Abstract
This study investigates married Palestinian women’s experiences of sexual rights, autonomy, and pleasure, emphasizing the interplay of religion, culture, and marital communication. Using a qualitative phenomenological design, 20 women from urban, rural, and refugee camp settings were interviewed. Findings reveal that women perceive sexual rights and pleasure in Islam as mutually reciprocal, yet cultural norms and social expectations often constrain the enactment of sexual autonomy and enjoyment. Religious guidance serves as both empowerment and a site of negotiation, helping women interpret their rights and navigate tension with local customs. Emotional wellbeing, trust, privacy, and knowledge of sexual rights emerged as critical enablers of sexual decision-making and pleasurable experiences. The study underscores the importance of culturally and religiously sensitive education, counseling, and marital support to foster sexual autonomy and pleasure, contributing to relational equity and wellbeing in Palestinian marital contexts.
Keywords
Introduction
Women’s sexual and reproductive health is increasingly recognized within global health and human rights scholarship as a central component of wellbeing, bodily autonomy, and health equity. Within this body of work, sexual pleasure is now understood as an integral dimension of sexual health, rather than a secondary or optional aspect, reflecting a broader shift toward more holistic and rights-based approaches to wellbeing. Sexual autonomy plays a key role in this regard, enabling individuals to make informed decisions about their bodies and to experience intimacy as safe, consensual, and fulfilling.1,2
Within contemporary sexual health scholarship, sexual autonomy is increasingly understood as a foundational condition for sexual pleasure, 3 enabling women to recognize their sexual desires as distinct from societal pressures, communicate their wishes, negotiate consent, and make informed decisions regarding contraception and sexual practices.4,5
Research demonstrates that women with higher sexual autonomy experience better sexual and reproductive health outcomes, including greater sexual satisfaction, emotional wellbeing, and relational intimacy, alongside reduced risk of sexually transmitted infections and increased use of modern contraceptive methods.1,5 Education, supportive interpersonal environments, and access to sexual health information are also linked to greater sexual autonomy and to more positive, pleasure-inclusive sexual experiences. 6
However, much of this literature is grounded in Western or relatively stable contexts, with limited attention to conflict-affected, legally fragmented, or culturally conservative settings. This gap is particularly evident in Arab and Palestinian contexts, where women’s sexuality is shaped by intersecting socio-cultural, legal, and political constraints that influence both access to care and experiences of intimacy.
In Israel and Palestine, women’s sexual and reproductive health is shaped by a complex interplay of cultural norms, fragmented legal systems, and political instability, which collectively constrain women’s bodily autonomy, intimate wellbeing, and the capacity to experience sexual pleasure, as well as access to reproductive healthcare.7,8 Muslim women face multiple barriers, including personal status laws 9 adjudicated through Shariʿa courts that prioritize male authority, restricted access to reproductive services, social stigma surrounding sexual health, and cultural silences around women’s sexual desire and pleasure, alongside the structural obstacles created by the Israeli occupation.10–12 Women’s experiences of imprisonment, collective punishment, and militarized violence further compound these barriers, as documented in recent research on Palestinian women jailed by Israel and on the use of hi-tech weaponry against Gaza.13–15 While the occupation constitutes a pervasive structural condition affecting mobility, access to services, and everyday life, its influence on intimate and sexual wellbeing may vary depending on locality, exposure to violence, and socio-political conditions—an issue that this study engages with and reflects upon. The ongoing genocide in Gaza has created an unprecedented crisis for sexual and reproductive health and rights, with devastating consequences for women’s bodily autonomy and access to care. 16
Within marital relationships, gendered power dynamics further shape women’s sexual autonomy and experiences of pleasure, highlighting the importance of examining intimacy within relational and institutional contexts. Sexual scripting theory posits that women are expected to adhere to socially constructed roles that prioritize passivity, 17 marital obligation, and relationship-specific stability, often positioning sexual activity as a duty rather than a site of desire or enjoyment.18,19 Such norms may discourage women from refusing unwanted sex, expressing sexual needs, or negotiating condom use, while intimate partner violence further reduces both autonomy and the possibility of pleasurable sexual experiences.4,20 Fear of violent consequences, including retaliation or honor-based violence, can also undermine women’s sexual decision-making.21,22
In contrast, sexually autonomous women are better able to communicate desires, assert boundaries, and engage in safer and more satisfying sexual practices.23,24 A culturally sensitive measurement of sexual autonomy, such as that developed for college students, helps to capture context-specific dimensions of women’s agency. 25 Unlike sexual agency, which emphasizes exerting power within sexual encounters, sexual autonomy foregrounds the right to choice, 26 consent, and self-determined pleasure, particularly within long-term and marital relationships.1,27,28
