Long-Distance Relationships: Just as beneficial as Proximal Relationships?

Posted on Sep 18, 2017

By Cindy Mackie

My mother always told me to never sacrifice my schooling, a career, or an important goal of mine for a guy. But what are you supposed to do if you are in a loving relationship and an opportunity arises in a location geographically far from your partner? While many people fear long-distance relationships, they may be more rewarding than you think.

Although it is well established that living near, or with, your partner has its benefits such as physical contact, researchers have shown that being in a long-distance relationship might actually be beneficial to your health. Researchers at Adler University in Chicago gathered relationship and health ratings from 296 married couples through an online survey; 201 of these couples were in proximal relationships, and 95 of these couples were in long-distance relationships [1].

Du Bois et al.’s study is based on a concept called the “Marriage-Health-Association”. This concept basically says that married couples are healthier, both mentally and physically, than their single counterparts. Up until recently, evidence for this association has primarily been gathered from couples living together or near each other. Du Bois et al. wished to expand the research on the Marriage-Health-Association to include data from couples in long-distance marriages.

The study compared two groups: married couples in a proximal relationship (PR) and married couples in a long-distance relationship (LDR). Couples in a proximal relationship had to have reported seeing each other daily in a typical month and to have spent no more than 2 days per week separated by over 50 miles. Couples in a long-distance relationship had to have reported seeing their partner less than daily in a typical month and to have spent over three days a week over 50 miles apart. There was no difference in the mean length of marriage or participant age between the two groups. Some of their key findings are highlighted here:

Compared to couples in proximal relationships, couples in long-distance relationships reported:

  • Better overall health
  • Greater satisfaction with their social role
  • Less anxiety
  • Less depression
  • Better eating habits
  • More frequent exercise

The authors speculated that couples in long-distance relationships may have more free time they can spend on themselves, which is why they may exercise more. They also suggested it could have something to do with hormone differences between LDR and PR couples. The authors referenced a study [2] that found LDR couples to have higher testosterone levels than those in a PR. Du Bois et al. suggested that these elevated testosterone levels in LDR couples can increase evolutionary “competitive behaviours”, such as working out to appear more attractive, because their hormone physiology is more similar to being “single” than “in a relationship”.

Although couples in long-distance relationships reported many positive behavior urs, they also reported higher stress levels both inside and outside the relationship. The authors hypothesized that this could be because couples living together, or near each other, have the benefit of physical contact which has been shown to decrease stress levels prior to a stressful event. Fortunately, the authors explained that developing good coping mechanisms, conflict management skills, developing more ways to support each other from afar, and incorporating each other more frequently into your daily lives (via Skype, phone calls, etc.) can alleviate some, or much, of the stress involved with being apart.

Therefore, if opportunity comes knocking a plane-ride away, you don’t necessarily have to choose between your career and your partner. As we have seen, couples in long-distance relationships can have relationships just as happy and healthy as couples in proximal relationships.


[1] Du Bois, S. N. Du, T. G. Sher, K. Grotkowski, T. Aizenman, N. Slesinger, and M. Cohen. “Going the Distance: Health in Long-Distance Versus Proximal Relationships.” The Family Journal 24, no. 1 (2015): 5-14. doi:10.1177/1066480715616580.

[2] Anders, Sari M. Van, and Neil V. Watson. “Testosterone levels in women and men who are single, in long-distance relationships, or same-city relationships.” Hormones and Behavior 51, no. 2 (2007): 286-91. doi:10.1016/j.yhbeh.2006.11.005.

The Pros and Cons of the Sex Robot Revolution

Posted on Sep 4, 2017

By Justin Dubé

If you’ve been paying attention to the news, your grandparents, or society in general, you’ve likely been privy to the technology debate. On the one hand, early tech adopters expound on the benefits of progress, of efficiency, of swiping right (or, left?). On the other hand, luddites bemoan the loss of our planet, free-time, and conversation with strangers. Advances in artificial intelligence, robotics, and the ability to build anatomically correct dolls have added some (sexy) fuel to the tech debate. Specifically, should humans be harnessing our technological prowess to build sex-bots (a.k.a., pleasure-bots, service droids, R2-D2, etc.)? Some argue that it’s only a matter of time before human-robot sex becomes as ubiquitous as other human-computer interactions, such as using an iPhone to order pizza [1, 2, 3]. Indeed, four companies are currently shipping sex-bots, and sex-bot brothels are now operating throughout Europe and Asia [4]. While the dawn of pleasure droids may seem inevitable (even for the decidedly low tech and low funded), it’s never too late to consider the opportunities and challenges that accompany advances in the $30 billion (!!!) sex-tech industry [5]. This post will provide a brief (and somewhat lighthearted) summary of the pros and cons of sex-bots.

The following arguments have been made in favour of using robots for sex:

  • Sex robots could provide an alternative for people with socially unacceptable or harmful sexual preferences (i.e., paraphilias), such as pedophila or bestiality [4]
  • Sex robots could take the place of prostitution [3] and mitigate human trafficking.
  • According to the Foundation of Responsible Robotics, pleasure-bots could provide a sexual outlet and companionship for elderly individuals in long-term care homes [4], an argument reminiscent of using robo-pets in nursing homes
  • You could fulfill a lifelong dream of having sex with a robot that kind of looks like a creepy version of a celebrity, like this guy did.
  • Having routine robot sex could make instances of non-robot sex (in which you have sex with a real, live, sweaty human) seem more satisfying [1] – a satisfaction akin to eating Vera Pizza Napoletana after months of eating frozen grocery store pizza.

So, if sex-bots have the potential to mitigate human suffering, fill a niche, and make sex between humans more satisfying, then what’s the big deal? Before getting to the crux of this big deal (spoiler alert: the current state of sex-bot affaires perpetuates harmful gendered ideals of sexuality), I’ll outline some cons of using robots for sex, which include the following:

  • Robots haven’t bought into the tinder hookup culture, so it’s pretty hard to meet robots for sex using dating apps.
  • Sex-bots could increase social isolation.
  • Some argue that sex robots used to treat paraphilias, such as a child sex-bot, could reinforce paraphilic orientations, such a pedophilia. This is similar to the argument made against child sex dolls, which are currently illegal in the UK and are being debated in Canadian courts.
  • Sex-bots are being created by (mostly) men with gendered ideas. This leads to robots being created with biased gender norms, which perpetuate preexisting stereotypes [5]. For example, sex-bots currently on the market have settings to reflect submissive (and even frigid) notions of female sexual companions [4].

