finkel, E. J., Gangestad, S. M., & Simpson, J. A. (2016). Pair-bonded relationships and romantic alternatives: Toward an integration of evolutionary and relationship science perspectives. Advances in Experimental Social Psychology, 53, 1–74. https://doi.org/10.1016/bs.aesp.2015.09.001
Ellis, B. J., Figueredo, A. J., Brumbach, B. H., & Schlomer, G. L. (2009). Fundamental dimensions of environmental risk: The impact of harsh versus unpredictable environments on the evolution and development of life history strategies. Human Nature, 20(2), 204–268. https://doi.org/10.1007/s12110-009-9063-7
Finkel, E. J., Eastwick, P. W., & Reis, H. T. (2015). Best research practices in psychology: Illustrating epistemological and pragmatic considerations with the case of relationship science. Journal of Personality and Social Psychology, 108(2), 275–297. https://doi.org/10.1037/pspi0000007
Finkel, E. J., Simpson, J. A., & Eastwick, P. W. (2017). The psychology of close relationships: Fourteen core principles. Annual Review of Psychology, 68, 383–411. https://doi.org/10.1146/annurev-psych-010416-044038
Fleischman, D. S., Hamilton, L. D., Fessler, D. M., & Meston, C. M. (2015). Disgust versus lust: Exploring the interactions of disgust and fear with sexual arousal in women. PLoS ONE, 10(6), e0118151. https://doi.org/10.1371/journal.pone.0118151
Frederick, D. A., Lever, J., Gillespie, B. J., & Garcia, J. R. (2017). What keeps passion alive? Sexual satisfaction is associated with sexual communication, mood setting, sexual variety, oral sex, orgasm, and sex frequency in a national U.S. study. Journal of Sex Research, 54(2), 186–201. https://doi.org/10.1080/00224499.2015.1137854
French, J. E., Altgelt, E. E., & Meltzer, A. L. (2019). The implications of sociosexuality for marital satisfaction and dissolution. Psychological Science, 30(10), 1460–1472. https://doi.org/10.1177/0956797619868997
French, J. E., & Meltzer, A. L. (2020). The implications of changing hormonal contraceptive use after relationship formation. Evolution and Human Behavior, 41(4), 274–283. https://doi.org/10.1016/j.evolhumbehav.2020.04.003
Garcia, L. T., & Markey, C. (2007). Matching in sexual experience for married, cohabitating, and dating couples. Journal of Sex Research, 44(3), 250–255. https://doi.org/10.1080/00224490701443817
Gewirtz-Meydan, A., & Finzi-Dottan, R. (2018). Sexual satisfaction among couples: The role of attachment orientation and sexual motives. Journal of Sex Research, 55(2), 178–190. https://doi.org/10.1080/00224499.2016.1276880
Griffin, D., & Gonzalez, R. (1995). Correlational analysis of dyad-level data in the exchangeable case. Psychological Bulletin, 118(3), 430–439.
Haavio-Mannila, E., & Kontula, O. (1997). Correlates of increased sexual satisfaction. Archives of Sexual Behavior, 26(4), 399–419.
Haidt, J., McCauley, C., & Rozin, P. (1994). Individual differences in sensitivity to disgust: A scale sampling seven domains of disgust elicitors. Personality and Individual Differences, 16(5), 701–713. https://doi.org/10.1016/0191-8869(94)90212-7
Hicks, L. L., McNulty, J. K., Faure, R., Meltzer, A. L., Righetti, F., & Hofmann, W. (2021). Do people realize how their partners make them feel? Relationship enhancement motives and stress determine the link between implicitly assessed partner attitudes and relationship satisfaction. Journal of Personality and Social Psychology, 120, 335–369. https://doi.org/10.1037/pspi0000247
House, J. S., Landis, K. R., & Umberson, D. (1988). Social relationships and health. Science, 241(4865), 540–545. https://doi.org/10.1126/science.3399889
Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: A meta-analytic review. PLoS Medicine, 7(7), e1000316. https://doi.org/10.1371/journal.pmed.1000316
Hudson, W. W. (1998). Index of Sexual Satisfaction. In C. M. Davis, W. L. Yarber, R. Bauserman, G. Schreer, & S. L. Davis (Eds.), Handbook of sexuality-related measures (pp. 512–513). New York: Sage.
Impett, E. A., Muise, A., & Peragine, D. (2014). Sexuality in the context of relationships. In D. L. Tolman & L. M. Diamond (Eds.), APA handbook of sexuality and psychology: Vol 1. Person-based approaches (pp. 269–315). Washington, DC: American Psychological Association.
