Tag Archives: Sexuality

The sexual functions, activities, attitudes, and orientations of an individual. Sexuality, male or female, becomes evident at PUBERTY under the influence of gonadal steroids (TESTOSTERONE or ESTRADIOL), and social effects.

Married women’s negotiation for safer sexual intercourse in Kenya: Does experience of female genital mutilation matter?

Clinical Simulation in Nursing. 2017 Dec;14:79-84. doi: 10.1016/j.srhc.2017.09.003. Epub 2017 Sep 30.

Married women’s negotiation for safer sexual intercourse in Kenya: Does experience of female genital mutilation matter?

Chai X, Sano Y, Kansanga M, Baada J, Antabe R


OBJECTIVE: Married women’s ability to negotiate for safer sex is important for HIV prevention in sub-Saharan Africa, including Kenya. Yet, its relationship to female genital mutilation is rarely explored, although female genital mutilation has been described as a social norm and marker of womanhood that can control women’s sexuality. Drawing on the social normative influence theory, this study addressed this void in the literature. METHODS: We analysed data from the 2014 Kenya Demographic and Health Survey using logistic regression. Our sample included 8,602 married women. Two indicators of safer sex, namely the ability to refuse sex and the ability to ask for condom use, were explored. RESULTS: We found that women who had undergone genital mutilation were significantly less likely to report that they can refuse sex (OR=0.87; p<.05) and that they can ask for condom use during sexual intercourse (OR=0.62; p<.001) than their counterparts who had not undergone genital mutilation, while controlling for theoretically relevant variables. CONCLUSION: Our findings indicate that the experience of female genital mutilation may influence married women’s ability to negotiate for safer sex through gendered socialization and expectations. Based on these findings, several policy implications are suggested. For instance, culturally sensitive programmes are needed that target both married women who have undergone genital mutilation and their husbands to understand the importance of safer sexual practices within marriage.

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The ‘heat’ goes away: sexual disorders of married women with female genital mutilation/cutting in Kenya.

Reprod Health. 2017 Dec 2;14(1):164. doi: 10.1186/s12978-017-0433-z.FREE

The ‘heat’ goes away: sexual disorders of married women with female genital mutilation/cutting in Kenya.

Esho T, Kimani S, Nyamongo I, Kimani V, Muniu S, Kigondu C, Ndavi P, Guyo J


BACKGROUND: Female genital mutilation/cutting (FGM/C) has been implicated in sexual complications among women, although there is paucity of research evidence on sexual experiences among married women who have undergone this cultural practice. The aim of this study was to investigate the sexual experiences among married women in Mauche Ward, Nakuru County. METHODS: Quantitative and qualitative data collection methods were used. Quantitative data were obtained from 318 married women selected through multistage sampling. The women were categorized into: cut before marriage, cut after marriage and the uncut. A questionnaire was used to collect demographic information while psychometric data were obtained using a female sexual functioning index (FSFI) tool. The resulting quantitative data were analyzed using SPSS® Version 22. Qualitative data were obtained from five FGDs and two case narratives. The data were organized into themes, analyzed and interpreted. Ethical approval for the study was granted by Kenyatta National Hospital-University of Nairobi Ethics and Research Committee. RESULTS: The mean age of the respondents was 30.59 ± 7.36 years. The majority (74.2%) had primary education and 76.1% were farmers. Age (p = 0.008), number of  children (p = 0.035) and education (p = 0.038) were found to be associated with sexual functioning. The cut women reported lower sexual functioning compared to the uncut. ANOVA results show the reported overall sexual functioning to be significantly (p = 0.019) different across the three groups. Women cut after marriage (mean = 22.81 ± 4.87) scored significantly lower (p = 0.056) than the uncut (mean = 25.35 ± 3.56). However, in comparison to the cut before marriage there was no significant difference (mean = 23.99 ± 6.63). Among the sexual functioning domains, lubrication (p = 0.008), orgasm (p = 0.019) and satisfaction (p = 0.042) were significantly different across the three groups. However, desire, arousal and pain were not statistically different. CONCLUSION: Generally, cut women had negative sexual experiences and specifically adverse changes in desire, arousal and satisfaction were experienced among cut after marriage. FGM/C mitigating strategies need to routinely provide sexual complications management to safeguard women’s sexual right to pleasure subsequently improving their general well-being.

