The current study investigated the associations between sexually submissive and dominant behaviors and sexual dysfunction in Finnish men and women. We analyzed three population-based data sets from 2006, 2009, and 2021–2022, including 29,821 participants in total. Participants filled out a questionnaire about their sexually submissive and dominant behaviors, Sexual Distress Scale, Checklist for Early Ejaculation Symptoms and International Index of Erectile Function Questionnaire-5 (men), and Female Sexual Function Index (women). Pearson Correlations showed that for both sexes, sexually submissive (men: r = 0.119, p < 0.001; women: r = 0.175, p < 0.001) and dominant (men: r = 0.150, p < 0.001; women: r = 0.147, p < 0.001) behaviors were both associated with more sexual distress. However, for men, sexually submissive (r = −0.126, p < 0.001) and dominant behaviors (r = −0.156, p < 0.001) were associated with less early ejaculation symptoms. Both sexually submissive (r = 0.040, p = 0.026) and dominant behaviors (r = 0.062, p < 0.001) were also associated with better erectile function while sexually dominant behavior alone was associated with better orgasmic function (r = 0.049, p = 0.007), intercourse satisfaction (r = 0.068, p < 0.001), and overall satisfaction (r = 0.042, p = 0.018). For women, both sexually submissive (r = 0.184, p < 0.001) and dominant behaviors (r = 0.173, p < 0.001) were also associated with better overall female sexual function. One possible explanation is that these individuals have a clear idea of what they prefer sexually facilitating arousal. Particularly, sexually submissive behavior may reduce high-level self-awareness and, in this way, contribute to reduced performance anxiety. However, non-normative interests seem to simultaneously result in increased sexual distress probably due to the absence of self-acceptance. Further research about the causal mechanisms between non-normative sexual interest and sexual function is needed.
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The datasets generated during and/or analyzed during the current study are available from the corresponding author.
Diagnostic and Statistical Manual of Mental Disorders. 5th ed: American Psychiatric Association; 2013.
Connolly PH. Psychological functioning of bondage/domination/sado-masochism (BDSM) practitioners. J Psychol Human Sex. 2006;18:79–120.
Lantto R, Lundberg T. (Un)desirable approaches in therapy with Swedish individuals practicing BDSM: client’s perspectives and recommendations for affirmative clinical practices. Psychol Sex. 2022;13:742–55.
Hébert A, Weaver A. Perks, problems, and the people who play: A qualitative exploration of dominant and submissive BDSM roles. Can J Hum Sex. 2015;24:49–62.
Renaud CA, Byers E. Exploring the frequency, diversity, and content of university students’ positive and negative sexual cognitions. Can J Hum Sex. 1999;8:17–30.
Richters J, Grulich AE, de Visser RO, Smith AM, Rissel CE. Sex in Australia: autoerotic, esoteric and other sexual practices engaged in by a representative sample of adults. Aust NZJ Public Health. 2003;27:180–90.
Botta D, Nimbi FM, Tripodi F, Silvaggi M, Simonelli C. Are role and gender related to sexual function and satisfaction in men and women practicing BDSM? J Sex Med. 2019;16:463–73.
Paarnio M, Sandman N, Kallstrom M, Johansson A, Jern P. The prevalence of BDSM in Finland and the association between BDSM interest and personality traits. J Sex Res. 2022;7:1–9.
Rosen RC, Taylor JF, Leiblum SR, Bachmann GA. Prevalence of sexual dysfunction in women: Results of a survey study of 329 women in an outpatient gynecological clinic. J Sex Marital Ther. 1993;19:171–88.
Frank EA. Carol; Rubinstein, Debra. Frequency of sexual dysfunction in “normal” couples. N Engl J Med. 1978;299:111–5.
Oksuz E, Malhan S. Prevalence and risk sactors for female sexual dysfunction in Turkish women. J Urol. 2006;175:654–8.
Santtila P, Sandnabba NK, Jern P. Prevalence and determinants of male sexual dysfunctions during first intercourse. J Sex Marital Ther. 2009;35:86–105.
Colson MH, Cuzin B, Faix A, Grellet L, Huyghes E. Current epidemiology of erectile dysfunction, an update. Sexologies. 2018;27:e7–e13.
Mark KP, Leistner CE, Garcia JR. Impact of contraceptive type on sexual desire of women and of men partnered to contraceptive users. J Sex Med. 2016;13:1359–68.
Mitchell KR, Mercer CH, Ploubidis GB, Jones KG, Datta J, Field N, et al. Sexual function in Britain: findings from the third national survey of sexual attitudes and lifestyles (Natsal-3). The Lancet. 2013;382:1817–29.
Brown GR, Wise TN, Costa PT Jr., Herbst JH, Fagan PJ, Schmidt CW Jr. Personality characteristics and sexual functioning of 188 cross-dressing men. J Nerv Ment Dis. 1996;184:265–73.
Wise TN, Fagan PJ, Schmidt CW, Ponticas Y, Costa PT. Personality and sexual functioning of transvestitic fetishists and other paraphilics. J Nerv Ment Dis. 1991;179:694–8.
Richters J, De Visser RO, Rissel CE, Grulich AE, Smith AMA. Demographic and psychosocial features of participants in bondage and discipline, “sadomasochism” or dominance and submission (BDSM): data from a national survey. J Sex Med. 2008;5:1660–8.
