The Relationship between Sex Guilt and Sexual Desire in a ...

JOURNAL OF SEX RESEARCH, 49(2–3), 290–298, 2012Copyright # The Society for the Scientific Study of SexualityISSN: 0022-4499 print=1559-8519 onlineDOI: 10.1080/00224499.2010.551792The Relationship between Sex Guilt and Sexual Desire in a CommunitySample of Chinese and Euro-Canadian WomenDownloaded by [The University of British Columbia] at 10:24 13 March 2012Jane S. T. WooDepartment of Psychology, University of British ColumbiaLori A. BrottoDepartment of Obstetrics and Gynecology, University of British ColumbiaBoris B. GorzalkaDepartment of Psychology, University of British ColumbiaMany studies have documented significant differences in sexual desire between individuals ofEuropean and Chinese descent, but few have examined the mechanisms that underlie thesedifferences. A recent study of university students found that sex guilt is one mechanism bywhich culture influences sexual desire among Chinese and Euro-Canadian women. The goalof this study was to examine whether sex guilt also mediates the relationship betweenethnicity and sexual desire in a sample that is more representative of women in the generalpopulation. Euro-Canadian (n ¼ 78; mean age ¼ 42.1 years) and Chinese (n ¼ 87; meanage ¼ 42.8 years) women were recruited from the community. Euro-Canadian womenreported greater sexual desire and less sex guilt. In the entire sample, sex guilt mediatedthe relationship between ethnicity and sexual desire such that the Chinese women reportedgreater sex guilt, which, in turn, was associated with lower sexual desire. Among the Chinesewomen, sex guilt mediated the relationship between mainstream acculturation (degree ofWesternization) and sexual desire such that more Westernized Chinese women reported lesssex guilt, which, in turn, was associated with greater sexual desire. These results supportrecent findings and further suggest that sex guilt may be one mechanism by which ethnicityaffects sexual desire.Research comparing individuals of European and Asiandescent on sexuality-related variables has found significantgroup differences across almost every domain ofsexuality that has been examined. However, there hasbeen a remarkable paucity of research on the causes ofthese cultural differences in sexuality, with few studiesthat have examined variables that may mediate thesecultural effects. A better understanding of such mediatingvariables has important implications for treatmentof low desire, the most prevalent of women’s sexualfunctioning concerns (Cain et al., 2003; Laumann et al.,This research was supported by a Hampton Fund Research Grantfrom the University of British Columbia awarded to Lori A. Brotto.Jane S. T. Woo was funded by a Predoctoral Fellowship from theCanadian Institutes of Health Research and a Predoctoral ResearchTrainee Award from the Michael Smith Foundation for HealthResearch. We acknowledge Dr. Del Paulhus for his help with thestatistical analyses.Correspondence should be addressed to Lori A. Brotto, Departmentof Obstetrics and Gynecology, University of British Columbia,2775 Laurel St., 6th Floor, Vancouver, British Columbia V5Z 1M9,Canada. E-mail: Lori.Brotto@vch.ca2005) but a condition with few evidence-based optionsavailable. The goal of the current study is to clarifythe role of sex guilt as a possible underlying mechanismby which culture influences sexual desire in Euro-Canadian and Chinese women. Rapid growth in theAsian population in North America has promptedgreater research interest in the influence of culture ondomains of sexuality ranging from sexual knowledgeto sexual attitudes, sexual dysfunctions, sexual behaviors,and reproductive health. Much of the researchefforts in this area have focused on comparing Asianwith Western sexuality. A review of the literature revealsthat there are notable differences between the two culturesthat span the various dimensions of sexuality thathave been studied, with individuals of Asian descentconsistently reporting more sexually conservative tendenciesthan their European descent counterparts.Research in university samples has found that comparedto North American norms, Asian individuals possessless accurate sexual knowledge (e.g., Brotto, Chik,Ryder, Gorzalka, & Seal, 2005; Meston, Trapnell, &

SEX GUILT AND SEXUAL DESIREDownloaded by [The University of British Columbia] at 10:24 13 March 2012Gorzalka, 1998; Woo, Brotto, & Gorzalka, 2009) andreport more conservative sexual attitudes (e.g., Ahrold& Meston, 2010; Higgins & Sun, 2007; Meston,Trapnell, & Gorzalka, 1996; Woo, Brotto, & Gorzalka,2010a). Asian individuals also report higher rates ofsexual difficulties (e.g., Brotto et al., 2005; Woo et al.,2010a), and more acceptance of sexual harassment(Kennedy & Gorzalka, 2002), demonstrate a restrictedrange of sexual behaviors (e.g., Meston & Ahrold,2010; Meston et al., 1998; Tang, Lai, & Chung, 1997;Woo et al., 2009), and exhibit lower rates of participationin preventive screening procedures in reproductivehealth (e.g., Woo et al., 2009). Similar findingshave been reported in community-based samples (e.g.,Cain et al., 2003; Hislop et al., 2004; Kagawa-Singer &Pourat, 2000; Laumann et al., 2005; Taylor et al.,2002; Tu et al., 2005; Yu, Wu, & Mood, 2005).In addition to studying ethnic differences as one indicatorof cultural effects, some researchers have alsoexamined how acculturation within Asian individualsaffects various domains of sexuality. Acculturationrefers to the process by which an individual who belongsto an ethnic minority group assimilates aspects of thedominant culture’s values, attitudes, and behaviors intotheir self-identity (Ryder, Alden, & Paulhus, 2000). Theindividual’s self-identity and extent of affiliation withboth the culture of origin and