Religious frameworks, particularly Islamic teachings, play a dual role in shaping women’s sexual lives, functioning both as systems of moral regulation and as potential resources for agency and empowerment. Islamic ethical teachings emphasize dignity, mutual respect, consent, and compassion within marriage, and recognize sexual intimacy as a legitimate source of emotional and physical fulfillment.^28 However, these principles are often overshadowed by social norms and legal constraints, creating a persistent gap between religious ideals and lived realities.7,28 Palestinian women’s attitudes toward marriage rights in Islamic Sharia and CEDAW reveal complex negotiations between religious authority and rights-based claims. 29 At the same time, evolving legal and policy debates, such as those surrounding the Family Protection Law—a proposed framework aimed at addressing domestic violence and safeguarding vulnerable family members—illustrate the contested and dynamic nature of gender, rights, and protection in the Palestinian context. Broader patterns of patriarchy and political participation also shape women’s public and private agency, with implications for health and wellbeing. 30
Addressing this gap is essential not only for improving women’s sexual and reproductive health outcomes but also for advancing sexual pleasure as a dimension of wellbeing and sexual rights. By explicitly situating sexual autonomy within broader discussions of health equity, structural inequality, and policy relevance, this study contributes to ongoing scholarly and policy debates on how marginalized populations experience and negotiate intimate wellbeing under conditions of constraint. By centering sexual pleasure as an emotionally grounded, relational, and culturally mediated experience, and by integrating sexual autonomy within the Palestinian legal, cultural, and political context, this study aims to illuminate the barriers and opportunities shaping married Palestinian women’s sexual lives. In doing so, it responds directly to global calls for empirically grounded, culturally situated research on sexual pleasure, while remaining attentive to Islamic ethical frameworks and international human rights principles.
Theoretical framework
This study is guided by a multilayered, pleasure-inclusive theoretical framework that integrates Sexual Script Theory, Self-Determination Theory, and Feminist/Gender and Power perspectives. Together, these approaches enable a critical examination of how sexual pleasure, sexual autonomy, and emotional wellbeing are constructed, negotiated, and constrained in the marital lives of Muslim Palestinian women living under conditions of cultural regulation, religious authority, and political occupation in Palestine and Israel. Importantly, these three perspectives are not used independently, but as complementary levels of analysis that jointly explain how individual experiences of sexuality are shaped by both psychological processes and broader socio-structural forces. This combined framework allows for a nuanced understanding of women’s sexual experiences within the intersecting domains of religion, culture, emotion, and relational dynamics.
Sexual Script Theory and the regulation of sexual pleasure
Sexual Script Theory19,31 posits that sexual meanings, behaviors, and expectations are shaped by socially constructed scripts operating at cultural, interpersonal, and intrapsychic levels. In this study, Sexual Script Theory is used primarily to analyze how culturally and religiously informed norms shape expectations surrounding marital sexuality and sexual pleasure. For Muslim women in Palestine and Israel, sexual pleasure is embedded within multiple, and often competing, scripts: Islamic teachings that frame marital sexuality as reciprocal and legitimate, cultural norms that prioritize female modesty, silence, and marital obligation, and personal desires rooted in emotional comfort, safety, and intimacy. Participants’ accounts of negotiating intimacy privately with their spouses, concealing sexual needs from extended family or community scrutiny, or selectively invoking religious knowledge to legitimize mutual enjoyment illustrate how women actively navigate and reinterpret these scripts. Sexual pleasure thus emerges not as a taken-for-granted outcome of marriage, but as a negotiated experience shaped by moral, cultural, and political constraints.
Self-Determination Theory and the Conditions for Sexual Pleasure
Self-Determination Theory (SDT) 32 emphasizes autonomy, competence, and relatedness as fundamental psychological needs underpinning wellbeing. Within this framework, SDT is used to interpret sexual pleasure as a psychologically grounded and relationally dependent experience. In this study, SDT is used to conceptualize sexual pleasure as a relational and emotional experience that depends on the satisfaction of these needs within marriage. Women’s ability to consent to or refuse sexual activity, articulate preferences, and assert boundaries reflects autonomy; feelings of emotional safety, trust, and mutual care enable pleasure through relatedness; and religious or sexual knowledge that allows women to interpret Islamic rights and negotiate intimacy reflects competence. Where these needs are unmet—due to fear, coercion, silence, or misunderstanding—sexual pleasure is diminished or absent, even within legally sanctioned marital relationships. SDT thus provides a framework for understanding how emotional and relational conditions mediate women’s capacity to experience pleasure, not merely sexual participation.
