Waris Qidwai  ( Assistant Professor Family Medicine Division, Department of Community Health Sciences, The Aga Khan University Karachi. )

Objective: To study the perceptions about female sexuality among young Pakistani men, presenting to family physicians at a teaching hospital in Karachi, Pakistan
Study Design: A questionnaire based prevalence study.
Setting: Questionnaire administered to 188 young Pakistani men, between the ages 18-30 veai-s, who presented to family physicians, at the outpatient department of the Aga Khan University Hospital, Karachi, Pakistan.
Main Outcome Measures: Perception among Pakistani young men about enjoyment of sexual experiences in women, whether women stop to enjoy sexual experiences during stress, menstruation, pregnancy and after menopause. Whether they are aware about “orgasm” in women and their belief in who can initiate sexual experiences, husband, wife or both.
Results: The age of the study population was uniformly distributed between 18-30 years. The majority of the respondents were professionals, with a high school or a higher level education and belonged to the middle socioeconomic group.Well over 40% of the respondents thought that sexual experiences ill women in comparison to men arc less enjoyable. 22% believed that women cannot enjoy sex during pregnancy while 20% ihought they can’t enjoy after menopause. 58% of the respondents were aware of the phenomenon of orgasm in women. 6.4% believed that the initiation of sexual experience lies with husband only.
Conclusion: We have found a high prevalence of misconceptions about female sexuality among Pakistani young men in our study sample. We expect the situation to be more adverse in the society where education is less and people belong to the lower socio-economic class. We strongly recommend sex education of our youth Ul’MA 50:74, 2000).

It is suspected that in Pakistani society, men are unaware about female sexuality. They do not realize that women are human beings with sexual desires and can experience orgasm, equivalent to ejaculation in men. As a result of such misconceptions, a disturbed relationship emerges between the couple. soon after marriage, resulting in a disturbed family life. The consequences of this has far reaching effects, resulting in problems with the rearing of children and ultimately harming the well being of future generations.
The literature shows lack of data in d Pakistan and the adjoining region on the issue. We therefore decided to study the misperceptions about female sexuality in the mind of our young men.

A self-administered questionnaire was developed, in English and Urdu languages, in keeping with the study objectives. It was developed, based on extensive literature search and the experience of our colleagues. The demographic profile of the patient, which included age, marital status, level of education and socio-economic status was also recorded.
The questionnaire was administered to men between the ages of 18 to 30 years, visiting the General Practitioners at the outpatient department of the Aga Khan University Hospital, Karachi, Pakistan. The objectives of the study were explained to them and a consent form was signed if they agreed to participate. Men were selected by convenience sampling. The investigator was present during questionnaire administration to answer any questions for clarification. Sex education was imparted aller the questionnaire was filled.
A sample size of 188 was selected, based on 95 % confidence intervals. The study was approved by the Human Subjects Committee of the hospital followed by pilot testing of the questionnaire. The actual study was carried out between October 1 995 and July I 996.
There was double entry of the data obtained from questionnaires and the demographic form into the computer program. using the lox Pro for windows and the SPSS for windows.

The age of the study population was uniformly distributed between I 8 to 30 years. Around 80% were married and 20% unmarried. The majority of the respondents were professionals, belonging to the middle socio-economic group, and had a high school or higher level education. Well over 40% of the respondents thought sexual experience in women in comparison to men is less enjoyable. Twenty-one percent thought it to be more enjoyable while less then 10% considered it as equally enjoyable. (Figure 1).

When a woman could not enjoy sexual experience was attributed by 40%, 22% and 20% when she was tense, pregnant or after menopause respectively (Figure 2).

A substantial 42% did not know about orgasm in women (Figure 3).


Around 80% of’ the respondents thought that the initiation of sexual experience lies with both male as well as female partners, but a 6.4% believed it to be only with the husband (Figure 4).

