{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T12:10:58Z","timestamp":1785413458891,"version":"3.56.0"},"reference-count":107,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100018822","name":"Western Sydney University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100018822","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/03t52dk35","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Healthcare"],"abstract":"<jats:p>Background\/Objectives: Current research on vaginismus predominantly represents White cisgendered and heterosexual women of reproductive age. It is unclear how health professionals (HPs) navigate and support the needs of patients with vaginismus who are gender, sexually, ethnically, religiously, age and\/or disability diverse. Therefore, this qualitative study explored health professionals\u2019 experiences and perceptions of patient diversity to holistically assess and support people with vaginismus. Methods: In 2023\u20132024, 23 HPs in general practice, uro\/gynaecology, pelvic floor physiotherapy, mental health, nursing and clinical education participated in semi-structured interviews. Data were inductively thematically analysed with a critical feminist poststructuralist focus on heteronormativity, cisnormativity, ethnocentricity, chrononormativity, and able-bodied normativity. Results: Two themes were developed. The first theme on \u2018uneven attention of diversity dimensions in the assessment and support of vaginismus\u2019 explored patients\u2019 ethnicity, religion, sexuality, gender, age and disability. The second theme on \u2018sexually and gender-diverse people\u2019s varied treatment goals for vaginismus\u2019 examined nuanced challenges between heterosexual and non-heterosexual women and limited representation of gender-diverse people. Conclusions: The findings suggest that not discussing patients\u2019 diversity may contribute to their identity erasure and ethnocentric exaltation of White centrality. Treatment approaches may uphold heteronormativity. HPs often described vaginismus as a young woman\u2019s problem. It is recommended that HPs review whether patients with advancing age and\/or disability suppress desires for pain-free sex due to societal norms. Decolonising approaches and abject theory could inform the development of inclusive health resources. This can assist HPs to sensitively and supportively assess patients\u2019 diversity to improve their holistic health and well-being outcomes for vaginismus.<\/jats:p>","DOI":"10.3390\/healthcare14101261","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T12:15:07Z","timestamp":1778156107000},"page":"1261","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Health Professionals\u2019 Approaches to Support Patient Diversity in the Assessment of Vaginismus: A Critical Feminist Qualitative Study for Inclusive Care"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7499-9393","authenticated-orcid":false,"given":"Rashmi","family":"Pithavadian","sequence":"first","affiliation":[{"name":"School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW 2750, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7116-7068","authenticated-orcid":false,"given":"Vijayasarathi","family":"Ramanathan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine & Health, University of Sydney, 3 Parramatta Rd, Camperdown, NSW 2050, Australia"},{"name":"Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2750, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5351-2697","authenticated-orcid":false,"given":"Sowbhagya","family":"Micheal","sequence":"additional","affiliation":[{"name":"Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2750, Australia"},{"name":"School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2750, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5758-7525","authenticated-orcid":false,"given":"Tinashe","family":"Dune","sequence":"additional","affiliation":[{"name":"Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2750, Australia"},{"name":"Faculty of Health, Charles Darwin University, Ellengowan Drive, Darwin, NT 0909, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"key":"ref_1","first-page":"17455057231199383","article-title":"The experiences of women seeking help for vaginismus and its impact on their sense of self: An integrative review","volume":"19","author":"Pithavadian","year":"2023","journal-title":"Womens Health"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1097\/01.ogx.0000464926.75285.1c","article-title":"Understanding and Treating Vaginismus: A Multimodal Approach","volume":"70","author":"Pacik","year":"2015","journal-title":"Obstet. Gynecol. Surv."