Feminist and gendered power perspectives in a context of occupation
Feminist and Gender and Power perspectives33,34 highlight how structural inequalities and gendered hierarchies shape intimate relations and access to bodily autonomy. In this study, these perspectives are used to situate women’s sexual experiences within broader systems of structural inequality, including gender hierarchy, legal pluralism, and the conditions of military occupation. For Palestinian Muslim women in Israel and the occupied Palestinian territories, gendered power relations are intensified by intersecting systems of legal pluralism, militarized occupation, and economic precarity, which collectively constrain women’s sexual decision-making. Cultural pressures, family surveillance, and male-dominated marital hierarchies shape not only women’s ability to refuse sex, but also their right to experience sexual pleasure without guilt, fear, or moral sanction. Motivations for revenge and retaliation after divorce, as well as attitudes toward honor killing crimes, reflect the extreme consequences of patriarchal control over women’s sexuality.35,36 Participants’ narratives of navigating societal scrutiny, reframing religious obligations, or cultivating private marital understanding illustrate forms of constrained agency exercised within deeply unequal power structures.
Integrative conceptualization and application to methodology
The three theoretical perspectives operate at different but interconnected levels. Sexual Script Theory captures the socio-cultural construction of sexual norms; Self-Determination Theory explains the psychological and relational conditions necessary for sexual wellbeing; and Feminist/Gender and Power perspectives locate these experiences within structural systems of inequality and control. Together, they conceptualize sexual pleasure as a multidimensional and context-dependent phenomenon shaped by the interaction of cultural expectations, psychological needs, and structural power relations. Sexual autonomy is positioned as a central mediating construct through which these forces influence women’s lived sexual experiences (Figure 1). Conceptual Framework of Sexual Pleasure and Autonomy among Palestinian Muslim Women.
These frameworks also directly informed the research design. They guided the development of the semi-structured interview guide by ensuring that questions addressed (1) cultural and religious sexual norms (Sexual Script Theory), (2) emotional, relational, and psychological conditions of intimacy (Self-Determination Theory), and (3) structural and gendered constraints on sexual autonomy (Feminist/Gender and Power perspectives). During data analysis, the frameworks were used as sensitizing concepts in thematic analysis, guiding interpretation while also allowing for emergent themes outside the initial theoretical expectations. This approach ensured both theoretical depth and openness to participants’ lived experiences.
Integrative statement
By integrating these three perspectives, the framework conceptualizes sexual pleasure as a multidimensional, context-dependent experience shaped by individual desires, emotional safety, relational negotiation, and broader cultural, religious, and political structures. Sexual autonomy is understood not as an end in itself, but as a critical pathway through which Muslim Palestinian women may access, negotiate, or be denied sexual pleasure within marriage. This theoretical lens facilitates a critical interpretation of the findings, highlighting how women’s intimate lives reflect ongoing tensions between Islamic ethical ideals, cultural regulation, and lived realities under conditions of structural inequality in Palestine and Israel.
Statement of the problem
Although Palestinian Muslim women’s sexual and reproductive lives are shaped by fragmented legal systems, restrictive socio-cultural norms, and prolonged political instability,7,8 empirical research has largely overlooked how women themselves understand, negotiate, and experience sexual pleasure and autonomy within marriage. Legal frameworks that privilege male authority in matters of guardianship, divorce, and marital obligations continue to limit women’s bodily autonomy and decision-making power,^8 while barriers to reproductive healthcare—shaped by stigma, restrictive abortion laws, and the structural constraints of military occupation—further restrict women’s capacity to make informed sexual and reproductive health decisions.10,11 Research on South Asian victims of intimate partner violence has shown that such violence is associated with sexual health concerns, and similar dynamics likely operate in Palestinian contexts. 22 However, the influence of these structural conditions may vary depending on locality, exposure to violence, and socio-political context, which remains underexplored in empirical research on intimate and marital experiences. These structural conditions not only affect access to healthcare and legal protections but also shape the emotional, relational, and psychological contexts in which marital intimacy and sexual pleasure are negotiated.
