Sexual Self-Esteem

Sexual self-esteem, i.e. a person's assessment of their value as a sexual being, plays a central role in the quality of their sex life. Indeed, body image and physical complexes are among the personal factors that most influence sexual self-esteem (Zeanah & Schwarz, 1996, Sanchez-Fuentes, 2014). They also affect the relationship between partners during sexual activities.

Sexual self-esteem refers to the set of judgements a person makes about their sexual skills and attractiveness. It encompasses emotional dimensions (feelings about one's sexual worth), cognitive dimensions (beliefs about one's body and sexual skills) and behavioural dimensions (confidence in expressing one's desires).

Although it is distinct from overall self-esteem, the two are closely linked: low overall self-esteem tends to undermine sexual self-esteem, and vice versa (Zeanah & Schwarz, 1996). Sexual self-esteem also incorporates the sexual self-schema, which is based on past experiences and influences future behaviour (Andersen & Cyranowski, 1994), as well as sexual identity and body perception in intimate situations.

The Sexual Self-Esteem Inventory for Women (SSEI-W), a resource validated for assessing female sexual self-esteem, comprises five dimensions:

1. Skills/experience: feeling of effectiveness in pleasing and responding to sexual solicitations,
2. Attractiveness: perception of one's own sexual attractiveness,
3. Control: ability to manage one's sexual thoughts and behaviours,
4. Moral judgement: consistency between one's personal values and sexual behaviours,
5. Adaptability: ability to align one's sex life with one's aspirations and values.

These areas are influenced by psychosocial experiences (relationships, dating, past sexual experiences, etc.), which either increase or decrease overall sexual self-esteem (Zeanah & Schwarz, 1996).

Body image (how we evaluate and feel about our own bodies) is a strong predictor of sexual satisfaction, particularly in women. People with a positive body image report, on average, greater desire, more frequent sexual activity and higher satisfaction (Pujols et al., 2010; Quinn-Nilas, 2016).

Conversely, a negative body image is associated with reduced desire, avoidance of sexual intercourse, and distracting thoughts during sex (e.g., concerns about appearance). In other words, a person may have an appropriate physiological response to sexuality, but if their attention is captured by negative judgements about their body, the subjective experience of pleasure and satisfaction diminishes (Pujols et al., 2010; Quinn-Nilas, 2016).

According to Pujols et al. (2010), body dissatisfaction accounts for 15 to 20% of female sexual dissatisfaction. Indeed, body image can influence sexual desire, sexual arousal, pleasure, orgasm, the quality of intimate relationships, and even the perception of pain (Mayer et al., 2003). Satisfaction with one's body shape is therefore a predictor of good physiological sexual functioning (Afshari et al., 2016).

Positive body awareness also increases sexual response, even in women suffering from sexual disorders (Seal & Meston, 2007). These parameters reinforce each other in a virtuous circle: high sexual self-esteem promotes desire, arousal and orgasm, and these positive sexual experiences then reinforce sexual self-esteem (Andersen & Cyranowski, 1994; Shapiro & Schwarz, 1997).

This leads to behavioural avoidance: to escape shame or perceived judgement, some people avoid nudity, sexual positions that are too exposed to the gaze of the other, or intimate contexts altogether. As a result, the frequency of sexual intercourse decreases and a tendency towards sexual restriction is observed in people who are very dissatisfied with their bodies (Afshari et al., 2016; Pujols et al., 2010).

This reduces communication and intimacy. Feeling embarrassed about one’s body can prevent a person from expressing their needs and preferences to their partner, reducing the quality of sexual and emotional exchanges, which are important elements for sexual satisfaction (Mayer et al., 2003; Sánchez-Fuentes et al., 2014). And dissatisfaction reinforces complexes: the body is blamed for its flaws and held responsible for sexual failure, thus completing the cycle.

Socio-cultural factors and aesthetic norms contribute to the critical view of the body. According to Hannier et al. (2017), contemporary ideals of beauty, particularly low BMI as the dominant norm, strongly influence body esteem. As a result, women who are dissatisfied with their bodies have lower sexual self-esteem, regardless of their age (Dalley et al., 2009; Knauss et al., 2007). Indeed, beauty standards promoted by the media and reinforced by society create unattainable ideals, fuelling our complexes.

Furthermore, media exposure to idealised bodies leads to self-objectification, i.e. the tendency to perceive oneself through the eyes of others (similar to spectatoring in sexual activity) (Calogero & Thompson, 2009). Self-objectification can promote body shaming and self-monitoring (Tiggemann & Williams, 2012).

The majority of studies on sexual health have historically focused on women, confirming time and again the correlation between negative body image and female sexual dysfunction (decreased desire, difficulty becoming aroused, anorgasmia, dissatisfaction, etc.). However, research on men also shows a significant effect: concerns about weight, muscle tone, or penis size can affect male sexual self-esteem and sexual satisfaction (Gogolin et al., 2024).

Furthermore, certain populations (sexual minorities, people with disabilities, etc.) are particularly exposed to these pressures and show increased levels of body concerns. Indeed, social stigma and pressure to conform to body standards often intensify body and sexual dissatisfaction (Santoniccolo et al., 2025; Taleporos & McCabe, 2002).

Sexual violence and objectification are major factors in the deterioration of sexual self-esteem. Mayer et al. (2003) showed that degrading comments, harassment and sexual assault lead to guilt, shame and self-loathing, permanently affecting self-perception and the ability to experience pleasure. Women who were sexually abused as children also have lower sexual self-esteem (Van Bruggen et al., 2006).

The consequences of trauma can include dissociation strategies (distancing oneself from sensations and emotions) and avoidance of physical touch. Indeed, women who have experienced sexual trauma and have a degraded body image report greater emotional and physical detachment during sexual intercourse.

Low body esteem encourages rumination, self-criticism and comparison, which in turn increases the risk of anxiety and depressive episodes (Dalley et al., 2009; Calogero & Thompson, 2009). Feeling uncomfortable in one's own body generates feelings of helplessness, a reduced sense of efficacy and a gradual disengagement from social or intimate activities (Claudat & Warren, 2014). Women who internalise thinness standards are also more likely to develop eating disorders linked to low body image (Calogero & Thompson, 2009).

Finally, physical changes related to illness or surgery often affect self-image and can have repercussions on sexuality. Professional care is therefore recommended.

Restoring only the body's ‘function’ (e.g., undergoing treatment, surgery, or doing exercise) without addressing body image, cognition, and relational communication rarely leads to lasting improvements. Therefore, treatment may include:

• Cognitive behavioural therapies (CBT), which target negative thoughts related to the body and spectatoring: cognitive restructuring, cognitive and behavioural exposure exercises, training to focus attention on sexual sensations rather than appearance, etc.
• Mindfulness in a sexual context (e.g. through slow sex exercises) helps to focus attention on present sensations and reduces distraction related to appearance, thereby improving satisfaction.
• Couples therapy promotes communication, emotional validation and the expression of sexual needs. This helps to reduce body shame within the couple and increase shared satisfaction. In their study of 103 heterosexual couples (2014), Gagnon-Girouard et al. demonstrated that the level of sexual assertiveness of both partners is positively correlated with sexual and marital satisfaction.
  

Sexual self-esteem and body image play a central role in sexual satisfaction. Cognitive processes, such as spectatoring or distraction related to appearance, explain why body image issues can alter desire, arousal, or orgasm. An effective therapeutic approach requires integrating body image assessment and addressing thoughts, feelings, and the couple's relationship in order to achieve lasting improvements in sexual well-being.