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Sexual Function, Mental Well-being and Quality of Life among Kurdish Circumcised Women in Iran.

FREEIran J Public Health. 2017 Sep;46(9):1265-1274.

Sexual Function, Mental Well-being and Quality of Life among Kurdish Circumcised Women in Iran.

Daneshkhah F, Allahverdipour H, Jahangiri L, Andreeva T


BACKGROUND: Female genital mutilation is an intentional inhumane procedure that threatens girls and women’s health. It is especially widespread in developing countries due to cultural, traditional and religious preferences. The aim of the current study was to investigate how circumcision affects women’s sexual function. METHODS: This cross-sectional study was conducted in the urban and rural area of Piranshahr County, Iran, in 2015 among convenience samples of 200 women, 15-49 yr old, who were applying to health care centers for receiving routine health care services. Data collection was conducted with the use of a self-administered written questionnaire to assess female sexual function, mental well-being, and quality of life. RESULTS: Significant differences were found between circumcised and non-circumcised women in total score of female sexual function index (FSFI) in domains of desire, arousal, vaginal moisture, orgasm, satisfaction, and pain [(P<0.001), MD(95%CI)=5.64(3.64 to 7.64)] and based on Hotelling’s T-square, significant differences were found in dimensions of quality of life and FSFI. CONCLUSION: The revealed sexual dysfunction among mutilated women gives ground to require that public health systems take actions aimed at implementing special sexual education program to improve sexual functions of mutilated women and changing beliefs and social norms in the community level.

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Virility, pleasure and female genital mutilation/cutting. A qualitative study of perceptions and experiences of medicalized defibulation among Somali and Sudanese migrants in Norway.

FREEReprod Health. 2017 Feb 10;14(1):25. doi: 10.1186/s12978-017-0287-4.

Virility, pleasure and female genital mutilation/cutting. A qualitative study of perceptions and experiences of medicalized defibulation among Somali and Sudanese migrants in Norway. 

Johansen RE.


BACKGROUND: The most pervasive form of female genital mutilation/cutting-infibulation-involves the almost complete closure of the vaginal orifice by cutting and closing the labia to create a skin seal. A small opening remains for the passage of urine and menstrual blood. This physical closure has to be re-opened-defibulated-later in life. When they marry, a partial opening is made to enable sexual intercourse. The husband commonly uses his penis to create this opening. In some settings, a circumciser or traditional midwife opens the infibulated scar with a knife or razor blade. Later, during childbirth, a further opening is necessary to make room for the child’s passage. In Norway, public health services provide surgical defibulation, which is less risky and painful than traditional forms of defibulation. This paper explores the perceptions and experiences of surgical defibulation among migrants in Norway and investigates whether surgical defibulation is an accepted medicalization of a traditional procedure or instead challenges the cultural underpinnings of infibulation. METHODS: Data derived from in-depth interviews with 36 women and men of Somali and Sudanese origin and with 30 service providers, as well as participant observations in various settings from 2014-15, were thematically analyzed. RESULTS: The study findings indicate that, despite negative attitudes towards infibulation, its cultural meaning in relation to virility and sexual pleasure constitutes a barrier to the acceptance of medicalized defibulation. CONCLUSIONS: As sexual concerns regarding virility and male sexual pleasure constitute a barrier to the uptake of medicalized defibulation, health care providers need to address sexual concerns when discussing treatment for complications in infibulated women. Furthermore, campaigns and counselling against this practice also need to tackle these sexual concerns.

