Sexual health is a fundamental but persistently under addressed dimension of cancer care. Despite the high prevalence of sexual dysfunction following diagnosis and treatment, conversations about sexual wellbeing occur in less than a third of patients undergoing treatment even though most oncologists report feeling responsible for discussions regarding sexual function with patients. Healthcare providers cite discomfort, time constraints, no angle or motive for asking and lack of knowledge and training as key barriers. For patients from culturally and linguistically diverse (CALD) backgrounds, these challenges are compounded by overlapping layers of inequity that require specific, evidence-informed responses.
Research identifies three broad categories of barriers experienced by CALD populations accessing sexual and reproductive healthcare: (1) Access and inclusion failures where there is an absence of adequate accessible resources, lack of time and inconsistent interpreter availability; (2) inadequate cultural responsiveness with healthcare providers’ and patients’ concerns regarding the stigma surrounding sexual health discussions, modesty and gender norms and (3) bias and discrimination against patients of advanced age or undergoing palliative treatments.
The gender of practitioners and religious or community beliefs about sexuality as fate further shape engagement with care. At the same time, existing sexual health resources developed for general CALD populations have been described by CALD communities as patronising, oversimplified, and culturally inappropriate — with participants in one Australian study describing materials as sounding like they were "talking to a child."
Critically, however, research also shows that many CALD individuals consider a medical context an acceptable space to discuss sexual health, even when such conversations may be taboo within their communities, highlighting opportunities, in the right contexts, for healthcare providers to engage in meaningful and holistic sexual health discussions. Frameworks to facilitate discussions in sexual health can be used although their appropriateness, acceptability and efficacy in diverse CALD populations remain under-studied.