Introduction

Sexual health is a fundamental component of personal health (mental and physical), which affects males and females of all ages (Biri et al., 2007; Sadat et al., 2016). According to the WHO (2012), sexuality is “a central aspect of being human throughout life” (Rousdy, 2013). Sexual education has a vital role in healthy sexuality; it refers to a lifelong process of acquiring information and forming attitudes, beliefs and values of sexual development, reproductive health, interpersonal relationships, affection, intimacy, body image and gender roles. In other words, sexual education addresses the biological, sociocultural, psychological, and spiritual dimensions of sexuality” (UNFPA, 1994). Knowledge about sex aims at establishing and protecting sexual development. It gradually provides children and young persons with needed knowledge and positive attitudes to realize their bodies and enjoy their future sexual life, have safe and fulfilling healthier, stronger, and meaningful sexual relationships and take responsibility for their own and their intimate partner’s sexual health (Rousdy, 2013). Thus, sexual education ought to start in early childhood and develop through adolescence and adulthood (Dong et al., 2022; European Expert Group on Sexuality Education, 2016). In this vein, Farah and Shahram (2011) stated that having sexual knowledge can have powerful impacts on feelings toward sexual relationships, conflict resolution, and overall marriage satisfaction. Additionally, it can strengthen positive emotions between partners, strengthen beliefs around how sex contributes to marriage preservation, increase personal satisfaction, and facilitate the conversational discussion of sexual issues. This can lead to improved marital satisfaction.

Considering the prior literature, three myths can be related to sexual education or sex in general. First, in some cultures (Eastern culture as a model), having some knowledge about sex may provoke young people to have sex earlier than expected. On the other hand, the absence of scientific sexual knowledge may lead to receiving destructive messages from insufficient sources such as family, peers, and media, and in the long term, they may have unhealthy and dissatisfied sexual experiences with their intimate partners (European Expert Group on Sexuality Education, 2016; UNESCO, 2009). In contrast, it has been shown in research from Europe that proper sexuality education leads to delayed sexual debut and more responsible sexual behavior. This does not mean that children's "innocence" is robbed – equipping them with scientifically accurate, nonjudgmental, and age-appropriate information about sexuality can be beneficial for them (UNESCO, 2009; Van Keulen et al., 2015).

Second, programs related to sexuality do not teach teenagers how to have sex or/and increase their sexual desire physiologically, psychologically, and morally. These programs aim at teaching vital information regarding sexual physiological changes, as they are undergoing and are concerned about human body structure, marriage and reproduction. In addition, sexual psychology programs involve fostering teens' self-awareness, helping them recognize their sexuality and develop their interpersonal skills. In addition, sexual morality refers to an individual's attitude toward sex, and the education of sexual morality aims at helping young adults develop their own attitude toward sex (Dong et al., 2022; Lingyan, 2009). In addition, they involve crucial information that aims to protect them from risky behavior (Rousdy, 2013). Thus, these programs may lead to a reduction in pregnancies and abortions and a decline in rates of sexually transmitted infections among young people (European Expert Group on Sexuality Education, 2016; UNESCO, 2009).

Third, although most young people are curious about sex, gender inequity and social norms are obvious in this issue because traditional sexual morality has more strict restrictions on girls. Young women often lack power and control in their sexual relationships, whereas young men may feel pressured to act according to masculine standards of behavior and act in ways that can be controlling or even dangerous (Dong et al., 2022; European Expert Group on Sexuality Education, 2016; Sadat et al., 2016). In this vein, Oliver & Hyde (1993) stated that men tend to show a more unrestricted sexual tendency than women, show positive attitudes toward casual sex, and fantasize more about the actual sex act. Therefore, adults tend to ignore discussion about sexuality, especially with girls; when they ask questions about sexual matters or express their sexual desires, adults frequently respond with anger, which can make girls feel guilty and ashamed. Subsequently, it is essential that girls receive support and guidance from adults to make well-informed decisions about their sexual and reproductive health. Without such adult guidance, girls may be at risk of taking part in potentially hazardous sexual behaviors, as well as being exposed to potential exploitation by sexual predators, putting young girls at risk of sexually transmitted infections (Koch et al., 2019). Hence, a basic right for women and men is to provide them with the necessary understanding of their sexual responsibilities and enrich proper sexual knowledge, which can help couples have a more satisfying and healthy relationship (Dong et al., 2022; European Expert Group on Sexuality Education, 2016; Sadat et al., 2016).

