Development and Validation of the Sex-Positivity Scale

Background and Purpose:  Sexual functioning is an important aspect of living that is often ignored by health and human service professionals, in part due to personal discomfort.  Sex-positive human services have been proposed to relate with positive client outcomes such as the acknowledgment and resolution of sexual concerns, but definitions of sex-positivity are often vague and little research has actually been conducted to assess the relationship between sex-positivity and quality of services.   The present work helps to close this gap by describing the development and validation of the Sex-Positivity Scale (SPS), which was designed to measure sex-positive attitudes among health and human service professionals.   Hypotheses of the validation study were that the SPS would have a factor-structure composed of six lower-order and two higher-order factors, and that the SPS and its subscales would have adequate internal consistency and construct validity with several theoretically relevant variables.  The factor structure of the SPS was also examined.

Methods: Development of the SPS began with the construction of an initial item pool, which was evaluated by a convenience sample of five experts in psychometrics and sexuality.  As a result of this process, the item pool was narrowed to a 40-item instrument which was used in the validation study.  The purposive, non-probability sample for the validation study was recruited via email from three social service agencies and one university. The sample was composed of 271 professionals and students in the health and human services.  Participants gave informed consent and completed the survey online. The survey included the SPS, a demographic questionnaire, and measures of theoretically related constructs, including homophobia, liberal sexual attitudes, and religiosity.  Cronbach’s alpha and the standard error of measurement (SEM) were calculated for each subscale to assess internal consistency.  Confirmatory factor analysis was used to evaluate the factor structure. Pearson correlation coefficients were used to assess construct validity with the theoretically related constructs.

Results: Reliability for the total scale was excellent (alpha = .96) and the subscales all had good internal consistency with alphas ranging from .83 to .94.  Factor analysis confirmed that a six-factor structure had adequate fit.  Scores on the SPS correlated in the expected directions with the theoretically related constructs of homophobia (r = -.36, p < .01), liberal sexual attitudes (r = .48, p < .01), and religiosity (r = -.51, p < .01). 

Conclusions and Implications: The findings suggest that the SPS is a valid and reliable measure of sex-positive attitudes within the sample.  The SPS can be used to evaluate the sex-positive attitudes of professionals and will allow future research to investigate how sex-positive attitudes among care providers relate to important outcomes such as the frequency with which clients’ sexual issues are assessed, addressed, and resolved by providers.