Self-esteem and sexual health: a multilevel meta-analytic review

Sexual health reflects physical, emotional, mental, and social elements of sexual well-being. Researchers often position self-esteem (i.e., global or domain-specific evaluations of self) as a key correlate of sexual health. We present the first comprehensive meta-analysis of correlations between self-esteem and sexual health. Our synthesis includes 305 samples from 255 articles, containing 870 correlations from 191,161 unique participants. The overall correlation between self-esteem and sexual health was positive and small (r = .12, 95% CI: .09, .15), characterised by considerable heterogeneity and robust to different corrections. Sexual functioning (r = .27, 95% CI: .21, .34) was more strongly associated with self-esteem than were safe sex (r = .10, 95% CI: .07, .13) and sexual consent (r = .19, 95% CI: .13, .24), and sexual permissiveness was unassociated with self-esteem (r = -.02, 95% CI: -.05, .008). Most moderators were nonsignificant, although moderator data were inconsistently available, and samples were North American-centric. Evidence of publication bias was inconsistent, and study quality, theory usage, and background research were not reliably associated with study outcomes. Our synthesis suggests a need for more specific theories of self-esteem corresponding to unique domains of sexual, highlighting a need for future theorising and research.