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1080\/14681994.2021.2007233","article-title":"Understanding vaginismus: A biopsychosocial perspective","volume":"39","author":"McEvoy","year":"2021","journal-title":"Sex. Relatsh. Ther."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.esxm.2019.07.006","article-title":"Case Series: Redefining Severe Grade 5 Vaginismus","volume":"7","author":"Pacik","year":"2019","journal-title":"Sex. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"100480","DOI":"10.1016\/j.ssmqr.2024.100480","article-title":"People discuss the men who can\u2019t get it up, but what about the women who can\u2019t get it in? Women\u2019s help-seeking experiences for sexual pain-penetration disorder","volume":"6","author":"Pithavadian","year":"2024","journal-title":"SSM\u2014Qual. Res. Health"},{"key":"ref_6","first-page":"100965","article-title":"Sexual self-concept and intimacy in context of vaginismus: A case\u2013control study","volume":"51","author":"Banaei","year":"2024","journal-title":"Clin. E Investig. En. Ginecol. Y Obstet."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2396134","DOI":"10.1080\/21642850.2024.2396134","article-title":"The interrelationship between women\u2019s help-seeking experiences for vaginismus and their sense of self: A qualitative study and abductive analysis","volume":"12","author":"Pithavadian","year":"2024","journal-title":"Health Psychol. Behav. Med."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Loue, S.J.D., and Sajatovic, M. (2008). Vaginismus. Encyclopedia of Aging and Public Health, Springer.","DOI":"10.1007\/978-0-387-33754-8"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1080\/13691058.2020.1718759","article-title":"Epistles of dyspareunia: Storying christian women\u2019s experiences of painful sex","volume":"23","author":"Azim","year":"2020","journal-title":"Cult. Health Sex."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1177\/10497323221110091","article-title":"\u201cWhy Would I Talk To Them About Sex?\u201d: Exploring Patient-Provider Communication Among Black Women Experiencing Sexual Pain","volume":"32","author":"Thorpe","year":"2022","journal-title":"Qual. Health Res."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Adams, O.R., Gesselman, A.N., and Bennett-Brown, M. (2024). Centering Women of Color: Chronic Vulvovaginal Pain (CVVP) Communication. Soc. Sci., 13.","DOI":"10.3390\/socsci13050265"},{"key":"ref_12","first-page":"1","article-title":"Family, religion, and sex education among women with vaginismus: A qualitative study","volume":"23","author":"Silva","year":"2021","journal-title":"Psicol.\u2014Teor. E Pr\u00e1tica"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.2307\/1229039","article-title":"Mapping the Margins: Intersectionality, Identity Politics, and Violence against Women of Color","volume":"43","author":"Crenshaw","year":"1991","journal-title":"Stanf. Law Rev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.2105\/AJPH.2012.300750","article-title":"The Problem With the Phrase Women and Minorities: Intersectionality\u2014An Important Theoretical Framework for Public Health","volume":"102","author":"Bowleg","year":"2012","journal-title":"Am. J. Public Health"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1080\/00207411.2025.2526215","article-title":"Intersectionality and healthcare experience for people diagnosed with mental illness\u2014A scoping review","volume":"54","author":"Butler","year":"2025","journal-title":"Int. J. Ment. Health"},{"key":"ref_16","first-page":"49","article-title":"Sex Inequalities in Medical Research: A Systematic Scoping Review of the Literature","volume":"3","author":"Merone","year":"2022","journal-title":"Womens Health Rep."},{"key":"ref_17","first-page":"1016","article-title":"\u201cI Just Want to Feel Safe Going to a Doctor\u201d: Experiences of Female Patients with Chronic Conditions in Australia","volume":"3","author":"Merone","year":"2022","journal-title":"Womens Health Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1007\/s10508-018-1246-z","article-title":"Women\u2019s Experiences of Vulvodynia: An Interpretative Phenomenological Analysis of the Journey Toward Diagnosis","volume":"48","author":"Shallcross","year":"2019","journal-title":"Arch. Sex. Behav."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Pithavadian, R., Dune, T., and Chalmers, J. (2024). Patients\u2019 recommendations to improve help-seeking for vaginismus: A qualitative study. BMC Womens Health, 24.","DOI":"10.1186\/s12905-024-03026-x"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1080\/14443058.2020.1796754","article-title":"White Medicine, White Ethics: On the Historical Formation of Racism in Australian Healthcare","volume":"44","author":"Mayes","year":"2020","journal-title":"J. Aust. Stud."