Network position and sexual dysfunction: implications of partner betweenness for men

Abstract

This article combines relational perspectives on gender identity with social network structural perspectives on health to understand men's sexual functioning. The authors argue that network positions that afford independence and control over social resources are consistent with traditional masculine roles and may therefore affect men's sexual performance. For example, when a heterosexual man's female partner has more frequent contact with his confidants than he does--which the authors refer to as partner betweenness--his relational autonomy, privacy, and control are constrained. Analyses of data from the National Social Life, Health, and Aging Project (NSHAP) show that about a quarter of men experience partner betweennessa and that these men are 92% more likely to report erectile dysfunction. Partner betweenness is strongest among the youngest men in the sample, which may reflect changing conceptions of masculinity in later life. The authors consider several explanations for these findings and urge additional research on the links between health, gender, and network structure.

Figure 1. Five Possible Ego-Partner-Confidant Triads, Based on Contact Frequency

Note: Solid lines represent frequent contact. Dashed lines represent (relatively) infrequent contact.

Figure 2. Observed Prevalence of Erectile Dysfunction in Different Age Groups

Note: Means are estimated using NSHAP person-level weights, with post-stratification adjustments for non-response and adjustments for probability of inclusion in the main analysis. Estimates are calculated for all cases for which data are available on all key variables in the multivariate analysis.

Figure 3. Prevalence of Partner Betweenness among Older Men with Different Numbers of Confidants (N = 678)

Note: Includes all male respondents who are known to have had sex in the past year, who have a current spouse/partner, and who have at least one confidant apart from their spouse/partner.

Figure 4. Predicted Probability of Erectile Dysfunction among Older Men, by Age Group and Partner Betweenness

Note: Estimates are predicted probabilities derived from the final model predicting difficulty getting and/or maintaining an erection, presented in Table 3. Covariates are held at their median values.

Figure 5. Predicted Probability of Erectile Dysfunction among Older Men, by Age and Network Kin Composition

Note: Estimates are predicted probabilities derived from the final model predicting difficulty getting and/or maintaining an erection, presented in Table 3. Covariates are held at their median values (assuming no partner betweenness).