(301) GENDER SENSITIVITY IN THE TREATMENT OF SEXUAL (DYS)FUNCTION: A CRITICAL REVIEW AND FUTURE DIRECTIONS
Authors: Zakhour S , Sardinha A , Egidio Nardi A 
Published: December 2024

Abstract

Introduction
To ensure effective and evidence-based care in sexual health, treatment must account for diverse gender identities and experiences. One-size-fits-all treatments fail to account for the diverse sociocultural determinants that influence sexual health outcomes. Today science recognizes the necessity of culturally sensitive treatments that consider sociocultural determinants such as ethnicity, religion, language, socioeconomic status and, critically, gender. Gender, as a key sociocultural determinant, significantly impacts the experience and treatment of sexual dysfunction, necessitating gender-sensitive approaches.

Objective
The aim of this study is to critically review literature on gender sensitivity in the treatment of sexual dysfunction, identify gaps, and propose recommendations for developing culturally and gender-sensitive clinical practices.

Methods
A systematic literature review of studies addressing gender differences in the treatment of sexual dysfunction was conducted. We combined and searched MeSH terms using databases including PubMed, Web of Science, Scielo and PsycINFO. We focused on treatment modalities, patient outcomes, sociocultural determinants, and gender-sensitivity in clinical practice.

Results
Significant gender disparities exist in the prevalence, diagnosis, and treatment of sexual dysfunctions. Men more frequently report erectile dysfunction, while women report higher rates of desire and arousal disorders. Transgender and non-binary individuals often face higher rates of sexual dysfunction due to minority stress and inadequate healthcare. Regarding treatment approaches and outcomes based on gender, men frequently receive pharmacological treatments, such as PDE5 inhibitors for erectile dysfunction, whereas women are often prescribed hormonal therapies or referred to psychosexual counseling for issues such as desire and arousal disorders. Transgender and non-binary individuals face unique challenges, including minority stress, provider bias, and inadequate healthcare access. Regarding therapy, psychological interventions for men may focus on performance anxiety, relationship issues, and psychological causes of erectile dysfunction while for women, therapy often addresses broader issues like body image, past trauma, emotional intimacy, and relationship dynamics, which can significantly impact desire and arousal. Also, when it comes to male sexual (dys)function, social stigma around discussing ED can lead to underreporting, but there is generally a higher public awareness and more direct marketing of treatments. While with women there is often less public awareness and more stigma surrounding female sexual dysfunction, leading to underdiagnosis and undertreatment. Sociocultural expectations around women’s sexual roles and behaviors also influence their experiences and treatment-seeking behaviors. Most treatment protocols reviewed lack customization based on gender-specific needs and broader sociocultural contexts.

Conclusions
This review highlights the critical need for integrating gender sensitivity into the treatment of sexual dysfunction. The significant gender disparities in prevalence, diagnosis, and treatment underscore the inadequacy of one-size-fits-all approaches. Our findings emphasize that treatment protocols must be customized to address the specific needs of different gender identities and consider broader sociocultural contexts. Culturally sensitive treatments that incorporate factors such as ethnicity, socioeconomic status, and gender are essential for improving patient outcomes. Future research should focus on developing and validating gender-sensitive treatment protocols and training healthcare providers to deliver inclusive and effective care. By addressing these gaps, sexual medicine can better serve diverse populations, ultimately promoting holistic sexual health and well-being.

Disclosure
No.