Women who have sex with women: a comprehensive review of the literature and conceptual model of sexual function

Women who have sex with women (WSW) have been underrepresented in studies on sexual function. Consequently, much of what is known of female sexual function may not be representative of, or generalizable to, the experiences of WSW. The purpose of this paper is to provide a comprehensive and critical review of the literature on the sexual function of WSW, followed by an integration of the literature in a conceptual model to guide and stimulate research. Twenty-six articles are reviewed and 15 factors are identified as contributing to sexual functioning in WSW and are subsequently included in the conceptual model. Of these, it is suggested that eight factors may contribute directly to sexual function. These include: age, income, religion, cultural recognition, relationship duration, sexual satisfaction, psychological well-being, and relationship satisfaction. The literature suggests the remaining seven factors may indirectly contribute to sexual function. These include: sexual frequency, desire discrepancy between partners, internalized homonegativity, power, social support, emotional intimacy, and a discrepancy between partners in level of being “out” as a lesbian or bisexual woman. Comparisons are made to the sexual function of women who have sex with men and the implications of having a model that recognizes similarities while also considering unique influences for WSW are discussed.