EXAMINING HOW SAME-GENDER AND MIXED-GENDER COUPLES NAVIGATE SEXUAL ISSUES IN THEIR RELATIONSHIPS

Sexual scripts—the definitions and expectations that individuals hold for sexual interactions—are thought to play an important role in the maintenance of sexual well-being. Sexual scripts can be rigid or flexible, and they can be concordant or discordant between members of a couple. Sex therapists support sexual script flexibility for maintaining sexual and relationship satisfaction when couples are navigating sexual issues. However, empirical research examining the role of sexual script flexibility and the degree of script concordance/discordance in couples’ sexual well-being has been limited, due in part to the limited measures available. Furthermore, within the existing research, there has been an unfortunate tendency to exclude individuals in same-gender relationships – perpetuating the long-standing knowledge gap in the literature on positive sexuality in diverse relationships. To address these gaps in the literature, we conducted a series of online studies that recruited individuals in diverse relationships. A measure of individual sexual script flexibility in response to sexual issues was developed (Chapter 2); in addition, the structure of an existing measure assessing couple sexual scripts in response to a sexual issue was evaluated (Chapter 3). Chapter 4 examined how individuals in diverse relationships compared on measures of individual sexual script flexibility and on couple sexual scripts. Findings suggest that there are more similarities than differences across diverse couples. Chapter 5 explored how flexibility in an individual’s approach to sexual issues relates to sexual well-being, specifically by assessing sexual communication and partner responses as mediators. Results suggest that individual sexual script flexibility relates to sexual well-being through reciprocal partner processes. Collectively, this research program suggests that more similarities than differences exist between individuals in same- and mixed-gender relationships, and that partners are important to consider in the relationship between individual sexual script flexibility and sexual well-being. These findings have implications for sex and couple therapy; these results emphasize the importance of interventions that target both members of the couple, and further our understanding of sexuality in same- and mixed-gender relationships.

Effects of retirement on cognitive function: A gender and international perspecive

Background: As the global population is ageing, studying cognitive impairments including dementia, one of the leading causes of disability in old age worldwide, is of fundamental importance to public health. As a major transition in older age, a focus on the complex impacts of the duration, timing, and voluntariness of retirement on health is important for policy changes in the future. Longer retirement periods, as well as leaving the workforce early, have been associated with poorer health, including reduced cognitive functioning. These associations are hypothesized to differ based on gender, as well as on pre-retirement educational and occupational experiences, and on post-retirement social factors and health conditions. Methods: A cross-sectional study is conducted to determine the relationship between duration and timing of retirement and cognitive function, using data from the five sites of International Mobility in Aging Study (IMIAS). Cognitive function is assessed using the Leganes Cognitive Test (LCT) scores in 2012. Data are analyzed using multiple linear regressions. Analyses are also done by site/region separately (Canada, Latin America, and Albania). Robustness checks are done with an analysis of cognitive change from 2012 to 2014, the effect of voluntariness of retirement on cognitive function. An instrumental variable (IV) approach is also applied to the cross-sectional and longitudinal analyses as a robustness check to address the potential endogeneity of the retirement variable. Results: Descriptive statistics highlight differences between men and women, as well as between sites. In linear regression analysis, there was no relationship between timing or duration of retirement and cognitive function in 2012, when adjusting for site/region. There was no association between retirement characteristics and cognitive function in site/region/stratified analyses. In IV analysis, longer retirement and on time or late retirement was associated with lower cognitive function among men. In IV analysis, there is no relationship between retirement characteristics and cognitive function among women. Conclusions: While results of the thesis suggest a negative effect of retirement on cognitive function, especially among men, the relationship remains uncertain. A lack of power results in the inability to draw conclusions for site/region-specific analysis and site-adjusted analysis in both linear and IV regressions.

Governmentality gone wild: How the separation of sex workers from 'communities' contributes to violence against sex workers

Sex workers are members of our communities, whether they are local or national communities. In law, mainstream media representations, and research sex workers are positioned as outside of or in opposition to communities. Even within marginalized communities sex workers are excluded when appeals to respectability politics are made. In this thesis I analyze three analytic sites from three areas of social life. The first chapter performs a textual analysis of The Bedford Decision (2013) and the resulting Protection of Communities and Exploited Persons Act (2014) as an examination of law. The second chapter is an analysis of filmic discourse on community, sex workers, and violence in the mainstream film London Road (2015) as an examination of mainstream media. The third chapter draws upon empirical research, i.e. in-depth interviews with three current and former sex workers in Ottawa, Canada and analyzes the transcripts using interpretative phenomenological analysis (IPA) to center how sex workers’ understanding of their work, community, and the laws and policies that are supposed govern and protect them. In my preface and conclusion I discuss some of the ethical dilemmas I encountered while conducting this research. My findings suggest that sex workers are being positioned and understood as outside of communities in ways that contribute to violence against sex workers. The implications of this research suggest that people who speak in the name of communities—communities in the sense of local neighborhood communities, activist communities, and national communities—need to recognize that sex workers are part of their communities and be accountable to ensuring they are treated as members. Researchers who conduct research on sex work and sex workers need to be accountable to their participants and the impacts their research may have on laws and policies. Sex workers are an over-researched population yet their voices are largely misappropriated or silenced in popular research and policy debates.

