Childhood sexual abuse (CSA) and adolescent/adult sexual assault (AASA) are significant public health issues that profoundly impact sexual well-being. This study examined the associations between CSA, AASA, and sexual function and distress across diverse demographic groups and cultural contexts. A cross-sectional, self-report study was conducted using the International Sex Survey with 82,243 participants from 42 countries. Data were analyzed using 3D association analyses and structural equation modeling to assess the impact of CSA and AASA on sexual function problems and sexual distress. Findings revealed significant associations between both CSA and AASA with higher levels of sexual distress and sexual function problems. Gender differences showed that men and gender-diverse individuals exhibited similar levels of sexual function problems and distress as women. Significant variations were observed across sexual orientations, with heterosexual and bisexual individuals reporting more sexual function problems and distress compared to queer, asexual, and pansexual individuals. These results emphasize the lasting impact of CSA and AASA on sexual well-being, highlighting the importance of trauma-informed and culturally sensitive interventions. Tailored approaches in trauma-informed sex therapy are critical, with particular attention to gender, sexual orientation, and cultural factors to effectively address the effects of abuse on sexual health.
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