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Sexual Anatomy and Function in Women With and Without Genital Mutilation: A Cross-Sectional Study

The Journal of Sexual Medicine, 2016;13 (2):226–237

Sexual Anatomy and Function in Women With and Without Genital Mutilation: A Cross-Sectional Study

Abdulcadir J, Botsikas D, Bolmont M Bilancioni A, Djema DA, Demicheli FB, Yaron M, Petignat P


Introduction: Female genital mutilation (FGM), the partial or total removal of the external genitalia for non-medical reasons, can affect female sexuality. However, only few studies are available, and these have significant methodologic limitations. Aim: To understand the impact of FGM on the anatomy of the clitoris and bulbs using magnetic resonance imaging and on sexuality using psychometric instruments and to study whether differences in anatomy after FGM correlate with differences in sexual function, desire, and body image. Methods: A cross-sectional study on sexual function and sexual anatomy was performed in women with and without FGM. Fifteen women with FGM involving cutting of the clitoris and 15 uncut women as a control group matched by age and parity were prospectively recruited. Participants underwent pelvic magnetic resonance imaging with vaginal opacification by ultrasound gel and completed validated questionnaires on desire (Sexual Desire Inventory), body image (Questionnaire d’Image Corporelle [Body Image Satisfaction Scale]), and sexual function (Female Sexual Function Index). Main Outcome Measures: Primary outcomes were clitoral and bulbar measurements on magnetic resonance images. Secondary outcomes were sexual function, desire, and body image scores. Results: Women with FGM did not have significantly decreased clitoral glans width and body length but did have significantly smaller volume of the clitoris plus bulbs. They scored significantly lower on sexual function and desire than women without FGM. They did not score lower on Female Sexual Function Index sub-scores for orgasm, desire, and satisfaction and on the Questionnaire d’Image Corporelle but did report significantly more dyspareunia. A larger total volume of clitoris and bulbs did not correlate with higher Female Sexual Function Index and Sexual Desire Inventory scores in women with FGM compared with uncut women who had larger total volume that correlated with higher scores. Conclusion: Women with FGM have sexual erectile tissues for sexual arousal, orgasm, and pleasure. Women with sexual dysfunction should be appropriately counseled and treated.

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The relation of female circumcision to sexual behavior in Kenya and Nigeria

Women Health. 2016 Jun 29:1-18. [Epub ahead of print]

The relation of female circumcision to sexual behavior in Kenya and Nigeria.

Mpofu S, Odimegwu C, De Wet N, Adedini S, Akinyemi J


One of the reasons for the perpetuation of female circumcision is that it controls female sexuality. In this study, the authors examined the relationship between female circumcision and the sexual behavior of women in Kenya and Nigeria. Data on women who were aware of circumcision and were circumcised were extracted from the Kenya Demographic and Health Survey of 2008-09 as well as the Nigeria Demographic and Health Survey of 2008. The sample size was 7,344 for Kenya and 16,294 for Nigeria. The outcome variables were age at first intercourse and total lifetime number of sexual partners. The study hypothesis was that women who were circumcised were less likely to have initiated sex early and to have only one sex partner. Cox proportional hazards regression and Poisson regression were used to examine the relations of female circumcision and other selected variables to sexual behavior. No association was observed between female circumcision and the outcomes for sexual behavior of women in Kenya and Nigeria. The argument of sexual chastity is insufficient to sustain the perpetuation of female circumcision.

This article can be accessed in this LINK

Effect of female genital mutilation/cutting on sexual functions.

Sex Reprod Healthc. 2016 Dec;10:3-8. doi: 10.1016/j.srhc.2016.07.002. Epub 2016 Jul 28.

Effect of female genital mutilation/cutting on sexual functions.

Biglu MH, Farnam A, Abotalebi P, Biglu S, Ghavami M


BACKGROUND: Female Genital Mutilation/Cutting (FGM/C) or female circumcision is the procedure of eliminating some or all parts of the external female genitalia. FGM/C is carried out by traditional circumcisers. They usually use cutting tools like a blade or straight-razor. Although FGM/C is well described in the African continent and some Arabic countries, data from Iran are scarce.