Although the lack of robots on tinder and the risk of increased social isolation are scary, the last point gives the most cause for concern. Indeed, the risk of perpetuating harmful gender stereotypes is at the heart of a position paper by Dr. Kathleen Richardson, a researcher in the Ethics of Robotics at the Centre for Computing and Social Responsibility [6]. In her paper, Richardson warns that the development of sex-bots may entrench gender relations that fail to respect the dignity of all parties involved in sexual exchanges. Although I agree with many of the ideas advanced by Richardson, I recognize the march of technology as inevitable. Thus, rather than joining Richardson’s campaign against sex robots, I feel it is more pragmatic to raise awareness of the pitfalls of human-robot sex and to provide people with the skills to foster meaningful and reciprocal human connections. And finally, costing an average of $15,000.00 CAD, who the heck can afford a sex-bot anyway?!


[1] Bodkin, H (2016, December 20th). Sex will be just for special occasions in the future as robots will satisfy everyday needs. The Telegraph. Retrieved from

[2] Gurley, G (2015, April 20th). Is This the Dawn of the Sexbots? Vanity Fair Retrieved from

[3] Levy, D. (2009). Love and sex with robots: The evolution of human-robot relationships. New York.

[4] Knapton, S (2017, July 5th). Sex robots on way for elderly and lonely…but pleasure-bots have a dark side, warn experts. The Telegraph. Retrieved from

[5] Jackson Gee, T (2017, July 5th). Why female sex robots are more dangerous than you think. The Telegraph. Retrieved from

[6] Richardson, K. (2016). The asymmetrical ‘relationship’: parallels between prostitution and the development of sex robots. ACM SIGCAS Computers and Society, 45(3), 290-293.

Trans health education in medical school: The current state of things

Posted on Aug 21, 2017

Image credit: Flickr user Hamza Butt

By Carmen Boudreau

A recent study published in LGBT Health explored the benefit of trans health-specific education sessions for health professions students [1]. In the study, 46 students were asked to complete ten lunchtime sessions where they were educated on transgender health and issues in care. Before and after the study, they were asked to complete measures of transphobia and their knowledge on best practice for trans patients. It was found that after completing the course, students were more competent in specific trans-related knowledge domains including use of appropriate terminology, how to collect gender identity, the DSM-5 diagnosis of gender dysphoria, medications used for gender affirmation, and relevant federal policy. Students also had reduced levels of transphobia. These outcomes speak to the importance increasing education and awareness of trans health among young professionals.

After reading this article, I found myself reflecting on my own experiences in learning about trans health. I am a Canadian medical student entering my third year of training. I have just completed the first two years, which consisted mainly of classroom time. It is during these years that we are able to explore not only the science, but the ethics, philosophy, and practice of modern medicine, with the ultimate goal of being prepared to enter the clinical phase of our training. When you only have two years to learn everything, it is safe to say that no topic is done justice, and trans health is no exception. Unfortunately, we did not have ten lunchtime sessions to explore the complex issues and barriers faced by trans patients. In true medical school form, we grazed the surface of this topic like we would any other: with one three-hour session.

It was a fantastic session.

Our class was divided into small groups of eight students and placed in tutorial rooms with a physician tutor and a volunteer trans patient. Although there were concrete objectives outlining what content to cover in this time, there was relaxed and conversational feel that made the interaction surprisingly organic. Over the course of three hours, we were educated on anatomy and physiology, language, inclusive practice strategies, barriers in care, interview techniques, and stigma against trans patients. We were also provided with an open and safe space to ask questions to our volunteer patient who was understanding and keen to help. It was an informative and engaging session threaded together with a first person narrative of experiencing the healthcare system as a trans patient. I left the tutorial room feeling more confident in my medical knowledge and in my ability to better serve my community as a more thoughtful and inclusive future physician.

The subject was never re-visited.


[1] Braun, H. M., Garcia-Grossman, I. R., Quinones-Rivera, A., & Deutsch, M. B. (2017). Outcome and Impact Evaluation of a Transgender Health Course for Health Profession Students. LGBT health, 4(1), 55-61.

We Need to Talk: Disclosure of Sexual Problems

Posted on Aug 8, 2017

By Kat Merwin

This blog summarizes our recently published paper: Merwin, K. E., O’Sullivan, L. F., & Rosen, N. O. (2017). We need to talk: Disclosure of sexual problems is associated with depression, sexual functioning, and relationship satisfaction in women. Journal of Sex & Marital Therapy. doi: 10.1080/0092623X.2017.1283378.

While there is no shortage of sex on our screens these days (be it TV shows, movies, or porn) we tend to only get shown the ‘good stuff.’ We see instant sexual arousal and orgasms (or implied orgasms) a-plenty! What we don’t see is an accurate depiction of what happens for many women: sexual problems.

Sexual problems (e.g., difficulties with desire, arousal, lubrication, orgasm, and pain during sexual activity) are common in women. Shifren and colleagues found that 43% of women reported experiencing at least one sexual problem and that 12% of these women were significantly distressed by their sexual problem(s) [1].

Not only are sexual problems common, but they can also adversely affect women’s psychological, sexual, and relationship well-being. Sexual problems are associated with more depressive symptoms [2-3], poorer sexual functioning [4-5], and lower relationship satisfaction [6-7]. Research tells us that sexual communication, and sexual self-disclosure in particular, is important for the well-being of individuals in romantic relationships [8-9].

But do women with sexual problems tell their partners about these difficulties?

Is telling a partner about sexual problems beneficial to a woman’s psychological, sexual, and relationship well-being?

This is what we wanted to know. Specifically, we wanted to (1) examine the proportion of women with sexual problems that disclose these problems to their partners, and (2) examine the associations between telling a partner about sexual problems and women’s depressive symptoms, sexual functioning, and relationship satisfaction.

What did we do?

We had 277 women (whom reported experiencing at least one distressing sexual problem) complete an online survey that included validated measures assessing sexual problems, relationship satisfaction, sexual functioning, and depressive symptoms. We also asked women to report whether or not they had told their current romantic partner about their sexual problems.

What did we find?

