Monica Ålgars

The association between disordered eating and gender identity was examined in a sample of 20 (11 female-to-male, 9 male-to-female) transgender Finnish adults, aged 21–62 years. Using semi-structured interviews, participants' own understanding of the underlying causes of their disordered eating was analyzed, as well as the effect of gender reassignment on eating behaviors and cognitions. A majority of the participants reported current or past disordered eating. Participants most frequently described strive for thinness as an attempt to suppress features of one's biological gender, or accentuate features of one's desired gender. Gender reassignment was primarily perceived as alleviating symptoms of disordered eating.

The Sexual Inhibition and Sexual Excitation Scales (SIS/SES) measure the propensity for sexual inhibition and excitation in men. According to the theoretical model underlying the SIS/SES, sexual response and associated behavior depend on dual control mechanisms in the brain involving the balance of excitatory and inhibitory systems which impinge on sexual response. Previous research with the SIS/SES has indicated one higher-order excitatory factor and two higher-order inhibitory factors affecting sexual response. The present study analyzed the item structure and the psychometric properties of the instrument in a population based sample of Finnish male twins (N = 1,289), and, including 37 out of 45 items of the original scales, estimated the heritability of and the environmental influences on the excitatory and inhibitory mechanisms.The twin correlations and the structural equation modeling suggested modest heritability for both inhibitory mechanisms. Sexual excitation, in contrast, was not influenced by genetic effects and similarities between twins for this mechanism seemed to be caused by the common environment of the twins.

Introduction.  Recently, in anticipation of the Diagnostic and Statistical Manual of Mental Disorders V, much consideration has been given to the diagnostic criteria for premature ejaculation (PE). The scientific community is yet to agree not only on the etiology of PE, but also on the most suitable diagnosis and forms of treatment. It has been suggested that the diagnostic criteria of PE should be strictly empirical and rely on intravaginal latency time alone, whereas others stress the need to also include psychological and personal factors.Aim.  To examine different indicators of PE and their relationship with and ability to predict sexual distress.Main Outcome Measures.  Statistical analyses of data on sexual distress and different measures of ejaculatory function on a population-based sample of 3,332 Finnish men.Methods.  The present study involved a population-based sample of 3,332 males, of which 2,328 were twins aged 18–33, and 1,004 were over 18-year-old siblings to the aforementioned (M = 26.17 years of age). The individual contributions of different PE-indicator variables to experienced sexual distress were investigated by calculating correlations and performing a regression analysis.Results.  All included indicators of PE were significantly associated with sexual distress, and significant and logical differences in sexual distress were found between intravariable levels for several of the indicator variables. Only variables relating to subjective experience (e.g., worrying about PE) were uniquely related to sexual distress when other indicators were controlled for.Conclusions.  The results suggest that variables measuring subjective experience may be useful when considering diagnostic criteria if indicators that are related to sexual distress are considered useful. However, overall, the association between PE and sexual distress is not especially strong, emphasizing the fact that more objective indicators of PE may not necessarily be associated with significant distress. Jern P, Santtila P, Johansson A, Varjonen M, Witting K, Ålgars M, Alanko K, von der Pahlen B, and Sandnabba K. Indicators of premature ejaculation and their associations with sexual distress in a population-based sample of young twins and their siblings. J Sex Med 2008;5:2191–2201.

The relation between gender identity and body dissatisfaction as well as disordered eating was examined in a population-based sample of Finnish adults aged 18 to 44 years (N = 1,142). Participants with a conflicted gender identity were compared to controls matched on age and biological sex. Participants with a conflicted gender identity showed higher levels of body dissatisfaction, women with a conflicted gender identity also showed more eating disturbance than controls. Among men with a conflicted gender identity, male–male sexual experience was associated with more body dissatisfaction and disordered eating. Among women with a conflicted gender identity, female–female sexual experience was related to less body dissatisfaction. Possible explanations for these findings and the potential clinical implications are discussed.

Introduction.  A number of different theoretical approaches to understanding the etiology of ejaculatory dysfunction have been proposed, but no behavior genetic study has yet, to our knowledge, been conducted to explore the genetic and environmental influences on ejaculatory dysfunction.Aim.  The aim of the present study was to explore the genetic and environmental effects on premature (PE) and delayed (DE) ejaculation in a population-based sample.Methods.  The genetic and environmental influences on PE and DE were investigated in a population-based sample of 1,196 Finnish male twins, age 33–43 years, with 91 identical and 110 complete twin pairs. Several different aspects of ejaculatory function were measured by a self-report questionnaire (e.g., latency time, subjective experience of ejaculatory control). Factor analyses distinguished two subcomponents of ejaculatory function, and subsequently, composite variables measuring PE and DE were created. Structural equation modeling was performed on the composite variables.Main Outcome Measures.  Measurement of genetic and environmental effects on PE and DE.Results.  The results suggested moderate genetic influence (28%) on PE, but not on DE (0%). There was a moderate familial effect on DE with shared environmental effects accounting for 24% of the variance. However, omission of the shared environmental component did not directly result in a significantly decreased model fit for DE, and omission of the additive genetic component did not directly result in a significantly decreased fit for the PE model.Conclusions.  The findings from the present study provide useful information regarding the etiology and understanding of ejaculatory dysfunction. Jern P, Santtila P, Witting K, Alanko K, Harlaar N, Johansson A, von der Pahlen B, Varjonen M, Vikström N, Ålgars M, and Sandnabba K. Premature and delayed ejaculation: Genetic and environmental effects in a population-based sample of Finnish twins. J Sex Med 2007;4:1739–1749.

OBJECTIVE. Body image and perceived attractiveness were examined, and the impact of age, gender, and body mass index (BMI) was analyzed and discussed from an evolutionary and a sociocultural perspective. METHOD. The population-based sample consisted of 11,468 Finnish men and women aged 18 to 49 years. RESULTS. Both age-related decrease and increase in body satisfaction was detected as well as interactions between age and gender. Some effects were nonlinear. Women were generally less satisfied with their bodies than men. BMI had a stronger influence on women's body image than men's. DISCUSSION. It was proposed that it is insufficient to merely study how age affects general body image because adults might become more satisfied with some aspects of their bodies as a function of age and less satisfied with other aspects. Body satisfaction might also fluctuate during different phases of the adult life, and the patterns possibly differ between men and women.

Associations between number of children, pregnancy, and overall relationship satisfaction were explored in a population-based sample of 2081 women, aged 33–43 years. Multiparous women had less orgasm problems compared to nulliparous women. Nulliparous women had more pain problems and were sexually less satisfied compared to women with children, regardless of the number. Women pregnant with the first child had fewer pain problems compared to a matched nonpregnant control and were sexually more satisfied. Being more satisfied with the overall relationship was related to higher sexual satisfaction and less sexual function problems.

Sexual body image was examined in a population-based sample of 9,532 Finnish men and women, age 18 to 49 years. More than one half of women and men were satisfied with their genitals, one half of the women were satisfied with their breasts. Higher levels of genital satisfaction were related to higher frequencies of sexual behavior and better sexual function for both genders. For men, penis size satisfaction was associated with lower levels of premature ejaculation and better erectile function. Sexual body image was related to overall perceived attractiveness, for women a higher body mass index was related to satisfaction with breast size. Having children was negatively related to women's sexual body image, abortions and miscarriages likewise. Limitations of the study and clinical implications of the findings are discussed.