Development and initial validation of the Positive Sexuality Scale for female adults

Aim and objectives: To develop and initially validate the Positive Sexuality Scale (PSS) to assess adult female-positive sexuality. Background: While traditional approaches focus on negative sexual experiences and sexual dysfunctions, within the positive psychology framework positive sexuality is a subjective experience of happiness and fulfilment with one’s sexual expression, which contributes to well-being. No measure exists that specifically measures adult female-positive sexuality and can be confidently used with women of any fertility/childlessness status. Design: Two-stage cross-sectional study with a 4-week test–retest, which follows the STROBE guidelines. Methods: Participants were 912 Italian women aged 18–45 (52.74% mothers, 23.79% voluntarily childless and 23.46% primary infertile), who completed the 5-item PSS and a self-report of psychological well-being. A subsample (n = 61) completed the 4-week test–retest. Results: Factor analyses supported a one-factor model with measurement invariance across adulthood stage and fertility/childlessness status and good reliability. Younger and fertile women showed higher PSS scores, and moderate-to-high variability in infertile women’s well-being was accounted for by PSS scores. Conclusion: The PSS is a brief self-report with initial evidence of validity and reliability that could be used in sex research, practice and education. Relevance to clinical practice: The PSS could assist health professionals to identify a positive resource to which women can draw on to deal with sex-related issues. Implementing the assessment of female-positive sexuality in infertility protocols could help professionals to identify a potential resource within couples facing infertility and its treatment.