Sexual dysfunction in gay men and lesbians

Sexual dysfunction can occur in gay men and lesbians, as it does in heterosexual men and women. However, the rates of sexual dysfunction are not clear as there has been very little research into the prevalence and aetiology of sexual dysfunction in gay men and lesbians. There is no evidence to suggest that the diagnosis or management of such cases is fundamentally different from sexual dysfunction presenting in heterosexuals, though some additional factors need to be remembered. The focus here is on those factors that are distinct for gay men and lesbians, such as intrapsychic conflicts which arise when an individual has difficulty negotiating a transition point in their lifecycle (e.g. leaving home for the first time, retirement). For gay men and lesbians, in addition to the usual transition points in their lifecycle, there may also be issues related to the private development and identity development and ‘coming out’. The couples may be at different stages of coming out, which may place additional pressures on them. In this contribution we aim to review the literature and identify some of the special factors that the therapist may find helpful in the assessment and management of sexual dysfunction in gay men and lesbians.