  • The majority of women (69%) reported that they had told their current romantic partner about the sexual problems they were experiencing.
  • Women who disclosed their sexual problems also reported fewer depressive symptoms, greater sexual functioning, and greater relationship satisfaction (compared to women who had not disclosed).

What do these findings mean?

Broadly, this research tells us that if you have a sexual problem, telling your partner about it may be beneficial to your psychological, sexual, and relationship well-being.


Our findings suggest that the majority of women with sexual problems share this information with their romantic partners, and that this disclosure is associated with fewer depressive symptoms, and greater sexual functioning and relationship satisfaction, compared to women who do not disclose their sexual problems.

Telling a partner about sexual problems may be beneficial to women’s well-being by enhancing intimacy or allowing couples to adapt sexual activities to accommodate sexual problems.

However, this study was cross-sectional, so the relationship between disclosure and well-being may go the other direction: It is possible that targeting the improvement of sexual functioning, depressive symptoms, or the global relationship might facilitate disclosure of any sexual problems and allow the couple to work together on improving their sexual well-being.


[1] Shifren, J. L., Monz, B. U., Russo, P. A., Segreti, A., & Johannes, C. B. (2008). Sexual problems and distress in United States women: Prevalence and correlates. Obstetrics & Gynecology, 112, 970–978.

[2] Dunn, K. M., Croft, P. R., & Hackett, G. I. (1999). Association of sexual problems with social, psychological, and physical problems in men and women: A cross sectional population survey. Journal of Epidemiology and Community Health, 53, 144–148.

[3] Echeverry, M. C., Arango, A., Castro, B., & Raigosa, G. (2010). Study of the prevalence of female sexual dysfunction in sexually active women 18 to 40 years of age in Medellín, Columbia. Journal of Sexual Medicine, 7, 2663–2669. doi:10.1111/j.1743-6109.2009.01695.x

[4] Meana, M., Binik, Y. M., Khalifé, S., & Cohen, D. R. (1997). Biopsychosocial pro le of women with dyspareunia. Obstetrics & Gynecology, 90, 583–589.

[5] Rosen, C., Brown, J., Heiman, S., Leiblum, C., Meston, R., Shabsigh, D., … D’Agostino, R. (2000). The Female Sex- ual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. Journal of Sex & Marital Therapy, 26, 191–208. doi:10.1080/009262300278597

[6] Burri, A., Radwan, S., & Bodenmann, G. (2015). The role of partner-related fascination in the association be- tween sexual functioning and relationship satisfaction. Journal of Sex & Marital Therapy, 41, 672–679. doi:10.1080/0092623X.2014.966398

[7] Burri, A., & Spector, T. (2011). Recent and lifelong sexual dysfunction in a female U.K. population sample: Prevalence and risk factors. Journal of Sexual Medicine, 8, 2420–2430. doi:10.1111/j.1743-6109.2011.02341.x

[8] Pazmany, E., Bergeron, S., Veraeghe, J., Van Oudenhove, L., & Enzlin, P. (2015). Dyadic sexual communication in pre-menopausal women with self-reported dyspareunia and their partners: Associations with sexual function, sexual distress and dyadic adjustment. Journal of Sexual Medicine, 12, 516–528. doi:10.1111/jsm.12787

[9] Rancourt, K. M., Rosen, N. O., Bergeron, S., & Nealis, L. J. (2016). Talking about sex when sex is painful: Dyadic sexual communication is associated with women’s pain, and couples’ sexual and psychological outcomes in provoked vestibulodynia. Archives of Sexual Behavior, 45, 1933–1944. doi:10.1007/s10508-015-0670-6

Understanding gender

Posted on Apr 24, 2017

By Maria Glowacka

A few years ago I went to a workshop entitled, Towards a Collaborative Approach to Trans Health Care. I thought that I knew all of the appropriate terms and how to respect everyone’s gender identities, but realized during this workshop that there was still more for me to learn. I recently came across my notes and thought that others may also want this information. Please note that I am a cisgender female sharing what I learned at a workshop and I welcome other interpretations and explanations. I am always open to learning about people’s experiences and receptive to feedback.

Everyone has the right to identify however they want to regardless of how they look. The following definitions are not meant to help you label others but, rather, to better understand when an individual identifies in a certain way.

Biological sex is measurable gonads, genes, hormones, and chromosomes. Intersex conditions involve variability in these characteristics. Biological sex is not always straightforward, even in those without intersex conditions.

Gender identity is how you think about yourself. It’s your internally felt sense of your gender – male, female, transgender, gender non-conforming, etc. Many cultures view gender identity on a continuum rather than binary.

Gender expression is how you demonstrate your felt sense of gender through your clothes, behavior, interactions, etc. This expression is largely socialized. Gender conformity refers to the societal expectation to adhere to social norms of gender expression.

Cisgender individuals are those people whose biological sex does not conflict with their gender identity. The term transgender encompasses many realities, including people who identify outside of the gender binary (male/female), those who identify on a continuum between male and female, those who identify as a 3rd or 4th gender, those who identify as encompassing both genders, and those who go beyond the boundaries of expressing gender based on social norms. The terms genderqueer, genderfluid, and non-binary encompass identities that are outside of the binary male/female system.

A transition is the process of transforming physically, psychologically, emotionally, and/or spiritually with the goal of self-actualization. Every transition is unique and this process of change can take years. It may or may not include hormones and surgeries. A social transition is expressing one’s true gender in public. A physical transition is when an individual transforms their appearance with or without medical means. Transition is often a very difficult time for individuals; it may come with grief, loss, marginalization, and an increased risk of being the target of violence. However, this process is also associated with increased authenticity, emotional availability, energy, creativity, and self-esteem.

Transphobia is fear and discrimination targetting individuals who identify as transgender, transsexual, queer, or anyone who does not fit into society’s gender categories. This can present in many ways, such as harassment, physical and sexual assault, preventing access to appropriate bathrooms, inappropriate questions, and intentional use of wrong pronouns or names. It can have a significantly negative impact on the lives of targeted individuals. For example, the rates of suicide attempts are substantially higher in transgender individuals.

The take home message is respect everyone, ask questions, and be open to being corrected.


