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Introduction <p>Women’s health care often focuses on reproductive issues, and heteronormative assumptions add challenges for sexual minority women. This study compared heterosexual and sexual minority women regarding sexual function and pelvic floor knowledge, alongside sociodemographic and health care characteristics.</p> Methods <p>This cross-sectional survey was administered March to December 2025 to Brazilian women aged 18 to 40 identifying as heterosexual or sexual minority. Chi-square tests examined group differences; binary logistic regression identified predictors of both outcomes.</p> Results <p>A total of 703 women participated (317 sexual minority, 386 heterosexual). Age differed significantly between groups; BMI, education, and income were similar. Sexual minority women had higher chronic disease prevalence (30.6% vs. 17.9%), lower comfort during gynecological visits (42.3% vs. 67.1%), more prejudice experiences (23.0% vs. 6.5%), lower use of protective barriers (4.1% vs. 27.2%; all <i>p</i> &lt; 0.001), and fewer recent visits (70.0% vs. 75.4%, <i>p</i> = 0.021). No significant differences were found in pelvic floor knowledge or sexual function. Sexual orientation did not predict either outcome; younger age (OR = 0.44–0.49) and low physical activity (OR = 1.58) predicted sexual dysfunction, while younger age (OR = 0.46) predicted low pelvic floor knowledge (all <i>p</i> &lt; 0.05).</p> Conclusions <p>Both groups showed high distress and low pelvic floor knowledge. Sexual orientation did not predict either outcome, suggesting disparities reflect care delivery, not socioeconomic factors.</p> Policy Implications <p>Professional training should address heteronormative assumptions, and pelvic floor education added to school curricula and primary care.</p>

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Sexual Orientation as a Health Determinant: Care Access, Pelvic Floor Knowledge, and Sexual Function Among Brazilian Women

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月5日

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  • Isabela Felix Alencar de Sousa,
  • Maria Fernanda Ribeiro Corrales,
  • Rafaella Carvalho da Silva

摘要

Introduction

Women’s health care often focuses on reproductive issues, and heteronormative assumptions add challenges for sexual minority women. This study compared heterosexual and sexual minority women regarding sexual function and pelvic floor knowledge, alongside sociodemographic and health care characteristics.

Methods

This cross-sectional survey was administered March to December 2025 to Brazilian women aged 18 to 40 identifying as heterosexual or sexual minority. Chi-square tests examined group differences; binary logistic regression identified predictors of both outcomes.

Results

A total of 703 women participated (317 sexual minority, 386 heterosexual). Age differed significantly between groups; BMI, education, and income were similar. Sexual minority women had higher chronic disease prevalence (30.6% vs. 17.9%), lower comfort during gynecological visits (42.3% vs. 67.1%), more prejudice experiences (23.0% vs. 6.5%), lower use of protective barriers (4.1% vs. 27.2%; all p < 0.001), and fewer recent visits (70.0% vs. 75.4%, p = 0.021). No significant differences were found in pelvic floor knowledge or sexual function. Sexual orientation did not predict either outcome; younger age (OR = 0.44–0.49) and low physical activity (OR = 1.58) predicted sexual dysfunction, while younger age (OR = 0.46) predicted low pelvic floor knowledge (all p < 0.05).

Conclusions

Both groups showed high distress and low pelvic floor knowledge. Sexual orientation did not predict either outcome, suggesting disparities reflect care delivery, not socioeconomic factors.

Policy Implications

Professional training should address heteronormative assumptions, and pelvic floor education added to school curricula and primary care.