Sexual well-being, integral to individual identity and health, is often neglected in health care. Occupational therapists, though well-suited to addressing this aspect, lack training and confidence. A literature review revealed that discomfort and avoidance surround the intimate topic for both clients and professionals. This leads to the underrepresentation of sexual well-being in occupational therapy education and treatment. The proposed solution, “TheOtherADL.com: Access to Knowledge, Skills, and Confidence to Promote Sexual Well-Being Within Israeli Occupational Therapy Treatments” (TheOtherADL.com), is an educational website. Drawing on established theories and models, it is designed to empower Israeli occupational therapists to address their client’s sexual well-being. Offering accessible resources in Hebrew and Arabic, the initiative aims to bridge the gap in addressing sexual well-being in occupational therapy in Israel. Provided free of charge, the long-term objectives include improved support for sexual well-being interventions and increased interest in sexual well-being education. The effectiveness of TheOtherADL.com will be evaluated for changes in awareness, knowledge, and confidence levels. A multifaceted marketing strategy will ensure widespread dissemination and engagement. A funding plan outlines potential funding sources as well as a subscription model. In conclusion, TheOtherADL.com is a pioneering initiative to enhance the often-overlooked aspect of sexual well-being in occupational therapy, positively impacting overall health and the health care system.

A study will be conducted to determine whether Acceptance and Commitment Therapy (ACT), improves the sexual well-being of survivors of sexual assault by decreasing experiential avoidance. The hypotheses for this study are that 1) Levels of reported sexual well-being will increase in participants in the ACT condition; 2) Based on ACT’s explicit emphasis on reduction of experiential avoidance (Hayes, 1999; Hayes, 2016), it is hypothesized that levels of reported avoidance will decrease in participants in the ACT condition; 3) Due to the link between avoidance and sexual problems in female survivors of sexual assault proposed by Ensink & Van Berlo (2000), it is hypothesized that avoidance will act as a mediator in the relationship between ACT and sexual well-being such that lower levels of avoidance will be correlated with higher levels of sexual well-being. A minimum of 128 female college students who have survived sexual violence will be recruited and randomly assigned to receive either the ACT condition or the Cognitive Behavioral Therapy (CBT) condition, which will serve as a control. Prior to experiencing therapy, participants will take the Demographic and Sexual History Questionnaire, adapted from Byers & Lemieux, 2008. After going through therapy, participants will take a survey measuring sexual well-being and avoidance. Since there are no established measures for sexual well-being, it will be measured by creating a composite score from three measures: sexual self-esteem, sexual functioning, and sexual anxiety.

This study explored multiple predictors of sexual well-being in a sample of 253 single, sexually active undergraduate females at a public Mid-Atlantic university. Several factors were identified from past research that might impact sexual well-being: casual sex, sexual agency, sexual attitudes, and sexual desire. Of the four factors, only sexual agency and sexual attitudes were found as significant predictors of sexual well-being. The results suggest that -- of single, sexually active undergraduate females -- those with a greater sense of agency and choice in their sexual interactions and those who maintain more open attitudes toward casual sex have a higher level of sexual well-being. Agency and openness may be important factors in the development of sexual well-being for young women. Limitations of the study, as well as implications for future research and psychoeducational and therapeutic interventions, are addressed. / Master of Science

The first year postpartum is often a challenging time for romantic partners. During this time, couples tend to experience less relationship intimacy and sexual satisfaction, which may be further exacerbated by individual stressors and vulnerabilities. Little is known about whether a maternal history of adverse life events and mental health prior to the infant’s birth negatively interfere with postpartum relationship and sexual well-being. Accordingly, the current study examined whether maternal trauma history, prenatal posttraumatic stress, and prenatal depressed mood were risk factors for poor postpartum couple adjustment. It also investigated whether perceiving a partner as motivated to meet one’s interest and disinterest in sexual activity, referred to as sexual communal strength for having sex (SCS for having sex) and sexual communal strength not having sex (SCS for not having sex), were buffers to relationship deterioration among mothers with this history of adversity. One hundred and sixty women (N = 160) who had completed an earlier