Johnson, P. O., & Neyman, J. (1936). Tests of certain linear hypotheses and their application to some educational problems. Statistical Research Memoirs, 1, 57–93.
Karney, B. R., & Bradbury, T. N. (1995). The longitudinal course of marital quality and stability: A review of theory, methods, and research. Psychological Bulletin, 118(1), 3–34. https://doi.org/10.1037/0033-2909.118.1.3
Kelley, H. H., & Thibaut, J. W. (1978). Interpersonal relations: A theory of interdependence. New York: Wiley.
Kenny, D. A., Kashy, D. A., & Cook, W. L. (2006). Dyadic data analysis. New York: Guilford Press.
Kenny, D. A., & Kashy, D. A. (2011). Dyadic data analysis using multilevel modeling. In J. Hox & J. K. Roberts (Eds.), The handbook of advanced multilevel analysis (pp. 335–370). New York: Taylor & Francis.
Kohut, T., Balzarini, R. N., Fisher, W. A., & Campbell, L. (2018). Pornography’s associations with open sexual communication and relationship closeness vary as a function of dyadic patterns of pornography use within heterosexual relationships. Journal of Social and Personal Relationships, 35(4), 655–676. https://doi.org/10.1177/0265407517743096
Koukounas, E., & McCabe, M. (1997). Sexual and emotional variables influencing sexual response to erotica: A psychophysiological investigation. Behaviour Research and Therapy, 35(3), 221–230. https://doi.org/10.1023/A:1010261315767
Lawrance, K. A., & Byers, E. S. (1995). Sexual satisfaction in long-term heterosexual relationships: The Interpersonal Exchange Model of Sexual Satisfaction. Personal Relationships, 2(4), 267–285. https://doi.org/10.1111/j.1475-6811.1995.tb00092.x
Liu, H., & Umberson, D. J. (2008). The times they are a changin’: Marital status and health differentials from 1972 to 2003. Journal of Health and Social Behavior, 49(3), 239–253. https://doi.org/10.1177/002214650804900301
Lykins, A. D., Janssen, E., Newhouse, S., Heiman, J. R., & Rafaeli, E. (2012). The effects of similarity in sexual excitation, inhibition, and mood on sexual arousal problems and sexual satisfaction in newlywed couples. Journal of Sexual Medicine, 9(5), 1360–1366. https://doi.org/10.1111/j.1743-6109.2012.02698.x
MacKinnon, D. P., Krull, J. L., & Lockwood, C. M. (2000). Equivalence of the mediation, confounding and suppression effect. Prevention Science, 1(4), 173–181. https://doi.org/10.1023/A:1026595011371
MacNeil, S., & Byers, E. S. (2009). Role of sexual self-disclosure in the sexual satisfaction of long-term heterosexual couples. Journal of Sex Research, 46(1), 3–14. https://doi.org/10.1080/00224490802398399
Mark, K. P., & Murray, S. H. (2012). Gender differences in desire discrepancy as a predictor of sexual and relationship satisfaction in a college sample of heterosexual romantic relationships. Journal of Sex and Marital Therapy, 38(2), 198–215. https://doi.org/10.1080/0092623X.2011.606877
Martin, J. A., Hamilton, B. E., Ventura, S. J., Osterman, M. J. K., & Mathews, T. J. (2013). Births: Final data for 2011. National Vital Statistics Reports (Vol. 62, No. 1). Bethesda, MD: National Center for Health Statistics.