the dominant cultureare modified to accommodate information about andexperiences with the new culture. Thus, studying acculturationis important as a richer understanding of howculture affects sexuality can be gained than by studyingthe effects of ethnic group alone. Both the degree ofaffiliation with the culture of origin (heritage culture)and the degree of affiliation with the dominant culture(mainstream culture) will vary among members of anethnic group, and examining these two dimensions ofacculturation separately (i.e., bidimensionally) enablesus to study the effects of culture between individualsof the same ethnic group.Among Asian individuals living in North America,significant associations have been found between acculturationand a number of sexuality-related variables. Infemale university students, for instance, greater mainstreamacculturation has been found to be significantlyassociated with higher sexual desire and arousal (Brottoet al., 2005), higher sexual arousability (Brotto et al.,2005), more accurate sexual knowledge (Woo et al.,2009), less sex guilt (Abramson & Imai-Marquez, 1982;Woo et al., 2010a), and higher participation rates insexual psychophysiological research (Woo, Brotto, &Yule, 2010). Similarly, greater heritage acculturationhas been found to be associated with lower rates of cervicalcancer screening (Woo et al., 2009), more conservativeattitudes toward casual sex and gender role traditionality(Ahrold & Meston, 2010), less experience in masturbationand oral sex (Meston & Ahrold, 2010), and olderage at sexual debut (Meston & Ahrold, 2010). Similarfindings have been reported among male universitystudents in North America. Greater mainstream acculturationhas been found to be associated with greatersexual openness and higher sexual functioning (Brotto,Woo, & Ryder, 2007), less sex guilt (Abramson &Imai-Marquez, 1982; Woo, Brotto, & Gorzalka,2010b), and higher rates of conducting testicular selfexaminations(Woo et al., 2010b). Greater heritage acculturationsignificantly predicted greater conservatism inattitudes toward casual sex, homosexuality, and genderrole traditionality (Ahrold & Meston, 2010). Older ageat sexual debut has also been associated with greater heritageacculturation in men (Meston & Ahrold, 2010).Overall, higher mainstream acculturation is associatedwith greater sexual openness, whereas greater heritageacculturation is linked to greater sexual conservatism.Thus, there are several studies that have explored ethnicdifferences between Asian and Western sexuality, aswell as a number of studies that have examined theeffects of acculturation on sexuality among Asian individuals.In contrast, research on the underlying mechanismsof these cultural differences has lagged behind.Given that cultural differences (both ethnic group andacculturation effects) have been observed and documentedin myriad facets of sexuality, and that these differenceshave been remarkably consistent in nature, acloser exploration of the mechanisms by which cultureaffects sexuality may improve the understanding ofcultural influences on sexuality.Among the research on cultural differences in sexualitythat has explored possible underlying mechanisms,one recent study examined the influence of acculturationand religiosity on sexual attitudes in Euro-American,Asian American, and Hispanic American individuals(Ahrold & Meston, 2010). No mediating effect of acculturationin the relationship between religiosity andsexual attitudes was found.The role of sex guilt has been explored as a possibleunderlying mechanism of culture-linked differences insexual desire among East Asian (Chinese, Japanese,and Korean) and Euro-Canadian female university students(Woo et al., 2010a). Woo et al. (2010a) drew onthe definition of sex guilt offered by Mosher and Cross(1971, p. 27): ‘‘a general expectancy for self-mediatedpunishment for violating or for anticipating violatingstandards of proper sexual conduct. Such a dispositionmight be manifested by resistance to sexual temptation,by inhibited sexual behavior, or by the disruption ofcognitive processes in sex-related situations.’’ Interestingly,Woo and colleagues (2010a) found that sex guiltmediated the relationship between ethnicity and sexualdesire, with East Asian ethnicity being significantly associatedwith greater sex guilt, which, in turn, was associatedwith less sexual desire. Sex guilt, but not sexualconservatism, was found to mediate the relationshipbetween mainstream acculturation and sexual desireamong the East Asian women, such that greater291

WOO, BROTTO, AND GORZALKADownloaded by [The University of British Columbia] at 10:24 13 March 2012mainstream acculturation was predictive of less sexguilt, which, in turn, was associated with greatersexual desire. No mediating effect of sex guilt was foundin the relationship between heritage acculturation andsexual desire.With East Asian women consistently reporting lowersexual desire than women of European descent, a greaterunderstanding of the role of sex guilt in sexual desiremay represent an important new avenue by which complaintsof low sexual desire may be addressed in psychologicaltreatment. However, one of the limitations ofthe study by Woo et al. (2010a) was the use of a universityconvenience sample in which participants were, onaverage, significantly younger than women in the generalpopulation (mean age ¼ 20 years). Thus, the vastmajority of the women were unmarried, rendering itimpossible to ascertain unequivocally the relationshipsamong culture, sex guilt, and sexual desire among EastAsian women in the general population. This is of particularsignificance in studying East Asian sexualitybecause of the traditional East Asian view that sexualactivity is acceptable only in the context of