  • Bauer, G., Nussbaum, N., Travers, R., Munro, L., Pyne, J., Redman, N. We’ve Got Work to Do: Workplace Discrimination and Employment Challenges for Trans People in Ontario. Trans PULSE e-Bulletin, 30 May, 2011. 2(1). Downloadable in English or French at
  • Françoise, S. (2014). Towards a Collaborative Approach to Trans Health Care, Halifax, NS.
  • Grant, J. M., Mottet, L. A., Tanis, J. Injustice at Every Turn: A report of the National Transgender Discrimination Survey National Center for Transgender Equality (NCTE) and National Gay and Lesbian Task Force (NGLTF), 2011.
  • Tervalon, M. & Murray-Garcia, J. Cultural Humility vs Cultural Competence:A Critical Distinction in Defining Physician Training Outcomes in Multicultural Education, Journal of Health care for the Poor and the Underserved. May 1998, 9(2)
  • definitions/


Fear-Based Reasons For Not Engaging in Sexual Activity During Pregnancy

Posted on Apr 12, 2017

By Jaimie Beveridge

This blog summarizes our recently published paper: Beveridge, J. K., Vannier, S. A., & Rosen, N. O. (2017). Fear-based reasons for not engaging in sexual activity during pregnancy: Associations with sexual and relationship well-being. Journal of Psychosomatic Obstetrics & Gynecology. doi: 10.1080/0167482X.2017.1312334.

TV shows and movies love to joke about having sex during pregnancy – especially about what could happen to the baby. Seth Rogen’s character in Knocked Up is worried about poking his unborn baby in the face, while Sarah Jessica Parker’s character in Sex and the City jokes that that’s where dimples come from.






While these concerns are comical when expressed by fictional characters, they are also concerns that people have in real life. In fact, research shows that about half of women report fears that sexual activity could harm their baby or cause serious complications to their pregnancy (like bleeding, preterm labour, or miscarriage) [1-3]. These fears are found across cultures and may even lead women to stop engaging in sexual activity while pregnant [4-8].

Are these concerns and fears about sex harming the pregnancy warranted? Should women be refraining from sex during pregnancy in order to avoid harm to their pregnancy?

Research tells us that, for low risk pregnancies (pregnancies without complications such as lower genital tract infection or placenta previa), sex is safe and may even have some benefits during pregnancy [9,10]*. This means that, for the majority of women, sex will not harm the pregnancy and so avoiding sex due to fear of harming the pregnancy is not necessary. That’s good news! However, women still report not engaging in sexual activity during pregnancy due to these fears and past research does not tell us is whether women who avoid sex due to fear of harming their pregnancy experience lower sexual and relationship well-being.

This is what we wanted to know. Specifically, we wanted to (1) describe the importance of fears of sexual activity harming the pregnancy in women’s decision not to have sex during pregnancy and (2) examine how these fear-based reasons for not engaging in sexual activity relate to women’s sexual functioning, sexual satisfaction, sexual distress, and relationship satisfaction during pregnancy.

What did we do?

We had 261 women complete an online survey that included validated measures of sexual functioning, sexual satisfaction, sexual distress and relationship satisfaction. We also asked women to think back on times they chose not to engage in sexual activity (defined as genital stimulation, oral sex, vaginal intercourse, and/or anal intercourse) in the last month and rate how important fears of complicating the pregnancy or harming the baby were in this decision. Fears were rated on a scale of 1 (not important at all) to 7 (extremely important) and included concerns about preterm labour, bleeding, infection, and harming or injuring the baby. Women were asked about their own fears as well as their partner’s fears.

What did we find?

  • Overall, we found that 58.6% of women endorsed (rated the fear above 1 [not at all important]) at least one fear as a reason for not engaging in sexual activity in the past month, but women’s average fear scores were low (average = 1.7 out of a possible 7).
  • We also found that women who reported more fear-based reasons for not engaging in sexual activity were more likely to experience greater sexual distress (negative feelings related to their sexuality and/or sexual relationship).
  • We did not find a link between women’s fear-based reasons for not engaging in sexual activity and their sexual functioning, sexual satisfaction, or relationship satisfaction.

What do these findings mean?

Broadly, this research tells us that if you have been pregnant, chances are that you felt at least a little concerned about being sexually active during your pregnancy, but that these concerns did not have a big impact on your overall sexual and romantic relationship.

Overall fear scores were low, and over 40% of women did not report any fear-based reasons. This means that most pregnant women do not rate fears as overly important in their decision not to engage in sexual activity during pregnancy.

When women do experience these fears they may be more likely to feel distressed about their sexual relationship. This includes feelings of guilt, frustration, unhappiness, and inadequacy. It is possible that women who are concerned about sex harming their pregnancy also pay more attention to the sexual changes that are common during pregnancy, such as reduced desire and changes in body image. In turn, this might lead to more distress and worry about their sexual relationship in general.


Taken together, our results suggest that fears of sexual activity harming the pregnancy are not a strong predictor of women’s overall sexual and relationship well-being during pregnancy. As such, interventions that focus specifically on women’s fears of sexual activity may not be necessary for most women, and may not be essential for promoting women’s broader sexual and relationship well-being during pregnancy. Instead, interventions that focus on other areas of women’s sexuality and relationship, such as normalizing changes in women’s sexual functioning or finding alternative and enjoyable sexual positions, may be more valuable. Still, interventions focused on minimizing fears related to sexual activity may help to reduce women’s global feelings of worry and anxiety about their sexual relationship during pregnancy.

* Note: Please talk to your doctor if you have any concerns about having sex while pregnant.


[1] Pauls RN, Occhino JA, Dryfhout VL. Effects of pregnancy on female sexual function and body image: A prospective study. J Sex Med 2008;5:1915-22.

[2] Bartellas E, Crane JMG, Daley M, Bennett KA, Hutchens D. Sexuality and sexual activity in pregnancy. BJOG 2000;107:964-68.

[3] Jamali S, Mosalanejad L. Sexual dysfunction in Iranian pregnant women. Iran J Reprod Med 2013;11:479-86.

[4] Gałązka I, Drosdzol-Cop A, Naworska B, Czajkowska M, Skrzypulec-Plinta V. Changes in the sexual function during pregnancy. J Sex Med 2015;12:445-54.

[5] Erol B, Sanli O, Korkmaz D, Seyhan A, Akman T, Kadioglu A. A cross-sectional study of female sexual function and dysfunction during pregnancy. J Sex Med 2007;4:1381-87.

