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Try out PMC Labs and tell us what you think. Learn More. The cultural compatibility of sexually related instruments is problematic because the contexts from which the concepts and meanings were extracted may be ificantly different from related contexts in a different society. This paper describes the instruments that have been used to assess sexual behaviors, primarily in Western contexts.

Suggested criteria are as follows: understanding, language of sexuality, ethics and morality. Therefore, developing a culturally comprehensive measure that can adequately examine Iranian women's sexual behaviors is needed. In order to assess sexual well-being and provide treatment or education for Iranian women's sexuality, it is necessary to understand their sexuality and the meanings they give to sexual behaviors.

We therefore sought a tool appropriate to measure their sexual behaviors. Thus, sexual behavior would be an act by someone that expresses their sexuality. In the Archive for Sexology , Erwin J. The functional analysis of sexual behaviors has led researchers to develop instruments to gather observable data. In order to change subjective meanings to observable data, the researchers need to extract meanings from the contexts and populations they seek to measure.

Many sexually related measures and instruments have been published; they measure perceptions, attitudes, beliefs and so on. However, the contexts from which the concepts and meanings were extracted to develop these instruments vary. Doubtless, their reliability in measuring sexual behaviors as socially constructed, complex and dynamic phenomena can be questioned.

In order to determine a research approach for the context of Iranian women's sexuality, review and assessment of existing instruments was essential. Finally, because we find these instruments insufficient, we suggest criteria for cultural-specific sexually related measures in the Iranian settings. A variety of mesh terms were used to access the sexually related measures.

Focused exclusively on the concept of sexual behavior, we screened titles and abstracts. Considering that not all abstracts highlighted the specified population and name of the applied tools, these articles were found in full, and methods sections were reviewed to identify populations and the tools used. Retrieved articles were included if they used a structured instrument s to measure sexual behaviors of the female population. We excluded those studies whose outcome of interest included risky sexual behaviors or sexual behaviors measured among same sex relationships.

We excluded same sex relationships because this form of relationships is illegal and deniable in Iran. We searched for the original articles which introduced the instrument. If the original paper was unavailable, we selected the article that used the given tool to measure the study outcomes. In this stage, tools in languages other than English, those employed just for menopausal women and those not related to sexual behaviors were excluded. Using Gagnon and Simon sexual script theory[ 3 ] as the theoretical framework, cultural appropriateness i.

This decisive factor was proved by three experts. All questions in a given tool were qualitatively assessed by two researchers. We reviewed all instruments and determined the subscales as well as measurement types [ Table 1 ]. These instruments were reviewed by the authors, who are Iranian experts in sexology, reproductive health, and epidemiology.

Of 50 instruments, we found 19 tools applicable in the Iranian culture [ Table 2 ]. For Iranian settings, 10 instruments were found culturally problematic [ Table 3 ]. The third group included those which were focused on a specific sexual problem rather than looking at sexual behaviors overall [ Table 4 ]. With this overview, it appears that there are ificant challenges to using these instruments in Iranian contexts.

In her linguistic analysis of sexuality expression of Iranian women, Merghati-Khoei[ 54 ] has revealed the ways of developing terminology and cultural explanations, which are juxtaposed with the exploration of the development of women's sexuality. Iranian women expressed their sexuality differently from Western women even though they understood and talked about the same issues.

Iranian women frankly speak about all the physical aspects of sexuality. These conversations include open teasing about the physical side of sexuality. There is, however, a hesitation when it comes to discussing or reporting the emotional aspects of sexual encounters. Similarly, culturally meaningful ambiguity in language guides Iranian people's behavior.

Thus, expressing sexuality in day-to-day conversation is limited. Therefore, employing instruments which use sexually explicit items is insufficient. Communication of sexual needs or interests with others is another feature of this tool.

As a neglected subject matter in the Iranian culture, questioning people about their sexual needs and interests or sexual-self concept seems impractical. Sexuality is an unspoken issue, and individuals might not be linguistically skilled to communicate their sexuality with an interviewer. In sum, the art of using a rich vocabulary of metaphors and euphemisms is a characteristic of Iranian speech, used to communicate and encapsulate matters not normally spoken explicitly.

Another difficulty in asking about sexuality during a study is the struggle between conscious embarrassment and sexual talk. By conscious embarrassment, we mean the shame, prohibition and modesty about sex. They are part of Iranian women's sexual script.

The majority of the women who participated in Merghati-Khoei's qualitative study pointed out that they were not culturally expected to be straightforward or frank in expressing sexual matters. Out of 14 items, 4 focus on masturbation and 2 items ask about having interest in casual sex. In Iranian contexts, none of these 6 items would be posed by researchers or responded to by the participants. Why human have sex? YSEX is another example, which measures of variables.

For instance, some of the items focus on motivations leading people to out-of-wedlock or casual sex. Although casual or extra marital sex happens in every society, questioning Iranians about these behaviors is not ethically and religiously possible or feasible. This assertion is based on the common assumptions. There is also the belief commonly permeating Iranian society that people are fairly innocent in terms of sexuality compared with non-Muslim or Western societies. Undoubtedly, these factors change behaviors and attitudes.

Social conduct and religiosity define the ethical aspect of sexuality in the Iranian culture. Moreover, as shown in Merghati et al. The concept of Nejabat modesty is the most important ethical code applied to an Iranian woman who is not sexually expressive. To investigate sexual behaviors in an Iranian context, we recognize the importance of identifying or developing an instrument to assess sexual behavior domains among women in the particular context of Iranian culture.