Proposed legislative reforms, such as the stalled Family Protection Law, reveal persistent societal tensions surrounding gender roles, religious authority, and modern legal frameworks, 28 contributing to an environment in which women’s sexual needs, desires, and right to pleasurable sexual experiences remain marginalized or rendered invisible. Despite growing global recognition of sexual pleasure as a central component of sexual health, wellbeing, and sexual rights, research in the Palestinian context has predominantly framed women’s sexuality in terms of risk, reproduction, or victimization, leaving a critical gap in understanding how married women conceptualize sexual rights, emotional safety, consent, and pleasure in their everyday marital lives. Emerging scholarship on Palestinian women’s engagement with AI in domestic spaces, as well as the psychological toll of war news on students, points to new dimensions of agency and constraint that intersect with intimate wellbeing.37,38 The experiences of West Bank student solidarity during the Gaza war also highlight how political fatigue and fear shape daily life and emotional capacity. 39
This study addresses this gap by examining how married Palestinian Muslim women perceive and experience sexual autonomy as a pathway to sexual pleasure and emotional wellbeing within marriage. Sexual autonomy is conceptualized not only as the capacity to make informed decisions regarding one’s body and sexual activity but also as the ability to communicate desires, establish boundaries, and engage in consensual, mutually satisfying sexual relationships. By critically examining the intersections of Islamic ethical guidance, cultural expectations, gendered power relations, and socio-political constraints, this research seeks to illuminate how women navigate, negotiate, and at times resist the conditions shaping marital intimacy. Centering women’s lived experiences, the study contributes empirically grounded insights into sexual pleasure in a culturally and politically specific context, responding directly to global calls for research that foregrounds pleasure, relational dynamics, and structural inequality.
Research questions
(1) How do married Palestinian Muslim women understand and experience sexual pleasure and sexual rights within Islamic teachings and broader socio-cultural contexts? (2) What cultural, social, emotional, and psychological factors shape women’s capacity to exercise sexual autonomy and experience sexual pleasure within marriage? (3) How do women navigate and reconcile tensions between religious guidance, cultural norms, and personal desires in the context of marital intimacy?
Materials and methods
Participants and sampling
Demographic characteristics of participants (N = 20).
Participants were recruited through community-based contacts and snowball referrals facilitated by trusted female intermediaries in the local community, in order to ensure cultural sensitivity and access to a hard-to-reach population discussing highly private experiences.
Inclusion criteria were: (1) being a married Muslim woman, (2) aged between 18 and 50 years, (3) currently residing in Palestine (urban, rural, or refugee camp settings), and (4) willingness to discuss marital intimacy and sexual experiences in a confidential interview setting. Women who were divorced, widowed, or unwilling to discuss intimate marital experiences were excluded.
The sample size is consistent with phenomenological research standards and is considered adequate to achieve thematic saturation, ensuring both recurring patterns and context-specific nuances are captured.
Thematic saturation was determined through an iterative analytic process. After approximately 17 interviews, no new substantive codes emerged; however, three additional interviews were conducted to confirm redundancy and ensure stability of themes across different demographic groups (e.g., urban/rural and employment status variations).
Data collection
Data were collected primarily through semi-structured, in-depth interviews, allowing participants to articulate their experiences of sexual pleasure, consent, and autonomy in their own terms, while providing sufficient structure to address key analytic domains relevant to the study.
All interviews were conducted face-to-face in private and secure locations chosen by participants (mainly participants’ homes or other mutually agreed private spaces that ensured confidentiality and comfort). No interviews were conducted in public settings.
Interviews were conducted by the author (a trained qualitative researcher with experience in sensitive gender and sexuality research), who is fluent in Arabic and familiar with the local cultural context. No external interviewers were involved. Interviews were conducted in Arabic to ensure linguistic and cultural comfort and lasted approximately 25–30 min.
All interviews were audio-recorded with consent, transcribed verbatim in Arabic, and then translated into English by the author. To ensure accuracy, selected transcripts were cross-checked by a bilingual academic colleague for linguistic and conceptual equivalence.
The semi-structured interview guide was designed to explore sexual pleasure as a relational, emotional, and culturally mediated experience, with particular attention to sexual autonomy, decision-making, bodily comfort, consent, and communication within marriage. Sample questions included.
Understanding sexual rights, autonomy, and pleasure
(1) “Can you describe your understanding of your sexual rights and sexual pleasure within marriage according to Islam?” (2) “What does sexual autonomy mean to you personally, and how does it relate to your sense of comfort, satisfaction, or enjoyment in intimacy?”
Influence of cultural and social expectations
(1) “How do family, community, or societal expectations influence your ability to express sexual needs or experience pleasure within marriage?” (2) “Have you experienced pressure to engage in sexual behaviors that affected your comfort or enjoyment? How did you respond?”
Religious guidance and sexual decision-making
(1) “How do you interpret Islamic teachings in relation to intimacy, consent, and mutual pleasure?” (2) “Can you describe situations where religious guidance has supported or constrained your experience of sexual autonomy or pleasure?”
Emotional and psychological dimensions
(1) “What emotional or psychological factors—such as trust, fear, stress, or safety—affect your experience of intimacy or pleasure?” (2) “How do anxiety or external pressures influence your ability to communicate or assert your needs?”
Health, safety, and privacy
(1) “How do concerns about health, safety, or privacy shape your sexual choices and experiences?” (2) “Have barriers to sexual or reproductive health information affected your sense of comfort or autonomy?”
