How Italians Transgress: A Survey on Rough Sexual Behaviors in a Sample of Italians

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Thank you for asking me to review this manuscript. I believe that this study would be of interest to sex researchers. For example, I am writing a paper on attitudes toward BDSM currently and was looking for studies reporting on the prevalence of rough sexual behaviours in the population. This is exactly the kind of study I would want to cite to put my findings into context. However, I do believe that the manuscript requires some revisions before it is suitable for publication.

I have listed my concerns/queries below. I hope these are helpful to the authors.

Written Expression:

There are some confusing sentences in the manuscript. For example, I found the sentences starting on lines 66, 70, 73, 422, 424 difficult to understand. I would suggest revising these and doing an additional copy edit of the entire manuscript.

The findings are sometimes described in way that is ambiguous, confusing, or potentially misleading. For example:

Line 411 says that .4% of participants fainted during choking. I think the authors actually mean .4% of participants who had engaged in choking, rather than .4% of participants (which would be an alarmingly high 185 participants).

Line 307 says that 69.75% of women were choked at an average age of 21.9, etc. This is confusing. I am not sure what the 69.75 is actually referring to (because only about 10% of the women in the sample had been choked). Further, is 21.9 a) the average age of this subsample of participants who had been choked, or b) the average age at which participants report first being choked. Either way, this sentence should be adjusted to clarify for the reader.

Line 270 says that most participants had received anal sex without consent, which is incorrect.

Line 189 and 191: the phrase “performed received” is difficult to understand.

Line 211: These are technically subscripts not superscripts.

“Chocking” is sometimes used rather than “choking”

In the method there are subheadings titled “Frequency of Rough Sex Behaviors” and “Frequency of Engagement in Rough Sex Behaviors”. Based on subheading alone it is unclear how these differ.

There is a high degree of repetition in the manuscript. Typically, percentages are reported in tables, then again in the text of the Results section, and sometimes again in the Discussion. I understand that some degree of repetition is hard to avoid in descriptive studies such as this, but I would recommend that the authors consider if there are ways to reduce the repetition in the manuscript.

Methodological concerns:

In a descriptive study such as this, it is important to establish the likely representativeness of the sample. Accordingly, the researchers should give further details of the recruitment approach. For example, which subreddits was the study posted to? Etc.

Further, was any information recorded on the relationship status of participants? Additional details on relationship status would be helpful if available.

In terms of the chi-square tests, I have concerns about including the TGNB group in the analysis, given that there were so few TGNB group members (especially relative to the remainder of the sample). Some texts state that an assumption of chi-square tests of contingency is that no cell has an expected cell count of less than 5 (some authors even say 10). Just eyeballing the tables, I would guess that some of the cells for the TGNB group could have an expected cell count of less than 5 (some cells may even have an expected count under 1). I would suggest that the authors check and report on this and rerun all these tests excluding the TGNB groups if necessary.   

The authors should add a table note to Table 3 explaining the subscript system used to denote pairwise comparisons.

Discussion

Given that this study was positioned as a replication of the Herbenick study, there is relatively little discussion of how the results of the current study differ or align the findings of Herbenick. Are the prevalence figures reported in this study different to those reported in Herbenick? If so, why? Cultural differences? Sampling differences? Etc. If not, what does this indicate about the likely validity of the results.

There were a few results reported for men and women which seem inconsistent or contradictory. For example, around 50% of women report having asked a sexual partner to choke them at least once. However, only 20% of men report having being asked to choke a sexual partner. Similarly, 50% of women report choking a sexual partner, but only 20% of men report being choked; over 40% of women report hard spanking a sexual partner at least once, but only 20% of men report having being hard spanked; etc. I know these percentages would be influenced by instances of same-sex sexual behaviour, but these seems like big gaps even when taking into account same-sex behaviour. What might be driving these differences? Are men not picking up on when their partners ask them to choke them? Are men underreporting engaging in passive sexual behaviours (like being spanked) etc. Are women overreporting engaging in assertive sexual behaviours? This is an extremely interesting aspect of the findings, but one that is barely touched on in the discussion.

Comments on the Quality of English Language

Above comments contain statements on the quality of the English expression. 

Author Response

Dear reviewer, thank you for taking the time to review our manuscript and give your input and comments. Please find below the changes we made, which we think will improve our work.

 

 

