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Archives of Sexual Behavior

, Volume 45, Issue 6, pp 1299–1315 | Cite as

Development and Psychometric Evaluation of the Gay Male Sexual Difficulties Scale

  • Lorraine K. McDonagh
  • Ian Stewart
  • Melanie A. Morrison
  • Todd G. MorrisonEmail author
Original Paper

Abstract

Sexual difficulties (i.e., disturbances in normal sexual responding) have the potential to significantly and negatively affect men’s social and psychological well-being. However, a review of published measurement tools indicates that most have limited applicability to gay men, and none offer a nuanced understanding of sexual difficulties, as experienced by members of this population. To address this omission, the Gay Male Sexual Difficulties Scale (GMSDS) was developed using a sequential mixed-methods approach. The 25-item GMSDS uses a 6-point frequency Likert-type response format and examines: difficulties with receptive and insertive anal intercourse (5 items each); erectile difficulties (4 items); foreskin difficulties (4 items); body embarrassment (4 items); and seminal fluid concerns (3 items). The measure’s scale score dimensionality, assessed using both exploratory and confirmatory factor analyses, as well as scale score reliability and validity (e.g., known-groups and convergent) was tested and deemed to be satisfactory. Limitations of the current series of studies and directions for future research are discussed.

Keywords

Sexual dysfunction Gay men Sexuality Psychometrics Sexual behavior 

References

  1. Allison, P. D. (2001). Missing data. Thousand Oaks, CA: Sage.Google Scholar
  2. Althof, S. E. (2002). Quality of life and erectile dysfunction. Urology, 59(6), 803–810. doi: 10.1016/S0090-4295(02)01606-0.PubMedCrossRefGoogle Scholar
  3. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (Fourth ed., text rev.). Washington, DC: Author.Google Scholar
  4. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.Google Scholar
  5. Amr, M., El Gilany, A. H., & El-Hawary, A. (2008). Does gender predict medical students’ stress in Mansoura, Egypt? Medical Education Online, 13(12), 1–8. doi: 10.3885/meo.2008.Res00273.Google Scholar
  6. Angst, J. (1998). Sexual problems in healthy and depressed persons. International Clinical Psychopharmacology, 13(Suppl. 6), S1–S4. doi: 10.1097/00004850-199807006-00001.PubMedCrossRefGoogle Scholar
  7. Araujo, A. B., Durante, R., Feldman, H. A., Goldstein, I., & McKinlay, J. B. (1998). The relationship between depressive symptoms and male erectile dysfunction: Cross-sectional results from the Massachusetts Male Aging Study. Psychosomatic Medicine, 60(4), 458–465. doi: 10.1093/aje/152.6.533.PubMedCrossRefGoogle Scholar
  8. Bancroft, J., Carnes, L., Janssen, E., Goodrich, D., & Long, J. S. (2005). Erectile and ejaculatory problems in gay and heterosexual men. Archives of Sexual Behavior, 34(3), 285–297. doi: 10.1007/s10508-005-3117-7.PubMedCrossRefGoogle Scholar
  9. Bancroft, J., Janssen, E., Strong, D., Carnes, L., Vukadinovic, Z., & Long, J. S. (2003). Sexual risk-taking in gay men: The relevance of sexual arousability, mood, and sensation seeking. Archives of Sexual Behavior, 32(6), 555–572. doi: 10.1023/A:1026041628364.PubMedCrossRefGoogle Scholar
  10. Barlow, D. H. (1986). Causes of sexual dysfunction: The role of anxiety and cognitive interference. Journal of Consulting and Clinical Psychology, 54(2), 140–148. doi: 10.1037/0022-006X.54.2.140.PubMedCrossRefGoogle Scholar
  11. Beck, A. T. (1967). Depression: Clinical, experimental, and theoretical aspects. New York: Harper & Row.Google Scholar
  12. Bishop, C. J., Kiss, M., Morrison, T. G., Rushe, D. M., & Specht, J. (2014). The association between gay men’s stereotypic beliefs about drag queens and their endorsement of hypermasculinity. Journal of Homosexuality, 61(4), 554–567.PubMedCrossRefGoogle Scholar