According to previous studies, there is a lack of knowledge about sexuality in conservative societies comparable with Western societies. For example, Sadat et al. (2016) demonstrated that approximately 50% of Iranian premarital couples had insufficient knowledge regarding sexual health. Consistently, a qualitative study was conducted among Iranian adolescents to identify the barriers that may prevent them from gaining sexual knowledge and reproductive health. The results revealed that four main categories of barriers were social and cultural issues such as taboos, structural and administrative issues such as a less-than-adequate health system, political obstacles such as a lack of strategy adopted by the government, and the nonutilization of religious potential (Shariati et al., 2014). Another study conducted by Agha Mahdian Sherbaf et al. (2005) agreed that Iranian women who are about to marry are prevented from having sexual and reproductive knowledge. The importance of sexual training before marriage among couples was 81% for men and 73% for women. In addition, the importance of having regular sexual relations was 51% for women and 67% for men. The ability to articulate sexual needs by women was 34% easily, and by men, it was 59% easily. Offering to have intimate intercourse by women was 41% never and 5% always, and by men, it was 5% never and 24% always. A woman's ability to arouse a sexual partner was always 24%, and a man's ability to arouse a sexual partner was always 27%. The ability to satisfy a sexual partner by women was always 37%, and by men, it was always 34%. Over the past few decades, sexual education has been a crucial component of the educational system in the United States, a developed Western nation. However, the disparity for African American adolescent girls, who may have fewer opportunities to receive the same education as other teenagers, is one example of a point that is still being overlooked (Dong et al., 2022). Another Indian study showed that India is an extremely conservative society about educating students about sexual matters in high schools. In addition, professional medical settings do not transfer the needed skills and knowledge concerning sexual health. Therefore, Indians are often exploited by “healers” who spread misconception about sex (Rao et al., 2012).

Discussion about human sexuality is rarely investigated in the Middle East as conservative cultures because it is considered one of the taboos. Consequently, there are societal constraints and limitations to examining sexuality (Abdelaziz, 2009). Parents and/or youth can be reluctant toward sexual education, and officials, such as schools, universities, religious institutions, and youth centers, are often unwilling to take initiative. For instance, many Egyptian families do not share basic knowledge about human sexuality with their children, as they are uncomfortable having this type of conversation or simply lack the needed information. Accordingly, the ignorance of young people and easy accessibility to social media have increased exposure to misinformation and misconception about sexuality, leaving them more vulnerable to undesirable practices and their negative consequences (Abdelaziz, 2009; Rousdy, 2013). It is religiously and culturally common in Egypt that having sex is only related to sexual activity between married couples, and it is culturally unacceptable and undesirable to disclose about sexual needs before marriage, especially for women (Rousdy, 2013). However, sexual behavior is not limited to sexual activity between married couples; it also includes masturbation, safe and risky sexual behavior, reproductivity, sexually transmitted infections, and sexual dysfunction (Rousdy, 2013; Sadat et al., 2016). In this context, a study conducted by Abdelaziz (2009) to examine the results of sexual knowledge and practices among Egyptian and Jordanian women revealed that both groups of women have a lack of satisfaction and misconception about sex.

A theoretical framework for the present paper is provided by an examination of the challenges that women face as they attempt to sexually emancipate themselves in conservative and patriarchal societies (e.g., Egypt). A key component of emancipation theory, introduced by Welzel (2013), is the contextual consideration of the surrounding circumstances that facilitate women's emancipation (Mousa 2022; Mousa & Samara, 2022). According to the theory of emancipation, an emancipating woman comes as a result of liberation of human beings either as individuals or groups from social, legal, cultural, economic, or/and political restraints and oppression (Kolasi, 2023; Mousa 2022; Mousa & Samara, 2022; Welzel, 2013, 2014). Emancipation theory is perceived because of the three primary dimensions. First, action resources reflect how much control women perceive, and they have over their own lives based on their perceptions of their physical, intellectual, and material resources (Mousa 2022; Mousa & Samara, 2022; Welzel, 2013, 2014). Second, emancipative values, a woman’s level of authority, safety, security, and appreciation, can be reflected in the extent to which they participate and engage fully within their societies (Mousa, 2022; Mousa & Samara, 2022; Welzel & Inglehart, 2010). Finally, institutional empowerment indicates how serious society, and its institutions are about institutionalizing and protecting the rights and freedoms of unheard voices of women and describes the extent to which women enjoy political, sociocultural, and economic rights to enforce gender equality (Grosvold & Brammer, 2011; Mousa 2022; Mousa & Samara, 2022). Overall, there seems to be some evidence indicating that women have poorer knowledge about sex than men, and few studies address such a sensitive topic in conservative cultures (Egypt as a Model). Hence, the current study offers some important insights into attitudes toward sexual knowledge among premarital and married Egyptian women and women's agency in presenting sexual desires and gaining sexual knowledge in Egypt.

