Sexual Self-Efficacy and Entitlement to Pleasure: The Association of the Female Sexual Subjectivity Inventory with Sexual Risk Taking and Experience of Orgasm

Young women's understanding of their own sexuality has increasingly been acknowledged as an important component of their sexual health. The Female Sexual Subjectivity Inventory (FSSI) was developed to measure five distinct factors of young women's experiences of sexual pleasure and empowerment. No studies have explicitly evaluated the association between FSSI scores and clinical sexual health outcomes. We conducted a cross-sectional survey of women to assess the association between FSSI factors and the occurrence of three clinical sexual health outcomes in the prior 12 months: acquisition of an STI, unwanted pregnancy, or taking emergency contraception (Plan B). We also assessed the association between FSSI scores and self-reported orgasm frequency during partnered sexual activity. We used multivariate logistic regression models to estimate associations. Finally, we used the FSSI scale in a novel way to identify a population of women who are discordant on their levels of entitlement to pleasure from a partner and self-efficacy in achieving sexual pleasure. We did not find any statistically significant associations between mean score on any of the FSSI factors and clinical sexual health outcomes of interest in the prior year. We found that all FSSI factors except Sexual Self-Reflection were positively associated with increased orgasm frequency. Our study underscores the validity of the FSSI as a measure to assess psychosocial constructs relevant to young women's ability to experience sexual pleasure with a partner and introduces a novel way to use the scale to assess the development of women's sexual subjectivity.