study during pregnancy participated in a subsequent online survey between six and twelve months postpartum. Using path analysis to investigate the prospective relationships between maternal trauma history, prenatal mental health difficulties, and postpartum relationship and sexual well-being, trauma history was found to significantly predict sexual satisfaction and desire. Specifically, childhood maltreatment predicted poorer sexual well-being following childbirth, whereas adult sexual victimization predicted improved sexual well-being. No other pathways in the model were significant. Additionally, contrary to predictions, sexual communal strength did not moderate associations between maternal prenatal adversity and postpartum relationship outcomes in the primary analyses. However, follow-up analyses including only mothers who reported some symptoms of PTSD revealed that SCS for having sex moderated the association between these symptoms and relationship satisfaction. Results from this research highlight that childhood maltreatment likely has enduring detrimental implications for women’s sexual well-being as they transition- either again or for the first time - to motherhood. Further implications and directions for future research in this area are discussed. / Graduate

For decades, sexual expression in older adulthood was a taboo topic in the public discourse and ignored in the empirical literature. As a result of several significant sociocultural changes and medical developments as well as an increasingly older population, however, perspectives are shifting and acceptance and interest in the sexual lives of older adults is growing. The purpose of this dissertation was to investigate sexual well-being in older adulthood and explore its diversity. Study 1 involved a systematic review of the literature on factors associated with the maintenance and cessation of sexual activity in adults 60 years of age and older. Data were extracted from a total of 57 studies and each was assessed for methodological quality. Surprisingly, only four factors (i.e., partner’s interest in sexual activity, past frequency of sexual activity, presence of erectile dysfunction, and partner-related illness) were consistently related, in more than one study, to whether or not older adults were sexually active. Significant variability in study results highlighted methodological caveats of the body of literature, but also the heterogeneity of older adults’ sexuality. Study 2 built upon the findings and recommendations of Study 1 and further examined diversity in sexual well-being. Sexual function and satisfaction, the absence of sexuality-related distress, breadth of sexual experience, and overall frequency of sexual activity were considered as indicators of sexual well-being. The Dual Control Model of Sexual Response (DCM) was used as the theoretical framework in this study of women 50 years of age and older. The DCM posits that sexual response depends on the relative activation of sexual excitatory and sexual inhibitory processes, two separate and independent systems. Study 2 results indicated that, independently, women’s propensities for sexual excitation and sexual inhibition were significantly associated with the majority of the indicators of sexual well-being and the directions of associations were consistent with the tenets of the DCM. The only association that proved not statistically significant was the relationship between sexual excitation and sexual distress. When examined together, sexual excitation and sexual inhibition factors significantly predicted sexual function, satisfaction, and frequency. Sexual distress was predicted more strongly by sexual inhibition factors and sexual breadth by sexual excitation factors. Partner physical and mental health and participant mental health were further identified as moderating variables of these associations. The results of Study 2 expand current knowledge regarding the DCM and its relevance to older women; sexual excitation and sexual inhibition appear to have heuristic value to better understand the variability in sexual activity and well-being in women aged 50 years and older. The results of this dissertation have important implications for the study of sexuality and ageing, perhaps most prominently in terms of highlighting the inter-individual variation in older adulthood and the conclusion that generalizations about “older adults” as a group may not be appropriate.

