Background Published studies show good psychological health of people involved in bondage-discipline, dominance-submission, and sadism-masochism (BDSM) activities; nevertheless, there are few studies on characteristics related to gender, role in the BDSM scene, sexual functioning, and satisfaction among BDSM practitioners. Aim The aim of this study was to explore gender and role differences, prevalence of sexual complaints, related distress, and sexual satisfaction in BDSM participants compared with the general population. Methods A group of 266 Italian consensual BDSM participants (141 men and 125 women) were recruited with a snowball sampling technique. An anonymous protocol, including self-reported ad hoc and validated questionnaires, was used. The control group was composed of 100 men and 100 women who were not significantly different from the BDSM group for the sociodemographic data and were randomly extracted from an Italian database on sexual functioning of the general population. Main Outcome Measures Self-reported demographic factors, including favorite and most frequent BDSM practices, the Sexual Complaint Screener, and the Sexual Satisfaction Scale, were completed by the participants. Results The mean age of the BDSM group was 41.42 ± 9.61 years old (range 18–74). Data showed a varied outlook of practices, fantasies, rules, and roles. With regard to concerns about BDSM activities (fantasies and behaviors), participants reported a very low self-declared degree of distress. The dominant and switch groups appear to be more satisfied and less concerned about sexuality than the general population and the submissive group. Role in the BDSM scene was the only significant predictor of sexual satisfaction, showing a medium effect size. Clinical Implications Results from this study could be helpful to inform sexual health care professionals and to reduce the stigma related to the BDSM population. Strengths & Limitations In general, this study may help to describe better some characteristics related to gender, role, sexual preferences, function, and satisfaction. The main limitation regards the sampling method, which does not allow us to consider the group as representative of BDSM participants in general. Conclusion Data showed a varied outlook of practices, fantasies, rules, and roles in both BDSM men and women. BDSM participants (especially dominant and switch groups) appear to be more satisfied and less concerned about sexuality than the general population. This is an attempt to increase the attention of researchers and health care professionals to this important topic and to improve the care provided to people with specific preferences and behaviors.

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Purpose of Review The purpose of this review is to summarize the current knowledge around sexual desire, fantasies, and related biopsychosocial factors that may facilitate or obstruct sexual expressions in lesbian women and gay men. Recent Findings Sexual desire levels and related problems do not seem significantly different in people who identify as gay or lesbian compared to their heterosexual counterparts. Evidence has shown lesbian women and gay men may have specific desire expressions and biopsychosocial factors influencing their sexual health. This may suggest the importance of deepening the understanding of the unique factors of LGBT+ sexuality and relationships while paying attention to the sociocultural background in which lesbian and gay people grow and develop their identities. Summary A lack of specific and unbiased literature on sexual desire and fantasies in gay and lesbian people is reported. Available evidence is controversial and often biased. LG people showed a variety of sexual expressions that are hard to categorize referring to the heteronormative sexual standards that permeate literature and clinical practice. Implications for future research and clinical practice are discussed.

Introduction The literature showed the need for a better understanding of the male sexual response, which has historically been considered as simpler and more mechanistic compared with that in women. Aim To examine the literature on biopsychosocial factors associated with the level of sexual desire in men and discuss some interesting directions for future research. Methods A systematic literature review was conducted. Main outcome measures 169 articles published in Google Scholar, Web of Science, Scopus, EBSCO, and Cochrane Library about male sexual desire and related biopsychosocial factors. Results We found a lack of multidimensional studies on male sexual desire. Most existing research has focused on hypoactive sexual desire disorder in coupled heterosexual men. Biological factors play important roles in the level of sexual desire, but they are insufficient to explain the male sexual response. Psychological, relational, and sexual factors (eg depression, anxiety, emotions, attraction, conflicts, communication, sexual functioning, distress, satisfaction) are involved in the development/maintenance of lack of sexual interest in men. Cultural influence is also relevant, with cognitive factors linked to gender roles and sexual scripts of masculinity identified as important predictors of low sexual desire. Conclusion Male sexual desire is characterized by an interplay among biological, psychological, sexual, relational, and cultural elements. This interplay merits further study to better understand how sexual desire works and how treatments for low sexual interest could be improved.

Background The literature lacks studies of the male sex drive. Most existing studies have focused on hypoactive sexual desire disorder in coupled heterosexual men, highlighting some of the main related biological, psychological, and social factors. Aim To evaluate the role of selected psychological and social variables affecting male sexual desire such as quality of life, sexual function, distress, satisfaction, psychological symptoms, emotions, alexithymia, couple adjustment, sexism, cognitive schemas activated in a sexual context, sexual dysfunctional beliefs, and different classes of cognitions triggered during sexual activity about failure anticipation, erection concerns, age- and body-related thoughts, erotic fantasies, and negative attitudes toward sexuality. Methods A wide self-administered survey used snowball sampling to reach 298 heterosexual Italian men (age = 32.66 ± 11.52 years) from the general population. Outcomes 13 questionnaires exploring psychological and social elements involved in sexual response were administrated: International Index of Erectile Function, Short Form 36 for Quality of Life, Beck Depression Inventory–II, Symptom Check List–90–Revised, Toronto Alexithymia Scale, Premature Ejaculation Severity Index, Sexual Distress Scale, Sexual Satisfaction Scale, Dyadic Adjustment Scale, Ambivalent Sexism Inventory, Sexual Modes Questionnaire, Sexual Dysfunctional Belief Questionnaire, and Questionnaire of Cognitive Schema Activation in Sexual Context. Results Results showed lack of erotic thoughts (β = −0.328), fear (β = −0.259) and desire to have a baby (β = −0.259) as the main predictors of the level of sexual desire in this group. Energy-fatigue, depression, premature ejaculation severity, sexual distress, compatibility, subjective sexual response, and sexual conservatism had a weaker effect on sexual desire. Sexual functioning (13.80%), emotional response (12.70%), dysfunctional sexual beliefs (12.10%), and negative automatic thoughts (12.00%) had more variable effects on sexual drive. Clinical Translation Analyzed variables could represent important factors that should be considered in the assessment of desire concerns and discussed in therapy. Strengths and Limitations The strength of this study is the analysis of novel psychological and social factors on male sexual desire. Recruitment and sample size do not allow generalization of the results, but some crucial points for future research and clinical practice are discussed. Conclusion Our findings showed that male sexual desire could be affected by many psychological and social elements. Other factors remain to be explored, in their direct and interactive effects, aiming to better explain male sexual desire functioning.