We thought that such an instrument would be essential tool for achieving a more systematic and in-depth understanding of Iranian women's sexuality, may be useful in applied settings, and would advance sexuality research as a whole. No matter the context or use, however, measuring a construct such as sexual behavior is subjective and therefore entirely dependent on self-report. It has been argued that Iranian women may not report properly if they believe sexuality has nothing to do with health. This suggests the idea that the culture of sexuality affects people's interpretations of sexually related problems.

Developing a contextualized instrument to measure the domains of sexual behavior would allow sexuality and gender researchers to better answer questions related to the influence of culture in those domains, sexual scripts across diverse cultures, and other factors influencing sexual health outcomes. In the s, Gagnon and Simon's Sexual Conduct represented the first truly sociological analysis of sexual behavior.

They produced a critique that moved us beyond the objective definition of sexual behavior:. Our concern here is to understand sexual activities of all kinds … as the outcome of a complex psychological process of development, and it is only because they are embedded in social scripts that the physical acts themselves become possible … it is neither fixed by nature or by the organs themselves.

The very experience of sexual excitement that seems to originate from hidden internal sources is in fact a learned process and it is only our insistence on the myth of naturalness that hides these social components from us. Sexuality has been regarded as the product of societies and histories. We categorized instruments as culturally compatible or incompatible based on the sexuality domains they tend to measure.

The instruments, by which the biological aspects of sexual behaviors are measured were found applicable for any given community or population, the Iranian context included. Most of the tools seem reasonable candidates for use in the Iranian culture and society with minor revisions [ Table 1 ].

Review of these instruments shows that most of them are functional based, such as the most used scale in literature, FSFI. Some other tools are problem-focused [ Table 3 ] and specific to measure only disorder-based outcomes. We argue that the medically oriented instruments employed in the field are drawn from concepts and meanings based on investigations conducted in Western societies. These very well-structured tools are constantly applied to the clients.

Yet as researchers, we sometimes found ourselves disappointed by the level of difficulty, which we professionals encountered in fitting our participants into those biomedical frameworks. These instruments may not project the understandings of those who participate in our studies. The culture-bound nature of sexuality limits the research-based information in Iran. In our society, the lack of information in the sexual domain will be most productively addressed first through research attention to subjective concepts. Lack of sufficient knowledge in the field of sexuality in Iranian contexts, makes it important to identify normative sexual behaviors qualitatively before applying problem-oriented tools in research.

There are social and cultural challenges arising from the recognition that Iranians use culturally specific sexual expressions. These expressions may construct different ways of perceiving sexuality that are not easily translatable or even understandable by outsiders. This means that sexuality is a complex phenomenon embedded in various meanings and understandings, not merely objective and measurable behavior.

The basic sexuality criteria of Iranian women are relatively argued. Therefore, exploring and analyzing the lexicon and expressions used by the Iranian women creates a ground for developing a culturally comprehensive measure, which can adequately examine how these women explain their sexual behaviors. Thanks to the Isfahan University of Medical Sciences, School of Nursing and Midwifery, for funding the research, in research project code Our special thanks to the authors and scholars who supported our review by responding to our inquiries and providing us with their priceless papers.

We would like to sincerely thank Professor Thomas Smith for reviewing the paper and his invaluable input. Source of Support: This study is funded by a grant from Isfahan University of Medical Sciences, with grant code: Conflict of Interest: Nil. National Center for Biotechnology Information , U. J Educ Health Promot. Published online Aug Author information Copyright and information Disclaimer. Address for correspondence: Dr. E-mail: moc. This is an open-access article distributed under the terms of the Creative Commons Attribution , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

This article has been cited by other articles in PMC. Abstract The cultural compatibility of sexually related instruments is problematic because the contexts from which the concepts and meanings were extracted may be ificantly different from related contexts in a different society. Keywords: Iranian women, measure, sexual behavior.

Table 1 Instruments features including the subscales. Open in a separate window. Table 2 Compatible scales for Iranian culture. Table 3 Instruments incompatible with Iranian culture. Table 4 Problem-focused instruments. Understanding and language of sexuality In her linguistic analysis of sexuality expression of Iranian women, Merghati-Khoei[ 54 ] has revealed the ways of developing terminology and cultural explanations, which are juxtaposed with the exploration of the development of women's sexuality.

They produced a critique that moved us beyond the objective definition of sexual behavior: Our concern here is to understand sexual activities of all kinds … as the outcome of a complex psychological process of development, and it is only because they are embedded in social scripts that the physical acts themselves become possible … it is neither fixed by nature or by the organs themselves.

Webster M. Haeberle EJ. Critical Dictionary. Gagnon JH, Simon W. Chicago: Hutchinson of London; Sexual conduct; the social sources of human sexuality. J Sex Marital Ther. Geneva: WHO; The developement of the WHO quality of life assessement instrument. A cross-national study of subjective sexual well-being among older women and men: Findings from the Global Study of Sexual Attitudes and Behaviors.

Arch Sex Behav. The Sexuality Scale: An instrument to measure sexual-esteem, sexual-depression, and sexual-preoccupation. J Sex Res. Haning RV. Masters thesis.

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