Cross-cultural Validation of the Arizona Sexual Experience Scale (ASEX) in 42 Countries and 26 Languages
Authors: Ballester-Arnal Rafael , Elipe-Miravet Marcel , Castro-Calvo Jesús , Beltrán-Martínez Patricia , Nagy Léna , Koós Mónika , Kraus Shane W. , Demetrovics Zsolt , Potenza Marc N. , Batthyány Dominik , Bergeron Sophie , Billieux Joël , Briken Peer , Burkauskas Julius , Cárdenas-López Georgina , Carvalho Joana , Chen Ji-Kang , Chen Lijun , Ciocca Giacomo , Corazza Ornella , Csako Rita I. , Fernandez David P. , Fernandez Elaine F. , Fujiwara Hironobu , Fuss Johannes , Gabrhelík Roman , Gewirtz-Meydan Ateret , Gjoneska Biljana , Gola Mateusz , Grubbs Joshua B. , Hashim Hashim T. , Islam Md. Saiful , Ismail Mustafa , Jiménez-Martínez Martha C. , Jurin Tanja , Kalina Ondrej , Klein Verena , Költő András , Lee Sang-Kyu , Lewczuk Karol , Lin Chung-Ying , Lochner Christine , López-Alvarado Silvia , Lukavská Kateřina , Mayta-Tristán Percy , Miller Dan J. , Orosová Oľga , Orosz Gábor ,   Sungkyunkwan University’s research team NA, Ponce Fernando P. , Quintana Gonzalo R. , Garzola Gabriel C. Quintero , Ramos-Diaz Jano , Rigaud Kévin , Rousseau Ann , De Tubino Scanavino Marco , Schulmeyer Marion K. , Sharan Pratap , Shibata Mami , Shoib Sheikh , Sigre-Leirós Vera , Sniewski Luke , Spasovski Ognen , Steibliene Vesta , Stein Dan J. , Ünsal Berk C. , Vaillancourt-Morel Marie-Pier , Van Hout Marie Claire , Bőthe Beáta 
Published: October 2024

Abstract
Introduction
The Arizona Sexual Experiences Scale (ASEX) is a brief questionnaire that evaluates five major aspects of sexual function: sex drive, arousal, erectile function/vaginal lubrication, ability to reach orgasm, and satisfaction with orgasm. An advantage of the ASEX is its simplicity and brevity (five items), making it suitable for the screening of sexual function problems in healthcare contexts and large-scale studies. The main objective of this study was to examine the psychometric properties of the ASEX in a multi-national sample, as well as to explore sexual function according to countries, genders, and sexual orientations.

Methods
The psychometric examination of the ASEX was conducted with a sample of 82,243 participants (women = 57.02%; men = 39.59%; gender-diverse = 3.38%; Mage = 32.39 years; SD = 12.52) from 42 different countries speaking 26 languages.

Results
The CFA supported a one-factor solution. Multigroup CFAs supported configural, metric, partial scalar, and residual invariance across countries, languages, genders, and sexual orientations. Furthermore, the ASEX showed good internal consistency (ω = .85) and convergent validity (e.g., significant negative associations with masturbation and sexual intercourse frequency). Finally, individuals in Eastern countries, women, and asexual participants reported higher levels of sexual function issues.

Conclusions and Policy Implications
The findings supported the use of the ASEX as a tool to screen for sexual function problems across diverse populations in multi-cultural settings. This scale may be used to improve our knowledge on the cross-cultural differences on the expression of sexual function, serving as the basis for the development of culturally tailored interventions for the improvement of this basic aspect of well-being.