(012) THE IMPACT OF SEXUAL ORIENTATION ON THE EXPERIENCE OF ENDOMETRIOSIS
Authors: O'Donnell S , Abarbanell L 
Published: June 2024

Abstract

Introduction
Endometriosis affects an estimated one in ten people assigned female at birth (AFABs) worldwide (WHO, 2021), yet it remains understudied. In particular, there is a lack of literature on the impact of endometriosis on marginalized groups, including those with underrepresented sexual orientations (USOs). In the present study, I examine the impact of identifying with a USO on the experience of living with endometriosis. Endometriosis is a chronic disease characterized by tissue similar to the lining of the uterus growing outside of the uterus. Symptoms can include severe pelvic pain especially during menstruation, pain with intercourse and bowel movements/urination, nausea, fatigue, and infertility, and can have a profound effect on quality of life (Gao et al., 2006). There is presently no cure, with surgical excision being the gold standard for treatment; however, this is costly, often ineffective for long-term relief, and largely inaccessible (WHO, 2021). Although endometriosis is not classified as a sexual health disorder, it can have an enormous impact on sufferers' sexual function, including, but not limited to, painful sex, desire/libido, and satisfaction (Yang et al., 2021). There is limited research on the impact of identifying with a USO on the experience of living with endometriosis. A review of the literature found only one study that mentioned sexual orientation, in which one participant mentioned that it was easier to cope with the pain “because vaginal penetration was not essential to her sexual relationship” (Wahl et al., 2021).

Objective
The goal of the present study was to determine how identifying with a USO affects AFABs’ experience of living with endometriosis.

Methods
150 AFAB participants between the ages of 20-50 years old (M = 31.93, SD: 6.75) who had been surgically diagnosed with endometriosis completed a Qualtrics survey. Participants reported their sexual orientation using the following categories: asexual, bisexual, gay, lesbian, pansexual, queer, heterosexual, and other. Due to the small number identifying as USOs (N = 31), participants were coded as either USO or heterosexual for analysis. The impact of endometriosis was measured using the Endometriosis Impact Questionnaire (EIQ, Moradi et al., 2019), which consists of six subscales assessing its impact on different aspects of participants’ lives.

Results
An independent-samples t-test revealed that participants who reported identifying with a USO had higher EIQ impact scores on the physical, psychological, and social subscales than heterosexual participants (all p’s &lt; .008). However, the effect of endometriosis on participants’ fertility appeared to have a lower impact for USO than for heterosexual participants (p = .008). Additionally, it took longer for USOs to be diagnosed (M = 12.58 years) than for heterosexual participants (M = 7.62, p = .002).

Conclusions
These results suggest practitioners and health educators need to consider the sexual orientation of patients with endometriosis. These results also make a valuable contribution to the psychological, public health, and women’s sexual health literatures that will help practitioners better understand, interact with, and treat patients who identify with a USO.

Disclosure
No.