marriage.Parents are highly intolerant of premarital sexualactivity, especially in daughters, and children arebrought up with strong parental and societal expectationsthat expressions of sexuality will be reserved formarriage (Lee & Chang, 1999; Youn, 2001).The purpose of this study was to determine outcomesin the general population by examining sex guilt andsexual desire in a sample of Euro-Canadian and Chinesewomen recruited from the community, and to examinethe possible protective effect of being married. Basedon the results of population-based studies that foundsignificant ethnic differences in sex guilt and sexualdesire (Abramson & Imai-Marquez, 1982; Cain et al.,2003; Laumann et al., 2005), we hypothesized that theChinese women would report greater sex guilt and lowersexual desire than their Euro-Canadian counterparts.Among the Chinese women, we hypothesized thatgreater mainstream acculturation and lower heritageacculturation would be associated with greater sexualdesire and less sex guilt. Furthermore, we hypothesizedthat sex guilt would mediate the relationship betweenethnicity and sexual desire in the entire sample, as wellas the relationship between acculturation and sexualdesire among the Chinese women.MethodParticipantsChinese and Euro-Canadian women 20 years of ageand older were eligible to participate in this study. Atotal of 165 women participated. Of these, 87self-identified as Chinese, and 78 self-identified asEuro-Canadian. Participants were recruited from the292community using a variety of methods, including a lettermail campaign and the snowball method. Flyers werealso posted in public areas describing the inclusion criteriaand providing a brief description of the study. Ofthe participants in this study, 51 were recruited via a lettermail campaign, 64 were recruited through flyersposted in public places, and 50 were recruited by thesnowball method. About 200 letters were mailed outto Euro-Canadian and Chinese women as part of theletter mail campaign.There were significant ethnic differences in the proportionof participants recruited by the variousmethods, v 2 (2, N ¼ 165) ¼ 29.15, p < .001. Of the Euro-Canadian women, 51% were recruited by the letter mailcampaign, 19% by the snowball method, and 30% byseeing the posted flyers. Of the Chinese women, 13%were recruited by the letter mail campaign, 40% by thesnowball method, and 47% by seeing the posted flyers.There were no significant ethnic differences in age,but the Euro-Canadian women reported living inCanada for a significantly longer period of time thanthe Chinese women. Demographic data are presentedin Table 1.ProcedureInterested participants telephoned the laboratoryand were screened to ensure that they self-identified aseither Chinese or Euro-Canadian and met the minimumage requirement. Participants were interviewed in personby trained female psychology students at a timeand in a location of the participants’ choice. Locationsthat were commonly selected included the researchTable 1. Demographic Characteristics of Euro-Canadian(n ¼ 78) and Chinese (n ¼ 87) ParticipantsVariable Euro-Canadian ChineseMean age in years (SD) 42.1 (17.2) 42.8 (13.2)Place of birth (%) Canada or United States 82.1 9.2China=Hong Kong=Taiwan 1.3 86.2Southeast Asia 0.0 2.3Europe 11.5 0.0Other 5.1 2.3Years of residency in Canada (SD) 36.4 (18.6) 12.0 (10.4)Marital status a (%) Unmarried 51.4 23.5Common-law 8.1 2.9Married 24.3 58.8Divorced 13.5 10.3Widowed 2.7 4.4Mean acculturation score b (SD)Mainstream NA 59.0 (12.7)Heritage NA 68.4 (12.8)a Figures reported are for the 142 participants who responded to thisquestion.b Scale ranges from 20–180. p < .001.

SEX GUILT AND SEXUAL DESIREDownloaded by [The University of British Columbia] at 10:24 13 March 2012laboratory, participants’ homes, cafes, and libraries.All of the Euro-Canadian women were interviewed inEnglish. The Chinese women were interviewed inthe language of their choice (English, Cantonese, orMandarin). The interview consisted of a number ofvalidated measures that were verbally administered.Measures containing items of a more personal nature,such as those relating to sexual functioning, werecompleted by the participants themselves if they chose.Participants received a monetary honorarium for theirparticipation in this study. All procedures were approvedby the university’s Behavioural Research Ethics Board.MeasuresVancouver Index of Acculturation (VIA). The VIA(Ryder et al., 2000) is a self-report questionnaire thatassesses heritage and mainstream acculturation on twoseparate dimensions. ‘‘Heritage culture’’ refers to theindividual’s culture of birth or upbringing, whereas‘‘mainstream culture’’ refers to the predominant culturein the individual’s new environment. In the context ofthis study, heritage culture refers to Chinese culture,and mainstream culture refers to Western culture. TheVIA consists of 20 items, with two items associated witheach of 10 domains, including entertainment preferencesand cultural traditions. Higher scores on the mainstreamdimension indicate greater Westernization, and higherscores on the heritage dimension demonstrate greatermaintenance of Chinese culture and traditions. Examplesof items that comprise the heritage dimensioninclude, ‘‘I would be willing to marry a person frommy heritage culture,’’ and ‘‘I enjoy social activitieswith people from the same heritage culture as myself.’’Examples of items that comprise the mainstreamdimension include, ‘‘I am comfortable working withtypical North American people,’’ and ‘‘I enjoy NorthAmerican entertainment.’’ Both dimensions werefound to have good internal consistency in this sample(Cronbach’s a ¼ .90 for heritage acculturation and .89for mainstream acculturation).Female Sexual Function Index (FSFI). The FSFI(Rosen et al., 2000) is a 19-item, self-report questionnairethat assesses six domains of sexual function. In thisstudy, we examined only the desire subscale of the FSFIin which higher scores indicated higher levels of sexualdesire over the previous four weeks. The two questionsthat comprise the desire subscale are, ‘‘Over the past 4weeks, how often did you feel sexual desire or interest?,’’and ‘‘Over the past 4 weeks, how would you rate yourlevel (degree) of sexual desire or interest?’’ Internal consistencyin this sample was high (Cronbach’s a ¼ .91).Women with hypoactive sexual desire disorder (HSDD)may be differentiated from those without using the FSFI(Wiegel, Meston, & Rosen, 2005). The FSFI desiredomain is relevant for women who have been sexuallyactive over the previous four weeks, as well as thosewho have not (Meyer-Bahlburg & Dolezal, 2007).Revised Mosher Guilt Inventory (RMGI). TheRMGI (Mosher, 1988) is a self-report questionnairethat measures three dimensions of guilt: sex guilt, hostilityguilt, and guilty conscience. It consists of 114items in a limited comparison format. In this format,items are presented in pairs, and participants are askedto rate their responses on a seven-point Likert scalethat ranges from 0 (not at all true for me) to 6(extremely true for me) while comparing the degree oftrueness within each item pair. As the variable of interestin this study was sex guilt, only the 50 items thatcomprise the sex guilt subscale were administered:‘‘When I have sexual desires, I enjoy it like all healthyhuman beings,’’ and ‘‘When I have sexual desires, Ifight them because I must have complete control ofmy body.’’ The total score on this subscale ranges from0 to 300, with higher scores signifying greater sex guilt.Internal consistency for the sex guilt subscale in thissample was high (Cronbach’s a ¼ .95). The construct,convergent, and discriminant validity of earlier versionsof the Mosher Guilt Inventory have been establishedby various studies (e.g., Abramson & Mosher, 1979;Ruma & Mosher, 1967).Demographics questionnaire. An investigatorderivedquestionnaire assessing demographic variables,including relationship and sexual functioning, andexperience with various types of sexual activities wasalso administered.Statistical AnalysesSPSS Version 13 (SPSS Inc., Chicago, Illinois) wasused for all statistical analyses. T tests were used in comparisonsof the two ethnic groups on self-reported sexguilt and sexual desire. In analyses of the associationbetween ethnicity and sexual variables, the point-biserialstatistic was used.The bootstrap method for mediation analysis recommendedby Shrout and Bolger (2002) was used for allmediation analyses. Three thousand samples, withreplacement, were used in each mediation analysis.Mediation analyses were conducted using an SPSSmacro developed by Preacher and Hayes (2004).ResultsEthnic Group Comparisons on Basic DemographicCharacteristicsThere was no significant ethnic difference in age,t(144) ¼ 0.31, p > .05 (mean age of Chinese women ¼293

WOO, BROTTO, AND GORZALKADownloaded by [The University of British Columbia] at 10:24 13 March 201242.84 years, SD ¼ 13.21; mean age of Euro-Canadianwomen ¼ 42.10 years, SD ¼ 17.15). There was also nosignificant ethnic difference in the proportion of womenwho reported being in a relationship, v 2 (1, N ¼ 165) ¼1.46, p > .05. However, a significantly larger proportionof the Chinese women reported having been married(including those who reported being married, divorced,or widowed) than the Euro-Canadian women,v 2 (1, N ¼ 142) ¼ p < .01. There was also a significantethnic difference in years of education, with the Euro-Canadian women reporting more years of education,t(163) ¼ 3.73, p < .001.Ethnic Group Comparisons on Sexuality MeasuresThe two groups did not significantly differ in theproportion of women who had engaged in kissing,hugging, or holding hands (p > .05). However, theEuro-Canadian women were significantly more likelyto have engaged in touching with clothing removed,v 2 (1, N ¼ 89) ¼ 11.31, p < .01; touching partner’s genitals,v 2 (1, N ¼ 89) ¼ 14.47, p < .001; performing oralsex on their partner, v 2 (1, N ¼) ¼ 13.14, p < .001; receivingof oral sex from their partner, v 2 (1, N ¼ 88) ¼ 6.56,p < .05; and sexual intercourse, v 2 (1, N ¼ 91) ¼ 6.23,p < .05. All proportions are presented in Table 2.We adjusted for large family-wise error rate, applyinga Bonferroni correction by dividing the conventionalalpha level of .05 by two (the number ofcomparisons being made). Thus, ethnic differenceswere considered statistically significant only if p < .025Table 2.Ethnic Group Differences on Sexual Activity(.05=2 comparisons). Compared to the Chinese women,the Euro-Canadian women scored significantly higheron the desire subscale of the FSFI, indicating thatthe Euro-Canadian women reported significantlygreater sexual desire than the Chinese women in theprevious four weeks, t(155) ¼ 4.21, p < .001. TheChinese women scored significantly higher on theRMGI compared with the Euro-Canadian women,t(137) ¼ 13.00, p < .001, demonstrating that the Chinesewomen reported significantly higher levels of sex guilt(see Table 3).Scores on the RMGI and FSFI desire subscale weresignificantly and negatively correlated in both theEuro-Canadian, r(63) ¼ .47, p < .001; and Chinesewomen, r(72) ¼ .53, p < .001, indicating that more sexguilt was associated with lower sexual desire.The Mediating Role of Sex Guilt in the RelationshipBetween Ethnicity and Sexual DesireThe effect of ethnicity on sex guilt was demonstrated(B ¼ 75.25, p < .001), indicating that Chinese ethnicitywas associated with significantly greater sex guilt. Theeffect of sex guilt on sexual desire, holding ethnicity constant,was also significant (b ¼ 0.02, p < .001), showingthat increased sex guilt was linked to less sexual desire.The indirect effect of ethnicity on sexual desire, computedby multiplying the effect of ethnicity on sex guiltwith the effect of sex guilt on sexual desire while controllingfor ethnicity, was also significant (ab ¼ 1.29;SE ¼ 0.22; 95% confidence interval [CI] ¼ 0.74, 1.89).Variable Euro-Canadian ChineseWho have engaged in hugging, kissing, or holding hands 97.9% 88.9%Who have engaged in touching with clothing removed 95.6% 68.2%Who have touched their partner’s genitals 93.3% 59.1%Who have performed oral sex on their partner 68.2% 29.5%Who have had oral sex performed on them by their partner 61.4% 34.1%Who have engaged in vaginal–penile intercourse 93.3% 73.9% p < .05. p < .01. p < .001.Table 3. Ethnic Group Differences on Scores from the Desire Subscale of the Female Sexual Function Index (FSFI) and the RevisedMosher Guilt Inventory (RMGI)Euro-CanadianChineseVariable M SD M SD t (df) p Effect Size cFSFI desire a 3.64 1.16 2.82 1.26 4.21 (155)

SEX GUILT AND SEXUAL DESIREFigure 1. The mediating role of sex guilt in the relationship betweenethnicity and sexual desire in Euro-Canadian and Chinese women.Note. a represents the effect of ethnicity on sex guilt; b represents theeffect of sex guilt on sexual desire after controlling for the effect of ethnicity;c represents the direct effect of ethnicity on sexual desire; and c 0represents the effect of ethnicity on sexual desire after controlling forsex guilt. p < .001.Figure 2. The mediating role of sex guilt in the relationship betweenmainstream acculturation and sexual desire in Chinese women. Note. arepresents the effect of mainstream acculturation on sex guilt; b representsthe effect of sex guilt on sexual desire after controlling for theeffect of mainstream acculturation; c represents the direct effect ofmainstream acculturation on sexual desire; and c 0 represents the effectof mainstream acculturation on sexual desire after controlling for sexguilt. p < .001.Downloaded by [The University of British Columbia] at 10:24 13 March 2012Hence, sex guilt mediated the ethnic group difference insexual desire (see Figure 1).Effects of Acculturation (Chinese Women Only) onMeasures of SexualityMainstream acculturation was not significantly correlatedwith FSFI desire scores, r(81) ¼ .10, p > .05; butwas significantly correlated with RMGI scores,r(75) ¼ .24, p < .05, indicating that more WesternizedChinese women reported significantly less sex guilt.Heritage acculturation was not correlated with eitherFSFI desire or RMGI scores (all ps > .05).The Mediating Role of Sex Guilt in the Relationshipbetween Mainstream Acculturation and Sexual DesireA mediation analysis to examine whether sex guiltwould mediate the relationship between mainstreamacculturation and sexual desire was conducted. Theeffect of mainstream acculturation on sex guilt was notsignificant at conventional alpha levels (b ¼ 0.67,p ¼ .10), indicating that mainstream acculturation wasnot significantly associated with sex guilt. On the otherhand, the effect of sex guilt on sexual desire, holdingmainstream acculturation constant, was significant(b ¼ 0.02, p < .001), showing that greater sex guiltwas linked to less sexual desire after controlling forthe effect of mainstream acculturation. The indirecteffect of mainstream acculturation on sexual desire wassignificant (ab ¼ 0.01; SE ¼ 0.006; 95% CI ¼ 0.0004,0.02). Hence, sex guilt mediated the relationshipbetween mainstream acculturation and sexual desire inthe Chinese women (see Figure 2).DiscussionEthnicity and SexualityIn ethnic group comparisons, the Euro-Canadianwomen reported significantly greater sexual desirethan the Chinese women. This result supported ourhypothesis and is consistent with research showingethnic differences in general sexual function and insexual desire particularly (e.g., Brotto et al., 2005; Cainet al., 2003; Laumann et al., 2005; Woo et al., 2009;Woo et al., 2010a).Analyses of ethnic differences in sex guilt revealedthat the Chinese women reported significantly greatersex guilt compared to their Euro-Canadian counterparts.This finding fits with both the results of Wooet al. (2010a), who found less sex guilt among Euro-Canadian individuals, and the results of Abramsonand Imai-Marquez (1982), who found significantlyhigher levels of sex guilt in Japanese American thanEuro-American individuals.Interestingly, mediation analyses revealed that sexguilt mediated the relationship between ethnicity andsexual desire, such that higher levels of sex guilt in theChinese women accounted for the ethnic disparity insexual desire. This finding is consistent with the findingsof Woo et al. (2010a) in university students, and indicatesthat sex guilt is a mediator of the relationshipbetween ethnicity and sexual desire even in this samplethat was more diverse than the university conveniencesample that was studied by Woo et al. (2010a).These results raise the question of how the Chinesewomen came to experience higher levels of sex guiltcompared to the Euro-Canadian women. There havebeen three major influences on Chinese thought and culture,with Confucianism having the most profound andwidespread impact by far. Confucius was a Chinesethinker and philosopher who lived about 2,500 yearsago and whose teachings were perpetuated followinghis death by his disciples and eventually declared theofficial state doctrine. Confucius himself viewed sex aspositive as long as it did not disrupt interpersonalrelationships or cause social instability. Moreover, heconsidered sexual desire to be beneficial in fulfillingthe filial obligation of producing children to carry onthe family line. However, Neo-Confucian scholarsduring the Song Dynasty (960–1276 A.D.) gave theclassical Confucian teachings strict interpretations andprecipitated the more repressive view of sexuality as295