  13. Bjelland, I., Dahl, A. A., Haug, T. T., & Neckelmann, D. (2002). The validity of the Hospital Anxiety and Depression Scale: An updated literature review. Journal of Psychosomatic Research, 52(2), 69–78. doi: 10.1016/S0022-3999(01)00296-3.PubMedCrossRefGoogle Scholar
  14. Blumstein, P., & Schwartz, P. (1983). American couples. New York: William Morrow.Google Scholar
  15. Brubaker, S. J., & Johnson, J. A. (2008). ‘Pack a more powerful punch’ and ‘lay the pipe’: Erectile enhancement discourse as a body project for masculinity. Journal of Gender Studies, 17(2), 131–146. doi: 10.1080/09589230802008899.CrossRefGoogle Scholar
  16. Burk, L. R., Burkhart, B. R., & Sikorski, J. F. (2004). Construction and preliminary validation of the Auburn Differential Masculinity Inventory. Psychology of Men & Masculinity, 5(1), 4–17. doi: 10.1037/1524-9220.5.1.4.CrossRefGoogle Scholar
  17. Burnham, K. P., & Anderson, D. R. (2002). Model selection and multi-model inference: A practical information-theoretic approach (2nd ed.). New York: Springer.Google Scholar
  18. Byrne, B. M. (2010). Structural equation modeling with AMOS: Basic concepts, applications, and programming (2nd ed.). New York: Taylor & Francis Group.Google Scholar
  19. Campbell, T., & Whiteley, C. (2006). Working clinically with gay men with sexual performance problems. Sexual and Relationship Therapy, 21(4), 419–428. doi: 10.1080/14681990600597776.CrossRefGoogle Scholar
  20. Cassidy, W. L., Flanagan, N. B., Spellman, M., & Cohen, M. E. (1957). Clinical observations in manic-depressive disease: A quantitative study of one hundred manic-depressive patients and fifty medically sick controls. Journal of the American Medical Association, 164(14), 1535–1546. doi: 10.1001/jama.1957.02980140011003.PubMedCrossRefGoogle Scholar
  21. Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385–396. doi: 10.2307/2136404.PubMedCrossRefGoogle Scholar
  22. Cohen, S., & Williamson, G. M. (1988). Perceived stress in a probability sample of the United States. In S. Spacapan & S. Oskamp (Eds.), The social psychology of health (pp. 123–128). Thousand Oaks, CA: Sage.Google Scholar
  23. Costa, P. T., Fagan, P. J., Piedmont, R. L., Ponticas, Y., & Wise, T. N. (1992). The five-factor model of personality and sexual functioning in outpatient men and women. Psychiatric Medicine, 10(2), 199–215. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/1615160.
  24. Costello, A. B., & Osborne J. W. (2005). Best practices in exploratory factor analysis: Four recommendations for getting the most from your analysis. Practical Assessment, Research and Evaluation, 10(7), 1–9. Retrieved from http://pareonline.net/.
  25. Courtenay, W. H. (2000). Constructions of masculinity and their influence on men’s well-being: A theory of gender and health. Social Science and Medicine, 50(10), 1385–1401. doi: 10.1016/S0277-9536(99)00390-1.PubMedCrossRefGoogle Scholar
  26. Cove, J., & Boyle, M. (2002). Gay men’s self-defined sexual problems, perceived causes and factors in remission. Sexual and Relationship Therapy, 17(2), 137–147. doi: 10.1080/14681990220121257.CrossRefGoogle Scholar
  27. Cronbach, L. J., & Meehl, P. E. (1955). Construct validity in psychological tests. Psychological Bulletin, 52(4), 281–302. doi: 10.1037/h0040957.PubMedCrossRefGoogle Scholar
  28. Damon, W., & Rosser, S. B. R. (2005). Anodyspareunia in men who have sex with men: Prevalence, predictors, consequences and the development of DSM diagnostic criteria. Journal of Sex and Marital Therapy, 31(2), 129–141. doi: 10.1080/00926230590477989.PubMedCrossRefGoogle Scholar