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Ramalepe, L.M., and Maake, T.B. (2025). A Scoping Review of Heteronormativity in Healthcare and Its Implications on the Health and Well-Being of LGBTIQ+ Persons in Africa. Int. J. Environ. Res. Public Health, 22.","DOI":"10.3390\/ijerph22050717"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1016\/j.whi.2021.06.004","article-title":"\u201cThe Health System Just Wasn\u2019t Built for Us\u201d: Queer Cisgender Women and Gender Expansive Individuals\u2019 Strategies for Navigating Reproductive Health Care","volume":"31","author":"Carpenter","year":"2021","journal-title":"Womens Health Issues"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Ayalon, L., and Tesch-R\u00f6mer, C. (2018). Ageism in the Health Care System: Providers, Patients, and Systems. Contemporary Perspectives on Ageism, Springer International Publishing.","DOI":"10.1007\/978-3-319-73820-8"},{"key":"ref_24","first-page":"100650","article-title":"Structural ableism in public health and healthcare: A definition and conceptual framework","volume":"30","author":"Lundberg","year":"2024","journal-title":"Lancet Reg. Heal."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-5, American Psychiatric Association. [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"80","DOI":"10.4274\/balkanmedj.galenos.2023.2022-9-62","article-title":"Vaginismus: Diagnostic Challenges and Proposed Diagnostic Criteria","volume":"41","author":"Raveendran","year":"2024","journal-title":"Balk. Med. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1177\/26318318221089600","article-title":"Common Pitfalls in the Management of Vaginismus in Couples With Subfertility in India","volume":"4","author":"Ramanathan","year":"2022","journal-title":"J. Psychosexual Health"},{"key":"ref_28","unstructured":"Foucault, M. (1977). Discipline and Punish: The Birth of the Prison, Pantheon Books."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1177\/08861099211043166","article-title":"Critical Feminisms: Principles and Practices for Feminist Inquiry in Social Work","volume":"36","author":"Goodkind","year":"2021","journal-title":"Affilia"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e12564","DOI":"10.1111\/nin.12564","article-title":"A critical examination of epistemological congruence between intersectionality and feminist poststructuralism: Toward an integrated framework for health research","volume":"30","author":"Willett","year":"2023","journal-title":"Nurs. Inq."},{"key":"ref_31","first-page":"306","article-title":"Disrupting the Able-Bodied Normativity of Shared Power in the Duoethnographic Process: A Critical, Disability Studies Lens","volume":"7","author":"Nusbaum","year":"2016","journal-title":"Crit. Quest. Educ."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1080\/08952841.2024.2428891","article-title":"Unruly temporalities: Older queer women and non-binary people narrating later-life sexuality","volume":"37","author":"Looman","year":"2025","journal-title":"J. Women Aging"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1677","DOI":"10.1177\/0170840614550731","article-title":"Un\/doing Chrononormativity: Negotiating Ageing, Gender and Sexuality in Organizational Life","volume":"35","author":"Riach","year":"2014","journal-title":"Organ. Stud."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1111\/jocn.14685","article-title":"Let\u2019s talk about sex: A feminist poststructural approach to addressing sexual health in the healthcare setting","volume":"28","author":"Ollivier","year":"2019","journal-title":"J. Clin. Nurs."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1046\/j.1365-2648.2002.02134.x","article-title":"Feminist poststructuralism: A methodological paradigm for examining clinical decision-making","volume":"37","year":"2002","journal-title":"J. Adv. Nurs."},{"key":"ref_36","unstructured":"Liamputtong, P. (2020). Qualitative Research Methods, Oxford University Press Australia & New Zealand. [5th ed.]."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1097\/ACM.0000000000000388","article-title":"Standards for Reporting Qualitative Research: A Synthesis of Recommendations","volume":"89","author":"Harris","year":"2014","journal-title":"Acad. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2954","DOI":"10.1111\/jan.13031","article-title":"Systematic methodological review: Developing a framework for a qualitative semi-structured interview guide","volume":"72","author":"Kallio","year":"2016","journal-title":"J. Adv. Nurs."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1177\/1744987107081254","article-title":"Memoing in qualitative research: Two decades on","volume":"13","author":"Birks","year":"2025","journal-title":"J. Res. Nurs."