Björnsdotter, A & Engelin, K. Interventioner för ökat sexuellt välbefinnande under klimakteriet. Fokusgruppsintervjuer med hälso- och sjukvårdspersonal. Masteruppsats i sexologi 30 högskolepoäng. Malmö Universitet: Fakulteten för hälsa och samhälle, Institutionen för social arbete, 2023. Få kvinnor passerar klimakteriet obemärkt och helt utan besvär.Det övergripande syftet med den här studien var att utforska vilka erfarenheter sexualitetskompetent hälso- och sjukvårdspersonal hade av hur fysiska- och psykiska klimakteriebesvär påverkar sexuellt välbefinnande och vilka interventioner som uppfattades vara hjälpsamma. Tre kvalitativa fokusgruppsintervjuer utfördes i Malmö med totalt elva personer. Intervjuerna analyserades med en reflexiv tematisk analys. Analysen utmynnade i sex huvudteman och tolv tillhörande underteman. Huvudteman var Kunskapen är väldigt låg för väldigt många, Ibland funkar det, ibland inte. Samarbete tvärprofessionellt viktigt för både hjälpsökande och professionella, Kan lite om mycket. Och mycket utifrån sin grundprofession, Ingen hjälp – eller kanske värre, fel hjälp, Sexet funkar inte och Om du är resursstark kan du få hjälp men hur ska vi nå övriga? Studien visar att fysiska och psykiska klimakteriebesvär påverkar det sexuella välbefinnandet. Erfarenheterna från informanterna var att interventioner såsom exempelvis hormonterapi, psyko-edukation, basal kroppskännedom, bäckenbottenträning, avslappningsövningar och arbete kring lust och njutning var hjälpsamma. Deltagarna saknade lättillgänglig information och verktyg som anpassats efter olika kvinnors behov. Ökad kompetens inom vården och ett tvärprofessionellt samarbete var viktigt. Det framkom också att klimakterievården är ojämlik och bland annat intersektionella faktorer påverkar vem som söker och får vård idag. / Björnsdotter, A & Engelin, K. Interventions for sexual well-being during menopause. Focus group interviews with healthcare personnel. Master Thesis in Sexology 30 Credits. Malmö University: Faculty of Health and Society, Department of Social Work, 2023. Few women go through menopause unnoticed and without problems such as dry and fragile mucous membranes or problems with sleep. The overall purpose of this study was to explore the experiences of sexually competent healthcare professionals of how physical and psychological menopausal symptoms affect sexual well-being and which interventions were perceived as helpful. Three qualitative focus group interviews were conducted in Malmö with a total of eleven participants. The interviews were analyzed with a reflexive thematic analysis. The analysis resulted in six themes and twelve associated subthemes. The main themes were Knowledge is very low for very many, Sometimes it works, sometimes it does not. Cross-professional cooperation is important for both those seeking help and professionals, Know a little about a lot. And a lot based on their primary profession, No help – or perhaps worse, the wrong help, Sex does not work, and If you have resources you get help, but how are we going to reach the rest?  The study shows that physical and psychological menopausal symptoms affect sexual well-being. The experiences of the informants were that interventions such as hormone therapy, psychoeducation, body awareness training, pelvic floor training, relaxation exercises, and activities to improve sexual desire and pleasure were helpful. They lacked easily accessible information and tools adapted for different women’s needs. Increased competency in healthcare personnel and interprofessional collaboration were described as important.  The participants also noted that help for menopause problems are unequal and, among other things, intersectional factors affect who seeks and receives care today.

Bakgrund: Det pågår en bostadskris i många av Sveriges kommuner - framför allt i storstäderna. I dess svallvågor växer andra typer av boendeformer fram när förstahandskontrakt och bostadsrätter är allt svårare att få tillgång till. Unga vuxna är en av de grupper som är som mest utsatta på bostadsmarknaden och som har svårt att få tillgång till ett eget eller långsiktigt boende. I relation till tidigare forskning visar det att det finns ett tomrum när det kommer till att undersöka sexuellt välbefinnande och hälsa i relation till prekära boendeformer. Däremot finns det studier som berör andra aspekter av prekära boenden och bostadskris - där det tydligt identifieras att prekära boenden medför bland annat stress och psykisk ohälsa.  Syfte: Syftet med denna studie är att undersöka huruvida prekära boendesituationer påverkar sexualitet, sexuellt välbefinnande och sexualliv hos unga vuxna. Målet är även att fånga upp hur enskilda individer förstår och navigerar sina boendesituationer i relation till sin sexualitet, möjligheten till intimitet och att utveckla relationer.  Metod: Studien är baserad på sex kvalitativa intervjuer med unga vuxna som har erfarenhet av olika prekära boendeformer. Flera bor inneboende eller i kollektiv, en bor med förälder och en annan med ett andrahandskontrakt.  Resultat:Genomgående teman som identifierats i empirin är hur boendet påverkar sexualiteten, möjlighet till privatliv, relationer och intimitet. En viktig aspekt som fångas upp i empirin är hur prekära boendeformer på flera sätt suddar ut en given gräns mellan det privata och publika i de intervjuades liv - där boendet traditionellt får representera privatlivet. Empirin har analyserats med hjälp av Erving Goffmans begreppspar frontstage och backstage, Simon och Gagnons sexuella skript-teori samt Gayle Rubins sexuella värdehierarki.  