  29. DeVellis, R. F. (2012). Scale development: Theory and applications (3rd ed.). Thousand Oaks, CA: Sage.Google Scholar
  30. Dove, N. L., & Wiederman, M. W. (2000). Cognitive distraction and women’s sexual functioning. Journal of Sex and Marital Therapy, 26(1), 67–78. doi: 10.1080/009262300278650.PubMedCrossRefGoogle Scholar
  31. Eysenbach, G., & Wyatt, J. (2002). Using the Internet for surveys and health research. Journal of Medical Internet Research, 4(2), e13. doi: 10.2196/jmir.4.2.e13.PubMedPubMedCentralCrossRefGoogle Scholar
  32. Fabrigar, L. R., Wegener, D. T., MacCallum, R. C., & Strahan, E. J. (1999). Evaluating the use of exploratory factor analysis in psychological research. Psychological Methods, 4(3), 272–299. doi: 10.1037/1082-989X.4.3.272.CrossRefGoogle Scholar
  33. Fergus, K. D., Gray, R. E., & Fitch, M. I. (2002). Sexual dysfunction and the preservation of manhood: Experiences of men with prostate cancer. Journal of Health Psychology, 7(3), 303–316. doi: 10.1177/1359105302007003223.PubMedCrossRefGoogle Scholar
  34. Field, A. (2009). Discovering statistics using SPSS (3rd ed.). London: Sage.Google Scholar
  35. Fredrickson, B. L., & Roberts, T. A. (1997). Objectification theory. Psychology of Women Quarterly, 21(2), 173–206. doi: 10.1111/j.1471-6402.1997.tb00108.x.CrossRefGoogle Scholar
  36. Furr, R. M., & Bacharach, V. R. (2008). Psychometrics: An introduction. Thousand Oaks, CA: Sage.Google Scholar
  37. Gil, S. (2007). Body image, well-being and sexual satisfaction: A comparison between heterosexual and gay men. Sexual and Relationship Therapy, 22(2), 237–244. doi: 10.1080/14681990600855042.CrossRefGoogle Scholar
  38. Goldberg, H. (1976). The hazards of being male: Surviving the myth of masculine privilege. New York: Signet Press.Google Scholar
  39. Good, G. E., Heppner, P. P., DeBord, K. A., & Fischer, A. R. (2004). Understanding men’s psychological distress: Contributions of problem-solving appraisal and masculine role conflict. Psychology of Men & Masculinity, 5(2), 168–177. doi: 10.1037/1524-9220.5.2.168.CrossRefGoogle Scholar
  40. Gosling, S. D., Vazire, S., Srivastava, S., & John, O. P. (2004). Should we trust web-based studies? A comparative analysis of six preconceptions about internet questionnaires. American Psychologist, 59(2), 93–104. doi: 10.1037/0003-066X.59.2.93.PubMedCrossRefGoogle Scholar
  41. Graham, J. W. (2009). Missing data analysis: Making it work in the real world. Annual Review of Psychology, 60(1), 549–576. doi: 10.1146/annurev.psych.58.110405.085530.PubMedCrossRefGoogle Scholar
  42. Harrison, J., Chin, J., & Ficarrotto, T. (1992). Warning: Masculinity may be dangerous to your health. In M. S. Kimmel & M. A. Messner (Eds.), Men’s lives (pp. 271–285). New York: Macmillan Press.Google Scholar
  43. Hayton, J. C., Allen, D. G., & Scarpello, V. (2004). Factor retention decisions in exploratory factor analysis: A tutorial on parallel analysis. Organizational Research Methods, 7(2), 191–205. doi: 10.1177/1094428104263675.CrossRefGoogle Scholar
  44. Hirshfield, S., Chiasson, M. A., Wagmiller, R. L, Jr., Remien, R. H., Humberstone, M., Scheinmann, R., & Grov, C. (2010). Sexual dysfunction in an internet sample of U.S. men who have sex with men. Journal of Sexual Medicine, 7(9), 3104–3114. doi: 10.1111/j.1743-6109.2009.01636.x.PubMedPubMedCentralCrossRefGoogle Scholar
  45. Johns, M. M., Pingel, E., Eisenberg, A., Santana, M. L., & Bauermeister, J. (2012). Butch tops and femme bottoms? Sexual positioning, sexual decision making, and gender roles among young gay men. American Journal of Men’s Health, 6(6), 505–518. doi: 10.1177/1557988312455214.PubMedPubMedCentralCrossRefGoogle Scholar
