Gender Bias Hypoactive Sexual Desire

Low sexual desire is the most common sexual complaint in women across the life cycle (Brotto, 2017). Across a variety of countries, it has been shown that at least a third of women experience low sexual desire for several months over the past year (Brotto, 2017; De Graaf & Wijsen, 2018). In men, low sexual desire has received less attention despite an estimated prevalence of 1-20% (Brotto, 2010; De Graaf & Wijsen, 2018)  going up to 37% in ageing men (Beutel et al., 2008). While hypoactive sexual desire in men is often presented with the primary complaint of erectile dysfunction, prevalences of  hypoactive sexual desire are presumably underestimated.

Despite evidence that men and women can become equally aroused in the same way and just as easily as demonstrated by a laboratory study (Laan & Everaerd, 1995), it has been suggested that, in general, men experience sexual desire more frequently and more intensely than women (Baumeister et al., 2001). However, this reflects common wisdom and whether or not gender differences are observed is influenced by measurement and report biases (Dawson & Chivers, 2014; Van Anders et al, 2022). Moreover, these supposed differences are largely driven by differences in sexual stimulation and the impact of gender stereotyping considering women’s sexual desire as being weak and difficult to achieve and men’s sexual desire as strong and spontaneous (Attwood et al., 2015; Graham et al., 2017). Men and women conform to these gender stereotypes, both in sexual practice and in reported needs. 

It has been shown that gender bias, one of the most common expressions of stereotyping, influences the clinical evaluation, estimated amenability to treatment and chosen treatment regarding diverse clinical conditions (e.g., Prunas et al., 2018; Norman, 2014). This topic has remained underexposed regarding sexual complaints. This is remarkable given that sexual dysfunctions are highly prevalent, affecting about 15-43% of women and 11-31% of men and given the evident gender stereotypes regarding sexual functioning (Rosen, 2000; Graaf, de & Wijsen, 2018). The effect of sexual stereotyping on pathologizing, explaining and treating low hypoactive sexual desire, has not been investigated yet. Accounting for  a potential gender bias in health care professionals assessing these sexual complaints, as a result of social categorization and stereotyping, men or women might be more at risk for adverse consequences of underestimating and not treating complaints of low sexual desire. To identify these risks in order to act on them if necessary, the present research will explore the role of stereotyping on pathologizing, explaining and treating hypoactive sexual desire as well as the expected effectiveness of sexological treatment once the patient is referred to a sexologist.  

The aim of this study is to investigate whether the social categorization process based on the patient’s gender (within this study only subdivided into cis-men and cis-women) affects the clinical evaluation, treatment of hyposexual sexual desire and estimated amenability to sexological care. More specifically, the main question is whether medical professionals’ judgement of hypoactive sexual desire being stereotypical for women is affected by the gender of the patient.  In addition, the gender of the medical professional judging the patient will be taken into consideration. 

Because explicit bias is less prevalent than implicit bias, which occurs unconscious and is not self-reported (Boyson, 2009), the impact of gender bias will be examines using a  vignette study. 

One main vignette will be composed based on a real case, heterosexual patient with complaints regarding hypoactive sexual desire. The vignettes will be judged by diverse sexological caregivers. Two versions will be constructed which only vary on a female name (and male name for the partner) or a male name (and female name for the partner). Each participant will judge one vignette based on randomization. After reading the case vignette, participants will be asked to fill in a survey with questions about the degree of pathologizing, treatment chosen and explanation model. 

This is a cross-sectional, observational study.

Not applicable

The study does not involve real patients. Medical professionals are the participants. Participation will take only one-time 15 minutes. Participants receive no compensation.