<p>Demographic characteristics.</p>

Among 135 women with FGM/C, approximately two-thirds reported sexual dysfunction, most commonly dyspareunia (45.9%), loss of sexual pleasure (28.9%), and loss of libido (25.9%). Absence or attenuation of the clitoris, labia minora, or labia majora was not associated with these outcomes. In contrast, depression (odds ratio [OR] 2.80), post-traumatic stress disorder (PTSD) (OR 3.86), and intact memory of the FGM/C event (OR 2.82) were associated with loss of libido.

Depression was also associated with loss of sexual pleasure (OR 4.67). After adjustment for age and genital anatomy, depression (adjusted OR 3.87) and PTSD (adjusted OR 3.67) remained associated with composite arousal-pleasure dysfunction. In this well-documented cohort with FGM/C, sexual dysfunction was more closely associated with trauma-related and psychiatric factors than with genital tissue loss.

These findings support prioritizing mental health and trauma-focused interventions for sexual health after FGM/C and underscore the need for prospective multicenter studies.</p></div>