Methodology

Sample and Data Collection

Convenience sampling was used. A total of 32 Egyptian women volunteered to participate in the current study (as shown in Table 1). The age of the participants ranged between 21 and 45 years old. The data were collected in March 2023 in Egypt. The current study draws volunteers from personal networks. The snowballing method was adopted to recruit more respondents. All women were assured that their participation was voluntary, that their shared experiences and information would be used only for scientific purposes and that they would remain anonymous. In addition, the respondents were also told that they could withdraw from the interview at any time, and the author attempted to accord them a comfortable and safe space to share their experiences. Given the sensitivity of the topic, the author took very detailed notes throughout the interviews after participants’ permission. Primary data were collected through semistructured interviews with respondents, and the duration of each interview was approximately 30–40 min. An interview manual (see the appendix) was prepared based on a literature review (e.g. Abdelaziz, 2009; Menshawy et al., 2021). Broadly, open- and close-ended questions were included to determine the women’s knowledge and attitudes about sex. The Arabic language was used in all of the interviews. Furthermore, to ensure the accuracy of the translation, the author subsequently made parallel back-and-forth translations to convert their English transcripts into Arabic to compare the original transcript with the developed transcript.

Table 1 Respondents characteristics
Full size table

Data Analysis

A qualitative content analysis was used to analyze the collected data. Content analysis represents a systematic and objective means of describing and quantifying phenomena. Based on the view of Hsieh and Shannon (2005), qualitative content analysis is “a research method for the subjective interpretation of the content of text data through the systematic classification process of coding and identifying themes or patterns”. The data were analyzed manually by the author in three steps. First, data coding is performed to determine which categories of data are representative of the concept. Second, analyzing the coded data helps to combine the categories to create themes. Third, the author has summarized the identified findings that emerged from the coding to formulate and restate them so that they can be understood easily and applied, as well as to articulate the patterns and relationships among the findings (White & Marsh, 2006). Data analysis follows a deductive approach, which is guided by prior literature. However, the interview process allowed for new themes and patterns to emerge throughout (Shousha, 2023), whereby more insight into women’s sexual education was gained.

Results

Three main themes were constituted from the conducted interviews: (a) attitudes toward being sexually educated, (b) gender inequity in sexual knowledge, and (c) general knowledge about sex. The section that follows defines details of each theme and highlights some narratives offered by respondents.

Theme 1: Attitudes Toward Being Sexually Educated

This theme has captured three subthemes of women’s attitudes regarding sexual education in Egyptian society. First, religion's view of sexual education; 18 respondents stated that they do not believe religion prevents people from being sexually educated, whereas 13 respondents stated they were not certain about religion's position on sexual education (most of the sample were Muslims). Second: women’s fears of social stigmatization; 20 women reported that they were not comfortable discussing such topics with their family members or relatives. Furthermore, most women were uncertain whether they could consult a sexual health professional. Third, regarding attitudes toward sex, according to most respondents (30 women), sexual education is a mandatory topic for adults; 21 women said it is a mandatory topic for children; and 23 women reported they are not ashamed or embraced by the word "sex". Overall, the findings showed that most of the women had a positive attitude toward sexual education. Therefore, the findings have revealed that there is still some embarrassment and shame associated with women expressing their sexual needs or seeking more information.

Theme 2: Gender Inequity in Sexual Knowledge

In the second theme, the respondents expressed their concerns regarding women's social oppression when expressing their sexual needs. It was agreed that men have the right to obtain knowledge about sex and that Egyptian society supports men in acquiring such knowledge. This is noted in the following quotes:

“The community provides men with greater space and freedom to express their sexual desires compared to women".

Another woman said, "Men have everything in our society. They are luckier than us; they can do anything without others’ blame."

“Our community maximizes and accepts a man's sexual desire, and he is more sexually inclined than a woman. However, if a woman expresses her sexual desires, it is considered unusual, anti-traditional, and shameful."

“In Eastern culture, it is believed that men are afraid of women who have knowledge about sex, as they assume that this knowledge is a result of previous sexual experiences, which is considered unacceptable.”

Some respondents stated that “men may fear women who have knowledge about sex, believing that women may demand more, and this may not suit their sexual abilities”.

In the current study, participants stated that Egyptian society stigmatizes women who ask for a divorce if their partner has sexual difficulty:

“The community views them as lustful, lacking in education, and seeking to satisfy their desires without regard for their family's interests."

