Beyond Cultural Averages: A Person-Centered Examination of Sexual Function and Distress Among North American Migrants

Study Description: Immigrants represent a significant and growing segment of the North American population (Statistics Canada, 2023) and face unique and often unmet sexual health needs (Damabi et al., 2024). Despite substantial research on the sexual function experiences in Euro-North American samples (Dworkin et al., 2015; Klein et al., 2022), comparatively little is known about the sexual function experiences of immigrants. Existing studies suggest that North American immigrants may experience poorer sexual function (i.e., desire, arousal, orgasm) relative to non-immigrant and Euro-North American populations. Relative to non-immigrants, immigrants report lower sexual desire (Woo et al., 2012; Brotto et al., 2012), fewer orgasms (Wetzel et al., 2025; Woo & Brotto, 2008) lower arousal (Brotto et al., 2005), and higher rates of genital pain (Woo & Brotto, 2008). Though no studies to our knowledge compare sexual distress between immigrant and non-immigrant/Euro-North American populations, existing research suggests differences in the types of sexual experiences that people from different cultures report as distressing, which in turn corresponds with varying rates of sexual problems cross-culturally (Atallah et al. 2016; Hall, 2019; McCool et al., 2016). Observed sexual function disparities may reflect the complex interplay of migration-related social stressors—such as socioeconomic challenges, language barriers, and discrimination—combined with the task of reconciling distinct cultural norms surrounding sexuality (Damabi et al., 2024). Migrants arriving from more conservative or religious societies must often navigate internal conflicts between traditional values and the more liberal sexual attitudes of their host culture. Indeed, migrants frequently endorse more conservative sexual values, emphasizing sex within committed relationships and expressing greater discomfort toward casual or uncommitted sex (Asif, 2021; Alarcão et al., 2017). Acculturation to mainstream North American culture has been linked to more liberal sexual attitudes, higher desire, and lower sex guilt, whereas stronger adherence to heritage culture predicts greater anxiety around sex and sexual avoidance (Brotto et al., 2005; Woo et al., 2012). These findings highlight the importance of considering not only biological and psychological correlates of sexual function but also the roles of social and cultural factors in shaping sexual function and distress about one’s sexuality. Gender may be a key factor in understanding sexual function and distress experiences among migrant populations. Not only might cultural values influence the degree to which sexual well-being is universally experienced, but these values appear to shape men’s and women’s experiences in distinct ways. Adherence to sexually traditional values is often intertwined with traditional gender role expectations, both of which are strongly informed by religiosity and patriarchal cultural norms (Inglehart & Norris, 2003). Within such contexts, women’s sexual roles are frequently framed around male gratification rather than personal pleasure or autonomy (Wiederman, 2005), and thus traditional values tend to limit women’s opportunity for sexual experience and expression, more so than men’s (Baumeister & Twenge, 2002; Hall, 2019). Indeed, cross-cultural findings consistently show that men’s sexual experiences (e.g., sexual debut, interest and participation in casual sex, sexual satisfaction) are less influenced by cultural context, whereas women’s sexuality appears more culturally bound – varying more depending on cultural context (Laumann et al., 2006; Lippa, 2007; Schmitt et al., 2005). Research on sexual function and sexual distress among migrants remains limited in several important ways. Most studies have relied on demographically narrow samples, often restricted to comparisons between two ethnocultural groups (e.g., East Asian vs Euro-North Americans; Woo & Brotto, 2008; Woo et al., 2012; Brotto et al., 2012), have only examined one facet of sexual function, and no studies have examined sexual distress. Finally, prior research has primarily used mean-based comparisons between groups. Such analyses assume that cultural background is the factor that differentiates experiences of sexual function, overlooking the possibility of heterogeneity within and between cultural groups. This approach also obscures the possibility that biopsychosocial and cultural factors intersect to shape sexual function and distress experiences. The present study aims to: 1) identify distinct profiles of sexual function and sexual distress separately by gender in a sample of ethnoculturally diverse North American immigrants; and 2) to examine how biopsychosocial and cultural factors predict membership in these profiles. By using a person-centered analytic approach, this study moves beyond group-mean comparisons typical to previous studies describing differences between immigrants and non-immigrants. We aim to capture the heterogeneity of sexual experiences across a diversity of cultural backgrounds, contributing to a more inclusive understanding of sexual health among migrant populations. Once the latent profiles of sexual function and distress are identified, we will examine predictors of profile membership to validate and contextualize the derived profiles (Spurk et al., 2020). Prior work indicates that age, relationship status, and partnered sexual frequency are robust correlates of sexual function and general sexual well-being (Kleinstäuber, 2017; Park & MacDonald, 2022). Psychological factors such as sexual growth beliefs (Maxwell et al., 2017; Raposo et al., 2021), sexual assertiveness (Santos-Iglesias et al., 2013; Snell et al., 1993), and sexual importance (Dossett, 2014; Hayes et al., 2008) are also expected to differentiate individuals across profiles, given that previous research indicates these beliefs/attitudes vary across culture and are associated with greater sexual function. In addition, previous research indicates that key social and cultural variables —including socioeconomic status (Higgins et al., 2022), access to sexual education (Golzari et al., 2020), religiosity (Lefevor et al., 2024), gender role adherence (Smets et al., 2025), mainstream and heritage acculturation (Ryder et al., 2000; Woo et al., 2012), and visible minority status (Nkansah & Alzweri, 2023)—are associated with distinct sexual function experiences. Including all predictors in a multivariate framework allows for testing their unique contributions to sexual function and distress profiles.

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