Matuschek, H., Kliegl, R., Vasishth, S., Baayen, H., & Bates, D. (2017). Balancing type I error and power in linear mixed models. Journal of Memory and Language, 94, 305–315. https://doi.org/10.1016/j.jml.2017.01.001
McNulty, J. K., Wenner, C. A., & Fisher, T. D. (2016). Longitudinal associations among relationship satisfaction, sexual satisfaction, and frequency of sex in early marriage. Archives of Sexual Behavior, 45(1), 85–97. https://doi.org/10.1007/s10508-014-0444-6
Meltzer, A. L., Makhanova, S., Hicks, L. L., French, J. E., McNulty, J. K., & Bradbury, T. N. (2017). Quantifying the sexual afterglow: The lingering benefits of sex and their implications for pair-bonded relationships. Psychological Science, 28(5), 587–598. https://doi.org/10.1177/0956797617691361
Meltzer, A. L., McNulty, J. K., Jackson, G. L., & Karney, B. R. (2014). Sex differences in the implications of partner physical attractiveness for the trajectory of marital satisfaction. Journal of Personality and Social Psychology, 106(3), 418–428. https://doi.org/10.1037/a0034424
Mirecki, R. M., Chou, J. L., Elliott, M., & Schneider, C. M. (2013). What factors influence marital satisfaction? Differences between first and second marriages. Journal of Divorce & Remarriage, 54(1), 78–93. https://doi.org/10.1080/10502556.2012.743831
Montoya, R. M., Horton, R. S., & Kirchner, J. (2008). Is actual similarity necessary for attraction? A meta-analysis of actual and perceived similarity. Journal of Social and Personal Relationships, 25(6), 889–922. https://doi.org/10.1177/0265407508096700
Morandini, J. S., Veldre, A., Holcombe, A. O., Hsu, K., Lykins, A., Bailey, J. M., & Dar-Nimrod, I. (2019). Visual attention to sexual stimuli in mostly heterosexuals. Archives of Sexual Behavior, 48(5), 1371–1385. https://doi.org/10.1007/s10508-019-1419-4
Muise, A., Impett, E. A., & Desmarais, S. (2013). Getting it on versus getting it over with: Sexual motivation, desire and satisfaction in intimate bonds. Personality and Social Psychology Bulletin, 39(10), 1320–1332. https://doi.org/10.1177/0146167213490963
Norton, R. (1983). Measuring marital quality: A critical look at the dependent variable. Journal of Marriage and Family, 45(1), 141–151. https://doi.org/10.2307/351302
Osgood, C. E., Suci, G., & Tannenbaum, P. (1957). The measurement of meaning. Champaign: University of Illinois Press.
O’Shea, K. J., DeBruine, L. M., & Jones, B. C. (2019). Further evidence for associations between short-term mating strategy and sexual disgust. Personality and Individual Differences, 138, 333–335. https://doi.org/10.1016/j.paid.2018.10.019
Penke, L., & Asendorpf, J. B. (2008). Beyond global sociosexual orientations: A more differentiated look at sociosexuality and its effects on courtship and romantic relationships. Journal of Personality and Social Psychology, 95(5), 1113–1135. https://doi.org/10.1037/0022-3514.95.5.1113
Preacher, K. J., Curran, P. J., & Bauer, D. J. (2006). Computational tools for probing interactions in multiple linear regressions, multilevel modeling, and latent curve analyses. Journal of Educational and Behavioral Statistics, 31(4), 437–448. https://doi.org/10.3102/10769986031004437
Proulx, C. M., Helms, H. M., & Buehler, C. (2007). Marital quality and personal well-being: A meta-analysis. Journal of Marriage and Family, 69(3), 576–593. https://doi.org/10.1111/j.1741-3737.2007.00393.x
Purnine, D. M., & Carey, M. P. (1999). Dyadic coorientation: Reexamination of a method for studying interpersonal communication. Archives of Sexual Behavior, 28(1), 45–62. https://doi.org/10.1023/A:1018741605446
Rehman, U. S., Rellini, A. H., & Fallis, E. (2011). The importance of sexual self-disclosure to sexual satisfaction and functioning in committed relationships. Journal of Sexual Medicine, 8(11), 3108–3115. https://doi.org/10.1111/j.1743-6109.2011.02439.x
Rempel, J. K., & Baumgartner, B. (2003). The relationship between attitudes towards menstruation and sexual attitudes, desires, and behavior in women. Archives of Sexual Behavior, 32(2), 155–163. https://doi.org/10.1023/A:1022404609700
Robles, T. F., Slatcher, R. B., Trombello, J. M., & McGinn, M. M. (2014). Marital quality and health: A meta-analytic review. Psychological Bulletin, 140(1), 140–187. https://doi.org/10.1037/a0031859
Schoen, R., & Canudas-Romo, V. (2006). Timing effects on divorce: 20th century experience in the United States. Journal of Marriage and Family, 68(3), 749–758. https://doi.org/10.1111/j.1741-3737.2006.00287.x
Schumm, W. R., Paff-Bergen, L. A., Hatch, R. C., Obiorah, F. C., Copeland, J. M., Meens, L. D., & Bugaighis, M. A. (1986). Concurrent and discriminant validity of the Kansas Marital Satisfaction Scale. Journal of Marriage and Family, 48(2), 381–387. https://doi.org/10.2307/352405
Snijders, T. A., & Bosker, R. J. (2011). Multilevel analysis: An introduction to basic and advanced multilevel modeling (2nd ed.). London: Sage Publications.