Written Expression: There are some confusing sentences in the manuscript. For example, I found the sentences starting on lines 66, 70, 73, 422, 424 difficult to understand. I would suggest revising these and doing an additional copy edit of the entire manuscript.	We improved the comprehensibility of sentences in lines 71-77. Sentences starting on lines 422 and 424 have been removed
The findings are sometimes described in way that is ambiguous, confusing, or potentially misleading. For example: Line 411 says that .4% of participants fainted during choking. I think the authors actually mean .4% of participants who had engaged in choking, rather than .4% of participants (which would be an alarmingly high 185 participants).	We clarified it in line 488
Line 307 says that 69.75% of women were choked at an average age of 21.9, etc. This is confusing. I am not sure what the 69.75 is actually referring to (because only about 10% of the women in the sample had been choked). Further, is 21.9 a) the average age of this subsample of participants who had been choked, or b) the average age at which participants report first being choked. Either way, this sentence should be adjusted to clarify for the reader. Line 270 says that most participants had received anal sex without consent, which is incorrect. Line 189 and 191: the phrase “performed received” is difficult to understand. Line 211: These are technically subscripts not superscripts. In the method there are subheadings titled “Frequency of Rough Sex Behaviors” and “Frequency of Engagement in Rough Sex Behaviors”. Based on subheading alone it is unclear how these differ.	We have modified the entire results section to make the presentation of the data less redundant. Thus, these comments cannot be applied.
Chocking” is sometimes used rather than “choking”	Fixed the spelling throughout the document.
There is a high degree of repetition in the manuscript. Typically, percentages are reported in tables, then again in the text of the Results section, and sometimes again in the Discussion. I understand that some degree of repetition is hard to avoid in descriptive studies such as this, but I would recommend that the authors consider if there are ways to reduce the repetition in the manuscript.	As written above, the entire results section has been lightened by presenting only the main results in general, and for subsamples.
Methodological concerns: In a descriptive study such as this, it is important to establish the likely representativeness of the sample. Accordingly, the researchers should give further details of the recruitment approach. For example, which subreddits was the study posted to? Etc.	We better described the recruitment approach. Please see sentences starting in line 92.
Further, was any information recorded on the relationship status of participants? Additional details on relationship status would be helpful if available.	Although not present in the original study, we have included it in Table 1.
In terms of the chi-square tests, I have concerns about including the TGNB group in the analysis, given that there were so few TGNB group members (especially relative to the remainder of the sample). Some texts state that an assumption of chi-square tests of contingency is that no cell has an expected cell count of less than 5 (some authors even say 10). Just eyeballing the tables, I would guess that some of the cells for the TGNB group could have an expected cell count of less than 5 (some cells may even have an expected count under 1). I would suggest that the authors check and report on this and rerun all these tests excluding the TGNB groups if necessary.	We replicated the analyses as in Herbenick's original study. There were few TGNB subjects in that study as well. In line 190, we have added a sentence which clarifies how our sample size is representative of reality.
The authors should add a table note to Table 3 explaining the subscript system used to denote pairwise comparisons.	Done. Please see under Table 3
Discussion Given that this study was positioned as a replication of the Herbenick study, there is relatively little discussion of how the results of the current study differ or align the findings of Herbenick. Are the prevalence figures reported in this study different to those reported in Herbenick? If so, why? Cultural differences? Sampling differences? Etc. If not, what does this indicate about the likely validity of the results.	We added a comparison between lines 701 and 724
There were a few results reported for men and women which seem inconsistent or contradictory. For example, around 50% of women report having asked a sexual partner to choke them at least once. However, only 20% of men report having being asked to choke a sexual partner. Similarly, 50% of women report choking a sexual partner, but only 20% of men report being choked; over 40% of women report hard spanking a sexual partner at least once, but only 20% of men report having being hard spanked; etc. I know these percentages would be influenced by instances of same-sex sexual behaviour, but these seems like big gaps even when taking into account same-sex behaviour. What might be driving these differences? Are men not picking up on when their partners ask them to choke them? Are men underreporting engaging in passive sexual behaviours (like being spanked) etc. Are women overreporting engaging in assertive sexual behaviours? This is an extremely interesting aspect of the findings, but one that is barely touched on in the discussion.	We added sentences in line 657

Reviewer 2 Report

Comments and Suggestions for Authors

Overall this is an important study, extending the exploration of rough sexual behaviors to an Italian population.  However I have a number of criticisms, as follows:

1. "cohcking" is misspelled in teh abstract; it is spelled correctly throughout the rest of the paper.

2.  More information as to the language extended to potential study participants should be included.  Was this advertised as a study invovling "rough sexual behaviors" or otherwise.  

3.  This is not a random sample or representative sample from the Italian population, but I think that some effort should be made to compare this with actual epidemiological data of the Italian population.  For instance, if it is known, how does the study data compare with data from the general population?  What percent of the general population are heteroexual, gay, lesbian.  What percent of the population have various educational levels; what is the age distribution of the population?  How does this data compare with that of the general population?

Comments on the Quality of English Language

The English is excellent

Author Response

 

Dear reviewer, thank you for taking the time to review our manuscript and give your input and comments. Please find below the changes we made, which we think will improve our work.

 

"cohcking" is misspelled in teh abstract; it is spelled correctly throughout the rest of the paper.	Fixed the spelling throughout the document.
More information as to the language extended to potential study participants should be included. Was this advertised as a study invovling "rough sexual behaviors" or otherwise.	The study is part of a larger research project about Sexual behavior and sexual satisfaction in transgender people and in cisgender people. But specifically, this single study was advertised as a Survey on sexual behaviors in cisgender and transgender population.
This is not a random sample or representative sample from the Italian population, but I think that some effort should be made to compare this with actual epidemiological data of the Italian population. For instance, if it is known, how does the study data compare with data from the general population? What percent of the general population are heteroexual, gay, lesbian. What percent of the population have various educational levels; what is the age distribution of the population? How does this data compare with that of the general population?	In line 190, we have added a sentence which clarifies how our sample size is representative of reality.