Introduction: Research shows that sex workers are particularly vulnerable to mental health challenges. As sex workers are a very heterogeneous group, research focusing on associations between personal working conditions of sex workers and their mental health is needed. Methods: In this cross-sectional, anonymous online survey, we used Spearman rank order correlations to examine, in a convenience sample of 76 sex workers from different countries surveyed in 2022, whether the degree of self-determination in the engagement in sex work, the degree of self-organization of sex work, the role-identification as a sex worker, and sex work motive (engaging in sex work to meet financial needs versus for pleasure) and internalized sex work stigma (Internalized Sex work Stigma Scale) are associated with psychological distress (Patient-Health-Questionnaire-4). Thematic analysis of open text answers was used to identify sex workers’ suggestions for political and social change. Results: Psychological distress was negatively correlated with self-determination and positively correlated with internalized sex work stigma. The participants advocated for the decriminalization and destigmatization of sex work, improved access to health care, improved workers’ rights, and fighting sexual exploitation. Conclusions: The results emphasize the need for efforts to challenge stigmatization of sex workers, internalized stigma in sex workers, and the need to counteract working conditions where sex workers’ self-determination is limited. Destigmatization, decriminalization, health care access, workers’ rights, and sexual exploitation are topics of concern to sex workers. Policy Implications. Perspectives by sex workers should be used to inform policy decisions to first understand and then better implement the needs of this diverse group.

Antologin belyser hur seuxalitet tolkas, bemöts och hanteras som ett socialt problem i en svensk välfärdskontext. Boken erbjuder analytiska perspektiv på sexualitet inom professionsområdet socialt arbete. Samtidigt konkretiseras frågor om sexualitet och social utsatthet genom empiriska exempel inom tre kunskapsområden: (1) Sexualitet i välfärdspolitiken, (2) Att möta frågor om sexualitet i praktiskt socialt arbete och (3) Erfareneter av sexuell utsatthet i relation till kunskaps- och professionsområdet socialt arbete.

PURPOSE: This study investigates whether Acquired Brain Injury (ABI) is associated with changes in sexual function and satisfaction and how such changes are experienced, focusing on invisible impairments after ABI.

MATERIALS AND METHODS: A study-specific questionnaire was distributed in 2018-2019. The sample included individuals aged 20-90 years diagnosed with ABI due to subarachnoid hemorrhage (SAH), trauma, infection, or anoxia (ischemic stroke and intracerebral hemorrhage excluded), who participated in brain injury rehabilitation in Sweden, 2014-2016. Chi-square and Logistic regression analyses were used.

RESULTS: The study consists of 250 participants (response rate was 40%). Among participants 78% (194/250) had resumed sexual life. Participants reporting sexual changes also experienced more consequences related to ABI. Those with decreased sexual desire (63%, 148/234) reported more ABI consequences, including decreased memory (86% vs 65%, p = 0.000), decreased concentration ability (82% vs 65%, p = 0.003), and increased tiredness (91% vs 70%, p = 0.000) compared to those with intact desire. Such consequences can be invisible to others.

CONCLUSION: Visible impairments are known to impact sexual functions and satisfaction after ABI. Our results show how invisible impairments also have a great impact. From a biopsychosocial perspective, these results imply that individuals should receive sexual rehabilitation, irrespective of ABI impairment.

Mot bakgrund av det senaste decenniets diskussioner om sexuellt samtycke, av lagreformen 2018 och av läroplansändringar som trädde i kraft 2022, belyser kapitlet frågor om sexuella möten, sexuella gränsdragningar och sexuellt samtycke bland unga människor. Det övergripande syftet har varit att skapa förståelse för hur unga själva resonerar och förhåller sig till frågor som berör sexuellt samtycke. Hur tolkas och uttrycks sexuellt samtycke i praktiken? Vad är frivilligt sex? Antologibidraget tar utgångspunkt i en empirisk studie om unga människors resonemang och föreställningar om sexuella gränsdragningar, sexuellt samtycke och sexuella möten.

Introduction: A dominant narrative, referred to as “the standard tale,” prevails in popular representations about female genital cutting (FGC) that often contrast with how cut women traditionally narrate their FGC experience as meaningful in contexts where FGC is customary. However, scholarship has increasingly highlighted how global eradication campaigns and migration to countries where FGC is stigmatized provide women with new frames of understanding which may lead to a reformulation of previous experiences. This article subjects the storytelling itself to analysis and explores how participants narrate and make sense of their FGC experience in a post-migration setting where FGC is stigmatized.

Methods: Semi-structured focus groups (9) and individual interviews (12) with Swedish-Somali girls and women (53) were conducted.

Results: The article highlights how the participants navigate their storying in relation to "the standard tale" of FGC in their efforts to make sense of their experiences. Navigation was conducted both at an intrapersonal level through continuous identity work, and in relation to the social context in interpersonal encounters, i.e., with service providers and others, among whom the standard tale has become a truth.

Discussion: The article places the analysis within broader discussions about anti-FGC work and considers the implications in relation to efforts to end FGC.

