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Sexual Self-Esteem and Orgasm Consistency: Exploring the Unique Roles of Body Image and Genital Image

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We explored the unique roles that body and genital image play in behavior-specific orgasm consistency, beyond overall sexual self-esteem. US adults (N = 599; 64% women) completed questionnaires online. Hierarchical regression analyses predicted orgasm consistency during receptive oral sex and penile-vaginal intercourse (PVI) with additional clitoral stimulation (WAS) and with no additional clitoral stimulation (NAS) for the woman. Body image, genital image, and gender were entered in later steps to assess model improvement above sexual self-esteem. Models accounted for age, sexual and racial minority identities, and current relationship status. Results indicated that genital image improved all models and predicted higher orgasm consistency across all behaviors for men and women. For orgasm during receptive oral sex and PVI–NAS, sexual self-esteem was no longer significant once genital image was included. Genital image was a stronger predictor of women’s versus men’s orgasm during PVI–NAS; no significant gender differences were found for oral sex and PVI–WAS. Body image was not significant in any models, contrary to expectations, suggesting role overlap with sexual self-esteem. Genital image appears to play a unique role in sexual pleasure beyond overall sexual self-esteem and body image.

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Fig. 1

Availability of Data and Material

Due to the sensitive nature of the questions asked in this study, survey respondents were assured raw data would remain confidential and only published in aggregate. Data are available via request by contacting the corresponding author.

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R code is available via request by contacting the corresponding author.


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This work was supported by a grant from Wheelhouse Collective, which was awarded to the first and third authors. The funding agency had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Authors and Affiliations



SMB Conceptualization, Data curation, Formal analysis, Writing-Original draft, Writing-Reviewing and editing, Visualization, Supervision. KH Conceptualization, Writing-Original draft, Writing-Reviewing and editing. JLL Data curation, Writing-Reviewing and editing.

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Correspondence to Shari M. Blumenstock.

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The authors report there are no competing interests to declare.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Human Research Protection Program at Indiana University-Bloomington, IRB ID 13989) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Blumenstock, S.M., Hoskins, K. & Lehmiller, J.J. Sexual Self-Esteem and Orgasm Consistency: Exploring the Unique Roles of Body Image and Genital Image. Arch Sex Behav 53, 2035–2044 (2024).

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