Body, emotions, and sexuality in the metaverse: A Randomized Control Trial Exploring the Use of Second Life for an Avatar-based Intervention to support women With Female Orgasmic Disorder

A randomized controlled trial was conducted for testing the efficacy of an avatar-based intervention for women with female orgasmic disorder (FOD). The trial was registered on ClinicalTrial.gov (trial identifier: NCT06187246). Participants were 31 women who were randomly assigned to an avatar-based intervention in Second Life, or control group based on minimum therapeutic contact. The avatar-based intervention was based on the CBT and ACT approaches, and it consisted of 12 weekly online individual sessions, and aimed at improving the FOD diagnosis, sexual satisfaction, function and initiative (primary outcomes), and sexual self-esteem, sex-guilt, and sexual anxiety (secondary outcomes). Participants were assessed at baseline, after treatment, and at 1- and 3-month follow-ups. Changes over time were analyzed using linear mixed models, considering treatment group, measurement time point, and group-by-time interactions as fixed effects. Effect sizes were computed (Cohen's d; number needed to treat; reliable change index). Participants in the avatar-based intervention showed a significant improvement in every primary and secondary outcome, while control group measurements did not change over time. The differences between the baseline and posttreatment and follow-up levels for all variables, and the differences between the intervention and control group, were statistically and clinically significant. 100% of the intervention participants and 0% of the control participants recovered after the treatment. The avatar-based intervention showed the potential to eliminate the FOD disorder criteria in both the short- and long-term. The preliminary results of this study suggest that women with FOD might benefit from an avatar-based intervention specifically designed to target the disorder.