Sexuality in Morocco: Women sexologist's point of view

(1)

Sexologies (2010)19, 20—23

ORIGINAL ARTICLE

Sexuality in Morocco: Women sexologist’s point of view ^夽

N. Kadri (MD)

^∗

, K. Mchichi Alami (MD) , S. Berrada (MD)

Centre psychiatrique universitaire Ibn Rochd, rue Tarik Ib Ziad, Casablanca, Morocco Available online 24 April 2009

KEYWORDS Sexuality;

Islam;

Sexual dysfunctions;

Child abuse;

Sexual behavior

Summary After a brief overview of the religious and cultural aspects that underpin sexuality in Morocco, we look at various studies of sexuality for Moroccan women conducted by our team in past years. Studies in Casablanca, Morocco have investigated various aspects of sexuality in traditional Muslim society: sexual behavior, sexuality during ‘‘Ramadan’’, sexual dysfunctions, sex-abuse of children, and the impact of menopause, pregnancy and mastectomy on sexuality. The following conclusions were reached: there are still overwhelming taboos in Moroccan society, information is lacking, the sexual practices and disorders are the same as in Western countries, and sex education focuses on the ‘‘hashouma’’ (a mixture of shame and interdicts), and on preserving one’s virginity.

• Morocco is a country of great contrast and diversity, in the process of major socioeconomic transition, with its roots in Arab and Muslim traditions.

• Islam is a monotheistic religion which encourages mutual pleasure between spouses; sex can only take place within the boundaries of marriage.

DOI of original article:10.1016/j.sexol.2009.03.004.

夽 Également en version franc¸aise dans ce numéro : Kadri N, Mchichi Alami K, Berrada S. La sexualité au Maroc : point de vue de sexologues femmes.

∗Corresponding author.

E-mail address:n.kadri@menara.ma(N. Kadri).

• Studies have underlined the importance of taboos, the lack of information, the same sexual practices and dysfunctions as in Western countries.

• Sex-education focuses on ‘‘hashouma’’ (a mixture of shame and interdicts) and on upholding virginity.

History and Introduction

In 1948, in the United States, Alfred Kinsey published a ground-breaking report on the sexual habits of his compa- triots. This document had the effects of a bomb. For the ﬁrst time, human sexual behavior was scientiﬁcally studied.

His work unleashed unprecedented passion and controversy which still rages today.

doi:10.1016/j.sexol.2009.03.005

(2)

Sexuality in Morocco: Women sexologist’s point of view 21 Fifty years later, in 2000, in Morocco, Khadija Mchichi

Alami and Nadia Kadri have conducted a major epidemiological survey into female sexual behavior (Mchichi Alami et al., 2000).

The two authors used as inspiration the standard proto- cols and questionnaires established in 1992 by Alfred Spira’s team similar studies conducted in France.

This survey investigated different aspects of sexuality for the ﬁrst time without taboos or prejudice, using the tech- nique developed by Alfred C. Kinsey:

• knowledge, attitudes, beliefs, practices, sexual dysfunctions, sexual violence;

• premenstrual dysphoric disorder (PMDD), impact on the couple’s relationship, on their mental and physical health, etc.

The results of this major survey totally broke down the taboos on sexuality in Moroccan society, and enabled all the players to be brought together as experts in their ﬁeld.

And thus it could ﬁnd its identity, a status, a karyotype combining several well-deﬁned and distinct genes:

• from anthropology;

• from sociology;

• from philosophy;

• from art;

• from psychoanalysis;

• from law;

• from religion;

• from clinical practice;

• and so on.

The results of this study have been recorded in a national database on sexuality in Morocco and the ﬁrst diploma in clinical sexology ever to be awarded in an Arab-Berber- Muslim country was given in 2004, 6 years after the survey of female sexual behavior in Morocco (KhadijaMchichi Alami et al., 2000).

An overview of Morocco

Morocco’s geographic position is to the West of Algeria, with the Mediterranean Sea to the North, the Atlantic Ocean to the West and Mauritania to the South. The country is a constitutional monarchy and Islam is the ofﬁcial religion. Its demographic density is approximately 44 km², with the highest concentrations of population in the cities such as Casablanca which is the second most populated city in Africa. The illiteracy level is 41.2%, with the highest prevalence in the rural areas. Although the Moroccan population is young, the population continues to age. Current life- expectancy is about 70 years.

