(290) The Fawn Response in the Bedroom: Chronic People-Pleasing as an Etiology in Female Sexual Dysfunction

Introduction Female sexual dysfunction (FSD) is a prevalent, multifactorial condition affecting up to 50% of women, with significant impacts on quality of life and interpersonal relationships. Etiologies include biological, psychological, interpersonal, and sociocultural factors. There is recent attention to maladaptive relational patterns such as chronic people-pleasing, conceptualized as the "fawn response." High agreeableness and prosocial tendencies may predispose individuals to prioritize partner needs over personal sexual agency, potentially contributing to sexual dissatisfaction and distress. Objective The objective of this review is to critically evaluate the literature on chronic people-pleasing as a psychosocial etiology in FSD, emphasizing mechanisms, assessment, and clinical implications. Methods A comprehensive literature review was conducted, focusing on studies and guidelines addressing FSD, psychological risk factors, and personality traits relevant to people-pleasing. Key sources included clinical guidelines and recent meta-analyses on perfectionism and agreeableness. Observational and analytical studies examining the intersection of interpersonal dynamics, perfectionism, and sexual health were included. Results FSD is associated with chronic medical conditions, psychological distress, and interpersonal dynamics. Chronic people-pleasing is linked to increased relational investment and social norm orientation, which may result in diminished sexual satisfaction and increased distress when personal needs are consistently subordinated. Psychosocial risk factors, including poor self-image, history of abuse, and persistent stress, are established contributors to low sexual desire and arousal disorders. The American College of Obstetricians and Gynecologists recommends comprehensive assessment of interpersonal and psychological factors in FSD.Cognitive behavioral therapy is first-line for desire and arousal disorders, with tailored psychotherapeutic interventions indicated for cases involving maladaptive relational pattern. Conclusions Chronic people-pleasing, as conceptualized by the "fawn response," represents a plausible and under-recognized etiological factor in female sexual dysfunction. Integrating assessment of perfectionism and interpersonal dynamics into clinical practice may improve identification and management of FSD. Future research should directly investigate the impact of chronic people-pleasing on sexual health outcomes and evaluate targeted interventions. This review underscores the importance of a nuanced, biopsychosocial approach to FSD. Disclosure No