Sexual minority women (SMW), including lesbian, bisexual, and queer women, often face more physical and mental health challenges than heterosexual women, such as higher rates of anxiety, depression, and PTSD. They are also less likely to have health insurance and may experience barriers to medical care.

While research has explored these health disparities, there is little data on how sexual function and satisfaction differ between SMW and heterosexual women. Past studies have found mixed results. Some suggest SMW may experience higher sexual satisfaction and fewer sexual pain issues, while others show no significant differences.

A recent study aimed to better understand sexual function and distress in SMW compared to heterosexual women. By examining women seeking care at specialized menopause and sexual health clinics at Mayo Clinic locations in Minnesota, Arizona, and Florida, researchers hoped to improve knowledge and guide more inclusive, informed healthcare practices.

Specifically, the researchers focused on sexually active women aged 18 and older who participated in the Data Registry on Experiences of Aging, Menopause, and Sexuality (DREAMS) between 2016 and 2023. Women who were not sexually active in the past four weeks or did not complete required questionnaires were excluded.

Participants completed various surveys assessing sexual function, distress, menopause symptoms, mental health, and quality of life. Sexual dysfunction and distress were measured using the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale-Revised (FSDS-R), respectively. A lower FSFI score indicated more dysfunction, while a higher FSDS-R score reflected more distress. The methods used in this study to compare SMW and heterosexual women accounted for differences in age, menopause status, mental health, hormone therapy use, and past experiences of abuse.

In the end, the study included 6,241 sexually active women and found differences in health and sexual well-being between SMW and heterosexual women. About 3% of the participants identified as SMW (lesbian or bisexual), and they were generally younger (45 vs. 52 years old). SMW reported higher rates of anxiety and depression and lower relationship satisfaction and quality of life than the heterosexual women.

Sexual functioning issues were common among all women, with 75% experiencing concerns. However, SMW reported higher levels of sexual distress (71% vs. 63%) and more sexual pain compared to heterosexual women. Despite these differences, there was no significant overall difference in sexual dysfunction between the two groups.

Overall, factors linked to a higher risk of FSD included being postmenopausal, having severe menopause symptoms, anxiety, or depression. On the other hand, women who were single, perimenopausal, or using hormone therapy had a lower risk.

The study also highlighted that sexual pain in SMW is understudied. Some research suggests that bisexual women may be more prone to pain than lesbian or heterosexual women, possibly due to higher rates of penetrative sex. Future research should explore sexual function in different SMW subgroups rather than treating them as one group.

The study had limitations, including a predominantly white, educated sample, possible selection bias, and reliance on self-reported data. Additionally, the survey tool used may not fully capture the experiences of SMW. Despite these limitations, the study underscores the importance of considering sexual distress, not just function, when assessing FSD. More diverse research is needed to improve culturally responsive care for SMW.

References:

• Sobel, T., Faubion, S. S., Vencill, J. A., Cole, K., Winham, S., Williams, C., & Kling, J. M. (2025). An examination of sexual function & distress among sexual minority & heterosexual women seeking care at menopause and sexual health specialty clinics. The Journal of Sexual Medicine, 22(2), 317–323. https://doi.org/10.1093/jsxmed/qdae173