Gender power and marital relationship as predictors of sexual dysfunction and sexual satisfaction among young married couples in rural China: A population-based study

Objectives. To investigate associations between gender relationships and sexual dysfunction (SD) of younger married couples living in rural China. Methods. An anonymous cross-sectional population-based survey study was conducted in a rural area in Hunan, China. A random sample of 298 couples were recruited. Self-reported SD, sexual satisfaction, and variables related to gender power and marital relationship were measured. Results. Of the respondents, 28.2% and 45.6% of the husbands and wives were having at least one of the studied SDs, respectively. The results of the multivariate analyses showed that husbands not reporting a quality marital relationship (odds ratio [OR] 4.27, 95% confidence interval [CI] 2.13 to 8.57), who mistrusted their wives (OR 9.14, 95% Cl 4.22 to 19.78), who claimed themselves as the decision-maker regarding condom use (OR 2.41, 95% CI 1.20 to 4.85), and whose wife scored lower in the relationship control subscale of the sexual relationship power scale (OR 2.83, 95% CI 1.15 to 6.95) were more likely than other husbands to have at least one SD. Wives who were not trusted by their husbands (OR 2.94, 95% Cl 1.39 to 6.25), whose husbands were more powerful than they were in general decision-making (OR 1.98, 95% Cl 1.14 to 3.43), and who scored lower in the relationship control subscale (OR 3.77, 95% Cl 1.65 to 8.62) were more likely than other wives to have at least one SD. Conclusions. Gender relationships, including the quality of the marital relationship, mutual trust, decision-making, and relationship control, were significantly associated with SD. Gender inequality has been observed and needs to be taken into account in promoting sexual health among married couples living in rural China.