WOO, BROTTO, AND GORZALKADownloaded by [The University of British Columbia] at 10:24 13 March 2012being reserved for marriage and procreation (Ng & Lau,1990). This is the point of view that has persisted untilthe present day, with parents conveying their clearexpectation to their children, especially daughters, thatsexuality is not to be expressed outside of marriage.Acculturation in Chinese Women and SexualityAs another index of cultural influences, we examinedthe effect of bidimensional acculturation on sex guiltand sexual desire. The finding that mainstream acculturationwas not significantly correlated with sexualdesire stood in contrast to our hypothesis that greaterWesternization would be associated with higher levelsof sexual desire in Chinese women. This finding is alsoincongruent with other studies that have found a significantassociation between mainstream acculturation andsexual desire (e.g., Brotto et al., 2005; Woo et al.,2010a). One possible explanation for this finding is thatthis study may have been insufficiently powered, limitingour ability to detect a significant effect of mainstreamacculturation on sexual desire. We note that this sampleof Chinese women is much smaller than that studied byWoo et al. (2010a). On the other hand, mainstreamacculturation was found to be significantly correlatedwith sex guilt such that greater Westernization was associatedwith less sex guilt—a finding that is consistentwith the literature on the effects of acculturation onChinese sexuality (Woo et al., 2010a).The results of mediation analyses supported ourhypothesis that sex guilt would mediate the relationshipbetween mainstream acculturation and sexual desireamong the Chinese women and are in accord with theresults of Woo et al. (2010a), who found a similar mediatingeffect in a sample of female university students.Although mainstream acculturation was not significantlyassociated with sex guilt, a crucial step in the traditionalapproach to mediation popularized by Baronand Kenny (1986), the bootstrap approach used in thisstudy indicated that the indirect effect of mainstreamacculturation on sexual desire, through the interveningvariable sex guilt, was significant. The bootstrap methodwas used because of the temporally distal nature of thecausal process between culture and sexual desire. However,simulation research reveals that this method alsohas the advantages of greater power and better Type 1error control compared to the Baron and Kennyapproach (Hayes, 2009).In contrast to the mediating role that sex guilt playsin the relationship between mainstream acculturationand sexual desire, mediation analyses revealed that sexguilt did not mediate the relationship between heritageacculturation and sexual desire among the Chinesewomen. This finding did not support our hypothesis thatsex guilt would underlie the effect of heritage acculturationon sexual desire, but is consistent with the results ofWoo et al. (2010a), who found no mediation effect in the296relationship between heritage acculturation and sexualdesire. Jointly, these findings suggest that, althoughsex guilt is not associated with heritage acculturationand changes in sexual desire, sex guilt plays an importantrole in accounting for the augmenting effect ofWesternization on sexual desire.ImplicationsThese results were consistent with those of Woo et al.(2010a) in that sex guilt mediated both the relationshipbetween ethnicity and sexual desire in the entire sample,as well as that between mainstream acculturation andsexual desire in the Chinese women. It is interesting tonote, however, that the effect of ethnicity on sex guilt isstronger in this study than in the study by Woo et al.(2010a), as indicated by the relevant effect sizes (Cohen’sd ¼ 2.17 in this study vs. 1.48 in the study by Woo et al.,2010a). Although both effect sizes are large (Cohen,1992), the relative magnitude of the relationship betweenethnicity and sex guilt in the two studies suggests that sexguilt may vary with sample characteristics—that is,younger age and more education may be factors thatprotect individuals from experiencing greater guilt insex-related situations. Supporting this proposition,additional data analyses revealed that age was significantlycorrelated with sex guilt, such that older age wasassociated with greater sex guilt in both the Euro-Canadian and Chinese women—a finding that may nothave been detected in a university sample composed ofparticipants who are largely homogeneous in age. Thus,conclusions about culture and sexuality that are based onresearch with university samples must be made tentativelyand researchers might strive to include a moresocioeconomically and demographically diverse sample.Moreover, that the mediating effect of sex guilt in therelationship between culture and sexual desire was foundin this community-based sample may have implicationsfor the psychological treatment of sexual desire difficultiesin Chinese women. The limited research on psychologicaltreatments for female HSDD indicate that theseinterventions are generally effective (Brotto, Basson, &Luria, 2008; Hawton, Catalan, & Fagg, 1991; Hurlbert,1993; McCabe, 2001; Schover & LoPiccolo, 1982; Trudelet al., 2001), combining elements such as sensate focus,sexual skills training, sexual psychoeducation, mindfulnesstraining, cognitive restructuring, and behaviorchange. However, the extent to which these interventionsare effective in non-European descent groups is unclear,as this has not been studied. Given the significantdifferences between Chinese and Euro-Canadian individualsacross practically every domain of sexuality thathas been studied, and the growing evidence that sex guiltplays an important role in Chinese women’s level ofsexual desire, incorporating a specific focus on reducingsex guilt in psychological interventions may be especiallybeneficial for Chinese women with complaints of low