Communication and negotiation in marriage
(1) “How comfortable are you discussing sexual preferences, boundaries, or desires with your spouse?” (2) “Can you share an example of a time when communication enhanced—or limited—your sense of pleasure or mutual understanding?”
Constraints, strategies, and sources of support
(1) “What challenges limit your ability to experience sexual autonomy or pleasure in marriage?” (2) “Are there religious, familial, or social resources that help you navigate intimacy more positively?”
Where culturally appropriate, participants were also invited to keep brief reflective notes regarding moments of comfort, discomfort, or emotional connection related to marital intimacy, providing additional depth and triangulation.
In addition to interviews, brief reflective field notes were recorded by the interviewer immediately after each session to document non-verbal cues, emotional tone, and contextual observations, which were used to support interpretation and analytical depth.
Data analysis
All interviews were audio-recorded with participants’ consent, transcribed verbatim, and subjected to thematic analysis following Braun and Clarke’s (2006) six-phase framework. 40 The analysis began with familiarization, involving repeated readings of transcripts to develop an in-depth understanding of participants’ narratives concerning intimacy, sexual pleasure, and autonomy. Next, initial codes were generated by identifying meaningful segments related to sexual pleasure, consent, emotional safety, cultural expectations, religious interpretations, and relational dynamics. These codes were then organized into preliminary themes that captured patterns in how women experience, negotiate, or sometimes suppress sexual pleasure within marriage. During the theme review phase, the researchers refined these themes to ensure coherence, depth, and alignment with the research questions and theoretical framework. Subsequently, themes were defined and named to articulate the interconnections among sexual autonomy, pleasure, emotion, and structural constraints. Finally, the report was produced using rich, descriptive narratives and verbatim quotations, emphasizing how cultural, religious, emotional, and political factors collectively shape women’s intimate experiences and their exercise of sexual pleasure within marital relationships.
To enhance analytic rigor, coding and theme development were conducted iteratively, with regular peer debriefing sessions between the first author and a second qualitative researcher to challenge interpretations and ensure credibility of emerging themes.
Ethical considerations
Given the sensitive nature of the topic, rigorous ethical safeguards were implemented throughout the study.
Informed consent
Participants received detailed information about the study’s aims, procedures, and their right to withdraw at any time without consequence.
Confidentiality and anonymity
Pseudonyms were used in all transcripts and reports. Any potentially identifying contextual details (e.g., specific locations, occupations, or personal narratives) were removed or generalized during transcription and translation to prevent deductive identification.
Data security
Audio recordings and transcripts were stored on password-protected, encrypted devices accessible only to the research team.
Cultural and religious sensitivity
Interview questions were carefully framed to respect participants’ beliefs and comfort levels.
Psychological safety
Participants were informed they could decline to answer any question. Given the sensitivity of the topic, interviews were designed to avoid coercive probing, and participants were reminded that they could pause or terminate the interview at any time.
Results
Theme 1: Sexual rights, autonomy, and the conditional nature of pleasure
Interview questions
(1) “Can you describe your understanding of your sexual rights and your ability to make decisions about intimacy in marriage according to Islam?” (2) “How do you define sexual autonomy in your own life, and what does it mean to you personally?”
Participants generally framed sexual rights as mutual entitlements grounded in Islamic teachings; however, their narratives revealed tensions between ideal reciprocity and lived asymmetries in practice. While many emphasized pleasure and autonomy, others implicitly described situations where these ideals were difficult to fully enact.
P3 stated, “I believe it’s my right to have my needs met, just as I respect my husband’s desires,” emphasizing reciprocity as an ideal condition. Similarly, P1 explained, “Sexual autonomy means I can express my needs without guilt,” linking autonomy to emotional relief and improved intimacy.
However, not all accounts reflected equal negotiation power. P5, for instance, indirectly indicated constraint by noting that “sometimes I stay silent to avoid tension,” suggesting that autonomy may be context-dependent rather than consistently exercised. This introduces a subtle contradiction between normative rights discourse and relational realities.
At the same time, autonomy was frequently linked to enhanced pleasure when boundaries were respected. P6 reflected, “Being able to say no when I don’t feel comfortable actually makes intimacy better when I do say yes,” indicating that pleasure is relationally constructed through consent. Yet, this ideal was not uniformly experienced across all participants, pointing to variation in the enactment of autonomy within marriage.
Overall, sexual autonomy was constructed as both an ethical ideal and a negotiated practice, with pleasure emerging more consistently where emotional safety and mutual recognition were present.
Theme 2: Cultural and social expectations as a source of constraint and internalized silence
Interview Questions
(1) “How do family, community, or societal expectations influence your ability to make autonomous decisions regarding intimacy?” (2) “Have you experienced pressure to comply with certain sexual behaviors? If so, how have you managed this?”