Ett prekärt boende bidrar i många fall till att vissa interpersonella och intrapsykiska sexuella skript förändras i relation till boendet, där vissa strategier behöver tillämpas för att uppleva en möjlighet till sexuellt välbefinnande. Strategier som att vara tyst, bara ha sex när hyresvärden eller rumskamraterna är borta eller att ha sex hos andra framkommer i empirin. Studien visar också att möjligheter till handlingsutrymme också är en viktig aspekt av att få sex, relationer och intimitet att funka inom ett prekärt boende.  Slutsats: Ett prekärt boende påverkar aspekter av sexuellt välbefinnande och möjligheter till relationsskapande och intimitet. En aspekt som påverkar detta är de sociala, emotionella och materiella aspekterna av att bo i ett prekärt boende samt bristen eller få möjligheter till privatliv. Studien ger incitament till vidare forskning kring hur olika boendesituationer påverkar individers sexuella välbefinnande. / Background: There is a housing crisis in many of Sweden's municipalities, especially in the major cities. In its aftermath, other types of housing options are emerging as first-hand contracts and owned housing are becoming increasingly difficult to access. Young adults are one of the groups most vulnerable in the housing market and struggle to attain their own long-term accommodation. In relation to previous research, there is a gap in investigating sexual well-being and health in relation to precarious housing situations. However, studies exist that address other aspects of precarious housing and the housing crisis, clearly identifying that precarious housing leads to stress and mental health issues, among other things. Purpose: The purpose of this study is to examine whether precarious housing situations affect sexuality, sexual well-being, and sex life among young adults. The goal is also to understand how individuals comprehend and navigate their housing situations in relation to their sexuality, the possibility of intimacy, and developing relationships. Method: The study is based on six qualitative interviews involving young adults with experience in various precarious housing forms. Several participants live with roommates or in collective housing, one lives with a parent, and another has a sublease agreement. Results: Consistent themes identified in the empirical data include how housing affects sexuality, privacy, relationships, and intimacy. An important aspect captured in the data is how precarious housing blurs the boundary between the private and public spheres in the lives of the interviewees, where housing traditionally represents privacy. The data has been analyzed using Erving Goffman's front stage and backstage concepts, Simon and Gagnon's sexual script theory, as well as Gayle Rubin's sexual hierarchy of value. Precarious housing often leads to changes in interpersonal and intrapsychic sexual scripts related to the housing situation, requiring certain strategies to experience sexual well-being. Strategies such as being quiet, only having sex when the landlord or roommates are away, or having sex elsewhere emerged in the data. The study also demonstrates that opportunities for agency are a crucial aspect in achieving sexual experiences, relationships, and intimacy within a precarious housing situation. Conclusion: Precarious housing affects aspects of sexual well-being and opportunities for forming relationships and intimacy. One aspect influencing this is the social, emotional, and material aspects of living in precarious housing, as well as the lack of or limited opportunities for privacy. The study provides incentive for further research on how different housing situations impact individuals' sexual well-being.

Bakgrund: När individer diagnostiseras med ADHD är det inte ovanligt att individen påbörjar en centralstimulerande läkemedelsbehandling. Men forskningen kring läkemedelsbehandlingens påverkan på sexualiteten är skral både nationellt och internationellt. Det finns ett behov av att få bättre förståelse de konsekvenser som centralstimulerande läkemedelsbehandling kan ha för individers sexuella hälsa och välbefinnande. Syfte: För att fördjupa kunskapen inom detta område syftade denna studie att undersöka hur vuxna personer med ADHD upplever att centralstimulerande läkemedelsbehandling påverkar deras sexuella hälsa och välbefinnande samt vilka upplevelser de har av hälso- och sjukvårdens bemötande i relation till frågor som rör sexualitet och ADHD-läkemedel.Metod: Studien utgår ifrån en kvalitativ forskningsdesign bestående av nio semistrukturerade intervjuer. Empirin har analyserats utifrån en reflexiv tematisk analys.Resultat: Resultatdelen bygger på tre huvudteman: Medicinska biverkningars påverkan på sexualitet, Intervjupersoners upplevelser av sitt medicinerande sexuella jag – individuellt och relationellt och Sexualitet i en vårdkontext. Dessa har analyserats med hjälp av begreppen compulsory sexuality och compulsory able-bodiedness för att förstå hur normer kring sexualitet och kroppslig funktion samverkar och påverkar individers upplevelse av sin sexualitet. Slutsats: Resultaten visar att centralstimulerande läkemedel påverkar sexualiteten både positivt och negativt i relation till kroppsliga, psykologiska och sociala faktorer. I studien uppkommer även behov och önskemål om att sexologiska frågeställningar