Sobel Talia, Faubion Stephanie S, Vencill Jennifer A, Cole Kristin, Winham Stacey, Williams Courtney, Kling Juliana M
Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, AZ 85260, United States.
Mayo Clinic Center for Women's Health, Rochester, MN 55905, United States.
J Sex Med. 2025 Jan 9;22(2):317-323. doi: 10.1093/jsxmed/qdae173.
Sexual minority women (SMW) have worse mental and physical health outcomes compared to heterosexual women, but literature on sexual function in SMW compared to heterosexual women is lacking.
To evaluate sexual function and sexual distress in women across sexual orientations.
Questionnaire data were analyzed for women aged 18 and older who presented to women's health clinics at Mayo Clinic in Minnesota, Arizona, and Florida from 2016 to 2023. Female Sexual Function Index (FSFI) and Female Sexual Distress Scale-Revised (FSDS-R) scores assessed sexual dysfunction (FSFI ≤ 26.55 and FSDS-R ≥ 11). Multivariable logistic models adjusted for confounding factors.
Our main outcome was female sexual dysfunction as defined by a composite of FSFI ≤ 26.55 and FSDS-R ≥ 11 to include both sexual function and sexual distress.
Of 6241 sexually active women, 3% were SMW and 97% were heterosexual women. The majority were White (93%), with average age 51.6 years old. There was no significant difference in sexual dysfunction rates between heterosexual and SMW by combined endpoint on univariate or multivariable analysis. SMW had higher total FSDS scores (17 vs 15, P = 0.037), indicating more sexual distress.
Sexual health concerns may differ between SMW and heterosexual women emphasizing the need for inclusive, culturally competent care.
STRENGTHS & LIMITATIONS: This study assessed the association of sexual orientation and sexual dysfunction by incorporating sexual functioning problems and sexual distress. Limitations include a small number of SMW and a predominantly White, married, employed, and educated study sample, limiting the generalizability of the findings.
Rates of sexual dysfunction were similar between mostly White SMW and heterosexual women presenting to tertiary care centers. SMW reported more sexual distress than heterosexual women. Evaluating these variables in larger, more diverse cohorts is a critical next step.
与异性恋女性相比，性少数群体女性（SMW）的身心健康状况更差，但与异性恋女性相比，关于SMW性功能的文献却很匮乏。
评估不同性取向女性的性功能和性困扰。
对2016年至2023年在明尼苏达州、亚利桑那州和佛罗里达州梅奥诊所女性健康诊所就诊的18岁及以上女性的问卷数据进行分析。女性性功能指数（FSFI）和女性性困扰量表修订版（FSDS-R）得分用于评估性功能障碍（FSFI≤26.55且FSDS-R≥11）。多变量逻辑模型对混杂因素进行了调整。
在6241名性活跃女性中，3%为SMW，97%为异性恋女性。大多数为白人（93%），平均年龄51.6岁。在单变量或多变量分析中，按联合终点计算，异性恋和SMW之间的性功能障碍发生率无显著差异。SMW的FSDS总得分更高（17对15，P = 0.037），表明性困扰更多。
SMW和异性恋女性的性健康问题可能不同，这强调了提供包容性、具有文化胜任力护理的必要性。
本研究通过纳入性功能问题和性困扰来评估性取向与性功能障碍之间的关联。局限性包括SMW数量较少，以及研究样本主要为白人、已婚、就业且受过教育，限制了研究结果的普遍性。
在三级医疗中心就诊的以白人为主的SMW和异性恋女性之间，性功能障碍发生率相似。SMW报告的性困扰比异性恋女性更多。下一步关键是在更大、更多样化的队列中评估这些变量。