SEX GUILT AND SEXUAL DESIREDownloaded by [The University of British Columbia] at 10:24 13 March 2012sexual desire. For example, thoughts and beliefs thatare linked to sex guilt may be identified, challenged,and substituted with more balanced thoughts. Examplesof thoughts that may be associated with sex guiltinclude, ‘‘Sex should happen only if a man initiates,’’‘‘A good mother must control her sexual urges,’’ and‘‘Experiencing pleasure during sexual activity is notacceptable in a virtuous woman’’ (Nobre, Gouveia, &Gomes, 2003).LimitationsThis study has some limitations that must beaddressed. First, although this study examined a sampleof women who were recruited from the community andwho were, therefore, more heterogeneous in their backgroundscompared to a university convenience sample,the sample was not nationally representative, whichmay limit the generalizability of the findings. Second,it is well-established that volunteer bias—the tendencyfor those who choose to take part in research studiesto differ from those who choose not to take part—isan ongoing concern in sex research (e.g., Plaud, Gaither,Hegstad, Rowan, & Devitt, 1999; Strassberg & Lowe,1995; Wiederman, 1993; Woo et al., 2010). Thus, theChinese women who participated in this study may havediffered from those who did not participate in their levelof acculturation. It is also possible that the women whochose to participate in this study may differ from womenin the general population with regard to their level of sexguilt. Given that both acculturation and sex guilt werevariables of interest in this study, volunteer bias in theseareas may affect the conclusions that can be drawnabout the role of sex guilt in the relationship betweenculture and sexual desire.ConclusionThe results of this study were consistent with priorresearch that examined differences in sexual desire andsex guilt in Chinese and Euro-Canadian women. Theseresults were also consistent with those of Woo et al.(2010a), who found that sex guilt is one mechanismby which culture influences sexual desire among Chinesewomen. Given that sex guilt has been found to play animportant role in Chinese women’s low sexual desirein both a university sample and a community-basedsample, an interesting extension of this researchwould be to investigate whether an interventiondesigned to target sex guilt may be effective in treatingChinese women seeking treatment for complaints oflow sexual desire. Furthermore, it is plausible that sexguilt may represent a concern for individuals inother cultural groups. Sustained empirical study of theinterrelationships among sex guilt, sexual desire, andculture may further our knowledge of how thesevariables interact with one another, as well as providean evidence base upon which interventions for complaintsof low sexual desire may be developed and improved.ReferencesAbramson, P. R., & Imai-Marquez, J. (1982). The Japanese-American:A cross-cultural, cross-sectional study of sex guilt. Journal ofResearch in Personality, 16, 227–237.Abramson, P. R., & Mosher, D. L. (1979). An empirical investigationof experimentally induced masturbatory fantasies. Archives ofSexual Behavior, 8, 27–39.Ahrold, T. K., & Meston, C. M. (2010). Ethnic differences in sexualattitudes of U.S. college students: Gender, acculturation, andreligiosity factors. Archives of Sexual Behavior, 39, 190–202.Baron, R. M., & Kenny, D. A. (1986). The moderator–mediatorvariable distinction in social psychological research: Conceptual,strategic, and statistical considerations. Journal of Personalityand Social Psychology, 51, 1173–1182.Brotto, L. A., Basson, R., & Luria, M. (2008). A mindfulness-basedgroup psychoeducational intervention targeting sexual arousaldisorder in women. Journal of Sexual Medicine, 5, 1646–1659.Brotto, L. A., Chik, H. M., Ryder, A. G., Gorzalka, B. B., & Seal, B.N. (2005). Acculturation and sexual function in Asian women.Archives of Sexual Behavior, 34, 613–626.Brotto, L. A., Woo, J. S. T., & Ryder, A. G. (2007). Acculturation andsexual function in Canadian East Asian men. Journal of SexualMedicine, 4, 72–82.Cain, V. S., Johannes, C. B., Avis, N. E., Mohr, B., Schocken, M.,Skurnick, J., et al. (2003). Sexual functioning and practices in amulti-ethnic study of midlife women: Baseline results fromSWAN. Journal of Sex Research, 40, 266–276.Cohen, J. (1992). A power primer. Psychological Bulletin, 112,155–159.Hawton, K., Catalan, J., & Fagg, J. (1991). Low sexual desire: Sextherapy results and prognostic factors. Behaviour Research andTherapy, 29, 217–224.Hayes, A. F. (2009). Beyond Baron and Kenny: Statistical mediationanalysis in the new millenium. Communication Monographs, 76,408–420.Higgins, L. T., & Sun, C. H. (2007). Gender, social background andsexual attitudes among Chinese students. Culture, Health &Sexuality, 9, 31–42.Hislop, T. G., Teh, C., Lai, A., Ralston, J. D., Shu, J., & Taylor, V. M.(2004). Pap screening and knowledge of risk factors for cervicalcancer in Chinese women in British Columbia, Canada. Ethnicity& Health, 9, 267–281.Hurlbert, D. F. (1993). A comparative study using orgasm consistencytraining in the treatment of women reporting hypoactive sexualdesire. Journal of Sex & Marital Therapy, 19, 41–55.Kagawa-Singer, M., & Pourat, N. (2000). Asian American and PacificIslander breast and cervical carcinoma screening rates andHealthy People 2000 objectives. Cancer, 89, 696–705.Kennedy, M. A., & Gorzalka, B. B. (2002). Asian and non-Asian attitudestoward rape, sexual harassment and sexuality. Sex Roles,46, 227–238.Laumann, E. O., Nicolosi, A., Glasser, D. B., Paik, A., Gingell, C.,Moreira, E., et al. (2005). Sexual problems among women andmen aged 40–80y: Prevalence and correlates identified in theGlobal Study of Sexual Attitudes and Behaviors. InternationalJournal of Impotence Research, 17, 39–57.Lee, O., & Chang, J. (1999). Women, family, and society. Seoul, Korea:Seyoungsa.McCabe, M. P. (2001). Evaluation of a cognitive behavior therapyprogram for people with sexual dysfunction. Journal of Sex &Marital Therapy, 27, 259–271.297

