Sexual Dysfunction Across Cultures

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Abstract
Sexual behaviour is particularly open to cultural and social influences. Culture affects sexual behaviour, attitudes and expectations. This paper discusses the available data on the presentation of sexual problems in different cultures, and considers the question of their clinical assessment and management. It also reflects on the applications of Western sex therapy in other cultural settings. Various ‘culture-bound' sexual syndromes that have been described in the literature are briefly discussed. The implications of these syndromes for the management of sexual dysfunction in various cultural settings are highlighted. A strongly held set of beliefs within the culture causes the vulnerable individual to develop concerns about sexual performance, thereby leading to anxiety which may then act as a mediator for the genesis and perpetuation of problems. The role of women, and the social expectations that are related to such roles, may also contribute to sexual dysfunction. Clinicians need to be flexible in their approach and demonstrate ingenuity in assessing and managing cases where sexual dysfunction is the presenting complaint.