Participants consistently identified cultural and familial norms as constraints; however, accounts varied in how these constraints were experienced—ranging from external pressure to internalized self-regulation.
P4 noted, “In my family, talking about sex is taboo,” suggesting structural silence that limits sexual expression. P6 added that intimacy “feels like an obligation rather than something I enjoy,” directly linking cultural expectations to diminished pleasure.
In contrast, some participants described active resistance strategies, though not without tension. P8 stated, “When relatives hint that it’s shameful to request intimacy, I hesitate,” but also added, “reminding myself of my rights helps me reclaim some confidence and pleasure.” This reflects an oscillation between internalized norms and self-empowerment.
A notable variation emerged in coping strategies. While P13 described “privatizing negotiation at home,” others like P10 emphasized emotional discomfort without clear resolution: “Cultural expectations make discussing intimacy awkward,” indicating ongoing constraint rather than adaptation.
Importantly, these findings show that cultural norms do not operate uniformly; rather, they produce a spectrum ranging from silence, negotiation, to partial resistance, with implications for the consistency of sexual pleasure.
Theme 3: Religion as a legitimizing but selectively interpreted framework
Interview questions
(1) “How do you reconcile religious teachings with cultural expectations in your decisions about intimacy?” (2) “Can you share examples where religious guidance has helped or limited your sexual autonomy?”
Religion was widely invoked as a legitimizing discourse supporting sexual rights and pleasure. However, participants’ narratives also revealed selective interpretation and tension between religious ideals and cultural practice.
P16 stated, “Islam allows women to request intimacy,” framing religion as empowering. Similarly, P12 noted that religious understanding “removes guilt that interferes with pleasure.”
Yet, contradictions emerged in how religion is applied in lived contexts. P7 observed, “Family sometimes uses religion incorrectly,” highlighting a discursive struggle over authority in interpreting religious norms. This suggests that religion is not a uniform liberating force but is mediated through social actors.
A more nuanced case was P2, who described postpartum experiences: understanding mutuality “helped me return to intimacy without fear or discomfort,” indicating religion as a recovery mechanism rather than continuous empowerment.
Overall, religion functioned both as empowerment and as a contested field, depending on who interprets it and in what context.
Theme 4: Emotional and psychological conditions as primary gatekeepers of sexual pleasure
Interview questions
(1) “What emotional or psychological factors affect your ability to make decisions about sexual activity or intimacy?” (2) “How does fear, anxiety, or stress influence your sexual decision-making or assertiveness?”
Participants consistently emphasized emotional safety as essential; however, there were important negative cases where emotional conditions suppressed desire entirely.
P1 stated, “Intimacy is about feeling close, not just the act,” while P4 emphasized, “If I don’t feel emotionally safe, I cannot enjoy intimacy.”
In contrast, P18 highlighted complete inhibition: “Fear of judgment blocks my desire completely,” representing a stronger form of emotional restriction not universal across participants.
Stress also functioned variably. While P5 stated, “Stress makes it impossible to think about intimacy,” P12 offered a more positive counterpoint, where emotional reassurance enabled enjoyment. This variation highlights that psychological conditions can either enable or disable sexual pleasure depending on relational context.
Thus, emotional wellbeing emerged not as a background factor but as a threshold condition determining whether pleasure is possible at all.
Theme 5: Health, safety, and privacy as enablers and boundaries of intimacy
Interview questions
(1) “How do health, safety, and privacy shape your decisions regarding intimacy?” (2) “Have you faced barriers in accessing sexual or reproductive health information?”
Health and privacy were consistently linked to comfort; however, participants differed in how they interpreted risk and safety.
P8 stated, “I avoid intimacy when it may harm my body,” while P11 linked safety to enjoyment: “Following what is healthy protects us.”
Privacy was widely viewed as enabling relaxation. P1 noted, “What happens between us stays private,” which “helps me relax and enjoy intimacy.”
However, a contrasting perspective emerged regarding
Theme 6: Communication as uneven but transformative for mutual pleasure
Interview questions
(1) “How comfortable are you discussing sexual preferences with your spouse?” (2) “Can you describe a time when communication improved intimacy?”
Communication was widely associated with improved intimacy, yet levels of comfort varied significantly across participants.
P8 stated, “When we talk openly, intimacy feels more natural,” while P11 described successful negotiation of timing, linking communication to improved comfort.
However, implicit variation appeared in cases where communication was limited or cautious. P5 described “suggesting changes and compromising,” which suggests communication exists but may be indirect or constrained rather than fully open.
P9 emphasized trust-building through expression of boundaries, but the absence of more explicit negative cases suggests that silence or partial communication remains underrepresented but likely present. Thus, communication emerged as a key mechanism for enhancing pleasure, but not uniformly accessible or equally practiced.
