(004) Examining the Experience of Sexual Dysfunction and Spiritual Abuse among cis-Gender Muslim Women In North America
Authors: Rahman S , Lamba A , Mohajir N , Ceesay H , Khayr Y , Akhtar-Khaleel W , Spitz G 
Published: May 2023

Abstract

Introduction
Unwanted sexual advances and sexual contact can lead to a lifetime of trauma. The NSVIS survey demonstrates that 43.6% of women (nearly 52.2 million) experienced some form of unwanted sexual contact sexual in their lifetime in the United States and 21.3% or an estimated 25.5 million women in the U.S. reported completed or attempted rape at some point in their lifetime (Smith et al., 2018). Additionally, prevalence rates for sexual pain for women in the U.S. vary and can be as high as 40% depending on the study. Muslim women are an underrepresented and underserved population in North America who often do not seek care for their sexual traumas and sexual difficulties. There are likely many factors involved and in order to better serve them with minimal bias, it is important for healthcare providers to understand their vast experiences in spiritual abuse and sexual dysfunction and reasons for not seeking care.

Objective
To understand the experiences of cis-gender Muslim women in North America with regards to sexual pain and spiritual trauma, along with looking at barriers to treatment and how to better serve this population.

Methods
A cross-sectional, IRB approved, online and anonymous survey was implemented in the United States and Canada for self-identified Muslim responders ages 18-45 in 2020. Survey was 151 questions that were based on validated survey instruments and implemented on Qualtrics. Snowball and purposive sampling was utilized to identify a total of 771 self-identified Muslims between the ages of 18-45. Participants were recruited via social media, listserv outreach, office visits and community partners. Demographics were assessed as well as religiosity, sexual function and dysfunction, sexual abuse and treatments. Descriptive statistics were utilized for analysis.

Results
The majority of respondents were heterosexual females, were part of the Sunni sect of Islam, had a bachelor’s degree or higher, and were of South Asian, Asian, Middle Eastern, or Arab ancestry. Aspects of sexual functioning such as the frequency of sexual desire, arousal during sexual intercourse, achievement of orgasm, and pain during or after vaginal penetration were assessed. Of the 158 respondents who reported having experienced sexual pain, 65.0% did not seek treatment for it. The main reasons included a sense of fear or shame, unawareness, disbelief that the situation would improve, and resolution of the pain on its own. 530 participants were asked if religion or spirituality have been used to: force them to make decisions they are opposed to (76.4%), force them to engage in a non-consensual sexual act (14.3%), isolate from others (57.9%), minimize the abuse they experienced (48.7%), or prevent them from speaking out against abuse (54.0%)

Conclusions
This data provides insight into a Muslim cohort’s frequency of sexual burdens which include dysfunction and abuse. Sexual abuse and sexual pain are common among cis-gender Muslim women in North America and it is underreported. Most of the patients who reported abuse and pain, did not seek treatment. Barriers to treatment may include cultural stigmas around sex, lack of cultural competence among providers, implicit bias, lack of awareness of it being a problem or there being solutions, and costs. Understanding how spiritual abuse can influence patients’ familial, romantic, and sexual relationships may help providers to administer culturally competent care to Muslim patients.

Disclosure
No