The main ethnic group is the Arab Berbers. The main language is Moroccan dialect which is quite different from classic Arabic (Kadri and Moussaoui, 2001).

The Koran lies down the main lines of sexual practice in about 12 verses, praising sexual pleasure as a necessary part of life for a believer: ‘‘They (women) are garments for you, and you for them (. . .). (the Koran«la Génisse»).

Although sexuality is strongly encouraged by Islam, this is because it plays three important roles:

• it enables believers to reproduce on earth; Islam is a pop- ulationist religion and the very action of reproduction is a symbol of power;

• Islam recommends that believers should taste the plea- sures of the senses, but only within an authorized environment (Kadri et al., 2001);

• Islam encourages believers to see their sexuality as an important and mandatory factor of pleasure and happi- ness within the couple; an important aspect of sexuality for Islam.

Sexuality in Islam is characterized by the following prin- ciples:

• it is only acceptable within a married couple;

• the man and the woman devote themselves to each other;

• it is a need that must be satisﬁed;

• pleasure is one of its objectives;

• it must be practiced in private;

• sexual relations between spouses is a charitable action;

• need for mutual attention during the sexual relationship;

• the man must satisfy his wife.

Overview of studies conducted on sexuality

Female sexual behavior, an epidemiological study on the general population (Mchichi Alami et al., 2000)

The objective of this study is to explore the sexuality of women aged 20 and over. The study was conducted on a sample of 800 women considered to be representative of the population of Casablanca. This study produced a certain amount of data:

• preserving one’s virginity is considered to be a social duty in 98.8% of cases;

• sex before marriage is prohibited for 82.8% of women;

15.9% of women had never had sexual relations in their life;

• sex-education is seen as having a negative impact on children in 31.5% of cases;

• adultery is considered to be forgivable for men, but not for women in 80% of cases;

• 83% of the women mixed up sexual longevity and hormonal activity; menopausal women speciﬁed that naturally, women have no interest in sex and could cease all sexual relations quite easily;

• a couple unable to have children is seen as a tragedy for most women because the woman is usually considered to be the cause of the sterility in the couple, and men are allowed to take additional wives for this reason;

• at least 30% of women reported no foreplay to inter- course, although one religious writing states ‘‘No man should fall upon his wife like an animal. There is a mes- senger between them. . .the kiss’’, as prescribed by Uum Salama;

(3)

22 N. Kadri et al.

• masturbation is considered to be prohibited by religion (90%), leading to shame and guilt (83%), or to be authorized by religion as a means of appeasing the effects of sexual abstinence (15%);

• the Hambalite school is very clear on the subject:

‘‘masturbation is tolerated only when it is used as a means to avoid adultery or a risk to physical health, or for those who cannot marry ‘‘Kachâfoul Qina and Ghâya- toul Mountahâ’’. The women were very reluctant to talk about sodomy, but 3.2% of them stated that their husbands forced them into it despite their refusal. It is prohibited in many religious texts: ‘‘A man is allowed to take his wife wherever he pleases, but with the aim of penetrating her vagina’’ (Al Boukhari, Moslim). ‘‘Allah does not respect a man who sodomises his wife’’ (An-nassa’i).

Sexual dysfunction in women: population based epidemiological study (Kadri et al., 2002)

The objective of this epidemiological study, conducted on a representative sample of the population of women aged 20 and over in Casablanca, Morocco, is to determine the prevalence of sexual dysfunction in women. Criteria of sexual dysfunction followed classiﬁcation by DSM-IV.

The main results were that 26.6% had sexual dysfunction always or often during the 6 months before the study. The most common ﬁnding was hypoactive sexual desire disorder;

age, ﬁnancial dependency, number of children, and sexual harassment were positively correlated with this result.

The prevalence of remaining disorders resembled that found in the literature (Kadri et al., 2007). Even though these women were aware of their disorder and its negative impact on their lives, only 17% of them asked for help.

Moroccan females with a history of sexual abuse:

population-based study (Mchichi Alami and Kadri, 2004)

Childhood sexual abuse is deﬁned as sexual contact imposed on a child whose development is still, from the emotional, cognitive and maturity point of view, lacking.

The objective of this epidemiological study, conducted among a representative sample of the female population aged 20 and over in Moroccan women, is to determine the prevalence of childhood sexual abuse and its long-term repercussions (Alami et al., 2006).

