Sexual dysfunction among patients of south-east Asian origin

As psychiatrists, we do not ask often enough about sexual symptoms, for fear of embarrassment, a perceived lack of importance or sensitivity (Abbasian, 2002). Among patients from a south-east Asian background who are unable to speak English, eliciting symptoms can be difficult and using interpreters is often the only solution. Asking questions of a sexual nature requires tact. A patient is unlikely to reveal problems of a sensitive nature to an interpreter, for fear of embarrassment, especially if they are from the same cultural background. Sex has always been a taboo subject in this community and it is difficult to find literal translations of terms used when taking a sexual history, without having to resort to colloquial slang. The accuracy of histories could be doubted.

With psychiatric illness already associated with stigma in south-east Asian communities, patients are unlikely to freely admit to sexual dysfunction as well, in a community in which male virility and fertility among males and females is seen as culturally desirable. Asian women are unlikely to want to discuss such sensitive issues with a male or agree to initimate examinations. Understanding of psychiatric illness can be limited, and sexual dysfunction may not be recognised as a symptom of illness or side-effect of medication.

Questioning patients about sexual dysfunction is a sensitive issue, especially when the patient is from another culture. As clinicians we must be aware of the need to ask about such symptoms.