Sexual and gender minority persons’ perception of the Female Sexual Function Index Journal Article


Authors: Austria, M. D.; Lynch, K.; Le, T.; Walters, C. B.; Atkinson, T. M.; Vickers, A. J.; Carlsson, S. V.
Article Title: Sexual and gender minority persons’ perception of the Female Sexual Function Index
Abstract: Background: Patient-reported outcome instruments to assess sexual functioning typically assume that patients are heterosexual and have a single sexual partner, thus they may have limited applicability for sexual and gender minority (SGM) populations as well as for nonpartnered individuals or those with multiple partners. Aim: To explore the perceptions of SGM persons regarding the Female Sexual Function Index (FSFI), a commonly used sexual functioning questionnaire. Methods: We conducted 2 rounds of cognitive interviews with 27 SGM persons with and without a cancer diagnosis. Interviews were audio-recorded and transcribed. Two researchers independently coded the transcripts using inductive thematic analysis to identify major themes. Outcomes: Themes identified via qualitative analysis. Results: Cognitive debriefing with the participants provided critical insights about the way we ask questions about sexual functioning in the oncology clinic. Three overarching themes arose from the data: (i) Certain aspects of the questionnaire were felt to unnecessarily medicalize sexuality; (ii) FSFI domains were perceived to represent a narrow and heteronormative experience of sexuality focused on penile-vaginal intercourse; (iii) Questionnaire domains emphasizing sexual “performance” were perceived as male-oriented. Clinical implications: Questionnaires such as the FSFI that were developed in research studies with specific eligibility criteria need to be adapted to the broader population seen in clinical practice. Strengths & Limitations: Strengths of the study include purposive sampling of SGM persons through LGBTQ networks. Our sample included individuals of different sexual orientations, gender identities, marital status, and cancer histories. However, a limitation is that the the majority of the sample was white and college-educated. Other limitations of the study include the potential sampling bias of self-selected participants with a particular interest in the study questions. Conclusion: The findings provide important evidence for the development of a more inclusive sexual function measure, moving away from the traditional heteronormative, cisnormative approach to measuring sexual function. Austria MD, Lynch K, Le T, et al. Sexual and Gender Minority Persons’ Perception of the Female Sexual Function Index. J Sex Med 2021;18:2020–2027. © 2021 International Society for Sexual Medicine
Keywords: adult; human tissue; outcome assessment; cancer diagnosis; clinical practice; vagina; genetic transcription; questionnaire; austria; interview; patient-reported outcomes; marriage; sexual function; sexual intercourse; perception; qualitative analysis; thematic analysis; female sexual function index; heterosexuality; gender identity; patient-reported outcome; cancer; human; male; female; article; eligibility criteria; sampling bias; lgbtq; sexual and gender minority; lgbtqia+ people
Journal Title: Journal of Sexual Medicine
Volume: 18
Issue: 12
ISSN: 1743-6095
Publisher: Elsevier Inc.  
Date Published: 2021-12-01
Start Page: 2020
End Page: 2027
Language: English
DOI: 10.1016/j.jsxm.2021.09.012
PROVIDER: scopus
PMCID: PMC8642307
PUBMED: 34732309
DOI/URL:
Notes: Article -- Export Date: 3 January 2022 -- Source: Scopus
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MSK Authors
  1. Andrew J Vickers
    880 Vickers
  2. Thomas Michael Atkinson
    155 Atkinson
  3. Sigrid Viktoria Carlsson
    220 Carlsson
  4. Chasity Burrows Walters
    48 Walters
  5. Kathleen A Lynch
    71 Lynch
  6. Tiffany Le
    20 Le