Cycles of shame: menstrual shame, body shame, and sexual decision-making

Journal of Sex Research,  Nov, 2005  by Deborah Schooler,  L. Monique Ward,  Ann Merriweather,  Allison S. Caruthers

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Similarly, in distancing herself from her own interests, a woman who is experiencing shame may find it difficult to protect herself from infection and unintended pregnancy. Avoidance responses, fears of negative evaluation, and self-objectification may inhibit a woman's sexual agency; her ability to act in accordance with her own interests and assert her own desires may be impaired. As a result, body shame could present a serious risk to sexual well-being by predisposing women to risky behavior. It is therefore necessary to assess directly the association between body shame and sexual decision-making.

The Current Study

This study examined the role of menstrual attitudes and body shame in predicting sexual decision-making. Our first research question examined the direct relation between menstrual attitudes and sexual decision-making. Because of the centrality of agency in our conceptualization of sexual decision-making, we focused on sexual assertiveness as our primary sexual outcome. We defined sexual assertiveness as the ability to express one's preferences in sexual situations, whether that involves requesting wanted behavior, refusing unwanted activity, or negotiating the use of protection. We expected that women who reported more shame about menstruation would report less sexual assertiveness, and consequently would report less accumulated sexual experience and more risky sexual behavior.

Our second research question examined the first path of the mediational model, exploring whether menstrual shame relates to a more generalized body shame. We expected that higher levels of menstrual shame would predict increased body shame. Our third research question examined the next path of the mediated model, investigating how body shame relates to sexual decision-making. Specifically, we expected that women who reported more body shame would be less sexually assertive, and therefore would report less accumulated sexual experience and more sexual risk. Our fourth research question used structural equation modeling to examine a mediated model whereby menstrual shame acts indirectly through body shame and sexual assertiveness to predict lifetime sexual experience and sexual risk. We expected that women who reported higher levels of menstrual shame would report less lifetime sexual experience and more risky sexual behavior, but that the strength of these relations would diminish once we accounted for body shame and sexual assertiveness.

As a secondary research question, we explored the extent to which particular aspects of women's backgrounds, such as age of menarche, race, and religiosity, contributed to their menstrual attitudes and sexual behavior. Consistent with previous research, we expected that women who had reached menarche earlier would report higher levels of menstrual shame, and subsequently, less healthy patterns of sexual decision-making. Ethnic group membership has also been found to contribute to women's sexual behavior (e.g., CDC, 1997; Gomez & VanOss Marin, 1996; Wyatt et al., 2000), although many of these outcomes are believed to be driven by socioeconomic status (SES; Bingham, Miller, & Adams, 1990; Wyatt, 1997). SES-related differences in menstrual attitudes have been documented as well (Kissling, 1996b; Lichtenstein & Nansel, 2000; Martin, 1987), such that low-income women appear to be less likely to celebrate menstruation. Consequently, both race and SES were examined as possible correlates of menstrual shame, body shame, and sexual decision-making. Finally, religiosity is a consistent predictor of sexual behavior, associated with both delayed sexual onset among teens (e.g., Herold & Goodwin, 1981) and infrequent condom use among nonvirgins (e.g., Zaleski & Schiaffino, 2000). Additionally, some religious traditions convey strong taboos regarding menstruation and proscribe ritual cleanings, such as the Mikvah in Jewish tradition (Delaney, Lupton, & Toth, 1988). Accordingly, religiosity was explored as a possible correlate of the central variables.