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"16094069241301383","DOI":"10.1177\/16094069241301383","article-title":"To Member Check or not to Member Check? An Evaluation of Member Checking in an Interpretive Descriptive Study","volume":"23","author":"Lloyd","year":"2024","journal-title":"Int. J. Qual. Methods"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual. Res. Psychol."},{"key":"ref_42","unstructured":"(2023). Quirkos 2.5.3 [Computer Software], Quirkos."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Weller, S.C., Vickers, B., Bernard, H.R., Blackburn, A.M., Borgatti, S., Gravlee, C.C., and Johnson, J.C. (2018). Open-ended interview questions and saturation. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0198606"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1177\/1468794120976072","article-title":"Beyond a coefficient: An interactive process for achieving inter-rater consistency in qualitative coding","volume":"22","author":"Hemmler","year":"2020","journal-title":"Qual. Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1080\/0142159X.2022.2057287","article-title":"A practical guide to reflexivity in qualitative research: AMEE Guide No. 149","volume":"45","author":"Stalmeijer","year":"2023","journal-title":"Med. Teach."},{"key":"ref_46","unstructured":"Guba, E.G., and Lincoln, Y.S. (1989). Fourth Generation Evaluation, Sage Publications."},{"key":"ref_47","first-page":"63","article-title":"Strategies for ensuring trustworthiness in qualitative research projects","volume":"22","author":"Shenton","year":"2004","journal-title":"Educ. Inf."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"117822","DOI":"10.1016\/j.socscimed.2025.117822","article-title":"Heteronormativity and cisgenderism in medical training: A scoping review of lesbian, gay, bisexual, transgender, queer and plus (LGBTQ+) issues in medical training in Asia","volume":"370","author":"Suen","year":"2025","journal-title":"Soc. Sci. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"117818","DOI":"10.1016\/j.socscimed.2025.117818","article-title":"Dimensions of cisheteronormativity that influence healthcare utilization practices in LGBTQ+ populations: A systematic review","volume":"371","author":"Bartels","year":"2025","journal-title":"Soc. Sci. Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1089\/lgbt.2020.0357","article-title":"Prevalence of Vulvar Pain and Dyspareunia in Trans Masculine Individuals","volume":"9","author":"Abern","year":"2022","journal-title":"LGBT Health"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1617","DOI":"10.1111\/j.1743-6109.2009.01217.x","article-title":"Development and initial validation of the Vaginal Penetration Cognition Questionnaire (VPCQ) in a sample of women with vaginismus and dyspareunia","volume":"6","author":"Klaassen","year":"2009","journal-title":"J. Sex. Med."},{"key":"ref_52","first-page":"336","article-title":"Development and validation of the multidimensional vaginal penetration disorder questionnaire (MVPDQ) for assessment of lifelong vaginismus in a sample of Iranian women","volume":"19","author":"Molaeinezhad","year":"2014","journal-title":"J. Res. Med. Sci."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1080\/0092623X.2023.2193587","article-title":"The Role of Vaginal Penetration Skills and Vaginal Penetration Behavior in Genito-Pelvic Pain\/Penetration Disorder","volume":"49","author":"Maldonado","year":"2023","journal-title":"J. Sex Marital Ther."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1007\/BF01542223","article-title":"The GRISS: A psychometric instrument for the assessment of sexual dysfunction","volume":"15","author":"Rust","year":"1986","journal-title":"Arch. Sex. Behav."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1038\/s41443-021-00409-8","article-title":"Management of hypoactive sexual desire disorder in transgender women: A guide for clinicians","volume":"33","author":"Cocchetti","year":"2021","journal-title":"Int. J. Impot. Res."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"American College of Obstetricians and Gynecologists\u2019 Committee on Practice Bulletins\u2014Gynecology (2019). Female Sexual Dysfunction: ACOG Practice Bulletin Clinical Management Guidelines for Obstetrician-Gynecologists, Number 213. Obs. Gynecol., 134, e1\u2013e18.","DOI":"10.1097\/AOG.0000000000003324"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1111\/j.1743-6109.2007.00452.x","article-title":"Surrogate versus couple therapy in vaginismus","volume":"4","author":"Rothschild","year":"2007","journal-title":"J. Sex. Med."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1752","DOI":"10.1016\/j.jsxm.2018.10.003","article-title":"Outcome of Medical and Psychosexual Interventions for Vaginismus: A Systematic Review and Meta-Analysis","volume":"15","author":"Maseroli","year":"2018","journal-title":"J. Sex. Med."