Stigma experiences among Chinese middle-aged women with pelvic floor disorders: a qualitative study

Pelvic floor disorders (PFDs) commonly evoke stigma, leading to delayed healthcare seeking and significantly impaired quality of life. For Chinese middle-aged women, this stigma is intensified by specific cultural norms and the pressures of their unique life stage. However, there is a lack of studies focusing on how this population experiences PFD-related stigma in the Chinese context. This study aiming to identify how Chinese middle-aged women experience and construct the meaning of PFDs-related stigma in their daily lives. An interpretive qualitative study was conducted. Seventeen Chinese middle-aged women with PFDs were recruited via purposive and snowball sampling from a specialized pelvic floor rehabilitation clinic in Shanghai between November 2024 and May 2025. Data were generated through semi-structured in-depth interviews and analyzed using reflexive thematic analysis. The analysis revealed that stigma is a concentric experience constituted of four themes. (1) Individual Stigma: body out of control, aging anxiety, sexual failure. (2) Interpersonal Stigma: implicit exclusion in family, workplace marginalization. (3) Cultural Stigma: “face” principle, gendered ageism, unclean in gynecological Issues, intergenerational transmission. (4) Institutional Stigma: secondary iatrogenic harm, systemic exclusion. The stigma experienced by Chinese middle-aged women with PFDs is a complex social product operating at individual, interpersonal, cultural, and institutional levels. Addressing this requires a multi-level approach. It calls for a dismantling of the “gendered ageism” that frames the aging female body as low-value. Moreover, it contributes to increasing awareness of the stigma from Chinese culture, and need for epistemic justice and structural support, urging a shift from a narrative of private stigma to one of rights to restore the dignity of these women.