Sexual wellbeing is continually being pushed to the margins of care for women, particularly those with migrant histories.
This is one of the key findings of a new qualitative study from Adelaide University researchers, published in the International Journal for Equity in Health.
“Previous research has found 40 to 50% of women experience at least one sexual health concern in their lifetime, yet only approximately 20% seek professional assistance,” lead author Negin Mirzaei Damabi said.
“Healthcare providers can also often hesitant to ask questions due to personal discomfort or insufficient training.
“These challenges are compounded for women with migration histories, who already face extra hurdles such as language barriers, cultural stigma, past trauma and difficulty accessing services.
“When their sexual health needs are overlooked, it adds to inequalities that already exist. Understanding why this happens is the first step towards fairer care.”
PhD candidate Damabi and team, from the University’s School of Public Health and Robinson Research Institute, interviewed 10 healthcare providers who delivered sexual and reproductive health to women with migrant histories in South Australia.
“We focused on sexual function, meaning things like desire, pleasure, satisfaction and comfort during sex, rather than only contraception or disease prevention,” Damabi said.
“Providers told us that conversations about sexual function rarely happen, because care tends to focus on contraception and reproduction instead.
“The same barriers came up again and again.
“Shame and stigma made it hard for both women and providers to start the conversation.
“Practical problems also got in the way, including women not being eligible for Medicare, the cost of care, and worries about privacy when interpreters came from the same small community.
“Providers also pointed to a lack of training and very limited access to culturally appropriate sexual therapy.”
Damabi said improvements are needed at two levels.
“Services need culturally sensitive sexual health information, support from well-trained interpreters, help navigating the health system, and Medicare-funded sexual therapy that suits women from different backgrounds,” Associate Professor Zohra Lassi said.
“Providers themselves need proper, mandatory training in culturally safe and trauma-informed care, backed by resources that are easy to find.
“These changes would help migrant and refugee women receive care that respects their whole health, including their sexual wellbeing.
“Sexual wellbeing is and should be considered a key part of overall health for all women, regardless of background.”