Female sexual dysfunction among foreign and Australian-born women: a cross-sectional study

Female sexual dysfunction (FSD) affects a substantial proportion of reproductive-aged women (15-49 years) globally, yet little is known about how migration shapes sexual function. This study compares and describes the patterns of FSD among foreign-born and Australian-born women residing in Australia.

This cross-sectional study recruited women through an online survey using a convenience sampling approach with equal recruitment targets for foreign-born and Australian-born women. FSD was assessed using the validated Female Sexual Function Index (FSFI), with dysfunction defined as a total score of 26.55 or below. Patterns of FSD were compared between groups and stratified by sociodemographic characteristics. Multivariable logistic regression was performed to compare FSD among overseas-born women with Australian born women, controlling for age, education, marital status, religion, area-level socioeconomic position, and gravidity.

A total of 678 women were included in the final analysis (342 Australian-born, 336 foreign-born). About 47.1% (95% CI: 41.7-52.5) Australian-born and 46.1% (95% CI: 40.7-51.6) foreign-born participants had FSD. Mean FSFI total scores were nearly identical (Australian-born: 26.35 ± 5.72, 95% CI: 25.74-26.95; foreign-born: 26.41 ± 5.69, 95% CI: 25.80-27.03; p = 0.876), with both groups falling just below the dysfunction threshold. Scores across all six FSFI domains were broadly comparable. There were substantial differences in the distribution of FSD cases by area-level socioeconomic status among Australian-born women, and by religious affiliation across the combined sample. After adjustment for sociodemographic confounders, overseas-born women had slightly lower odds of FSD compared with Australian-born women (aOR = 0.89, 95% CI: 0.62-1.28, p = 0.525), however the confidence interval included the null.

FSD affected 46.6% of survey participants overall. Future longitudinal research is needed to build a more complete understanding of sexual health equity across diverse populations.