Women’s Sexuality in India: The Silence Hurting Mental Health

The short answer: Sexual problems are common among Indian women, but very few seek help. Indian studies have found them in between a quarter and three-quarters of the women studied,[4][2] yet at one sexual health clinic in eastern India, only 0.8% of patients were women.[3] Sexual problems and stress, anxiety or depression often make each other worse. The good news: talking therapy, especially cognitive behavioural therapy (CBT), has good evidence for improving desire, arousal and satisfaction. When there is pain, it works best alongside a doctor.

Content note: this article talks about sexual violence and marital rape. If you are in danger or need to talk to someone now, call 112 in an emergency, the Women Helpline 181, or Tele-MANAS on 14416 (free, 24×7). More support numbers are at the end.

What is women’s sexuality, really?

Women’s sexuality is more than sex. It includes desire, pleasure, how you feel about your body, consent, relationships, identity, and the freedom to make your own choices about your body.

The World Health Organization (WHO) defines sexual health as feeling well physically, emotionally, mentally and socially in relation to sexuality, not just being free of disease. It adds that this is only possible when a person’s sexual rights are respected and protected.[1]

This matters in India. A woman can have no infection and no unwanted pregnancy and still not be well, if fear, shame, pain or pressure are part of her sexual life.

What do the numbers say about women’s sexual health in India?

The honest answer: not as much as they should. A review in the Indian Journal of Psychiatry found that most Indian studies of sexual problems looked at men, and only a few included women.[2] At one clinic for sexual problems in eastern India, the records of 237 patients showed that only 0.8% were women.[3] That is just one clinic, but it shows who usually comes forward for help.

Where women have been studied, the numbers are high. They vary a lot because each study looked at a different group of women and used different questionnaires.

The Indian Journal of Community Medicine notes that Indian data are still limited. In older studies, the problems women reported most were vaginismus (the vaginal muscles tightening on their own, which makes penetration difficult or impossible), painful sex and low desire.[6]

There is some good news from the government’s own survey. In the National Family Health Survey (NFHS-5, 2019–21), 82% of women said they can refuse sex with their husband.[7] Another report on the same survey looked at three situations: the husband has a sexual infection, he has sex with other women, or she is tired. About 80% of women and 66% of men said a wife is right to refuse in at least one of them.[8] Still, 8% of women and 10% of men said a wife cannot refuse for any reason.

Consent, violence and the law: where choice meets reality

A woman’s right to make choices about sex cannot be separated from her safety. NFHS-5 data show that 6.1% of women who have ever been married (3,895 of 63,851) reported sexual violence: roughly one in sixteen.[9] The Lancet Global Health reports that about 29% of women who have ever been married faced physical or sexual violence from a partner, down from 31% in the previous survey, NFHS-4.[10]

Very few women seek help. In an earlier national survey, only 23.7% of women facing violence from their husband told anyone. About 1% went to any formal source of help, such as the police or a health service.[11] That figure is from NFHS-3 (2005–06), so treat it as a picture of the past rather than today’s number.

The law adds another layer. Under Exception 2 to Section 63 of the Bharatiya Nyaya Sanhita (BNS), India’s main criminal law, sex by a man with his wife is not counted as rape if she is 18 or older.[12] On 9 September 2026, a Supreme Court bench led by the Chief Justice agreed to examine whether this exception is constitutional, under both the BNS and the old Indian Penal Code (IPC).[13] The case is listed for final hearing on a date still to be announced.[14] As of 2 October 2026, the Court had not decided.

One point is often missed. Even where this exception applies, forced sex within a marriage can still be treated as sexual abuse or domestic violence under the Protection of Women from Domestic Violence Act, 2005.[15]

How does silence about sex affect women’s mental health?

It works both ways. Worry and low mood can lead to sexual problems, and sexual problems can lead to worry and low mood. The research on this is consistent.