Theme 7: Constraints, coping, and partial reclamation of sexual pleasure
Interview questions
(1) “What challenges limit your sexual autonomy, and what strategies do you use?” (2) “What resources support your sexual autonomy?”
Participants identified cultural shame and emotional pressure as persistent barriers; however, responses showed variation in coping capacity and access to support.
P4 stated, “Cultural shame makes it hard to enjoy intimacy freely,” reflecting persistent constraint. In contrast, P12 actively reframed this through religion: “I remind myself that Islam supports my rights.”
Peer support also varied. While P7 found relief in talking to friends, others relied primarily on internal coping strategies, indicating uneven availability of social support systems.
Summary of themes and subthemes.
Discussion
Sexual rights and autonomy as relationally negotiated constructs
The findings suggest that sexual rights within marriage are not understood as fixed individual entitlements but as relationally negotiated constructs shaped by Islamic ethical discourse and marital reciprocity norms. While participants articulated awareness of mutual rights, the significance lies not in this awareness itself, but in how women actively use religiously grounded reciprocity to legitimize their own sexual agency within marriage.
From a theoretical perspective, this reflects an expansion of Self-Determination Theory (SDT), where autonomy is embedded within relational and moral frameworks rather than being purely individualistic. 32 Sexual Script Theory further explains how women actively reinterpret sexual norms into reciprocal marital scripts. 19 Rather than contradicting existing literature, these findings extend it by showing how sexual autonomy is culturally translated rather than universally expressed. Recent research on Palestinian women’s attitudes toward marriage rights in Islamic Sharia and CEDAW similarly highlights the relational and contested nature of rights claims. 29
Cultural norms as mechanisms of epistemic and behavioral constraint
Cultural and familial norms function not only as behavioral constraints but also as mechanisms of epistemic limitation, shaping early knowledge of sexuality and later expressions of agency.
Feminist theory explains this as symbolic gender regulation embedded in everyday socialization processes. 33 Sexual Script Theory further clarifies how such norms structure “acceptable” sexual behavior while limiting agency. 19 Consistent with prior research, the gap between awareness and enactment reflects the persistence of gendered power asymmetries in sexual relationships.18,33 Attitudes toward honor killing crimes among Palestinian students illustrate the extreme consequences of such cultural regulation. 36 From a health equity perspective, such epistemic constraints contribute to unequal access to sexual health knowledge and delayed reproductive health decision-making.1,5
Religious discourse as a site of competing authority
Religion emerged as a legitimizing framework for sexual rights, but its meaning was not fixed; rather, it was actively interpreted and contested across family and social contexts.
Within SDT, religious values can function as either autonomy-supportive or controlling depending on how they are internalized. 32 Feminist scholarship similarly highlights how religious discourse can both empower and constrain depending on interpretive authority.7,18 Thus, religion in this study is best understood not as a single explanatory variable but as a negotiated moral system shaping sexual legitimacy and pleasure. Broader patterns of patriarchy in Palestinian political and public life further reinforce the contested nature of religious authority in everyday decision-making. 30
Emotional safety as a foundational determinant of sexual autonomy
Emotional safety emerged as a core condition for sexual autonomy, suggesting that autonomy is not only cognitive but also affectively grounded.
This aligns with SDT’s relatedness need, which is essential for autonomous functioning. 32 Emotional wellbeing has also been identified in prior studies as a key predictor of sexual satisfaction and negotiation capacity. 24 The key contribution here is that emotional safety is not simply supportive of autonomy but may function as a threshold condition that determines whether autonomy can be enacted at all. In the Palestinian context, where collective punishment, imprisonment, and war-related trauma are pervasive, emotional safety is further compromised, as documented in studies on Palestinian women jailed by Israel and on the psychological toll of Gaza war news.13,38
Health, privacy, and safety as structural conditions of sexual wellbeing
Health, safety, and privacy were identified as integral to sexual autonomy, extending its definition beyond consent to include bodily integrity and informational access.
These findings align with SDT’s emphasis on autonomous regulation and feminist accounts of bodily integrity and privacy as central to agency.2,24 Importantly, lack of reliable sexual health information represents a structural barrier that limits informed decision-making and reinforces inequality in sexual health outcomes. The ongoing genocide in Gaza has created an unprecedented crisis for sexual and reproductive health and rights, with structural violence directly impeding privacy, safety, and access to care. 16 Moreover, the use of hi-tech weaponry and collective punishment in Palestine further undermines the structural conditions necessary for sexual wellbeing.14,15
Communication as a mediating mechanism of sexual equity within marriage
Communication functions as a key mechanism through which sexual autonomy is enacted, negotiated, or constrained within marriage.
