Lesbians and sexual dysfunction

Does sexual dysfunction only exist for heterosexual couple?  Another question I often get asked on my free 10 minute consults.  Sexual dysfunction can exist in any relationship. Lesbians bring unique relationship issues to the concept of female sexual dysfunction (FSD), there is a tremendous amount of overlap between the issues underlying FSD in the heterosexual woman and those underlying FSD in the homosexual woman. The most common type of dysfunction in both populations is hypoactive sexual desire disorder (HSDD) and the workup and treatment plans for this dysfunction is similar to heterosexual women. There is also a great deal of overlap in the underlying causes of HSDD in both populations, including the presence of young children in the household, hectic work schedules, depression, and economic stressors.  There are also  unique issues found in lesbian relationships.


Some of these issues may include:

  1. Internalized homophobia- Although lesbians report greater satisfaction with sex, some studies have shown that lesbian, gay, and bisexual people report a higher incidence of sexual dysfunction than do their straight counterparts. One theory to explain this high incidence is the so-called minority stress model, research has shown that as a result of their minority status, homosexual people experience a “unique chronic stress.” Internalized homophobia, the experience of homophobia in one’s daily life, and the stress of concealing one’s sexuality or “being in the closet” can also contribute not only to dysfunction in one’s sexual life, but also to depression and anxiety disorders that health care providers need to be sensitive to.
  2. Connectedness: Often lesbian couples have an intense attachment with their partner and that may play a role in the causes of sexual dysfunction. Studies have also shown that the incidence of FSD increases proportionally with the number of years in any female relationship. As a couple becomes more comfortable with one another and they begin to “settle down,” the initial sexual intensity tends to wax and wane- and more wane in some circumstances.
  3. Lesbian bed death: This is a myth and can be a very derisive term The belief that lesbian couples have less frequent sexual encounters has become known as lesbian bed death. Studies show there is a drop off in sexual activity that occurs about two years into long-term lesbian relationships. However this is also a similar finding in heterosexual couples. This decrease in sexual frequency is not distressing to all lesbian couples, nor does it occur in all lesbian relationships. Also studies have said that the quality of sexual encounters tends to be rated as more satisfying by lesbian women than by heterosexual women. Thus, this is a sexual dysfunction issue only in a couple with discordant views on the appropriate frequency of sex in a relationship.

When looking for a healthcare practitioner find a provider that remains open minded about the many types of lesbian relationships and sexual practices.  Sexual dysfunction is a fairly conventional relationship problem and not especially ‘lesbian’ in nature. Unfortunately,  these sorts of things don’t get better on their own without dialog

It is essential to communicate with  your partner and share with her your frustration. You will want to communicate also a message of love and affection, and maybe even humor here.  We often recommend looking at things from a biopsychosocial approach and suggest couples counseling which we can help you work thorough or refer you.