och information om sexuella biverkningar lyfts i hälso- och sjukvården. Resultaten är av vikt för den kliniska sexologin för att ämnet ska synliggöras och uppmärksammas i praktiken för att möjliggöra sexuellt välbefinnande hos vuxna personer med ADHD. / Background: When individuals are diagnosed with ADHD it is not uncommon that they begin a treatment with stimulant medication. However, research about the impact of said treatment is sparse, both nationally as well as internationally. There lies a need to make better understanding of what consequences central stimulants can have for the individual's sexual health and well-being. Aim: To deepen the knowledge within this field, the study aims to examine how adults diagnosed with ADHD experience how being treated with central stimulants affects their sexual health and well-being, as well as what experiences these individuals have regarding how they are being approached by health care professionals with reference to questions about sexuality and medication for ADHD. Method: A qualitative research method has been used in this study, consisting of nine semi-structured interviews. The observations have been analyzed with a reflexive thematic analysis.Results: The results are divided into three major themes: The influence that medical side effects have on sexuality, How the interviewees view their medicating sexual self - individually and with others and Sexuality in a health care context. The themes have been analyzed together with the concepts of compulsory sexuality and compulsory able-bodiedness in order to understand how social norms regarding sexuality and bodily function intertwine with - and affect – individuals’ view on their own sexuality. Conclusion: The results show that central stimulants affect sexuality in both positive and negative ways regarding bodily, psychological and social factors. The study also shows that there is a need for questions of sexological matter to be brought up by health care professionals, as well as giving information about potential side effects that have an impact on sexual health. The results are important for the clinical sexology field and practition, in order to raise awareness for this subject and to enable sexual well-being for adults with ADHD.

Thèse de doctorat présenté en vue de l'obtention du doctorat en psychologie - recherche intervention, option psychologie clinique (Ph.D) / Le bien-être sexuel, soit l’évaluation subjective des aspects physiques, émotionnels, cognitifs et sociaux de sa sexualité, inclut la satisfaction sexuelle, les pensées, connaissances, émotions et expériences personnelles en lien avec la sexualité. Il est associé à plusieurs bienfaits physiques et psychologiques et constitue un ingrédient essentiel des relations amoureuses satisfaisantes. Or, la satisfaction sexuelle tend à diminuer pendant la relation et les difficultés sexuelles sont fréquentes chez les couples de longue durée. Il est donc nécessaire de s’intéresser aux facteurs favorisant le bien-être sexuel chez ces couples. Selon le Interpersonal Emotion Regulation Model of women’s sexual dysfunction (Rosen & Bergeron, 2019), des facteurs relationnels, comme les caractéristiques de la relation (p. ex. intimité), les caractéristiques individuelles des partenaires (p. ex. attachement) et les caractéristiques des activités sexuelles précises (p. ex. motivations sexuelles), doivent être considérés dans l’étude du bien-être sexuel des couples. Ainsi, la thèse visait à examiner des facteurs relationnels liés au bien-être sexuel chez les deux partenaires de couples de longue durée de la population générale. À l’aide d’un devis dyadique prospectif, la première étude a investigué le bien-être sexuel de manière globale : elle s’est penchée sur les associations entre l’intimité et la satisfaction sexuelle et conjugale pendant 13 mois chez 145 couples. Les résultats suggèrent la présence d’associations bidirectionnelles entre l’intimité et la satisfaction sexuelle ainsi qu’entre l’intimité et la satisfaction conjugale. Une perception d’intimité plus élevée était associée à des niveaux de satisfaction sexuelle et conjugale plus élevés dans le temps. En retour, des niveaux de satisfaction sexuelle et conjugale plus élevés étaient associés à une perception d’intimité plus élevée dans le temps. La deuxième étude a examiné le bien-être sexuel de façon plus proximale à l’aide d’un devis dyadique à journaux quotidiens (21 jours) : elle a investigué les associations entre les insécurités d’attachement, les motivations sexuelles d’attachement et de soutien ainsi que les émotions ressenties par les deux partenaires de 149 couples lors des activités sexuelles. Les résultats démontrent que les individus présentant plus d’évitement de l’intimité avaient moins tendance à rapporter des motivations sexuelles de soutien, ce qui était associé à des expériences émotionnelles plus négatives lors des activités sexuelles. Les personnes présentant plus d’anxiété d’abandon rapportaient davantage de motivations sexuelles d’attachement, ce qui était associé à des expériences émotionnelles plus négatives pendant les activités