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1177\/03616843241245713","article-title":"Women\u2019s Experiences of Sexual Agency Under Constrained Choice: A Systematic Review","volume":"48","author":"Balint","year":"2024","journal-title":"Psychol. Women Q."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1080\/14681994.2015.1025183","article-title":"Sexual history of male partners of women with the diagnosis vaginismus","volume":"30","author":"Klein","year":"2015","journal-title":"Sex. Relatsh. Ther."},{"key":"ref_61","first-page":"61","article-title":"Insights Into the Vaginismus Treatment by Cognitive Behavioral Therapies: Correlation With Sexual Dysfunction Identified in Male Spouses of the Patients","volume":"15","author":"Eserdag","year":"2021","journal-title":"J. Fam. Reprod. Health"},{"key":"ref_62","first-page":"1242","article-title":"\u201cA lot to fall back on\u201d: Experiences of dyspareunia among queer women","volume":"13","author":"Ekholm","year":"2022","journal-title":"Psychol. Sex."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1463","DOI":"10.1016\/j.jsxm.2017.05.018","article-title":"Female Sexual Dysfunction\u2014Medical and Psychological Treatments, Committee 14","volume":"14","author":"Kingsberg","year":"2017","journal-title":"J. Sex. Med."},{"key":"ref_64","first-page":"Cd001760","article-title":"Interventions for vaginismus","volume":"2012","author":"Melnik","year":"2012","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/j.brat.2006.03.013","article-title":"Cognitive-behavioral therapy for women with lifelong vaginismus: Process and prognostic factors","volume":"45","author":"Melles","year":"2007","journal-title":"Behav. Res. Ther."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"37","DOI":"10.31128\/AJGP\/06-23-6870","article-title":"Clinical assessment and management of vaginismus","volume":"53","author":"Chalmers","year":"2024","journal-title":"Aust. J. Gen. Pract."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"23333936241275266","DOI":"10.1177\/23333936241275266","article-title":"Language Matters: Exploring Preferred Terms for Diverse Populations","volume":"11","author":"Marfo","year":"2024","journal-title":"Glob. Qual. Nurs. Res."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"S20","DOI":"10.1016\/j.jsxm.2022.05.045","article-title":"Attitudes Towards Transgender People Among Cisgender Women Who use Vaginismus and PCOS-related Online Forums","volume":"19","author":"Adams","year":"2022","journal-title":"J. Sex. Med."},{"key":"ref_69","first-page":"11","article-title":"Intercultural and Ethical Sensitivity Levels of Healthcare Professionals and Related Factors","volume":"31","author":"Adana","year":"2023","journal-title":"Florence Nightingale J. Nurs."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"104693","DOI":"10.1016\/j.jesp.2024.104693","article-title":"A colorblind ideal and the motivation to improve intergroup relations: The role of an (in)congruent status quo","volume":"116","author":"Gale","year":"2025","journal-title":"J. Exp. Soc. Psychol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"2019","DOI":"10.1007\/s40615-021-01141-1","article-title":"Colorblind Racial Ideology and Physician Use of Race in Medical Decision-Making","volume":"9","author":"Okah","year":"2022","journal-title":"J. Racial Ethn. Heal. Disparities"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1186\/s12939-024-02189-1","article-title":"The patient perspective on diversity-sensitive care: A systematic review","volume":"23","author":"Lauwers","year":"2024","journal-title":"Int. J. Equity Health"},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Kaya, Y., Tahta, T., Ayd\u0131n, Y., and Kaya, C. (2026). Belief in sexual myths and sociocultural factors associated with vaginismus: A case-control study in Turkish women. J. Turk. Gynecol. Assoc., online ahead of print.","DOI":"10.4274\/jtgga.galenos.2025.2025-9-9"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"404","DOI":"10.5798\/dicletip.987807","article-title":"The role of religiosity in the etiology of vaginismus in the light of socio-cultural features: The case of Turkey","volume":"48","author":"Mutlu","year":"2021","journal-title":"Dicle Med. J."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1016\/j.jsxm.2021.02.003","article-title":"Exploring Relationships Between Genito-Pelvic Pain\/Penetration Disorder, Sex Guilt, and Religiosity Among College Women in the U.S","volume":"18","author":"Azim","year":"2021","journal-title":"J. Sex. Med."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s12529-023-10236-4","article-title":"Medical Mistrust and Healthcare Seeking Among Women of Color with Chronic Vulvovaginal Pain","volume":"32","author":"Adams","year":"2025","journal-title":"Int. J. Behav. Med."