Sexual Rejection Behaviors Used by Men with Hypoactive Sexual Desire Disorder: Associations with Couples’ Sexual and Relationship Outcomes

Hypoactive sexual desire disorder (HSDD) in men, characterized by persistent and distressing low sexual desire, is associated with worse sexual and relationship well-being. Sexual rejection is a common and emotionally laden event that may be especially salient among couples coping with HSDD given likely desire discrepancies between partners. How men with HSDD reject their partner's sexual advances (i.e., deflecting, hostile, reassuring, or assertive rejection behaviors) may reflect their attempts to regulate emotions and have implications for well-being. In this study, men with HSDD (N = 51) reported on their sexual rejection behaviors and both they and their partners reported on sexual and relationship outcomes; results were not adjusted for multiple testing to prioritize discovery. Deflecting sexual rejection was associated with both partners' lower sexual satisfaction, relationship satisfaction, and perceived partner responsiveness, and men with HSDD's greater sexual distress. Hostile rejection was associated with partners' lower sexual satisfaction and both couple members' lower relationship satisfaction. Reassuring and assertive behaviors were associated with men with HSDD's higher sexual satisfaction and perceived partner responsiveness. Reducing less adaptive rejection strategies, like deflection and hostility, and increasing more adaptive strategies, like reassuring or assertive rejection, may be intervention targets to help couples coping with HSDD.