  46. Kennedy, S. H., Dickens, S. E., Eisfeld, B. S., & Bagby, R. M. (1999). Sexual dysfunction before antidepressant therapy in major depression. Journal of Affective Disorders, 56(2), 201–208. doi: 10.1016/S0165-0327(99)00050-6.PubMedCrossRefGoogle Scholar
  47. Kippax, S., & Smith, G. (2001). Anal intercourse and power in sex between men. Sexualities, 4(4), 413–434. doi: 10.1177/136346001004004002.CrossRefGoogle Scholar
  48. Kline, R. B. (2011). Principles and practice of structural equation modeling (3rd ed.). New York: Guilford Press.Google Scholar
  49. Kraut, R., Olson, J., Banaji, M., Bruckman, A., Cohen, J., & Couper, M. (2004). Psychological research online: Report of Board of Scientific Affairs’ Advisory Group on the Conduct of Research on the Internet. American Psychologist, 59(2), 105–117. doi: 10.1037/0003-066X.59.2.105.PubMedCrossRefGoogle Scholar
  50. Lau, J. T. F., Kim, J. H., & Tsui, H. Y. (2005). Prevalence of male and female sexual problems, perceptions related to sex and association with quality of life in a Chinese population: A population-based study. International Journal of Impotence Research, 17(6), 494–505. doi: 10.1016/S0022-5347(05)64302-9.PubMedCrossRefGoogle Scholar
  51. Laumann, E. O., Das, A., & Waite, L. J. (2008). Sexual dysfunction among older adults: Prevalence and risk factors from a nationally representative US probability sample of men and women 57-85 years of age. Journal of Sexual Medicine, 5(10), 2300–2311. doi: 10.1111/j.1743-6109.2008.00974.x.PubMedPubMedCentralCrossRefGoogle Scholar
  52. Laumann, E. O., Gagnon, J. H., Michael, R. T., & Michaels, S. (1994). The social organization of sexuality: Sexual practices in the United States. Chicago, IL: University of Chicago Press.Google Scholar
  53. Laumann, E. O., Nicolosi, A., Glasser, D. B., Paik, A., Gingell, C., Moreira, E., & Wang, T. (2004). Sexual problems among women and men aged 40-80 y: Prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. International Journal of Impotence Research, 17(1), 39–57. doi: 10.1038/sj.ijir.3901250.CrossRefGoogle Scholar
  54. Laumann, E. O., Paik, A., Glasser, D. B., Kang, J. H., Wang, T., Levinson, B., & Gingell, C. (2006). A cross-national study of subjective sexual well-being among older women and men: Findings from the Global Study of Sexual Attitudes and Behaviors. Archives of Sexual Behavior, 35(2), 143–159. doi: 10.1007/s10508-005-9005-3.CrossRefGoogle Scholar
  55. Laumann, E. O., Paik, A., & Rosen, R. C. (1999). Sexual dysfunction in the United States: Prevalence and predictors. Journal of the American Medical Association, 281(6), 537–544. doi: 10.1001/jama.281.6.537.PubMedCrossRefGoogle Scholar
  56. Leit, R. A., Pope, H. G., & Gray, J. J. (2001). Cultural expectations of muscularity in men: The evolution of Playgirl centerfolds. International Journal of Eating Disorders, 29(1), 90–93. doi: 10.1002/1098-108X(200101)29:1<90:AID-EAT15>3.0.CO;2-F.PubMedCrossRefGoogle Scholar
  57. Levesque, M. J., & Vichesky, D. R. (2006). Raising the bar on the body beautiful: An analysis of the body image concerns of homosexual men. Body Image, 3(1), 45–55. doi: 10.1016/j.bodyim.2005.10.007.PubMedCrossRefGoogle Scholar
  58. Lick, D. J., & Johnson, K. L. (2015). Intersecting race and gender cues are associated with perceptions of gay men’s preferred sexual roles. Archives of Sexual Behavior, 44(5), 1471–1481. doi: 10.1007/s10508-014-0472-2.PubMedCrossRefGoogle Scholar
  59. Little, R. J. (1988). A test of missing completely at random for multivariate data with missing values. Journal of the American Statistical Association, 83(404), 1198–1202. doi: 10.1080/01621459.1988.10478722.CrossRefGoogle Scholar
  60. Liu, W. M., Rochlen, A., & Mohr, J. J. (2005). Real and ideal gender-role conflict: Exploring psychological distress among men. Psychology of Men & Masculinity, 6(2), 137–148. doi: 10.1037/1524-9220.6.2.137.CrossRefGoogle Scholar
