Access, availability, and quality of service provision women and men experiencing problems related to their sexual health across Europe: Time to act in the wake of a survey on sexual and reproductive health care services by the European Board and College of Obstetrics & Gynaecology (EBCOG) and European Society of Contraception (ESC).
Tsiapakidou S, Kristufkova A, et al. • European journal of obstetrics, gynecology, and reproductive biology • 2025
Sexual and reproductive healthcare services for sexual dysfunctions, non-heterosexual orientation, gender incongruence, and sexual violence victims differ largely among European countries, with additional inequalities between urban and rural areas and for vulnerable groups.
Key Findings
Results
Care for women and men with sexual health problems including sexual dysfunctions, non-heterosexual orientation, and gender incongruence differs largely among European countries.
Assessment was based on expert opinion from 26 European countries
Survey was developed jointly by the European Board and College of Obstetrics and Gynaecology (EBCOG) and the European Society of Contraception (ESC)
Questionnaire responses were collected from experts in sexual and reproductive health across participating nations
Statistical analysis was performed using Microsoft Excel
Results
Care for victims of sexual violence differs largely among European countries.
This disparity was identified through expert opinion surveys across 26 European countries
This finding was part of a broader assessment of inequalities in sexual and reproductive healthcare (SRH) services
The survey represented a continuation of previous publications that highlighted disparities in contraception, abortion care, prenatal care, and STI prevention and care
Results
Inequalities exist in the availability and quality of sexual and reproductive health care between urban and rural regions across Europe.
Urban versus rural disparities were identified as a specific dimension of inequality assessed in the survey
The assessment covered 26 European countries
Rural regions were found to have comparatively lower access to SRH services based on expert assessment
Results
Vulnerable groups face inequalities in access to sexual and reproductive healthcare services across Europe.
The survey specifically assessed access to SRH services for vulnerable groups as a distinct research objective
Financial constraints and inadequate governmental commitment were identified as significant contributing factors to disparities impacting marginalised groups
These disparities persist despite policy changes across European nations
Background
Europe faces significant disparities in sexual and reproductive healthcare due to financial constraints and inadequate governmental commitment.
Disparities particularly impact marginalised groups
This survey was the third in a series, with two previous publications covering contraception, abortion care, prenatal care, and STI prevention
EBCOG and ESC have responded by creating curricula and exams for healthcare professionals to address identified gaps
What This Means
This research suggests that access to sexual health services across Europe is highly unequal depending on where people live and who they are. A survey of sexual and reproductive health experts from 26 European countries found major differences between nations in how well they provide care for people with sexual dysfunctions, LGBTQ+ individuals, people with gender incongruence, and survivors of sexual violence. These gaps are made worse by lack of funding and insufficient political commitment from governments.
The research also found that people living in rural areas have less access to quality sexual health services compared to those living in cities, and that vulnerable or marginalized groups face additional barriers to care. This study was part of a larger series examining reproductive healthcare across Europe, with previous reports covering contraception, abortion, prenatal care, and sexually transmitted infections.
This research suggests that significant policy reforms are needed across European countries to reduce these inequalities and ensure more consistent, high-quality sexual health services for everyone. In response to these findings, the European Board and College of Obstetrics and Gynaecology (EBCOG) and the European Society of Contraception have developed training curricula and examinations for healthcare professionals to help close these gaps.
Tsiapakidou S, Kristufkova A, Khattak H, Mukhopadhyay S, Mahmood T, Savona-Ventura C, et al.. (2025). Access, availability, and quality of service provision women and men experiencing problems related to their sexual health across Europe: Time to act in the wake of a survey on sexual and reproductive health care services by the European Board and College of Obstetrics & Gynaecology (EBCOG) and European Society of Contraception (ESC).. European journal of obstetrics, gynecology, and reproductive biology. https://doi.org/10.1016/j.ejogrb.2025.114034