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Sexual and relational wellbeing: diversity and commonality

In this issue of Sexual and Relationship Therapy, the authors address a wide range of physiological, psychological and social factors affecting – or being affected by – sexual/ relationship functioning. In the various authors’ focus on sexual and relational wellbeing, there is both great diversity, as well as commonality. The papers use different methods (surveys of target groups; case-control matched samples; international comparison surveys; clinical case studies and qualitative interviews), data come from different countries and address different issues (gender dysphoria, schizophrenia, child sexual abuse; ageing, partners of men with erectile functioning and people with out-of-control sexual behaviours). But all have a common focus: greater understanding of sexual and relationship health and well-being, and therapeutic approaches to assist clients with this. Miclutia, Popescu and Macrea compares data from 50 women with a long-term diagnosis of schizophrenia to a group of 50 age-matched controls. Key differences emerged with patients reporting lower frequency of sexual intercourse, lower satisfaction with body image, sex life, felt less attractive, and held stronger beliefs on a scale measuring a number of factors indicative of sexual dysfunction than controls. This study is a timely reminder that people are more than their ‘diagnosis’ and looking at the sexual satisfaction and functioning of people with schizophrenia provides valuable information for improving their health and well-being. Udeze, Abdelmawla, Khoosal and Terry present some controversial data from 40 randomly selected male-to-female transgender patients with gender dysphoria, showing that gender reassignment surgery had no significant effect on psychological functioning 6-months post-surgery – however, none of the patients had a score indicating a psychiatric diagnosis either before or after surgery. Although scores on SCL-90 were expected to improve, the authors discuss reasons why the data did not support this. The study has important implications for clinicians working with pre-surgery Gender Identity Disorder patients and the importance of appropriate screening and supportive counselling concerning patient expectations. Trudel, Villeneuve, Anderson and Pilon provide a timely update on the literature regarding post-retirement marital and sexual functioning and satisfaction. In most developed countries, there is a significant demographic shift that is well underway: since the population boom immediately following World War II, family sizes – and overall fertility rates – have shrunk and as the post-war babies age, they are forming an everincreasing proportion of the total population. In many countries, for the first time in history, the number of seniors outstrips the number of children. Thus, it is important to better understand the sexual and relationship functioning – and the needs that they are likely to bring into the clinician’s consulting rooms – as they are a group likely to increase in the caseload of the typical therapist. Trudel et al. point to the importance of adopting a biopsycho-social approach to these issues – which emphasises the critical role that sexologists Sexual and Relationship Therapy Vol. 23, No. 2, May 2008, 109–110