WOO, BROTTO, AND GORZALKADownloaded by [The University of British Columbia] at 10:24 13 March 2012Meston, C. M., & Ahrold, T. K. (2010). Ethnic, gender, and acculturationinfluences on sexual behaviors. Archives of Sexual Behavior,39, 179–189.Meston, C. M., Trapnell, P. D., & Gorzalka, B. B. (1996). Ethnic andgender differences in sexuality: Variations in sexual behaviorbetween Asian and non-Asian university students. Archives ofSexual Behavior, 25, 33–72.Meston, C. M., Trapnell, P. D., & Gorzalka, B. B. (1998). Ethnic, gender,and length-of-residency influences on sexual knowledge andattitudes. Journal of Sex Research, 35, 176–188.Meyer-Bahlburg, H. F., & Dolezal, C. (2007). The Female SexualFunction Index: A methodological critique and suggestions forimprovement. Journal of Sex & Marital Therapy, 33, 217–224.Mosher, D. L. (1988). Revised Mosher Guilt Inventory. In C. M.Davis, W. L. Yarber & S. L. Davis (Eds.), Sexuality-relatedmeasures (pp. 152–155). Lake Mills, IA: Graphic Publishing.Mosher, D. L., & Cross, H. J. (1971). Sex guilt and premarital sexualexperiences of college students. Journal of Consulting and ClinicalPsychology, 36, 27–32.Ng, M. L., & Lau, M. P. (1990). Sexual attitudes in the Chinese.Archives of Sexual Behavior, 19, 373–388.Nobre, P. J., Gouveia, J. P., & Gomes, F. A. (2003). Sexual DysfunctionalBeliefs Questionnaire: An instrument to assess sexualdysfunctional beliefs as vulnerability factors to sexual problems.Sexual and Relationship Therapy, 18, 171–204.Plaud, J. J., Gaither, G. A., Hegstad, H. J., Rowan, L., & Devitt, M.K. (1999). Volunteer bias in human psychophysiological sexualarousal research: To whom do our research results apply? Journalof Sex Research, 36, 171–179.Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures forestimating indirect effects in simple mediation models. BehaviorResearch Methods, Instruments, and Computers, 36, 717–731.Rosen, R., Brown, C., Heiman, J., Leiblum, S., Meston, C., Shabsigh,R., et al. (2000). The Female Sexual Function Index (FSFI): Multidimensionalself-report instrument for the assessment of femalesexual function. Journal of Sex & Marital Therapy, 26, 191–208.Ruma, E. H., & Mosher, D. L. (1967). Relationship between moraljudgment and guilt in delinquent boys. Journal of AbnormalPsychology, 72, 122–127.Ryder, A. G., Alden, L. E., & Paulhus, D. L. (2000). Is acculturationunidimensional or bidimensional? A head-to-head comparison inthe prediction of personality, self-identity, and adjustment.Journal of Personality and Social Psychology, 79, 49–65.Schover, L. R., & LoPiccolo, J. (1982). Treatment effectiveness fordysfunctions of sexual desire. Journal of Sex & Marital Therapy,8, 179–197.Shrout, P. E., & Bolger, N. (2002). Mediation in experimental andnonexperimental studies: New procedures and recommendations.Psychological Methods, 7, 422–445.Strassberg, D. S., & Lowe, K. (1995). Volunteer bias in sexualityresearch. Archives of Sexual Behavior, 24, 369–382.Tang, C. S., Lai, F. D., & Chung, T. K. H. (1997). Assessment of sexualfunctioning for Chinese college students. Archives of SexualBehavior, 26, 79–90.Taylor, V. M., Hislop, T. G., Jackson, J. C., Tu, S. P., Yasui, Y.,Schwartz, S. M., et al. (2002). A randomized controlled trial ofinterventions to promote cervical cancer screening among Chinesewomen in North America. Journal of the National Cancer Institute,94, 670–677.Trudel, G., Marchand, A., Ravart, M., Aubin, S., Turgeon, L., &Fortier, P. (2001). The effect of a cognitive-behavioural grouptreatment program on hypoactive sexual desire in women. Sexualand Relationship Therapy, 16, 145–164.Tu, S. P., Jackson, S. L., Yasui, Y., Deschamps, M., Hislop, T. G., &Taylor, V. M. (2005). Cancer preventive screening: A cross-bordercomparison of United States and Canadian Chinese women.Preventive Medicine, 41, 36–46.Wiederman, M. W. (1993). Demographic and sexual characteristics ofnonresponders to sexual experience items in a national survey.Journal of Sex Research, 30, 27–35.Wiegel, M., Meston, C., & Rosen, R. (2005). The Female Sexual FunctionIndex (FSFI): Cross-validation and development of clinicalcutoff scores. Journal of Sex & Marital Therapy, 31, 1–20.Woo, J. S. T., Brotto, L. A., & Gorzalka, B. B. (2009). The role ofsexuality in cervical cancer screening among Chinese women.Health Psychology, 28, 598–604.Woo, J. S. T., Brotto, L. A., & Gorzalka, B. B. (2010a). The role of sexguilt in the relationship between culture and women’s sexual desire.Archives of Sexual Behavior. Advance online publication. doi:10.1007=s10508-010-9609-0Woo, J. S. T., Brotto, L. A., & Gorzalka, B. B. (2010b). Sex guilt andculture-linked barriers to testicular examinations. InternationalJournal of Sexual Health, 22, 144–154.Woo, J. S. T., Brotto, L. A., & Yule, M. (2010). Do East Asian andCaucasian women differ in sexual psychophysiology researchparticipation? Journal of Sex Research, 47, 345–354. doi: 10.1080=00224490902999294Youn, G. (2001). Perceptions of peer sexual activities in Koreanadolescents. Journal of Sex Research, 38, 352–360.Yu, M. Y., Wu, T. Y., & Mood, D. W. (2005). Cultural affiliation andmammography screening of Chinese women in an urban countyof Michigan. Journal of Transcultural Nursing, 16, 107–116.298