Pascoal PM, Cardoso D, Henriques R. Sexual satisfaction and distress in sexual functioning in a sample of the BDSM community: a comparison study between BDSM and non-BDSM contexts. J Sex Med. 2015;12:1052–61.
Baumeister RF. Masochism as escape from self. J Sex Res. 1988;25:28–59.
Masters WH, Johnson VE. Human sexual inadequacy. Boston, Massachusetts: Little, Brown; 1970.
Xia JD, Han YF, Zhou LH, Xu ZP, Chen Y, Dai YT. Sympathetic skin response in patients with primary premature ejaculation. Int J Impot Res. 2014;26:31–4.
Turan Y, Gürel A. The heart rate recovery is impaired in participants with premature ejaculation. Andrologia. 2020;52:e13573.
Wright S. Discrimination of SM-identified individuals. J Homosex. 2006;50:217–31.
Reiersol O, Skeid S. The ICD diagnoses of fetishism and sadomasochism. J Homosex. 2006;50:243–62.
Johansson A, Jern P, Santtila P, Von der Pahlen B, Eriksson E, Westberg L, et al. The genetics of sexuality and aggression (GSA) twin samples in Finland. Twin Res Hum Genet. 2013;16:150–6.
Tybur JM, Wesseldijk LW, Jern P. Genetic and environmental influences on disgust proneness, contamination sensitivity, and their covariance. Clin Psychol Sci. 2020;8:1054–61.
Lewin B, Fugl-Meyer K, Helmius G, Lalos A, Månsson S-A. Sex i Sverige; Om sexuallivet i Sverige 1996: Folkhälsoinstitutet; 1998.
Carpenter JS, Reed SD, Guthrie KA, Larson JC, Newton KM, Lau RJ, et al. Using an FSDS-R item to screen for sexually related distress: a MsFLASH analysis. Sex Med. 2015;3:7–13.
Derogatis LR, Rosen R, Leiblum S, Burnett A, Heiman J. The Female Sexual Distress Scale (FSDS): Initial validation of a standardized scale for assessment of sexually related personal distress in women. J Sex Marital Ther. 2002;28:317–30.
Bae JH, Han CS, Kang SH, Shim KS, Kim JJ, Moon DG. Development of a Korean version of the female sexual distress scale. J Sex Med. 2006;3:1013–7.
DeRogatis L, Clayton A, Lewis-D’Agostino D, Wunderlich G, Fu Y. Validation of the female sexual distress scale-revised for assessing distress in women with hypoactive sexual desire disorder. J Sex Med. 2008;5:357–64.
Santos-Iglesias P, Bergeron S, Brotto LA, Rosen NO, Walker LM. Preliminary validation of the sexual distress scale-short form: Applications to women, men, and prostate cancer survivors. J Sex Marital Ther. 2020;46:542–63.
Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology. 1997;49:822–30.
Rhoden EL, Telöken C, Sogari PR, Vargas Souto CA. The use of the simplified International Index of Erectile Function (IIEF-5) as a diagnostic tool to study the prevalence of erectile dysfunction. Int J Impot Res. 2002;14:245–50.
Jern P, Piha J, Santtila P. Validation of three early ejaculation diagnostic tools: a composite measure is accurate and more adequate for diagnosis by updated diagnostic criteria. PloS One. 2013;8:e77676.
Rosen C, Brown J, Heiman S, Leiblum C, Meston R, Shabsigh D, et al. The female sexual function index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000;26:191–208.
Alwaal A, Breyer BN, Lue TF. Normal male sexual function: emphasis on orgasm and ejaculation. Fertil Steril. 2015;104:1051–60.
Rowland DL. Genital and heart rate response to erotic stimulation in men with and without premature ejaculation. Int J Impot Res. 2010;22:318–24.
Ponseti J, Dähnke K, Fischermeier L, Gerwinn H, Kluth A, Müller J, et al. Sexual responses are facilitated by high-order contextual cues in females but not in males. Evol Psychol. 2018;16:1–9.
Coppens V, Ten Brink S, Huys W, Fransen E, Morrens M. A survey on BDSM-related activities: BDSM experience correlates with age of first exposure, interest profile, and role identity. J Sex Res. 2020;57:129–36.
We acknowledge funding support from the Academy of Finland, European Research Council, and the Stiftelsen för Åbo Akademi Foundation.
The original data collections for Sample 1 were funded by Grants No. 210298, 212703, 136263, and 138291 from the Academy of Finland; and a Center of Excellence Grant No. 21/22/05 from the Stiftelsen för Åbo Akademi Foundation. Data collections for Samples 2 and 3 were funded by European Research Council (ERC) Grant StG-2015 680002-HBIS (awarded to Joshua Tybur) as well as grants No. 274521, 284385, and 319403 from the Academy of Finland (awarded to P. Jern).
The authors declare no competing interests.
Research plans for all three data collections were conducted in accordance with the Declaration of Helsinki and were approved by the Departmental or University level Research Ethics Committees at Åbo Akademi University, as appropriate. Informed consent was obtained from all the participants involved in the study.
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Huang, S., Jern, P., Niu, C. et al. Associations between sexually submissive and dominant behaviors and sexual function in men and women. Int J Impot Res (2023). https://doi.org/10.1038/s41443-023-00705-5