  61. Mao, L., Newman, C. E., Kidd, M. R., Saltman, D. C., Rogers, G. D., & Kippax, S. C. (2009). Self-reported sexual difficulties and their association with depression and other factors among gay men attending high HIV-caseload general practices in Australia. Journal of Sexual Medicine, 6(5), 1378–1385. doi: 10.1111/j.1743-6109.2008.01160.x.PubMedCrossRefGoogle Scholar
  62. Masters, W. H., & Johnson, V. E. (1966). Human sexual response. London: Churchill Livingstone.Google Scholar
  63. Masters, W. H., & Johnson, V. E. (1970). Human sexual inadequacy. Boston, MA: Little, Brown and Co.Google Scholar
  64. McCarthy, B. W. (1992). Treatment of erectile dysfunction with single men. In R. C. Rosen & S. R. Leiblum (Eds.), Erectile disorders: Assessment and treatment (pp. 313–340). New York: Guilford Press.Google Scholar
  65. McDonagh, L. K., Bishop, C. J., Brockman, M., & Morrison, T. G. (2014). A systematic review of sexual dysfunction measures for gay men. How do current measures, measure up? Journal of Homosexuality, 61, 781–816.PubMedCrossRefGoogle Scholar
  66. McDonagh, L. K., Morrison, T. G., & McGuire, B. E. (2008). The naked truth: Development of a scale designed to measure male body image self-consciousness during physical intimacy. Journal of Men’s Studies, 16(3), 253–265. doi: 10.3149/jms.1603.253.CrossRefGoogle Scholar
  67. McDonagh, L. K., Morrison, T. G., & McGuire, B. E. (2010). Male Body Image Self-Consciousness Scale. In T. D. Fisher, C. M. Davis, W. L. Yarber, & S. L. Davis (Eds.), Handbook of sexuality-related measures (pp. 116–117). Thousand Oaks, CA: Sage.Google Scholar
  68. McDonagh, L. K., Nielsen, E-J., & Morrison, T. G. (in press). “Something of a disaster”: A qualitative exploration of how heterosexual, gay, and bisexual men conceptualise sexual difficulties.Google Scholar
  69. McGartland Rubio, D., Berg-Weger, M., Tebb, S. S., Lee, E. S., & Rauch, S. (2003). Objectifying content validity: Conducting a content validity study in social work. Social Work Research, 27(2), 94–104. doi: 10.1093/swr/27.2.94.CrossRefGoogle Scholar
  70. Meyer-Bahlburg, H. F., & Dolezal, C. (2007). The Female Sexual Function Index: A methodological critique and suggestions for improvement. Journal of Sex and Marital Therapy, 33(3), 217–224. doi: 10.1080/00926230701267852.PubMedCrossRefGoogle Scholar
  71. Mishkind, M. E., Rodin, J., Silberstein, L. R., & Striegel-Moore, R. H. (1986). The embodiment of masculinity: Cultural, psychological, and behavioral dimensions. American Behavioral Scientist, 29(5), 545–562. doi: 10.1177/000276486029005004.CrossRefGoogle Scholar
  72. Moorey, S., Greer, S., Watson, M., Gorman, C., Rowden, L., Tunmore, R., & Bliss, J. (1991). The factor structure and factor stability of the Hospital Anxiety and Depression Scale in patients with cancer. British Journal of Psychiatry, 158(2), 255–259. doi: 10.1192/bjp.158.2.255.PubMedCrossRefGoogle Scholar
  73. Morrison, T. G., & Morrison, M. A. (2006). Psychometric properties of the Swansea Muscularity Attitudes Questionnaire (SMAQ). Body Image, 3(2), 131–144. doi: 10.1016/j.bodyim.2006.03.005.PubMedCrossRefGoogle Scholar
  74. Moskowitz, D. A., & Hart, T. A. (2011). The influence of physical body traits and masculinity on anal sex roles in gay and bisexual men. Archives of Sexual Behavior, 40(4), 835–841. doi: 10.1007/s10508-011-9754-0.PubMedCrossRefGoogle Scholar
  75. Nazareth, I., Boynton, P., & King, M. (2003). Problems with sexual function in people attending London general practitioners: Cross sectional study. British Medical Journal, 327(7412), 423–428. doi: 10.1136/bmj.327.7412.423.PubMedPubMedCentralCrossRefGoogle Scholar
