The Relationship Between Same-Sex Sexual Experience, Sexual Distress, and Female Sexual Dysfunction

INTRODUCTION: There is little research estimating the occurrence of female sexual dysfunction (FSD) in women with same-sex sexual experience and none incorporating a key feature of standardized DSM-IV diagnoses-sexual distress. AIM: To investigate the prevalence of FSD in women with and without same-sex sexual experience and whether any effects of same-sex sexual experience on women's sexual functioning are moderated by frequency and type of sexual activity. METHODS: The sample consisted of 5,998 female individuals aged 18-49 years. Prevalence of FSD was assessed by the Female Sexual Function Index and an abbreviated version of the Female Sexual Distress Scale. Measurement of frequency and variation in sexual activity was conducted using a modified version of the Derogatis Sexual Functioning Inventory. Lifetime same-sex experience was assessed with a single question. MAIN OUTCOME MEASURES: Prevalence estimates of FSD. Odds ratios (ORs) with 95% confidence intervals (CIs) for the subsample-specific, mediating role of frequency and mode of sexual activities on FSD. RESULTS: Women with same-sex sexual experience (13.6%) engaged significantly more in all sexual activities (P < 0.01) compared with women without such experience. They further reported significantly more desire (Z = 3.1, P < 0.05) and satisfaction problems (z = 10.6, P < 0.001). When controlling patterns of sexual activities no significant effect of same-sex sexual experience on desire could be detected (OR 1.1, CI 95% 0.9-1.2, P > 0.1), whereas the significant association between same-sex sexual experience and sexual dissatisfaction remained (OR 1.28, CI 95% 1.1-1.6, P < 0.05). Sexual distress was significantly more prevalent in women with same-sex sexual experience (23%) compared with their counterparts (19%). CONCLUSIONS: Same-sex sexual experience is related, both directly and indirectly, to FSD. Testing of the mediating factors underlying this association may offer important clues into the etiology of FSD in general. The results further highlight the need to consider sexual distress as a multidimensional concept.