[6] Orji E, Ogunlola I, Fasubaa O. Sexuality among pregnant women in South West Nigeria. J Obstet and Gynaecol 2002;22:166-68.

[7] Oruç S, Esen A, Laçin S, Adigüzel H, Uyar Y, Koyuncu F. Sexual behaviour during pregnancy. Aust N Z J Obstet Gynaecol 1999;39:48-50.

[8] Eryilmaz G, Ege E, Zincir H. Factors affecting sexual life during pregnancy in eastern Turkey. Gynecol Obstet Invest 2004;57:103-08.

[9] Jones C, Chan C, Farine D. Sex in pregnancy. CMAJ 2011;183:815-18.

[10] Sayle AE, Savitz DA, Thorp Jr JM, Hertz-Picciotto I, Wilcox AJ. Sexual activity during late pregnancy and risk of preterm delivery. Obstet Gynecol 2001;97:283-89.


So you’re applying for your clinical psychology residency…

Posted on Mar 20, 2017

By Kate Rancourt

First things first, take a deep breath. As you’re probably expecting, the process of securing your clinical psychology residency is not a walk in the park. But it’s also not a slog through the swamp of misery. I’d say it’s more like the average day in Canada: moments of sunshine, and moments of cloud-cover…moments of brutal winds, and moments of relative calm. The old “emotional roller coaster” idea works, too. The thing about emotional roller coasters is that they’re not a journey of ONLY unpleasantness, they’re a journey of unpleasantness AND pleasantness

How do I know? I just went through the long and drawn out APPIC Match! And I survived! I’m one week out from matching to a very good training program. Because it might be relevant to how strongly you consider the ino below, I will tell you that I am adult-focused and specializing in health psychology

You’ll get here, too! And to help you along the way, here are some of my reflections on the whole process. But before you start reading my words of wisdom, I want you to really focus on one thing that I wish someone had said to me before it all started

There is no right or wrong way to go through this process. YOU DO YOU.

Let this by your mantra


The biggest thing I learned about this phase is that it’s important to carefully weigh your desire to “get out and go anywhere” against your desire to have a residency program that you really want. This decision has repercussions for the rest of the process! Are you very much a generalist? Would you be happy with a wide array of training opportunities? Are you looking to specialize in a particular area, so only certain programs will appropriately set you up for the future you want? I fell into the latter category: I knew I would only be happy if I had a program that allowed me to specialize in health psychology. I also decided that I wasn’t going to apply to a program that felt like a mediocre fit (e.g., not the training model I wanted, heavy emphasis on research). Together, this meant that I put out fewer applications than some other applicants (FYI: 8 applications). When my applications went in, I felt confident because I had a refined list! In hindsight, I don’t think I really appreciated what it could mean moving forward. What it meant for me: I received fewer interviews (4 in total) relative to those who put out more applications, and I found this quite discouraging because I only applied to sites that I really thought were going to be a good fit. Also, only having four interviews put A LOT of pressure on doing those interviews well…anxiety!!!

Would I do it differently if I had a do-over? I’m not sure because everything worked out for me in the end. There were perks to only having 4 interviews: travel was less exhausting, I was away from home for a shorter period of time, it cost less money, and I was able to space out interviews more. But that pressure was a big con. So I think if I were to do it again, I’d probably apply to a few more.


This part of the process really wasn’t that bad in my opinion – kinda like the many scholarships you’ve probably applied for in the past ;

Standard advice applies:

Preparing your CV takes a looooong time!

  • Try to find examples of applications from former applicants, but take a stab at writing your essays before you look at theirs.
  • Definitely get a few people to read over your essays!
  • See if you can find an internship buddy to share info and resources with during this part.
  • Write one really good cover letter that you have a few people proof read, and then tweak it.

Prepare yourself from an emotional roller coaster. Notifications of interviews trickle in all day long. I didn’t hear from some sites until close to 5pm. And the notifications can come in any combination: bad news front-loaded and good news back-loaded, a nice balance, or good news front-loaded and bad news at the end of the day (that was more the case for me).

Do what you gotta do to get through it. Some people wanted to sit by their email and constantly hit refresh, others decided to try and distract themselves, and some, like me, fell somewhere in the middle. I definitely went to the gym this day, and was glad that I did!!! And then I took the night off and ordered take-out and watched Netflix with my hubby in PJs. Exactly what I needed. You do you.


This part was tough for me. I found it hard to work on my research because I was so preoccupied by the big task of interviews on the horizon! But I know many other people who were able to put it out of their mind for most of December. Again, it’s figuring out what works for you and being okay with it. I did written prep in December, and then put it away over the holidays and saved oral prep for January. In December, I met a few times with my internship buddies to brainstorm answers and discuss cases, etc. Having buddies was soooooo important to me at this stage! In January, I did mock interviews with my husband where he had my written prep document and just asked me random questions from there. I think my process worked well for me. One thing I learned was that small chunks of prep was better for me than cramming. In the days leading up to my first interview, I definitely found it hard to know what to do – I felt like I had plateaued in terms of prep, and so I felt like I was twiddling my thumbs because I was not in a mindsight to be able to work on my dissertation…


You’ve probably heard it before, but I felt interviews were a mix of stress/anxiety, excitement, and exhaustion. It was tough being on the road, but also exciting to get out of the hotel room and see the sights, dream of life in a new city, and meet new people. I really loved some of my interviews and had fun doing them. I definitely got to a point where I just couldn’t prep anymore, as I think many applicants do! And I also got to a point where I desperately wanted to be home, as I think everyone does…

One point I’d like to make about interviews that I wish I had known: In my experience, the interviews are all very different. Some sites take a very standardized interview approach, whereas others are more laid-back. Some sites, the standardized approach is comfortable, and others it feels stiff and impersonal. So for some interviews I felt really relaxed, and for some I felt more stressed and anxious. I suppose it kinda depends on what style suits you! Just prepare for the experience that you may have interviews where you feel like you didn’t win them over, or you feel like they didn’t want to get to know you and that this might actually reflect a standardized interviewing process rather than a bad interview. The result was that I found it tough to decide on my rankings when the interviews were so different because it made some attractive sites less attractive (even though they were still great on paper).


The nerves about match day began a few days before for me. I did not sleep well the night before match. The major pro about match day is that it’s much shorter than interview notification day: You find out in the morning, but the waiting is super stressful! I took the morning off and went bouldering because it was both physical exertion and mental distraction. But again, you do you.