  76. O’Connor, B. P. (2000). SPSS and SAS programs for determining the number of components using parallel analysis and Velicer’s MAP test. Behavior Research Methods, Instruments, & Computers, 32(3), 396–402. doi: 10.3758/BF03200807.CrossRefGoogle Scholar
  77. Philaretou, A. G., & Allen, K. R. (2001). Reconstructing masculinity and sexuality. Journal of Men’s Studies, 9(3), 301–321. doi: 10.3149/jms.0903.301.CrossRefGoogle Scholar
  78. Pollack, W. (1998). Real boys: Rescuing our sons from the myths of boyhood. New York: Henry Holt.Google Scholar
  79. Pope, H. G., Gruber, A. J., Mangweth, B., Bureau, B., deCol, C., Jouvent, R., & Hudson, J. I. (2000). Body image perception among men in three countries. American Journal of Psychiatry, 157(8), 1297–1301. doi: 10.1176/appi.ajp.157.8.1297.PubMedCrossRefGoogle Scholar
  80. Potts, A. (2004). Deleuze on Viagra (or, what can a ‘Viagra-body’ do?). Body and Society, 10(1), 17–36. doi: 10.1177/1357034X04041759.CrossRefGoogle Scholar
  81. Poynton, T. A. (2005). Computer literacy across the lifespan: A review with implications for educators. Computers in Human Behavior, 21(6), 861–872. doi: 10.1016/j.chb.2004.03.004.CrossRefGoogle Scholar
  82. Rosen, R. C., & Leiblum, S. R. (1988). A sexual scripting approach to problems of desire. In S. R. Leiblum & R. C. Rosen (Eds.), Sexual desire disorders (pp. 168–191). New York: Guilford.Google Scholar
  83. Rosser, B. R. S., Metz, M. E., Bockting, W. O., & Buroker, T. (1997). Sexual difficulties, concerns, and satisfaction in homosexual men: An empirical study with implications for HIV prevention. Journal of Sex and Marital Therapy, 23(1), 61–73. doi: 10.1080/00926239708404418.PubMedCrossRefGoogle Scholar
  84. Rosser, B. R. S., Short, B. J., Thurmes, P. J., & Coleman, E. (1998). Anodyspareunia, the unacknowledged sexual dysfunction: A validation study of painful receptive anal intercourse and its psychosexual concomitants in homosexual men. Journal of Sex and Marital Therapy, 24(4), 281–292. doi: 10.1080/00926239808403963.PubMedCrossRefGoogle Scholar
  85. Rowland, D. L. (2007). Sexual health and problems: Erectile dysfunction, premature ejaculation and male orgasmic disorder. In J. E. Grant & M. N. Potenza (Eds.), Textbook of men’s mental health (pp. 171–204). Washington, London: American Psychiatric Publishing.Google Scholar
  86. Rowland, D. L. (2012). Sexual dysfunction in men: Advances in psychotherapy, evidence-based practice. Cambridge, MA: Hogrefe Publishing.Google Scholar
  87. Rubin, R. (2004). Men talking about Viagra: An exploratory study with focus groups. Men and Masculinities, 7(1), 22–30. doi: 10.1177/1097184X03257439.CrossRefGoogle Scholar
  88. Ryan, T. A., Morrison, T. G., & McDermott, D. T. (2010). Body image investment among gay and bisexual men over the age of 40: A test of social comparison theory and threatened masculinity theory. Gay and Lesbian Issues and Psychology Review, 6(1), 4–20. Retrieved from http://www.groups.psychology.org.au/glip/glip_review/
  89. Sanchez, F. J., Greenberg, S. T., Liu, W. M., & Vilain, E. (2009). Reported effects of masculine ideals on gay men. Psychology of Men & Masculinity, 10(1), 73–87. doi: 10.1037/a0013513.CrossRefGoogle Scholar
  90. Sanchez, D. T., & Kiefer, A. K. (2007). Body concerns in and out of the bedroom: Implications for sexual pleasure and problems. Archives of Sexual Behavior, 36(6), 808–820. doi: 10.1007/s10508-007-9205-0.PubMedCrossRefGoogle Scholar
  91. Sandfort, T. G. M., & de Keizer, M. (2001). Sexual problems in gay men: An overview of empirical research. Annual Review of Sex Research, 12(1), 93–120. doi: 10.1080/10532528.2001.10559795.PubMedGoogle Scholar
  92. Scheffer, J. (2002). Dealing with missing data. Research Letters in the Information and Mathematical Sciences, 3, 153–160. Retrieved from http://muir.massey.ac.nz/handle/10179/4355