The main results were that 9.2% (N= 65) reported childhood sexual abuse. The mean age of this group was 31.34±9.43% years (20—63); 66.1% were housewives: 40%

were single and 10.8% were divorced.

The prevalence of genital abuse with penetration was 33.8% (22 cases). The abuser was known to the child in 56.2%

of cases and was a family member in 20.4% of the cases. Of the 800 women interviewed, 43.5% (N= 27) abused women and 29.5% (N= 83) non-abused women during childhood reported depressive symptoms with a positive association (p= 0.03). There was also an association between the most severe types of abuse and vaginismus. Generally speaking, all those abused during their childhood suffered sexual disturbances during their adult life.

Menopause and mental health: a comparative study between Moroccan and Tunisian populations (Kadri and Zarbib, 2000)

The objective of this study was to explore the mental condi- tion of menopausal women. Two populations of 100 women (Casablanca and Tunis) were included. They were aged between 40 and 60 years. They were married, multiparous, with low levels of education, low and moderate socio eco- nomic levels. The mean age of menopause was 51.64% years for Moroccan sample and 48.74% years for Tunisian ones (p= 0.5). Decreased sexual activity was found in 86.5% in Moroccan women and in 63.3% for Tunisian ones. Related causes for Moroccan sample: dyspareunia (8.9%), vaginal dryness (17.80%), for Tunisian sample: dyspareunia (5.5%), vaginal dryness (16.70%). A low rate of consultation was noted for 36% of Moroccan women and 30% of Tunisian ones.

Ramadan and sexuality (Berrada et al., 2007)

The objective of this study was to assess sexual activity during the month of Ramadan. The results of this study showed that:

• before Ramadan, the frequency of sexual relations was two to three times per week for 56% of those questioned and only 29% during Ramadan;

• sixteen percent had no sexual activity during Ramadan, the month of fasting: 52.3% reported a drop in sexual desire; 26.1% of those questioned said that they suffered from sexual abstinence.

Conclusion

From these studies, we found that sexuality in a country with an Islamic culture is the result of a mixture of beliefs, ignorance, and taboo. Moreover, it is very far from what the religion has specified. This confirms that perceptions and behaviour in this field are motivated more by tradition than by religion.

On the other hand, rates of sexual dysfunction, sexual violence and other disturbances are similar to other countries, notably in the Western world.

References

Alami KM, Kadri N, Berrada S. Prevalence and psychosocial corre- lates of depressed mood during pregnancy and after childbirth in a Moroccan sample. Arch Womens Ment Health 2006;9:343—6, Epub 2006 Oct 13.

Berrada S, Dorhmi S, Bouhaouli L, Kadri N. Sexualité durant le mois de Ramadan. Sexologies 2007;17:83—9, doi:10.1016/

j. sexol.2007.01.003.

Kadri N, Mchichi Alami K, Berrada S, Manoudi F, Rachidi L, Maftouh S, et al. Mental health of Moroccan women, a sexual perspective.

J Affect Disord 2007;102:199—207.

Kadri N, Moussaoui D. Mental health in women in the Arab world.

In: Okasha A, Maj M, editors. ‘‘An Arab perspective’’ World Psy- chiatric Association. Cairo, Egypt: Scientiﬁc book House; 2001.

Kadri N, Moussaid A, Tiraf A, Jadid M. Sexuality in Morocco. In:

Francoeur R, editor. The International Encyclopedia of Sexuality, vol. 4. New York: The Continuum International Publishing Group Inc.; 2001.

(4)

Sexuality in Morocco: Women sexologist’s point of view 23 Kadri N, Mchichi Alami Kh, Tahiri S. Sexual dysfunction in women.

A population-based epidemiological study. Arch Women Ment Health 2002;5:59—63.

Kadri N, Zarbib K. Ménopause et santé mentale. Caducee 2000;46:15—9.

Mchichi Alami Kh, Kadri N. Moroccan women with a history of child sexual abuse and its long-term repercussion: a population

based epidemiological study. Arch Women Ment Health 2004;7:

237—42.

Mchichi Alami K, Kadri N, Tahiri S. Étude épidémiologique sur le comportement sexuel de la femme. Thèse de médecine, n^o128. Casablanca: Faculté de Médecine Hassan II;

2000.

Sexuality in Morocco: Women sexologist's point of view

ORIGINAL ARTICLE