Another respondent said, “It’s normal in our community to support a man's decision to divorce his wife or marry another woman if she has a sexual problem. This is because it is his right both legally (she means Sharia law) and socially.

Theme 3: General Knowledge About Sex

Last, this theme includes three subthemes of women's sexual knowledge as follows: (A) Women’s sources of sexual knowledge; the internet is the most common source of information about sex, followed by books and then experienced friends. (B) Knowledge and attitudes of some sexual matters; there is agreement that intimate relationships should be an enjoyable experience for both partners. Therefore, all respondents agreed that they had heard of masturbation. Fifteen participants reported that they occasionally engaged in it, whereas 17 participants did not practice it. Consequently, participants' attitudes toward masturbation varied; the majority of women perceived it as a wrong habit and religious taboo, in addition to its medical harm; only six participants indicated that masturbation is a normal habit. As a result, 16 respondents stated that they are fully aware of sexual positions, and 12 said they have some understanding of sexual positions. Furthermore, fourteen participants indicated that the woman's sexual desire continued throughout her life, while 12 were unsure. Six participants mentioned that sexual desire stops at menopause. (C) Indications of successful sexual relationship; according to the participants in the current study, there are indicators of successful sex relationships, including penis length. Fourteen participants said there is no relationship between penis length and women's orgasm; 10 participants said they are unsure; and 8 participants connected penis length to pleasure. A further indication is that 25 women said that foreplay and achieving orgasm for both partners are essential. Furthermore, there was consensus among the participants that they could not determine the most appropriate duration for sexual intercourse.

Discussion

Western literature has highlighted the importance of sexual education; however, Arabian research initiatives, using Egypt as a model, have not yet addressed such sensitive issues. Regarding the first and third themes, the findings of this study are consistent with previously conducted empirical studies in conservative cultures, which focus on societal barriers that may prevent women from acquiring sexual knowledge (Agha Mahdian Sherbaf et al., 2005; Rao et al., 2012; Sadat et al., 2016). The current findings are in line with Abdelaziz (2009), who stated that human sexuality is considered a social taboo for women. In agreement with this, the results of the current study revealed that women were reluctant to consult professionals, and their families could not discuss their sexuality, which is consistent with the fact that the internet is the most common source for obtaining such knowledge. This result agrees with Abdelaziz, 2009 & Rousdy, 2013, who found that accessibility to social media has increased exposure to misinformation about sexuality. On the other hand, trustworthy sources, such as families, schools, and religious institutions, have reluctant attitudes toward sexual education and can be unwilling to discuss such topics. Moreover, there is a significant social stigma associated with being sexually educated in Egypt. Many families perceive that women's sexual knowledge may cause them to have illicit sexual relationships before and during marriage. Furthermore, there are other concerns about having such knowledge, such as the possibility that a woman's partner may suspect she has experienced sexual activity before getting married due to the result that prior research supports the notion that illiterate sexuality matters are important in conservative cultures (Abdelaziz, 2009; Rousdy, 2013; UNESCO, 2009).

Some religious fears may play a crucial role in conservative communities as a possible explanation for these results. Religious interpretations contain strict restrictions as to what constitutes acceptable and unacceptable sexual behavior. Moreover, sexual education has long been a source of anxiety for parents, especially those with extreme religiousness; parents want to ensure that educational curricula do not undermine their moral and extreme religious views (Bouma, 2018). In Islam (for example), there are religious texts that encourage sexual education as a means of protecting teenagers from unwanted practices and that sexual education is important for understanding marital rights and obligations for both men and women, while some religious men with extremist views (called Sheikh in Islam) prohibit sexual education for women while not imposing the same restrictions on men. Moreover, initiatives by the Egyptian Ministry of Education to incorporate reproductive physiology, human sexuality, and family planning information into science curricula for preparatory and secondary school students have proven insufficient (Halla, 1998), and as Rousdy (2013) explains, it is not just the reluctance of parents or young people who stands in the way of sex education but, more importantly, the reluctance of school and religious institutions to support these initiatives. Accordingly, a significant debate still exists in Egypt regarding the integration of sex education into school curricula, with supporters and opponents of such ideas.