This was by far the hardest part of the APPIC match process for me. I can’t say that everyone struggles with this aspect, but I’d hazard a guess to say that the vast majority do. And I think this is an important thing to talk about in training programs, and among your peers and your family and friends. Remember: APPIC is about a 6-month long journey, with multiple points of stress, but also multiple points of excitement and opportunity.

It was a challenge for me to go through the rollercoaster of emotions. This was my grad school experience that most taught me about the importance of self-care and coping. I had become very sure of myself through 5 years of grad school, and I found myself back in a place of insecurity and anxiety, which was confusing and hard. I had a friend and fellow applicant put it to me this way: APPIC is taking a bunch of brilliant, super-keeners who are at the end of a PhD, when they’re tired, stressed, and uncertain about the future, and putting them through a looooong, evaluative process. I found this really helped to contextualize the range of emotions I was feeling!

The other thing I want you to know about this piece is as follows: Please don’t listen to anyone who tells you how you should be feeling, or what you should be doing to get through it. Feel whatever you need to feel – I guarantee you it’s one of many very normal reactions to this stressful time! It’s okay to be super excited and not feel too much anxiety! It’s also okay to be discouraged by bad news – you don’t need to “keep your chin up.” Just try to find some ways to cope with it that allow you to keep going. For me, that was friends and family, exercise, and music and art.


Give some thought to how you are going to spend the Christmas holidays! What will be best for you? I spent 3 weeks away from home, which was nice in many ways, but it also meant that I was already tired of travelling before I even started the interview circuit. If I did it again, I personally would have spent more time in my own space to help me mellow as I prepared for interviews.


I can’t speak for everyone, but I’m still feeling nervous even though the match is over! It’s only one week out, so that might have something to do with it, but keep in mind that there’s a lot of change on the horizon once you match to a program! But that also comes with opportunity to start dreaming and getting excited about a new year ahead of you.





Sexual Distress and Sexual Problems during Pregnancy

Posted on Mar 12, 2017

This is a summary of our recently published paper: Vannier, S.A., & Rosen, N. O. (2017). Sexual Distress and Sexual Problems during Pregnancy: Associations with Sexual and Relationship Satisfaction. Journal of Sexual Medicine. doi: 10.1016/j.jsxm.2016.12.239

By Sarah Vannier

This study was part of our research program aimed at identifying ways to improve women’s and couples’ sexual and relationship well-being during pregnancy and the transition to parenthood (Read more here, here, and here). We know that sexual problems are very common during pregnancy. For example, 31% to 58% of pregnant women say that they feel less sexual desire, have more trouble feeling turned on, lubricating, or having an orgasm, and are feeling more genital or pelvic pain [1-4]. Similarly, a study in 2007 surveyed 589 pregnant women and found that a whopping 63% said they were dissatisfied with their sex life [5]. As sexual and relationship satisfaction are closely related, pregnant women who experience sexual problems may be at a higher risk for relationship problems during pregnancy and during the early stages of parenthood.

The main goal of this study was to look at women’s experiences of sexual distress during pregnancy. Sexual distress is defined as negative emotions about your sex life. These negative emotions include guilt, frustration, stress, worry, anger, and embarrassment.

In studies with non-pregnant women, women with more sexual distress tend to be less satisfied with their sexual relationship [6, 7]. Further, women with low sexual desire and high sexual distress were more likely to describe themselves as unhappy with their relationship as compared to women with low desire but no sexual distress [7]. Based on this, we expected that pregnant women who reported sexual distress would be at a higher risk for sexual and relationship dissatisfaction. We also expected that this would be particularly true for women who also reported sexual problems.

What did we do?

We recruited pregnant women online from August 2015 to March 2016 through Facebook, classified ads, word of mouth, and Reddit as part of a larger study on sexuality in pregnancy. To participate women had to be over the age of 18, in a romantic relationship, living in the United States or Canada, and fluent in English. Women completed online questionnaires measuring their sexual functioning, sexual distress, sexual satisfaction, and relationship satisfaction. They also answered questions about the demographics (e.g., age, education, income) and characteristics of pregnancy (e.g., how many weeks pregnant they were).


What did we find?

We looked at the data from 261 women. Women ranged in age from 19 to 41 years old (average = 28) and were between 4 and 40 weeks pregnant (average = 23). The average relationship length was just under seven years.

  • Overall, 42% of women reported sexual distress.
  • Among sexually active women (230 women):
    • 36% reported sexual problems.
    • 26% reported sexual distress and sexual problems.
    • 14% reported sexual distress but not sexual problems.
  • Women who reported sexual distress, sexual problems, or both, also reported lower sexual and relationship satisfaction compared to pregnant women with lower sexual distress and fewer sexual problems.

What does it mean?

The main take-home message from this study is that sexual distress is common during pregnancy and associated with lower sexual and relationship satisfaction. There are several possible reasons why many pregnant women experiencing sexual distress. In addition to an increase in sexual problems, many pregnant women say that they experience changes in their body image. In non-pregnant women, negative changes in body image have been linked with feelings of sexual distress. Some pregnant women may also find it difficult to reconciling the changing sexual and maternal parts of their self-identity. For example, thinking of themselves as both a mother and a sexual person. This might translate to feelings of guilt, frustration, worry, and embarrassment about sexuality, and might be linked with lower reduced sexual and relationship satisfaction, even in the absence of sexual problems.

We also found that sexual problems or distress alone may be enough to have a negative impact on women’s broader sexual and relationship well-being. It is possible that pregnant women who experience problems or distress are more likely to avoid sexual intimacy, and in non-pregnant samples this type of avoidance is linked with poorer sexual and relationship satisfaction [8,9].

Overall, this study suggests that there is a need for education and interventions aimed at minimizing sexual distress alone or with sexual problems among pregnant women. We encourage health care providers to ask pregnant women about feelings of sexual distress regardless of their level of sexual functioning. Pregnant women may benefit from conversations in which their health care providers normalize the discussion of sexuality in the context of their broader well-being. Further, sex therapy that incorporates cognitive-behavioral techniques can reduce sexual distress among women with sexual dysfunction [10] and may also be valuable for women experiencing sexual distress or problems during pregnancy.

What is next?