Sexual Script Theory conceptualizes communication as a site where sexual scripts are actively negotiated. 19 SDT further emphasizes the role of autonomy-supportive communication in enhancing relational wellbeing. 32 Feminist perspectives frame communication as a site of gendered negotiation and power. 23 However, variation in communicative access suggests that sexual equity is unevenly distributed within marital relationships. Motivations for revenge and retaliation after divorce, as documented in Palestinian contexts, highlight how breakdowns in communication can lead to extreme gendered violence. 35
Sexual autonomy as a dynamic process of constraint and reclamation
Sexual autonomy in this study emerged as a dynamic process shaped by constraint, adaptation, and partial reclamation rather than a fixed state.
Feminist theory conceptualizes this as everyday agency within structural constraint. 33 Prior research similarly highlights that sexual autonomy is socially produced and continuously negotiated rather than individually possessed.4,6 Importantly, participants’ strategies—such as selective silence, religious reinterpretation, and negotiation—illustrate that agency persists even under restrictive conditions. The experiences of West Bank student solidarity during the Gaza war, characterized by fatigue and fear, similarly demonstrate how agency is exercised within profound structural constraint. 39 Even in domestic spaces, Palestinian women are navigating tradition and innovation, including engagement with AI, as a new terrain for negotiating autonomy. 37
Conclusion
This study explored married Palestinian women’s perceptions and lived experiences of sexual rights, sexual autonomy, and sexual pleasure within marriage, focusing on how these are shaped by religious interpretations, cultural norms, emotional wellbeing, and relational negotiation. The findings suggest that participants hold a generally informed and often nuanced understanding of sexual rights as framed within Islamic teachings, where sexual intimacy is commonly viewed as a mutual and relational responsibility that includes both emotional connection and physical satisfaction.
However, the study also indicates that the translation of these perceived rights into lived experience is complex, context-dependent, and sometimes constrained by structural and cultural factors. Sexual pleasure emerged not as an automatic outcome of marital intimacy, but as a negotiated and sometimes uneven process shaped by communication patterns, emotional safety, and the interaction between religious meanings and sociocultural expectations. In many cases, cultural and familial norms appeared to mediate or constrain the practical expression of sexual autonomy, requiring women to navigate intimacy through private negotiation and personal reinterpretation of religious and social expectations.
Across participants’ accounts, emotional and psychological conditions—including trust, stress, and feelings of safety—were central in shaping whether sexual experiences were described as pleasurable or burdensome. Similarly, considerations of privacy, health, and safety functioned as enabling or limiting conditions for sexual wellbeing. Communication within marriage emerged as a key mechanism through which women attempted to assert boundaries, express preferences, and construct shared sexual satisfaction, although the degree of openness varied across relationships.
Taken together, these findings should be interpreted within the limits of a qualitative design and a relatively small, context-specific sample. Accordingly, the findings are not intended for statistical generalization but rather for in-depth contextual interpretation of lived experience.
From a community health equity perspective, this study contributes to understanding sexual wellbeing not only as an individual or biomedical issue, but as a socially, culturally, and structurally produced form of health shaped by gender norms, knowledge inequalities, and relational power dynamics. The findings highlight the importance of integrating culturally sensitive and rights-informed approaches into sexual and reproductive health education, with particular attention to strengthening sexual health literacy, promoting safe marital communication, and addressing misinformation that may limit women’s agency and wellbeing within marriage.
Future research should build on these findings by incorporating larger and more diverse samples, including male partners’ perspectives, and examining how sexual autonomy and pleasure evolve over time. There is also a need for applied research on interventions—such as community-based education, counseling programs, and health system initiatives—that can promote equitable access to sexual knowledge and support healthier, more communicative marital relationships.
Overall, this study contributes to a more comprehensive and context-sensitive understanding of sexual pleasure as an integral dimension of sexual rights and marital wellbeing, while also underscoring its relevance to broader discussions of gender equity, reproductive justice, and community health equity in Palestine.
Footnotes
Acknowledgements
The authors would like to express their sincere gratitude to all married women who voluntarily participated in this study and shared their valuable experiences.
Consent to participate
All participants provided informed consent prior to participation and were informed of their right to withdraw at any time.
Consent for publication
All participants consented to the use of anonymized quotes for publication purposes.
Funding
The author received no financial support for the research, authorship, and/or publication of this article.
Declaration of conflicting interests
The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data Availability Statement
Due to the sensitive and personal nature of the data collected, interview transcripts are available only in de-identified form upon reasonable request to the author.
Use of artificial intelligence
AI tools (e.g., ChatGPT) were used only to assist with language editing and formatting of the manuscript. The author retains full responsibility for the content, accuracy, and integrity of the work.