Concerning the second theme about gender inequity in sexual knowledge, the current investigation has found that there is a societal agreement that men should take the lead in acquiring knowledge about sex. In this vein, previous studies have demonstrated that adults ignore discussions about sexuality, particularly with girls. When girls express their sexual desires or ask questions about sexual matters, adults may react with anger, which may cause them to feel guilty or embarrassed, leaving girls uninformed and vulnerable when they are exposed to sexual issues (Dong et al., 2022; Koch et al., 2019; Oliver & Hyde 1993; Sadat et al., 2016). Furthermore, many barriers exist, including social, religious, and cultural barriers that prevent women, especially single women, from gaining sufficient knowledge about sexuality. (Agha Mahdian Sherbaf et al., 2005; Sadat et al., 2016; Shariati et al., 2014). These barriers can be reflected in expressing sexual needs considered unfavorable for women because it is indicative of their premarital experiences; it may adversely affect their reputation and often be met with adults’ judgmental attitudes (Abdelaziz, 2009; Koch et al., 2019; Rousdy, 2013; Shousha, 2020). With respect to the way Egyptian women are raised, they are raised to be dependent, oppressed, and devalued compared with men, as Shousha (2020, 2023) found that Egyptian society strongly endorses masculine stereotypes from childhood; men tend to be assertive, independent, control-oriented, and playful, have an expanded experience in sexual matters, and be dominant, while women tend to be supportive, innocent, caring, and dependent. Based on Emancipation theory, there are two arguments regarding attitudes toward sexual knowledge in Egypt. Progressive nationalists believe that women should be emancipated from erroneous religious prescriptions and traditional practices. For instance, it was argued by conservatives that any change in the direction of Western modernity, particularly as it pertains to women's positions in society, would mean the loss of cultural identity, and for that reason, gender relations were to be governed according to Islamic religious law (such as Sharia in Islam) as they understood it. Therefore, to maintain moral integrity and social cohesion (Göle, 2015), sexual conservation is mainly linked to the acceptance of traditional norms in addition to adherence to social values concerning sexuality. However, Islamist reformists that Islam did not restrict progress or that the modern ideals of gender equity and human rights could be embraced within Islam (Göle, 2015), called sexual liberalism, which is associated with the acceptance and/or affirmation of person sexual freedom and respect for one’s sexual autonomy (Guerra & Gou-veia 2012). Consistently, as a prerequisite for national progress, learning how adults themselves need liberation and emancipation from their own fears and discomfort with sexuality is one of the prerequisites to emancipating upcoming generations of young girls. Thus, the outcome of emancipating human beings is promoting human liberation values, such as self-realization, happiness, sexual fulfilment, and well-being (Kolasi, 2023). Accordingly, sexually emancipated girls need adults’ support and guidance to deal with complex sexual challenges (Koch et al., 2019). In addition, to enhance and liberate girls’ agency, it is imperative that they engage in proactive conversations about sexuality so that they may make sensible choices and become more comfortable with their own sexuality. Consequently, we first and foremost have to listen to their viewpoints on the ways in which adults engage with them in sexuality-related conversations (Koch et al., 2019).

Limitations

The present study contributes to the literature on women’s sexual education. This study has four limitations. First, the current sample design is nonrandom snowball sampling, which limits the generalization of the results. In other words, the findings may not be applicable to all Egyptian women. Second, another limitation might affect the generalization of the results by recruiting a small sample size. Third, the current study overlooked a number of demographic factors (e.g., educational level, marital status, income, and religion), which may affect attitudes toward sexual knowledge and education. Fourth, according to the qualitative analysis, there is a probability of participant bias because of the knowledge and experiences developed through interviews with experts. Consequently, it is endorsed to use exploratory sequential design as one of the mixed methods designs to guarantee more objectivity in the results.

Conclusion

Sexuality is about pleasure, health, and understanding our bodies and others’ needs. Sexual education has a crucial role in healthy sexuality through obtaining information and forming positive attitudes about interpersonal relationships, affection, and intimacy. However, sexual education has not been adequately examined in Egyptian literature because it is perceived as one of women's taboos. According to the current findings, women face two levels of barriers that may prevent them from gaining proper sexual knowledge: at the micro level, such as families, and at the macro level, reflected in religion and educational institutions and the health care system. Current research has demonstrated that most women have a positive attitude toward sexual education, which may be attributed to their high educational level. However, the findings also show that women still feel embarrassment and shame related to sharing their sexual needs or seeking more information. Furthermore, the respondents expressed their concerns regarding women's social oppression when expressing their sexual needs. This can be explained by gender discrimination in acquiring knowledge about sex. Moreover, the study revealed that women have quite a bit of sex knowledge; however, they mostly depend on the internet for this knowledge. Thus, sexual education helps enhance social-emotional health for all people. Accordingly, it is time for men and women in Egyptian culture to have equal rights to obtain knowledge about sexuality. This would strengthen their intimate relationship and, hence, have a positive impact on their marriage, especially their sexual satisfaction. On the one hand, including age-appropriate sexual education curricula in schools will increase students' understanding of their bodies and how to care for them.