title: Ethical and Sociocultural Aspects of Sexual Function and Dysfunction in Both Sexes.
abstract: OBJECTIVE
  This study aimed to highlight the salient sociocultural factors contributing to sexual health and dysfunction and to offer recommendations for culturally sensitive clinical management and research as well for an ethically sound sexual health care, counseling and medical decision-making.
  
  
  BACKGROUND
  There are limited data on the impact of sociocultural factors on male and female sexual function as well as on ethical principles to follow when clinical care falls outside of traditional realms of medically indicated interventions.
  
  
  METHODS
  This study reviewed the current literature on sociocultural and ethical considerations with regard to male and female sexual dysfunction as well as cultural and cosmetic female and male genital modification procedures.
  
  
  RESULTS
  It is recommended that clinicians evaluate their patients and their partners in the context of culture and assess distressing sexual symptoms regardless of whether they are a recognized dysfunction. Both clinicians and researchers should develop culturally sensitive assessment skills and instruments. There are a number of practices with complex ethical issues (eg, female genital cutting, female and male cosmetic genital surgery). Future International Committee of Sexual Medicine meetings should seek to develop guidelines and associated recommendations for a separate, broader chapter on ethics.
authors.affiliation: Clinique du Levant, Beirut, Lebanon.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Atallah
authors.affiliation: Obstetrics & Gynecology, Maricopa Integrated Health System, Phoenix, Arizona, USA.
authors.forename: Crista
authors.initials: C
authors.lastname: Johnson-Agbakwu
authors.affiliation: Haziporen 10bet, Beit Shemesh, Israel.
authors.forename: Talli
authors.initials: T
authors.lastname: Rosenbaum
authors.affiliation: Psychiatry, Medical School, University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Carmita
authors.initials: C
authors.lastname: Abdo
authors.affiliation: Department of Psychology, University of New Brunswick, Fredericton, New Brunswick, Canada.
authors.forename: E Sandra
authors.initials: ES
authors.lastname: Byers
authors.affiliation: Psychology, University of Southampton, Southampton, United Kingdom.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Graham
authors.affiliation: Faculty of Psychology and Educational Sciences, Center for Reseach in Psychology (CPUP), Porto University, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Nobre
authors.affiliation: Sexual Medicine, Porterbrook Clinic, Sheffield, United Kingdom.
authors.forename: Kevan
authors.initials: K
authors.lastname: Wylie
authors.affiliation: Obstetrics/Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Lori
authors.initials: L
authors.lastname: Brotto
mesh_terms: D000328:Adult; D019093:Circumcision, Female / Q000941:ethics* / Q000523:psychology; D000066491:Clinical Decision-Making / Q000941:ethics*; D054521:Cultural Competency; D018864:Cultural Diversity; D003695:Delivery of Health Care; D037001:Directive Counseling / Q000941:ethics*; D004992:Ethics, Medical; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D010819:Physician's Role; D010817:Physician-Patient Relations; D012067:Religion; D012725:Sexual Behavior / Q000941:ethics / Q000208:ethnology*; D012735:Sexual Dysfunction, Physiological / Q000208:ethnology / Q000628:therapy*; D020018:Sexual Dysfunctions, Psychological / Q000208:ethnology / Q000628:therapy*
keywords: Cultural Sensitivity; Culture; Ethics; Religious Beliefs; Sexual Dysfunction; Sociocultural