Sevi, B., Aral, T., & Eskenazi, T. (2018). Exploring the hook-up app: Low sexual disgust and high sociosexuality predict motivation to use Tinder for casual sex. Personality and Individual Differences, 133, 17–20. https://doi.org/10.1016/j.paid.2017.04.053
Simpson, J. A., & Gangestad, S. W. (1991). Individual differences in sociosexuality: Evidence for convergent and discriminant validity. Journal of Personality and Social Psychology, 60(6), 870–883. https://doi.org/10.1016/j.paid.2017.04.053
Sprecher, S., & Cate, R. M. (2004). Sexual satisfaction and sexual expression as predictors of relationship satisfaction and stability. In J. H. Harvey, A. Wenzel, & S. Sprecher (Eds.), Handbook of sexuality in close relationships (pp. 235–256). Mahwah, NJ: Lawrence Erlbaum.
Stevenson, R. J., Case, T. I., & Oaten, M. J. (2011). Effect of self-reported sexual arousal on responses to sex-related and non-sex-related disgust cues. Archives of Sexual Behavior, 40(1), 79–85. https://doi.org/10.1007/s10508-009-9529-z
Symons, D. (1979). The evolution of human sexuality. New York: Oxford University Press.
Theiss, J. A. (2011). Modeling dyadic effects in the associations between relational uncertainty, sexual communication, and sexual satisfaction for husbands and wives. Communication Research, 38(4), 565–584. https://doi.org/10.1177/0093650211402186
Timmers, A. D., Bossio, J. A., & Chivers, M. L. (2018). Disgust, sexual cues, and the prophylaxis hypothesis. Evolutionary Psychological Science, 4(2), 179–190. https://doi.org/10.1007/s40806-017-0127-3
Tofighi, D., & MacKinnon, D. P. (2011). RMediation: An R package for mediation analysis confidence intervals. Behavior Research Methods, 43(3), 692–700. https://doi.org/10.3758/s13428-011-0076-x
Trivers, R. L. (1972). Parental investment and sexual selection. In B. G. Campbell (Ed.), Sexual selection and the descent of Man: 1871–1971 (pp. 136–179). Chicago: Aldine Publishing.
Tybur, J. M., Bryan, A. D., Lieberman, D., Caldwell Hooper, A. E., & Merriman, L. A. (2011). Sex differences and sex similarities in disgust sensitivity. Personality and Individual Differences, 51(3), 343–348. https://doi.org/10.1016/j.paid.2011.04.003
Tybur, J. M., Lieberman, D., & Griskevicius, V. (2009). Microbes, mating, and morality: Individual differences in three functional domains of disgust. Journal of Personality and Social Psychology, 97(1), 103–122. https://doi.org/10.1037/a0015474
Van Laningham, J., Johnson, D. R., & Amato, P. R. (2001). Marital happiness, marital duration, and the u-shaped curve: Evidence from a five-wave panel study. Social Forces, 79(4), 1313–1341. https://doi.org/10.1353/sof.2001.0055
Velten, J., Brailovskaia, J., & Margraf, J. (2019). Exploring the impact of personal and partner traits on sexuality: Sexual excitation, sexual inhibition, and Big Five predict sexual function in couples. Journal of Sex Research, 56(3), 287–299. https://doi.org/10.1080/00224499.2018.1491521
Velten, J., & Margraf, J. (2017). Satisfaction guaranteed? How individual, partner, and relationship factors impact sexual satisfaction within partnerships. PLoS ONE, 12(2), e0172855. https://doi.org/10.1371/journal.pone.0172855
Yeh, H. C., Lorenz, F. O., Wickrama, K. A., Conger, R. D., & Elder, G. H. (2006). Relationships among sexual satisfaction, marital quality, and marital instability in midlife. Journal of Family Psychology, 20(2), 339–343. https://doi.org/10.1037/0893-3200.20.2.339
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical Approval
This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Florida State University.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Peters, S.D., Meltzer, A.L. Newlywed Couples’ Own and Partner Sexual Disgust Sensitivities Interact to Predict Their Marital Satisfaction Through Their Sexual Satisfaction. Arch Sex Behav 50, 2563–2577 (2021). https://doi.org/10.1007/s10508-020-01872-y
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10508-020-01872-y