Cultural and Socioeconomic Determinants of Sexual Dysfunction in South India: A Structured Narrative Review

Abstract

Sexual dysfunction is one of the most common yet highly neglected health concerns in South India, affecting not only physical health but also emotional well-being, relationships, and quality of life. In the South Indian context, sexual dysfunction is often viewed through the lens of shame, morality, cultural silence, and gender expectations rather than as a medical or psychological concern. This review aims to examine the sociocultural and socioeconomic determinants associated with sexual dysfunction in South India and to understand how these factors influence access to professional sex therapy. A structured review of literature was conducted using databases such as PubMed, Google Scholar, PsycINFO, IndMED, and Shodhganga, along with Indian psychiatric and psychological journals. The findings from the reviewed studies indicate that stigma, lack of sexual awareness, rigid gender norms, myths such as Dhat syndrome, poverty, low educational status, caste-based inequalities, and the rural–urban divide significantly contribute to the persistence of sexual dysfunction and delay help-seeking behaviour. The review also highlights the severe shortage of trained sex therapists and the large treatment gap, particularly in rural South Indian communities. Concluding these findings, there is a strong need for culturally sensitive interventions, improved sexual health education, professional training, and public health policies that address sexual dysfunction through a biopsychosocial and sociocultural approach rather than a purely biomedical perspective.