Adiposity, Sex Hormones, and Repetitive Element DNA Methylation in Healthy Postmenopausal Women

INTRODUCTION: Low levels of methylation within repetitive DNA elements, such as long interspersed nuclear element-1 (LINE-1) and Alu repeats, are believed to epigenetically predispose an individual to cancer and other diseases. The extent to which lifestyle factors affect the degree of DNA methylation within these genomic regions has yet to be fully understood. Adiposity and sex hormones are established risk factors for certain types of cancer and other illnesses, particularly amongst postmenopausal women. The aim of the current investigation is to assess the impact of adiposity and sex hormones on LINE-1 and Alu methylation in healthy postmenopausal women. METHODS: A cross-sectional study was conducted using baseline data from an ancillary study of the Alberta Physical Activity and Breast Cancer Prevention (ALPHA) Trial. Current adiposity was measured using a dual-energy x-ray absorptiometry (DXA) scan, computed tomography (CT) scan, and balance beam scale. Historical weights were self-reported in a questionnaire. Current endogenous sex hormone concentrations were measured in fasting blood serum. Estimated lifetime number of menstrual cycles was used as a proxy for cumulative exposure to ovarian sex hormones. Repetitive element methylation was quantified in white blood cells using a pyrosequencing assay. Linear regression was used to model the relations of interest while adjusting for important confounders. RESULTS: Adiposity and serum estrogen concentrations were positively related to LINE-1 methylation but were not associated with Alu methylation. Cumulative ovarian sex hormone exposure had a “U-shaped” relation with LINE-1 regardless of folate intake and a negative relation with Alu methylation amongst low folate consumers. Androgens were not associated with repetitive element DNA methylation in this population. CONCLUSION: Adiposity and estrogens appear to play a role in maintaining high levels of repetitive element DNA methylation in healthy postmenopausal women. LINE-1 methylation may be a mechanism whereby estrogen exposure protects against cardiovascular and neurodegenerative illnesses. These results add to the growing body of literature showing how the epigenome is shaped by our lifestyle choices. Future prospective studies assessing the relation between levels of repetitive element DNA methylation in healthy individuals and subsequent disease risk are needed to better understand the clinical significance of these results.

(MIS)PERCEIVED DRINKING NORMS AND HAZARDOUS DRINKING BEHAVIOURS IN UNIVERSITY FIRST-YEAR UNDERGRADUATE STUDENTS AND THE EFFECTS OF GENDER

Purpose: Across Canada, undergraduate university students are one of the highest alcohol-consuming populations. Many students engage in hazardous drinking and are at risk for negative health and social consequences. Social Norms Theory suggests that students’ overestimation of drinking norms can result in an increase in their drinking behaviour. As of yet, none of the literature addresses the possible link between drinking norm (mis)perception and hazardous drinking in a Canadian undergraduate context. This is the first Canadian study to examine this potential association in first-year undergraduate students across multiple universities using gender as an effect modifier. Methods: Using data collected by the Caring Campus Project, for 2347 first-year students from three Canadian universities, I evaluated the prevalence of drinking norm misperceptions by site and gender. Using multiple-logistic regression models, I analyzed the relationship between misperceived drinking norms and hazardous drinking behaviours (assessed via AUDIT-C). Results: The proportion of students who overestimated drinking and binge drinking frequency norms varied by site and gender. There was a positive relationship between overestimated drinking/ binge drinking frequency norms and hazardous drinking, modified by gender. Controlling for living arrangement and site, the odds of female students being hazardous drinkers increased by a factor of 2.27 (CI: 1.73-2.99) when the drinking frequency norm was overestimated. A non-significant association was found for male students. Among female students, when living arrangement and site were controlled, the odds of being a hazardous drinker were 1.83 (0.84-3.95) and 2.69 (1.24-5.83) times greater when the drinking frequency norm was perceived at “2-4 times per month” and “2 or more times per week”, respectively. Among male students, when living arrangement, previous residence and site were controlled, the odds of being a hazardous drinker were 4.03 (2.62-6.19) and 8.54 (5.41-13.49) times greater when the binge drinking frequency norm was perceived at “2-4 times per month” and “2 or more times per week”, respectively. Conclusion: This novel study enhances the understanding of the association between (mis)perceived drinking norms and drinking behaviours in Canadian undergraduate students. The demonstrated importance of gender and site provides a strong impetus for Canadian universities to develop targeted alcohol reduction interventions.