Sexual distress with partnered face-to-face sexual activity: an exploratory qualitative study with heterosexual cis people who seek and do not seek professional help

IntroductionSexual distress is interrelated with mental health and relationship quality and is fundamental for establishing a diagnosis of sexual dysfunction, even though it also affects people who do not seek professional clinical help. Research on sexual distress related to partnered sexual activi...

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Main Authors: Patrícia M. Pascoal, Gerhard Andersson, Vinicius J. Fischer, Andreia A. Manão, Cátia Oliveira, Catarina F. Raposo, Pedro J. Rosa, Magda Sofia Roberto, Graça Santos, Nuno Tomada, Annamaria Giraldi
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Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Psychology
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Online Access:https://www.frontiersin.org/articles/10.3389/fpsyg.2025.1553893/full
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author Patrícia M. Pascoal
Patrícia M. Pascoal
Patrícia M. Pascoal
Patrícia M. Pascoal
Gerhard Andersson
Gerhard Andersson
Gerhard Andersson
Gerhard Andersson
Vinicius J. Fischer
Vinicius J. Fischer
Andreia A. Manão
Cátia Oliveira
Catarina F. Raposo
Catarina F. Raposo
Pedro J. Rosa
Pedro J. Rosa
Magda Sofia Roberto
Graça Santos
Nuno Tomada
Nuno Tomada
Annamaria Giraldi
Annamaria Giraldi
author_facet Patrícia M. Pascoal
Patrícia M. Pascoal
Patrícia M. Pascoal
Patrícia M. Pascoal
Gerhard Andersson
Gerhard Andersson
Gerhard Andersson
Gerhard Andersson
Vinicius J. Fischer
Vinicius J. Fischer
Andreia A. Manão
Cátia Oliveira
Catarina F. Raposo
Catarina F. Raposo
Pedro J. Rosa
Pedro J. Rosa
Magda Sofia Roberto
Graça Santos
Nuno Tomada
Nuno Tomada
Annamaria Giraldi
Annamaria Giraldi
author_sort Patrícia M. Pascoal
collection DOAJ
description IntroductionSexual distress is interrelated with mental health and relationship quality and is fundamental for establishing a diagnosis of sexual dysfunction, even though it also affects people who do not seek professional clinical help. Research on sexual distress related to partnered sexual activity is limited, and no comprehensive model exists to guide research or clinical interventions. We conducted an online cross-sectional qualitative study to: 1) explore the reasons why people experiencing sexual distress in partnered face-to-face sexual activity do not seek professional clinical help; 2) analyze the experiences of participants’ of sexual distress in partnered sexual activity; 3) reflexively compare the experiences reported by participants who seek and do not seek professional help; and 4) reflexively compare experiences across genders.MethodsWe performed reflexive thematic analysis on 438 heterosexual people answers (Mage = 41.06, SD = 12.19), including 306 women (69.7%) and 132 men (30.1%).ResultsMost participants (54.1%) had not sought professional clinical help but wanted to do so. Some participants (13.2%) expressed a desire for clinical consultations but reported financial or time constraints. Using the reflexive thematic analysis on the qualitative data provided, we created three themes: (1) Sexual (dys)function (It’s the function), which focuses on sexual function and lack of pleasure; (2) Intimacy dynamics (It’s us!), which discusses relationship challenges; (3) Intrapersonal struggles (It’s me!), which highlight individual factors, some influenced by social messages. Comparison across groups revealed that people who sought professional clinical help emphasise genital function and negative emotions, and women highlighted experiencing sexual pain, while men emphasised desire discrepancies and erectile disorder.DiscussionOur results demonstrate that difficulties related to sexual pleasure and with penetrative sex are important sources of distress in partnered sexual activity, which is in line with DSM and ICD frameworks of sexual dysfunction. Participants’ accounts show that pre-existing psychological characteristics, partnered communication, cognitive, and emotional factors are key factors to shape the experience of sexual distress related to sexual dysfunctions. This has implications for clinical work as interventions should target transdiagnostic individual factors that may not be sexual specific (e.g., repetitive negative thinking) as well as couple-level factors (e.g., communication). Internet-based integrative therapies directed at these factors may be a promising venue for those who experience sexual distress with partnered sexual activity and are reluctant to seek in-person sexual healthcare.