As with all research it is important to consider the limitations of this study. Our measure of sexual problems could only be scored for women who had engaged in sexual activity in the past four weeks. This means that women who were not sexually active were left out of our main analyses. Our sample was mostly heterosexual, married, and in female-male relationships, which limits our ability to generalize to pregnant women more broadly. The data were cross-sectional, which means we only collected data at one time-point. This means that we cannot make conclusions about the directionality of associations between variables. For example, does sexual distress lead to lower sexual satisfaction, or are women with lower sexual satisfaction increase the risk of feeling sexual distress? Finally, we surveyed only pregnant women, but obviously sexual and romantic relationships are interpersonal and each partner affects the other person’s experience. The way a partner responds to sexual changes and distress during pregnancy may contribute to women’s experiences, and vice versa.

Our future plans include longitudinal research so we can look at the associations between distress and sexual and relationship satisfaction over time, and the links between sexual distress, sexual problems, and sexual and relationship satisfaction from pregnancy to the postpartum. We are also currently recruiting for a study of couples going through the transition to parenthood which will let us look at how one partner’s experience of sexual problems and sexual distress affects the other partner’s sexual and relationship well-being. Find out more about this study here.


  • [1]  Bartellas E, Crane JMG, Daley M, Bennett KA, Hutchens D. Sexuality and sexual activity in pregnancy. Br J Obstet Gynaecol. 2000;107: 964-68.
  • [2] Erenel AS, Eroglu K, Vural G, Dilbaz B. A pilot study: In what ways do women in Turkey experience a change in their sexuality during pregnancy? Sex Disabil. 2011;29: 207-16.
  • [3] Glowacka M, Rosen N, Chorney J, Snelgrove−Clarke E, George RB. Prevalence and predictors of genito‐pelvic pain in pregnancy and postpartum: The prospective impact of fear avoidance. J Sex Med. 2014;11: 3021-34.
  • [4] Pauleta JR, Pereira NM, Graça LM. Sexuality during pregnancy. J Sex Med. 2010;7: 136-42.
  • [5] Erol B, Sanli O, Korkmaz D, Seyhan A, Akman T, Kadioglu A. A cross-sectional study of female sexual function and dysfunction during pregnancy. J Sex Med. 2007;4: 1381-87.
  • [6] Stephenson KR, Meston CM. When are sexual difficulties distressing for women? The selective protective value of intimate relationships. J Sex Med. 2010;7: 3683-94.
  • [7] Rosen RC, Shifren JL, Monz BU, Odom DM, Russo PA, Johannes CB. Correlates of sexually related personal distress in women with low sexual desire. J Sex Med. 2009;6: 1549-60.
  • [8] Stephenson KR, Meston CM. Differentiating components of sexual well‐being in women: Are sexual satisfaction and sexual distress independent constructs? J Sex Med. 2010;7: 2458-68.
  • [9] Impett EA, Peplau LA, Gable SL. Approach and avoidance sexual motives: Implications for personal and interpersonal well-being. Pers Relationship. 2005;12: 465-82.
  • [10] Rosen NO, Muise A, Bergeron S, Impett EA, Boudreau GK. Approach and avoidance sexual goals in couples with Provoked Vestibulodynia: Associations with sexual, relational, and psychological well-being. J Sex Med. 2015;12: 1781-90.


Let’s talk about sex baby…

Posted on Mar 3, 2017

Image: Shutterstock/Alina Cardiae Photography

By: Kat Merwin

Do you ever communicate with your partner during sex? Do you let them know when you’re enjoying something? Or when you’re not? Then this article is for you!

Do you shudder at the very idea of attempting “dirty talk” during sex? Then this article is still for you!

Are you looking to ‘spice things up’ in the bedroom? Guess what –this article is for you!

It can be difficult to talk about sex –even with the person you’re having sex with! Talking about sex can make you feel vulnerable, and research has shown that people fear being misunderstood, or even rejected, by their partner when it comes to talking about sex [1]. Despite how scary it might be, discussing sexual topics with your partner is important and very worthwhile! When people talk about their sexual likes (and dislikes) with their partner, they experience greater sexual and relationship satisfaction [1-6]. It may be especially important to talk about sex with your partner if you’re in a long-term relationship; couples often experience declines in sexual satisfaction and desire over time [7].

While most research to date has examined the kinds of sexual discussions people have outside of sexual activity, it has become clear that the kinds of sexual talk people engage in during sex are also quite important [8]. In fact, when people communicate more with their partner about their sexual pleasure during sex –and when a person perceives that their partner is communicating more about sexual pleasure during sex—they experience greater sexual satisfaction [9, 10].

But what are couples talking about during sexual activity?

Are they having in-depth political debates? Probably not… unless that’s what turns you or your partner on –in which case, debate away!

Are they talking about their (or their partner’s) sexual pleasure? Probably!

A recent study actually examined the different types of sexual talk that people engage in during sexual activity, and found that there are 2 main types of sexual talk [8]. Note: the examples provided above are not an exhaustive list. The actual phrases that people say to their partner may differ depending on sexual orientation, gender identity, or personal preferences.

Mutualistic Talk: ‘other-focused’ sexual talk that relates to sharing the sexual experience with your partner.

Mutualistic talk includes:

Giving your partner positive feedback (e.g., “That feels so good!” or “You taste so good”)

Giving instructional statements (e.g., “Go harder/faster/slower” or “Go down on me”)

Statements of intimacy (e.g., “I love you” or “I feel so close to you”)

Talking about sexual fantasies (e.g., “Let’s pretend….” or “I’m imagining that people are watching us fuck”


Individualistic Talk: ‘self-focused’ sexual talk that relates to your own sexual experience and pleasure.

Individualistic talk includes:

Exclamations of excitement or pleasure (e.g., “Yes/yeah!” or “Oh god!”)

Statements that are sexually dominant (e.g., “Show me your pussy/cock”)

Statements that are sexually submissive (or inviting your partner to be sexually dominant) (e.g., “I’m all yours” or “Let me be your dirty slut”)

Messages of sexual ownership (e.g., “You’re mine now” or “Whose pussy/cock is this?”)

Both mutualistic and individualistic talk were found to be associated with greater sexual satisfaction —at least for the person doing the talking8 (research hasn’t examined whether the same holds for the person hearing the sexual talk).

Don’t use any of these types of sexual talk during sex, but want to?

