Gender-specific associations between sexual compulsivity, sexual functioning and sexual satisfaction: a mediation analysis in an Iranian community sample

BACKGROUND: Compulsive sexual behaviour disorder is recognised as a mental health disorder, characterised by the inability to control impulses and repetitive sexual behaviours, and is often associated with reduced sexual functioning and satisfaction. However, few studies have examined the associations between sexual compulsivity, sexual functioning and sexual satisfaction in non-Western populations, particularly with a gender perspective. METHODS: This study aimed to examine gender-specific patterns of these relationships in a community-based Iranian sample. Data were collected from 705 participants (81.6% male, 18.4% female) via snowball sampling and an online questionnaire. The Sexual Compulsivity Scale, the International Index of Erectile Function for men, the Female Sexual Function Index for women and the New Sexual Satisfaction Scale were used. Analyses were conducted using path analysis with observed total scores, estimated separately for each gender. RESULTS: Findings showed that in men, sexual functioning fully mediated the association between sexual compulsivity and sexual satisfaction. In women, sexual compulsivity had a direct negative association with sexual satisfaction without mediation by sexual functioning. These gender-specific patterns emphasise the importance of gender-sensitive approaches in understanding compulsive sexual behaviours. CONCLUSIONS: This study provides the first gender-specific structural evidence in the Iranian context, and suggests that clinical interventions should be performance-oriented for men and affective-relational for women.