• Stress shows up in the body. In the Ahmedabad study, women under psychological stress were clearly more likely to have sexual problems.[5]
• Depression and sexual problems feed each other. A clinical review describes a well-known two-way link between sexual problems and depression, and notes that some antidepressant medicines can themselves cause sexual side effects.[16] A book chapter on mood and anxiety disorders reports that people with depression are two to three times more likely to have sexual problems.[17]
• Pain and fear are connected. One clinical study found that anxiety and depression each raised the risk of pain during sex, and that the pain in turn added to anxiety and depression.[18]
• Violence harms health. In one Indian analysis, women who faced sexual violence had a 77% higher risk of sexually transmitted infections.[19]
• Silence itself gets in the way. A 2024 review in the Indian Journal of Psychiatry says the taboo around talking about sex needs to be tackled directly. It adds that doctors’ training on sexuality is still uneven across India.[20]

Stigma hits hardest at the margins. In a survey of 300 trans women and 300 men who have sex with men in India, stigma about their sexuality and gender predicted depression. Support from others and healthy ways of coping reduced its effect.[21] The lesson applies to everyone: connection protects, isolation harms.

A caution on reading all this. Most of these studies looked at people at a single point in time. They show that two things tend to go together, not that one causes the other.

Five myths about Indian women and sex, tested against evidence

What can be done to improve women’s sexual and mental health in India?

No single fix works. Change is needed at four levels at the same time.

1. For women, individually

• Learn the right words for your own body. Accurate information is the first step out of shame.
• Treat ongoing pain, loss of desire, fear of intimacy or distress after sex as health issues worth raising, not private failures.
• Have at least one safe person to talk to: a friend, a doctor or a counsellor.

2. For couples

• Talk about consent and comfort before problems start. NFHS-5 shows that most women feel able to say no, which is a good base to build on.[7]
• Treat a sexual difficulty as a problem you share. Couple therapy is one of the treatments recommended for vaginismus in the Indian clinic study.[22]

3. For schools and communities

• Expand comprehensive sexuality education: age-appropriate teaching about bodies, relationships and consent. A review of Indian programmes notes that mental health is starting to be included, but progress has been slow.[25]
• Prefer programmes that the community takes part in and helps shape. The school review suggests these deal with cultural taboos better.[23]

4. For doctors and policymakers

• Train gynaecologists, family doctors and psychiatrists to ask about sexual health. The Indian Journal of Psychiatry review recommends ongoing training courses and workshops.[20]
• Collect better data. Indian research on women’s sexual health is still thin.
• Settle the legal question on marital consent, which is now before the Supreme Court.

How can therapy help with sexual and emotional wellbeing?

Therapy does not mean being told what to do in your bedroom. It is a private, structured space to understand fear, shame, pain, past experiences and relationship patterns, and to learn practical skills.

What the research shows

• A 2025 meta-analysis (a study that pools the results of many trials) looked at 10 randomised trials with 837 women. CBT improved sexual function more than waiting for treatment (moderate-certainty evidence) and more than usual care (low-certainty evidence). The authors say larger trials are still needed.[24]
• A 2024 systematic review of seven trials with 448 women found CBT improved satisfaction, lubrication, desire, orgasm and the confidence to ask for what one wants. It did not reduce pain during sex.[26]
• For low desire, a meta-analysis cited in a 2025 study found CBT had its largest effect there (d = 0.91 compared with waiting, which counts as a large effect). The same paper reports that online CBT and mindfulness programmes also work.[27]
• In India, a case series followed five women with vaginismus for 3 to 8 months while mental health and gynaecology teams treated them together. Two of the women later became pregnant. It is very small, so see it as a hopeful example, not proof.[28]

What therapy typically works on

• Unhelpful beliefs such as “good women do not want sex” or “pain is normal”.
• Anxiety, pressure to perform, and avoiding intimacy. Techniques like sensate focus (step-by-step touch exercises with no pressure to have sex) shift attention from performance to sensation.[16]
• Trauma, body image and relationship conflict that lie underneath the problem.
• Communication and consent skills, alone or with a partner.

Why a team approach matters. Pain can have medical causes as well as links to fear and anxiety, so a clinical psychologist or psychiatrist often works alongside a gynaecologist. That is the approach used or recommended in the Indian vaginismus studies above.[22][28]

Where to start

• Look for a qualified clinical psychologist or psychiatrist trained in sexual health.
• Call Tele-MANAS on 14416, the government’s free 24×7 mental health helpline, run with NIMHANS.[29] It offers support in 20 languages,[30] and its topics include relationships, sexual abuse and gender identity.[31]
• If you are in danger or being forced into sex, your safety comes first. Contact someone you trust, the local police or a women’s helpline, and see a doctor.

Common questions

Related reading: sexual therapy for men in India, romantic attachment styles, couples therapy, and queer-affirmative care.