In relation to brain injury rehabilitation, research has stressed the importance of including sexuality issues due to increased risk for sexual dysfunctions after Acquired Brain Injury (ABI). This study aims to explore experiences after non-stroke ABI concerning individual and relational aspects of sexuality, received information about sexuality at rehabilitation, and gender differences. A postal nationwide survey was conducted in Sweden, 2018-2019. The sample included individuals who had participated in brain injury rehabilitation 2014-2016, response rate 40% (250/624). Among all participants 78% had resumed sexual activity, and there was a significant difference between males (84%, 118/140) and females (69%, 76/110, p = 0.004). Among all participants, 95% reported physical intimacy as important, 80% considered sex as important on an individual level, and 91% stated sexuality as important for the relationship (no gender differences). Significantly more females (52%) than males (22%) reported that they had tried sexual aids (p = 0.000), and more males (29%) than females (16%) reported that professionals addressed sexuality issues during brain injury rehabilitation (p = 0.024). However, only a few participants were offered specific sexual counseling during brain injury rehabilitation, such as individual counseling (3%), couples counseling (2%), and group counseling (3%). To conclude, the vast majority valued both individual and relational aspects of sex and sexuality highly, and more males than females had resumed sexual activity. Few had received information about sexuality after ABI, and even fewer females compared to males reported that the issue was raised during rehabilitation. Clinical implications are discussed in relation to sexual rehabilitation.

In Sweden, as well as in an international context, professionals are urged to acquire knowledge about possible health effects of female genital cutting (FGC) in order to tackle prevention and care in relation to the practice. While professionals are guided by policies and interventions focusing on medical effects of FGC, some scholars have cautioned that many popular beliefs about health risks rest on inconclusive evidence. The way professionals understand and respond to health information about FGC has in this context largely been left unexamined. This article aims to provide a qualitative exploration of how professionals in Sweden approach adolescent sexual and reproductive healthcare encounters in relation to acquired knowledge about FGC, using menstrual pain as an empirical example. The analysis shows that there was a tendency in counselling to differentiate young migrant women's menstrual complaints from ordinary menstrual pain, with professionals understanding pain complaints either in terms of FGC or as culturally influenced. The study shows how professionals navigated their various sources of knowledge where FGC awareness worked as a lens through which young women's health complaints were understood. Biomedical knowledge and culture-specific expectations and assumptions regarding menstrual pain also informed counselling. Finally, the article discusses how FGC awareness about health risks was used constructively as a tool to establish rapport and take a history on both menstrual pain and FGC. The analysis also recognises potential pitfalls of the approaches used, if not based in well-informed policies and interventions in the first place.

Although previous research and public debate argue that partnered sexual activity is construed in terms of being consensual or not, we know little about young people’s own reasoning on sexual consent. This study aimed to investigate how sexual consent and sexual negotiations are interpreted by young people in Sweden. Forty-four female and male participants, ranging from 18–21 years old, took part in 12 focus groups, organised according to a set of vignettes. All focus groups were analysed using inductive thematic analysis. The findings illustrate the complexity of the interpretation of sexual consent. There was a clear perception among the participants that sex between two individuals is a mutual process, and that sex should be consensual, expressed either through words, body language, or both. They all stated clearly that a ‘No’ has to be respected, independently of context. However, at the same time participants expressed contradictory norms and expectations in relation to the described situations, that showed an ambivalence concerning sexual scripts and consequences of challenging these in specific situations. Reasoning concerning discrepancy between ideals and actual possibilities to act in sexual encounters indicates differences in relation to gender, age and educational background and pathways.

BACKGROUND

The overall purpose is to investigate how the COVID-19 pandemic has affected individuals who have been or are going through assessment or treatment for involuntary childlessness, and their processes of trying to have children. Previous research on involuntary childlessness in relation to the pandemic has mainly been medical and quantitative, and there has been a lack of qualitative studies that explore the subject area on a more indepth level. The study is a project in ReproUnion, Challenge 5.

MATERIALS AND METHODS

In this qualitative study, we used semistructured interviews to collect data. The study includes individuals who have been or are going through assessment or treatment for involuntary childlessness in Sweden and Denmark during the pandemic. Participants were recruited from both public and private care. 26 individuals took part in the study, of which 18 women and eight men. The participants were between 24 53 years old and the sample consisted of both heterosexual and same sex couples. The interviews addressed experiences of assessment and treatment of involuntary childlessness during the COVID-19 pandemic in relation to e.g.access to care, socioeconomic factors and intimate relationships.

RESULTS AND CONCLUSION

The preliminary results show that the pandemic has affected the patients in many ways and made an already challenging process even more difficult.Obstacles mentioned are for example limit access to care with longer queues and uncertainty regarding when the treatment can be resumed. Many of the respondents has also suffered from the absence of partners during care visits. Furthermore, the fear of being infected by the Corona virus, which could cause the treatment to be postponed, has led to isolation and often a weaker support from family and friends. However, these negative consequences have affected patients to varying degrees, some worse than others. The results also show that the pandemic brought some positive consequences. For example, the isolation has been perceived as a relief for some as they easier could avoid being exposed to other people’s pregnancies as well as attending baptisms and baby showers.

“It has been extremely stressful for me to hear those messages [about delays of the treatment from the clinic], as it has taken so long to get started , and, yes, I am not getting any younger. That's how I feel. For every six months that goes by, I have kind of lost a chance to get pregnant.”

"We are young and have no underlying health problems, but we still really had to isolate ourselves, and we were very afraid that we would catch a cold or suffer from Corona so that the treatments would be cancelled. So, it was all the time that you were afraid to meet people, and you were afraid to meet your friends”

“I think the biggest impact was that I was not allowed to accompany and that I was not allowed to participate, also in combination with this stress that you could get sick. That was probably thebiggest impact for me and my wife.”

CONTACT

Ida Elisabet Hall

Research assistant, social worker, master in sexology

Centre for Sexology and Sexuality Studies, Malmö University

ida.hall@mau.se