},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Pandey, M., Maina, R.G., Amoyaw, J., Li, Y., Kamrul, R., Michaels, C.R., and Maroof, R. (2021). Impacts of English language proficiency on healthcare access, use, and outcomes among immigrants: A qualitative study. BMC Health Serv. Res., 21.","DOI":"10.1186\/s12913-021-06750-4"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"105268","DOI":"10.1016\/j.healthpol.2025.105268","article-title":"Immigrants\u2019 self-perceived barriers to healthcare: A systematic review of quantitative evidence in European countries","volume":"154","author":"Allegri","year":"2025","journal-title":"Health Policy"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"100312","DOI":"10.1016\/j.ssmqr.2023.100312","article-title":"\u2018White People are the default\u2019: A qualitative analysis of medical trainees\u2019 perceptions of cultural competency, medical culture, and racial bias","volume":"4","author":"Plaisime","year":"2023","journal-title":"SSM\u2014Qual. Res. Health"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1744","DOI":"10.1080\/00224499.2025.2562579","article-title":"Genitopelvic Pain: A Scoping Review of Studies in Minoritized Samples","volume":"62","author":"Pukall","year":"2025","journal-title":"J. Sex Res."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"S87","DOI":"10.1016\/j.jmig.2018.09.176","article-title":"An Assessment of the Role of Racial Demographics in the Management of Chronic Pelvic Pain","volume":"25","author":"Ogu","year":"2018","journal-title":"J. Minim. Invasive Gynecol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"PY23167","DOI":"10.1071\/PY23167","article-title":"A systematic search and narrative review of Aboriginal and Torres Strait Islander women and men pelvic health care: Demonstrated need for improvement","volume":"30","author":"Wise","year":"2024","journal-title":"Aust. J. Prim. Health"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1093\/pm\/pnaf039","article-title":"Discrimination and wellbeing are differentially related to pain severity for the racially marginalized","volume":"26","author":"Dasgupta","year":"2025","journal-title":"Pain Med."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1089\/jwh.2014.5164","article-title":"Presenting Symptoms Among Black and White Women with Provoked Vulvodynia","volume":"24","author":"Brown","year":"2015","journal-title":"J. Womens Health"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1093\/jsxmed\/qdac028","article-title":"Racialized differences across experiences and measurements of pain in genitopelvic pain\/penetration disorder","volume":"20","author":"Azim","year":"2023","journal-title":"J. Sex. Med."},{"key":"ref_86","doi-asserted-by":"crossref","unstructured":"Gatwiri, K., Rotumah, D., and Rix, E. (2021). BlackLivesMatter in Healthcare: Racism and Implications for Health Inequity among Aboriginal and Torres Strait Islander Peoples in Australia. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18094399"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"e003394","DOI":"10.1136\/bmjgh-2020-003394","article-title":"Decolonising global health: If not now, when?","volume":"5","author":"Kenney","year":"2020","journal-title":"BMJ Glob. Health"},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Nissen, R.D., and Andersen, A.H. (2022). Addressing Religion in Secular Healthcare: Existential Communication and the Post-Secular Negotiation. Religions, 13.","DOI":"10.3390\/rel13010034"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"qdad068.028","DOI":"10.1093\/jsxmed\/qdad068.028","article-title":"(029) Prevalence of Sexual Pain Among Cis-Gender Muslim Women in North America","volume":"20","author":"Rahman","year":"2023","journal-title":"J. Sex. Med."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1097\/JWH.0000000000000158","article-title":"\u201cI Just Beared Through It\u201d: Southern US Christian Women\u2019s Experiences of Chronic Dyspareunia","volume":"44","author":"Azim","year":"2020","journal-title":"J. Womens Pelvic Health Phys. Ther."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1111\/j.1743-6109.2008.01154.x","article-title":"Treatment of lifelong vaginismus in traditional Islamic couples: A prospective study","volume":"6","author":"Yasan","year":"2009","journal-title":"J. Sex. Med."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1093\/sxmrev\/qead019","article-title":"A review of the psychosocial factors that contribute to sexuality, female sexual dysfunction, and sexual pain among Muslim women","volume":"11","author":"Lamba","year":"2023","journal-title":"Sex. Med. Rev."