In Malaysia, female sexual dysfunction (FSD) among Malays is common, so understanding the meanings of sexuality becomes crucial, as they can vary with identity, and this may influence each woman's subsequent reaction to sexual experience. In this article, we explore the meanings of sexuality that Malay women had developed throughout their lived experience. This qualitative study, situated within a social cognitive theory and a phenomenological framework, was conducted through in-depth and photograph elicitation interviews with 26 Malay women who had self-reported experiencing FSD. The findings suggest that the meanings of sexuality for these women linked closely with fundamental factors of Malay identity, which is comprised of tradition (Adat), religion (Islam), and language, that all influence gendered roles. Malay women understood sexuality to be sexual intimacy within marriage, privileging their marital role as a "good wife" over their personal rights within a sexual relationship. This understanding of sexuality was reinforced by meanings attributed to procreation, which Malay women linked closely to the purpose of marriage and their role as a "good mother." The findings should provide useful evidence that could be used in sexual health promotions to help reduce FSD and in clinical practice to generate appropriate therapy in Malaysia and elsewhere.
Recognizing barriers to managing sexual issues makes it more likely that effective ways to overcome them will be found. In Malaysia, where discussion of sexual issues is taboo, sociocultural factors may influence how physicians manage patients with these types of problems. This article focuses on the challenges encountered by 21 Malay family physicians when women experiencing sexual problems and female sexual dysfunction (FSD) attended their clinics, an uncommon occurrence in Malaysia, despite their high prevalence. This qualitative study employed a phenomenological framework and conducted face-to-face in-depth interviews. Three main barriers to managing women with sexual problems were identified that can hinder assessment and treatment: insufficient knowledge and training; unfavorable clinic environments; and personal embarrassment. Some barriers were associated with physician characteristics but many were systemic. These were further evaluated using social cognitive theory. Professional attitudes appear important as those physicians with an interest in managing women's health seemed to make greater effort to explore issues further and work to gain trust. Physicians who appeared indifferent to the impact of FSD showed greater reluctance to find solutions. Systemic issues included unfavorable clinical settings, lack of training, and lack of local evidence. Any strategy to address FSD needs to be underpinned by appropriate policies and resources.