We have found a high prcvalence of misconceptions as regards female sexuality among Pakistani young men. It is indeed unfortunate that even in the better educated and socio-economically well placed respondents in our study, a large number are so unaware in matters of female sexuality.
Historically, conceptions of gender in education resolved around a distinctive set of assumptions about male and female sexuality. Girls are taught repression while boys expression¹. Open discussions o adolescent sexuality have long been taboo, adolescent female sexuality is doubly a taboo². A lot of misperceptions regarding female sexuality are ensure a result of such taboos. In Scandinavia, a study showed that traditional roles equating the relationship of women to men to that of prey to hunters, has led to serious problems such as impotency³. Such misconceptions and resulting consequences are prevalent in Pakistan, as shown by the finding that men consider it their right to initiate sexual experience.
Unfortunately female sexuality is poorly understood in general. Some of the greatest challenges facing psychologists today include limited understanding of female sexuality⁴. The adverse impact of such limited understanding of female sexuality for the general population is immense as shown by the findings of our study.
Because of patriarchal approach to female sexual expression and experience, difficulties are faced in counseling feniale clients⁵. Consequences of such an approach for the general population are again immense as shown by our study results, Findings of two surveys representing mothers in college in the 1950’s and daughters in college in 1970’s, about female sexuality suggest, that the later group is sexually more active. Also, the daughters are more communicative about sexuality compared to their mothers⁶. This supports our belief that present generation is more open to sex education.
Mcii fantasized about sex more and exhibited greater interest in partner variation and in the spectrum from domination to sadism. While male sexuality is described as aggressive/sadistic, female sexuality as passive/masochistic⁷. Practical implications for such a model can be disastrous and we need to prevent such thinking in the society through sex education.
Sexually assertive women reported higher frequency of sexual activity and orgasms, rated themselves as having greater subjective sexual desire, and reported greater marital and sexual satisfaction⁸. Therefore a more assertive role for females in our society is advocated with a good impact on sexual health.
A in isconccpt ion prevalent among our population is that women cannot enjoy sex after menopause. In a study conducted in Germany, 9 1 women were interviewed between the ages 50-9 I years. 53% were sexually active while 65% reported sexual interest⁹. The need for love and sexual intimacy does not diminish with age. It depends on the availability of a sexually active partner and presence of concurrent illnesses¹⁰. There is clearly a need to study’ views on issue of sexuality in the elderly women in our society.
On an average sexual interest and coital activity decreases sharply in the third trimester of pregnancy¹¹. Lack of interest in sex is conveniently blamed on biological. physical or psychological factors, ignoring the fundamental changes in sexuality that come with motherhood¹². There is a need to educate the masses on these issues.
Ninety-one German women ages 50-9 I years (birth cohorts: 1895-1936) were interviewed in depth about their sexual development through the life span. Data indicates that subjects born later were not only more experiential sexually but changed intraindividually more often in sexual matters, whereas the older women mostly ‘conserved’ the sexual morals and habits learned in youth¹³. We need to be aware of such changes in matters of sexuality in our society, if we want to preserve sexual health of our men and women.
India shares a cultural heritage with Pakistan. In a survey of female teachers, 22-24 years of age. in Bombay, India, 96% identified sexual desire as normal and healthy and thought that either spouse can take the initiative for sex. About 60.5% claimed that they enjoyed sex. A less than 1/5 of the respondents had received formal sex education. The majority indicated acceptance of sex education for both sons and daughters¹⁴. We believe sex education will find similar acceptance in Pakistan.
In a Sri Lankan study, 1233 unmarried men of 16-24 years of age were interviewed. More than 75% of them wanted their future wife to be virgin, hut only 17% of them knew that not all women bleed at first intercourse¹⁵. The findings of our study are 110 different little idea exists whether women are capable of achieving orgasm, and as high as 40% believe they enjoy sexual experiences less than men.
Women are considered to be inert subjects, who provide sexual enjoyment to men but are supposed to repress their own sexual desires and expressions’. A substantial number in our society believe that women are incapable of enjoying sexual experiences aller menopause. Studies have shown that contrary to such beliefs, women continue to enjoy sexual experiences regardless of age and continue to harbor sexual feelings and desires”. Another misconception prevalent among our men is that women cease to enjoy sexual experiences during pregnancy. Such misconceptions have lead to problems in sex life of couples following childbirth¹².
We must prepare ourselves since in future women in Pakistan are expected to be more aware of matters of sexuality and our men must also adapt themselves to such changes in thinking in matters of female sex uality.

I wish to thank Dr. Rukhsana W. Zuberi, Associate Professor, Community Health Sciences, The Aga Khan University, for her guidance iii carrying out the study.

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