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1097\/NMD.0000000000001622","article-title":"The Importance of Sociocultural Factors for Understanding and Managing Genito-Pelvic Pain\/Penetration Disorder: The Example of Muslim Societies","volume":"211","author":"Prasad","year":"2023","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref_94","unstructured":"Kristeva, J. (1982). Powers of Horror: An Essay on Abjection, Columbia University Press."},{"key":"ref_95","doi-asserted-by":"crossref","unstructured":"Schneider, A.J., Oldham, A.C., and Butcher, L.H.G. (2023). Anti-doping sciences, abjection and women\u2019s sport as a protected category. Front. Sports Act. Living, 5.","DOI":"10.3389\/fspor.2023.1106446"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"qdaf068.121","DOI":"10.1093\/jsxmed\/qdaf068.121","article-title":"(136) SEXUAL HEALTH CONCERNS OF OLDER WOMEN: A CROSS-SECTIONAL STUDY","volume":"22","author":"Karam","year":"2025","journal-title":"J. Sex. Med."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1016\/j.mayocp.2020.09.037","article-title":"Misconceptions About Sexual Health in Older Women: Why We Need to Talk About It","volume":"96","author":"Kuhle","year":"2021","journal-title":"Mayo Clin. Proc."},{"key":"ref_98","doi-asserted-by":"crossref","unstructured":"Shackelford, T.K. (2023). Sexual and Reproductive Health and Rights. Encyclopedia of Sexual Psychology and Behavior, Springer International Publishing.","DOI":"10.1007\/978-3-031-08956-5"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1111\/hypa.12248","article-title":"The Pain of Endo Existence: Toward a Feminist Disability Studies Reading of Endometriosis","volume":"31","author":"Jones","year":"2016","journal-title":"Hypatia"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.whi.2023.11.008","article-title":"Endometriosis and Disability: Analysis of Federal Court Appeals of Social Security Disability Insurance and Supplemental Security Income Claims by Individuals Suffering From Endometriosis","volume":"34","author":"Cromeens","year":"2024","journal-title":"Womens Health Issues"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"1716","DOI":"10.1111\/1471-0528.18322","article-title":"Effectiveness of Multidisciplinary Treatment Compared to Single Discipline Treatment of Female Chronic Pelvic Pain: A Systematic Review and Meta-Analyses","volume":"132","author":"McReynolds","year":"2025","journal-title":"BJOG Int. J. Obstet. Gynaecol."},{"key":"ref_102","doi-asserted-by":"crossref","unstructured":"Silva, I., Santos, A.C., and Oliveira, A. (2025). Disabling Norms, Affirming Desires: A Scoping Review on Disabled Women\u2019s Sexual Practices. Societies, 15.","DOI":"10.3390\/soc15060154"},{"key":"ref_103","doi-asserted-by":"crossref","unstructured":"Shah, S. (2017). \u201cDisabled People Are Sexual Citizens Too\u201d: Supporting Sexual Identity, Well-being, and Safety for Disabled Young People. Front. Educ., 2.","DOI":"10.3389\/feduc.2017.00046"},{"key":"ref_104","doi-asserted-by":"crossref","unstructured":"Boateng, G.O., Neilands, T.B., Frongillo, E.A., Melgar-Qui\u00f1onez, H.R., and Young, S.L. (2018). Best Practices for Developing and Validating Scales for Health, Social, and Behavioral Research: A Primer. Front. Public Health, 6.","DOI":"10.3389\/fpubh.2018.00149"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1080\/009262300278597","article-title":"The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function","volume":"26","author":"Rosen","year":"2000","journal-title":"J. Sex Marital Ther."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1080\/00926230290001448","article-title":"The Female Sexual Distress Scale (FSDS): Initial validation of a standardized scale for assessment of sexually related personal distress in women","volume":"28","author":"Derogatis","year":"2002","journal-title":"J. Sex Marital Ther."},{"key":"ref_107","doi-asserted-by":"crossref","unstructured":"Barrett, C., Wentzell, E., Camoletto, R.F., Barrett, C., and Hinchliff, S. (2018). Challenging the \u2018Viagrization\u2019 of Heterosexuality and Ageing. Addressing the Sexual Rights of Older People, Routledge. [1st ed.].","DOI":"10.4324\/9781315641751-10"}],"container-title":["Healthcare"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9032\/14\/10\/1261\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T04:28:24Z","timestamp":1778560104000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9032\/14\/10\/1261"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,7]]},"references-count":107,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["healthcare14101261"],"URL":"https:\/\/doi.org\/10.3390\/healthcare14101261","relation":{},"ISSN":["2227-9032"],"issn-type":[{"value":"2227-9032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,7]]}}}