OBJECTIVES: The major objective of this current study was to investigate the effects of FGM/C on the female sexual function of married women compared to the non-circumcised women in the Kurdistan province of Iran.

METHODS: A case-control study was conducted in a sample of 280 married women (140 circumcised-women and 140 non-circumcised-women) who referred to the healthcare centers for vaccination, midwifery, or family planning services. Participants were requested to complete the Persian-translated version of the Female Sexual Function Index.

MAIN OUTCOME MEASURES: The total score of the FSFI and its individual domains.

RESULTS: Of the circumcised women, 51.4% reported circumcision procedures before the age of 3 years. Religion motivation (53.6%) was mentioned as the most important factor for the family leading to FGM/C. Almost all operations were performed by traditional circumcisers. Non-circumcised women had significantly higher Persian-FSFI total score (25.3 ± 4.34) compared to the circumcised women (17.9 ± 5.39).

CONCLUSION: Sexual function in women with FGM/C is adversely altered. In Kurdistan province women, FGM/C is associated with reduction of scores of Persian-FSFI on all domain scores. Education in general and informing the people that FGM/C is not a religious Hadith certainly would have a great impact on the suffering of the women from FGM/C as well as the level of “desire, arousal, lubrication, orgasm, satisfaction, and pain in the sexual function of women”.

This article can be accessed in this LINK

Female genital mutilation: Cultural and psychological implications

Sexual and Marital Therapy. 2002, 17(2):161-170.

Female genital mutilation: cultural and psychological implications.

Whitehorn J, Ayonrinde O & Maingay S


Female genital mutilation (FGM) is widely practised in several regions of the world. It is often associated with physical, psychological, sexual and social sequelae. Migration of persons from cultures that actively practice FGM to the UK and other Western countries increases the chances that clinicians will be faced with patients who have undergone this procedure. Clinical presentations often occur against a background of differences in culture and social identity, which may pose a challenge to any form of intervention. Perceptions of normalcy, human rights violation and gender roles may also differ. This paper discusses historical, cultural, gender and identity issues associated with FGM and its psychological and sexual implications.

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Female genital mutilation: Consequences for reproductive and sexual health

Sexual and Marital Therapy. 1995, 10(2):189-200.

Female genital mutilation: consequences for reproductive and sexual health

McCaffrey, M


World-wide, female genital mutilation affects more than 80 million women and it is estimated that at least two million girls are mutilated each year. This paper describes the types of female genital mutilation performed and their effects on women’s physical and psychological health. Individual case histories are cited to illustrate these effects. A model of medical care, as provided at Northwick Park Hospital, Harrow in response to a growing problem, is outlined.

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(Im)perishable Pleasure, (In)destructible Desire: Sexual Themes in U.S. and English News Coverage of Male Circumcision and Female Genital Cutting.

J Sex Res. 2014 Sep 25:1-16. [Epub ahead of print]

(Im)perishable Pleasure, (In)destructible Desire: Sexual Themes in U.S. and English News Coverage of Male Circumcision and Female Genital Cutting.

Carpenter LM, Kettrey HH.


Under what conditions do sexual pleasure and desire get addressed in news coverage of sexual health issues like female genital cutting (FGC) and male circumcision (MC)? In this study we employed an embodied ethnosexuality approach to analyze sexual themes in 1,902 items published from 1985 to 2009 in 13 U.S. and 8 English newspapers and news magazines. Journalists’ discussions of sexual pleasure, desire, control, problems, and practices differed in quantity and quality depending on the practice and nation to which they pertained. News coverage in both nations presented FGC as impeding female sexual pleasure, desire, and activity in ways that reinforce (hetero)sexist understandings of sexuality. The English press depicted MC as diminishing male sexuality, whereas U.S. papers showed it as enhancing male sexuality. These patterns are influenced by, and serve to reinforce, cultural norms of embodiment and ethnosexual boundaries based on gender, race, and nationality. They may, in turn, shape public understandings of FGC and MC as social problems.

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