Awesome! Maybe start small, such as exclamations of excitement/pleasure or telling your partner when you like what they’re doing. (After all, everyone likes to hear when they’re doing a good job at pleasing their partner!)

Figure out what terminology you want to use. Does ‘vagina’ sound too clinical to you? Try an alternative, such as ‘pussy.’ Do you find the word ‘cock’ sexy, but the word ‘dick’ is a huge turn-off? Share this with your partner! Once you know the words you’re comfortable saying (or hearing) that will make it easier to start using some dirty talk during sex with your partner!

Do you already use some of those types of sexual talk with your partner(s)?

Awesome! Maybe try out some different types of sexual talk (if you and your partner are comfortable with it) or just keep doing what you’re doing!

Final Tip

(insert ‘that’s what she said’ joke here)

Try not to not take it too seriously –have fun with it!




[1] Rehman, U. S., Rellini, A. H., & Fallis, E. (2011). The importance of sexual self-disclosure to sexual satisfaction and functioning in committed relationships. Journal of Sexual Medicine, 8, 3108-3115. doi: 10.1111/j.1743-6109.2011.02439.x

[2] Byers, S. E. (2011). Beyond the birds and the bees and was it good for you?: Thirty years of research on sexual communication. Canadian Psychology, 52, 20-28. doi: 10.11037/a0022048

[3] Byers, S. E., & Demmons, S. (1999). Sexual satisfaction and sexual self-disclosure within dating relationships. The Journal of Sex Research, 36, 180-189. doi: 10.1080/00224499909551983

[4] Coffelt, T. A., & Hess, J. A. (2014). Sexual disclosures: Connections to relational satisfaction and closeness. Journal of Sex & Marital Therapy, 40, 577-591. doi:10.1080/0092623X.2013.811449

[5] Greene, K., & Faulkner, S. (2005). Gender, belief in the sexual double standard, and sexual talk in heterosexual dating relationships. Sex Roles, 53, 239-251. doi: 10.1007/s11199-005-5682-6

[6] MacNeil, S., & Byers, S. E. (2009). Roles of sexual self-disclosure in the sexual satisfaction of long-term heterosexual couples. The Journal of Sex Research, 46, 3-14. doi:10.1080/00224490802398399

[7] Klusmann, D. (2002). Sexual motivation and the duration of partnership. Archives of Sexual Behaviour, 31, 275-287. doi: 10.1023/A:1015205020769

[8] Jonason, P. K., Betteridge, G. L., & Kneebone, I. I. (2016). An examination of the nature of erotic talk. Archives of Sexual Behaviour, 45, 21-31. doi: 10.1007/s10508-015-0585-2

[9] Babin, E. A. (2012). An examination of predictors of nonverbal and verbal communication of pleasure during sex and sexual satisfaction. Journal of Social and Personal Relationships, 30, 270-292. doi: 10.1177/0265407512454523

[10] Brogan, S. M., Fiore, A., & Wrench, J. S. (2009). Understanding the psychometric properties of the sexual communication style scale. Human Communication, 12, 421-445. Retrieved from

New Parents: How empathy for your partner can be beneficial for your relationship post-baby

Posted on Nov 18, 2016


This is a summary of our recently published paper: Rosen, Mooney,  & Muise, (2016). Dyadic Empathy Predicts Sexual and Relationship Well-Being in Couples Transitioning to Parenthood. Journal of Sex & Marital Therapy. doi: 10.1080/0092623X.2016.1208698

By Kayla Mooney

Having a baby is often an exciting time for a couple; however, the transition to parenthood can also bring new emotions and stressors that a couple has never faced before. New parents are transitioning from being just partners, to now being partners and parents. You may notice that you start to view each other differently. Your stress levels are higher, you’re sleep-deprived, and there’s less time to spend together as a couple. Some prior research has shown that this transition may also lead to:

  • Increased conflict within your relationship and lower overall satisfaction with your relationship.
  • Decreased sexual desire, frequency of sexual activity, and lower sexual satisfaction.

We don’t want to alarm you, though: not all couples experience these declines. In fact, approximately 1/3 to 1/2 of couples don’t see a decline in their relationship satisfaction, and some couples even report increases in their relationship satisfaction when becoming parents! But, if you do notice some of these changes, rest assured that you are not alone. New research has shown that aspects of new parents’ personality may help protect against some of these changes, and may even help improve the adjustment to new parenthood!

Recent research by Dr. Natalie Rosen and colleagues suggests that one important key to protecting your romantic and sexual relationship post-baby is to express empathy towards your romantic partner. In this context, empathy refers to your ability to understand your partner’s point of view, and feel compassion as a result of your partner’s experiences. In Dr. Rosen’s study, the researchers found that greater empathy can be beneficial for both you and your partner during the transition to parenthood.

Here’s a brief summary of what the study found:

  • When women and men reported higher empathy, they were also more satisfied with their sexual and romantic relationships.
  • Reporting higher empathy was not only beneficial for the self, but also for one’s partner: women and men who reported higher empathy also had partners who were more satisfied with their sexual and romantic relationships.
  • When women demonstrated higher empathy, they also tended to experience higher sexual desire.
  • One surprising, seemingly contradictory finding, was that women with more empathic partners reported lower sexual desire. It’s possible that this is because women who experience lower desire actually elicit more empathy from their partners (in other words, it’s not that empathy leads to lower desire, but the other way around).

Showing more concern for your partner, and trying to view things from their point of view, may help you talk about your sexual relationship more openly, which can help improve your own and your partner’s satisfaction with both your sex life and relationship. Similarly, when partners are more empathic it can help you both feel that you’re facing parenthood together as a unit – this not only helps you cope with the novel stressors that we talked about earlier (like sleep deprivation), but can help improve your satisfaction with your relationship!

Even though partner empathy was linked to lower sexual desire in mothers, this doesn’t mean you should be less empathic as a partner. It is also possible that when new mothers experience lower sexual desire their partners are more likely to respond with empathy. Because the researchers did not follow couples over time it is not possible to determine whether empathy leads to lower desire or if lower desire elicits greater empathy. And, as the study showed, empathy can be very beneficial for your relationship and sex life, so this one finding should be interpreted with caution until more research is done on the topic.

To read more about this study take a look at some recent media coverage by the CBC.

Image credit: Flickr user PedroCancion