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spelling doaj-art-dab43cc190bb4259a1138b93d04bb4d62025-08-20T03:44:43ZengFrontiers Media S.A.Frontiers in Psychology1664-10782025-08-011610.3389/fpsyg.2025.15538931553893Sexual distress with partnered face-to-face sexual activity: an exploratory qualitative study with heterosexual cis people who seek and do not seek professional helpPatrícia M. Pascoal0Patrícia M. Pascoal1Patrícia M. Pascoal2Patrícia M. Pascoal3Gerhard Andersson4Gerhard Andersson5Gerhard Andersson6Gerhard Andersson7Vinicius J. Fischer8Vinicius J. Fischer9Andreia A. Manão10Cátia Oliveira11Catarina F. Raposo12Catarina F. Raposo13Pedro J. Rosa14Pedro J. Rosa15Magda Sofia Roberto16Graça Santos17Nuno Tomada18Nuno Tomada19Annamaria Giraldi20Annamaria Giraldi21Lusófona University, HEI-Lab: Digital Human-Environment Interaction Labs, Lisbon, PortugalClínica Universitária de Psiquiatria e Psicologia Médica, Faculdade de Medicina, Universidade de Lisboa, Lisbon, PortugalPSYLAB, Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Lisbon, PortugalCenter for Psychology at the University of Porto, Faculty of Psychology and Educational Sciences of the University of Porto, Porto, PortugalLusófona University, HEI-Lab: Digital Human-Environment Interaction Labs, Lisbon, PortugalDepartment of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, SwedenDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenDepartment of Health, Education and Technology, Luleå University of Technology, Luleå, SwedenCentre Hospitalier Neuro-Psychiatrique (CHNP), Rehaklinik, Zentrum fir Psychotherapie, Ettelbruck, LuxembourgUniversity of Luxembourg, Student Services, Esch-sur-Alzette, LuxembourgLusófona University, HEI-Lab: Digital Human-Environment Interaction Labs, Lisbon, PortugalLusófona University, HEI-Lab: Digital Human-Environment Interaction Labs, Lisbon, PortugalLusófona University, HEI-Lab: Digital Human-Environment Interaction Labs, Lisbon, PortugalCenter for Psychology at the University of Porto, Faculty of Psychology and Educational Sciences of the University of Porto, Porto, PortugalLusófona University, HEI-Lab: Digital Human-Environment Interaction Labs, Lisbon, Portugal0Instituto Superior Manuel Teixeira Gomes, Portimão, Portugal1CICPSI—Centro de Investigação em Ciência Psicológica, Faculdade de Psicologia, Universidade de Lisboa, Lisbon, Portugal2Hospital da Luz, Odivelas, Portugal3Instituto de Investigação e Inovação em Saúde, Porto, Portugal4School of Psychology and Life Sciences (EPCV) of Lusófona University, Lisbon, Portugal5Sexological Clinic, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark6Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, DenmarkIntroductionSexual distress is interrelated with mental health and relationship quality and is fundamental for establishing a diagnosis of sexual dysfunction, even though it also affects people who do not seek professional clinical help. Research on sexual distress related to partnered sexual activity is limited, and no comprehensive model exists to guide research or clinical interventions. We conducted an online cross-sectional qualitative study to: 1) explore the reasons why people experiencing sexual distress in partnered face-to-face sexual activity do not seek professional clinical help; 2) analyze the experiences of participants’ of sexual distress in partnered sexual activity; 3) reflexively compare the experiences reported by participants who seek and do not seek professional help; and 4) reflexively compare experiences across genders.MethodsWe performed reflexive thematic analysis on 438 heterosexual people answers (Mage = 41.06, SD = 12.19), including 306 women (69.7%) and 132 men (30.1%).ResultsMost participants (54.1%) had not sought professional clinical help but wanted to do so. Some participants (13.2%) expressed a desire for clinical consultations but reported financial or time constraints. Using the reflexive thematic analysis on the qualitative data provided, we created three themes: (1) Sexual (dys)function (It’s the function), which focuses on sexual function and lack of pleasure; (2) Intimacy dynamics (It’s us!), which discusses relationship challenges; (3) Intrapersonal struggles (It’s me!), which highlight individual factors, some influenced by social messages. Comparison across groups revealed that people who sought professional clinical help emphasise genital function and negative emotions, and women highlighted experiencing sexual pain, while men emphasised desire discrepancies and erectile disorder.DiscussionOur results demonstrate that difficulties related to sexual pleasure and with penetrative sex are important sources of distress in partnered sexual activity, which is in line with DSM and ICD frameworks of sexual dysfunction. Participants’ accounts show that pre-existing psychological characteristics, partnered communication, cognitive, and emotional factors are key factors to shape the experience of sexual distress related to sexual dysfunctions. This has implications for clinical work as interventions should target transdiagnostic individual factors that may not be sexual specific (e.g., repetitive negative thinking) as well as couple-level factors (e.g., communication). Internet-based integrative therapies directed at these factors may be a promising venue for those who experience sexual distress with partnered sexual activity and are reluctant to seek in-person sexual healthcare.https://www.frontiersin.org/articles/10.3389/fpsyg.2025.1553893/fullsexual distresssexual pleasuresexual dysfunctionpartnered sexual activityhelp-seekingclinical practice
spellingShingle Patrícia M. Pascoal
Patrícia M. Pascoal
Patrícia M. Pascoal
Patrícia M. Pascoal
Gerhard Andersson
Gerhard Andersson
Gerhard Andersson
Gerhard Andersson
Vinicius J. Fischer
Vinicius J. Fischer
Andreia A. Manão
Cátia Oliveira
Catarina F. Raposo
Catarina F. Raposo
Pedro J. Rosa
Pedro J. Rosa
Magda Sofia Roberto
Graça Santos
Nuno Tomada
Nuno Tomada
Annamaria Giraldi
Annamaria Giraldi
Sexual distress with partnered face-to-face sexual activity: an exploratory qualitative study with heterosexual cis people who seek and do not seek professional help
Frontiers in Psychology
sexual distress
sexual pleasure
sexual dysfunction
partnered sexual activity
help-seeking
clinical practice
title Sexual distress with partnered face-to-face sexual activity: an exploratory qualitative study with heterosexual cis people who seek and do not seek professional help
title_full Sexual distress with partnered face-to-face sexual activity: an exploratory qualitative study with heterosexual cis people who seek and do not seek professional help
title_fullStr Sexual distress with partnered face-to-face sexual activity: an exploratory qualitative study with heterosexual cis people who seek and do not seek professional help
title_full_unstemmed Sexual distress with partnered face-to-face sexual activity: an exploratory qualitative study with heterosexual cis people who seek and do not seek professional help
title_short Sexual distress with partnered face-to-face sexual activity: an exploratory qualitative study with heterosexual cis people who seek and do not seek professional help
title_sort sexual distress with partnered face to face sexual activity an exploratory qualitative study with heterosexual cis people who seek and do not seek professional help
topic sexual distress
sexual pleasure
sexual dysfunction
partnered sexual activity
help-seeking
clinical practice
url https://www.frontiersin.org/articles/10.3389/fpsyg.2025.1553893/full
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