  93. Schreiner-Engel, P., & Schiavi, R. C. (1986). Lifetime psychopathology in individuals with low sexual desire. Journal of Nervous and Mental Disease, 174(11), 646–651. doi: 10.1097/00005053-198611000-00002.PubMedCrossRefGoogle Scholar
  94. Shah, M., Hasan, S., Malik, S., & Sreeramareddy, C. T. (2010). Perceived stress, sources and severity of stress among medical undergraduates in a Pakistani medical school. BMC Medical Education, 10(2), 1–8. doi: 10.1186/1472-6920-10-2.Google Scholar
  95. Sharpe, M. J., & Heppner, P. P. (1991). Gender role, gender-role conflict, and psychological well-being in men. Journal of Counseling Psychology, 38(3), 323–330. doi: 10.1037/0022-0167.38.3.323.CrossRefGoogle Scholar
  96. Štulhofer, A., Šević, S., & Doyle, D. M. (2014). Comparing the prevalence and correlates of sexual health disturbances among heterosexual and nonheterosexual men: An overview of studies. Sexual Medicine Reviews, 2(3–4), 102–111. doi: 10.1002/smrj.31.CrossRefGoogle Scholar
  97. Sullivan, L. M., & D’Agostino, R. B. (1992). Robustness of the t test applied to data distorted from normality by floor effects. Journal of Dental Research, 71, 1938–1943. doi: 10.1177/00220345920710121601.PubMedCrossRefGoogle Scholar
  98. Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics (5th ed.). Boston, MA: Allyn & Bacon.Google Scholar
  99. Thompson, B. (2004). Exploratory and confirmatory factor analysis: Understanding concepts and applications. Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  100. Tiefer, L. (1986). In pursuit of the perfect penis: The medicalization of male sexuality. American Behavioral Scientist, 29(5), 579–599. doi: 10.1177/000276486029005006.CrossRefGoogle Scholar
  101. Underwood, S. G. (2003). Gay men and anal eroticism: Tops, bottoms, and versatiles. New York, NY: Harrington.Google Scholar
  102. Weaver, A. C. (2006). Secure sockets layer. Computer, 39(4), 88–90. doi: 10.1109/MC.2006.138.CrossRefGoogle Scholar
  103. Worthington, R. L., & Whittaker, T. A. (2006). Scale development research: A content analysis and recommendations for best practices. The Counseling Psychologist, 34(6), 806–838. doi: 10.1177/0011000006288127.CrossRefGoogle Scholar
  104. Yelland, C., & Tiggemann, M. (2003). Muscularity and the gay ideal: Body dissatisfaction and disordered eating in homosexual men. Eating Behaviors, 4(2), 107–116. doi: 10.1016/S1471-0153(03)00014-X.PubMedCrossRefGoogle Scholar
  105. Yule, M., Davison, J., & Brotto, L. (2011). The International Index of Erectile Function: A methodological critique and suggestions for improvement. Journal of Sex and Marital Therapy, 37(4), 255–269. doi: 10.1080/0092623X.2011.582431.PubMedCrossRefGoogle Scholar
  106. Zheng, L., Hart, T. A., & Zheng, Y. (2012). The relationship between intercourse preference positions and personality traits among gay men in China. Archives of Sexual Behavior, 41(3), 683–689. doi: 10.1007/s10508-011-9819-0.PubMedCrossRefGoogle Scholar
  107. Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67(6), 361–370. doi: 10.1111/j.1600-0447.1983.tb09716.x.PubMedCrossRefGoogle Scholar
  108. Zilbergeld, B. (1978). Men and sex. London: Fontana.Google Scholar
  109. Zilbergeld, B. (1992). The new male sexuality. New York: Bantam Books.Google Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Lorraine K. McDonagh
    • 1
  • Ian Stewart
    • 2
  • Melanie A. Morrison
    • 3
  • Todd G. Morrison
    • 3
    Email author
  1. 1.Research Department of Primary Care and Population HealthUniversity College LondonLondonUK
  2. 2.School of PsychologyNational University of Ireland GalwayGalwayIreland
  3. 3.Department of PsychologyUniversity of SaskatchewanSaskatoonCanada

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