Academic Journal
LGBTQIA+ sexual health: a SITCC clinical framework for integrating cognitive-behavioral therapy and sexual medicine.
| Τίτλος: | LGBTQIA+ sexual health: a SITCC clinical framework for integrating cognitive-behavioral therapy and sexual medicine. |
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| Συγγραφείς: | Einaudi G; Department of Psychology, University of Turin, 10124 Turin, Italy.; Centro Clinico Crocetta, Scuola di Specializzazione in Psicoterapia Cognitiva, 10129 Turin, Italy., Dibennardo F; Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy., Finzi S; Department of Psychology, University of Turin, 10124 Turin, Italy.; Centro Clinico Crocetta, Scuola di Specializzazione in Psicoterapia Cognitiva, 10129 Turin, Italy., Polloni G; Centro Terapia Cognitiva, 22100 Como, Italy., Ratti F; Studio Psicoterapia Cognitiva, 6900 Lugano, Switzerland., Tienforti D; Andrology Unit, Department of Clinical Medicine, Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy., Baiardini I; Department of Health and Life Sciences, European University of Rome, 00163 Rome, Italy., Iuliano C; School of Cognitive Psychotherapy (SPC), 80122 Naples, Italy., Amato L; Sexology Interest Group (AIS), Italian Society of Behavioral and Cognitive Therapy (SITCC), 00185 Rome, Italy., Stringo J; Department of Human and Social Sciences, University of Bergamo, 24129 Bergamo, Italy., Traini S; Sexology Interest Group (AIS), Italian Society of Behavioral and Cognitive Therapy (SITCC), 00185 Rome, Italy.; S.I.R.U. Società Italiana della Riproduzione Umana, 00198 Rome, Italy., Moretto C; Andrology Unit, Department of Clinical Medicine, Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy., Corradelli C; Sexology Interest Group (AIS), Italian Society of Behavioral and Cognitive Therapy (SITCC), 00185 Rome, Italy., Barbonetti A; Andrology Unit, Department of Clinical Medicine, Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy., Monticelli F; Department of Human Sciences, European University of Rome, 00163 Rome, Italy., Cavallo F; School Integrated Psychotherapy (SPI), 20121 Milan, Italy. |
| Πηγή: | The journal of sexual medicine [J Sex Med] 2026 Oct 07; Vol. 23 (11). |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Oxford University Press Country of Publication: Netherlands NLM ID: 101230693 Publication Model: Print Cited Medium: Internet ISSN: 1743-6109 (Electronic) Linking ISSN: 17436095 NLM ISO Abbreviation: J Sex Med Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2023- : [Oxford] : Oxford University Press Original Publication: Malden, MA : Blackwell Pub. |
| Ιατρικοί όροι (MeSH): | Sexual and Gender Minorities*/psychology , Cognitive Behavioral Therapy* , Sexual Health*, Sexual Dysfunctions, Psychological/therapy ; Humans ; Female ; Male |
| Περίληψη: | Introduction: Sexual and gender diverse (LGBTQIA+) individuals experience significant sexual health disparities shaped by minority stress processes, trauma exposure, mental health burden, and historically heteronormative and cisnormative clinical frameworks. Although international guidelines, standards of care, and professional guidance documents increasingly endorse affirmative and evidence-informed care, their integration into routine sexual medicine and psychotherapeutic practice remains inconsistent, particularly in the assessment and clinical management of sexual dysfunctions in LGBTQIA+ populations. Objectives: To present an evidence-informed Italian Society of Behavioral and Cognitive Therapy (SITCC) clinical framework for integrating cognitive-behavioral therapy (CBT), minority stress-informed formulation, trauma-informed assessment, and sexual medicine in affirmative care for LGBTQIA+ individuals, with attention to queer-specific sexual dysfunctions, gender-affirming care, non-normative relationships, and multidisciplinary practice. Methods: This clinical framework was developed within the SITCC through a structured, multistage institutional process involving multidisciplinary discussion, manuscript development, and formal Society review and approval. It was informed by a narrative synthesis of international clinical guidelines, standards of care, professional guidance documents, and empirical and conceptual literature. Targeted, non-systematic searches of PubMed, PsycINFO, and Google Scholar in 2025 covered 2015-2025 publications, complemented by earlier foundational sources and working-group suggestions. Results: The SITCC working group identified minority stress as a central framework linking stigma, internalized stigma, concealment, hypervigilance, psychological distress, relational functioning, embodiment, and sexual health. Trauma and PTSD/CPTSD symptoms, when clinically present, emerged as relevant dimensions of assessment and treatment, particularly when sexual difficulties are associated with shame, dissociation, embodied unsafety, disrupted agency, or relational insecurity. Queer-specific sexual dysfunctions-including genito-pelvic pain in women who have sex with women, anodyspareunia in men who have sex with men, and sexual function changes related to gender-affirming hormone therapy and surgeries-may be insufficiently captured by heteronormative and cisnormative diagnostic frameworks. The framework emphasizes the integration of affirmative CBT, trauma-informed care, psychosocial sex therapy interventions, and sexual medicine to address psychological, relational, anatomical, endocrinological, and social determinants of sexual distress. Its clinical specificity is greater for lesbian, gay, and transgender and gender-diverse populations, with less extensive evidence for bisexual populations and provisional applicability to intersex and asexual-spectrum individuals. Conclusion: The SITCC framework provides an evidence-informed foundation for integrating affirmative CBT, trauma-informed assessment, and sexual medicine in LGBTQIA+ care. By linking minority stress and psychological, relational, and medical dimensions of sexual health, it translates affirmative principles into a shared approach to individualized case formulation and multidisciplinary care planning, centered on patients' needs, agency, and sexual well-being. (© The Author(s) 2026. Published by Oxford University Press on behalf of The International Society for Sexual Medicine.) |
| Contributed Indexing: | Keywords: cognitive-behavioral therapy; health disparities; minority stress; psychotherapy; sexual and gender minorities; sexual dysfunctions; sexual health; sexual medicine; transgender persons |
| Entry Date(s): | Date Created: 20261008 Date Completed: 20261008 Latest Revision: 20261008 |
| Update Code: | 20261009 |
| DOI: | 10.1093/jsxmed/qdag316 |
| PMID: | 42847759 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1743-6109 |
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| DOI: | 10.1093/jsxmed/qdag316 |