sexuelles pour les deux partenaires. Toutefois, les personnes présentant plus d’anxiété d’abandon rapportaient également plus de motivations sexuelles de soutien et cela était associé à des expériences émotionnelles plus positives pendant les activités sexuelles pour les deux partenaires. Les résultats de la thèse mettent en relief l’importance de considérer les prédispositions individuelles, les caractéristiques de la relation ainsi que les raisons pour lesquelles les individus s’engagent dans des interactions sexuelles pour mieux comprendre le bien-être sexuel des partenaires de couples de longue durée. La thèse apporte une contribution théorique de par son investigation de postulats théoriques peu étudiés empiriquement à ce jour. Plusieurs implications cliniques découlent également des résultats et sont discutés dans la thèse. / Sexual well-being, i.e., subjective evaluation of physical, emotional, cognitive, and social aspects of one’s sexuality including, for instance, sexual satisfaction, thoughts, knowledge, emotions and personal experiences related to sexuality, is associated with important physical and psychological health benefits. It is also an essential ingredient of a satisfying romantic relationship for many adults. However sexual satisfaction tends to decrease with the length of the relationship, and sexual difficulties are often a concern for couples in relationship therapy. Thus, there is a need to address factors that may promote sexual well-being in long-term couples. According to the Interpersonal Emotion Regulation Model of women's sexual dysfunction (Rosen & Bergeron, 2019), multiple relational factors, such as relationship characteristics (e.g., intimacy), partners’ individual characteristics (e.g., attachment), and characteristics of sexual activities (e.g., sexual motivations), must be considered when studying couples' sexual well-being. As such, the overall purpose of this dissertation was to examine relational factors related to sexual well-being in both partners of long-term couples in the general population. The first study investigated global sexual well-being by examining its involvement in relationship dynamics with a longitudinal dyadic design. Specifically, this study examined the associations between intimacy and sexual and relationship satisfaction over a 13-month period in 145 couples. The results suggest that the associations between intimacy and sexual satisfaction as well as between intimacy and relationship satisfaction are bidirectional. Indeed, higher perceived intimacy was associated with higher levels of sexual and relationship satisfaction over time. In turn, higher levels of sexual and relationship satisfaction were also associated with higher perceived intimacy over time. The second study examined sexual well-being more proximally using a dyadic daily diary design (21 days). The purpose of this study was to investigate associations between attachment insecurities, attachment- and caregiving-related sexual motives, and emotions experienced during sexual activities by both partners of 149 couples. Analyses revealed that individuals with higher levels of attachment avoidance were less likely to report caregiving sexual motives, which was associated with more negative emotional experiences during sexual activities. Individuals with higher levels of attachment anxiety reported more attachment sexual motives, which was associated with more negative emotional experiences during sexual activities for these individuals and their partners. However, individuals with higher levels of attachment anxiety also reported more caregiving sexual motives and this was associated with more positive emotional experiences during sexual activities for both partners. Overall, the dissertation and its two articles highlight the importance of considering partners’ individual predispositions, relationship characteristics, as well as the reasons why individuals engage in sexual interactions to better understand the sexual well-being of partners in long-term couples. This research makes a substantial theoretical contribution by investigating theoretical assumptions that have rarely been studied empirically to date. Several clinical implications also arise from the findings and are discussed in the dissertation.

Thèse de doctorat présenté en vue de l'obtention du doctorat en psychologie - recherche intervention, option psychologie clinique (Ph.D) / L'infertilité est reconnue non seulement comme une maladie médicale, mais aussi comme une condition sociale et émotionnelle (Burns et Covington, 2006; Pawar et al., 2020; The Lancet Global Health, 2022). Bien que les études aient, de plus en plus, commencé à étudier l'impact de l'infertilité sur le bien-être psychologique et social (p. ex., Drosdzol et Skrzypulec, 2008; Hasanpoor-Azghdy et al., 2015), les chercheurs en connaissent toujours peu sur le bien-être sexuel des couples qui suivent un traitement de fertilité. Des recherches ont montré que les couples ayant recours à la procréation médicalement assistée (PMA) sont plus susceptibles d'éprouver des difficultés sexuelles que les couples fertiles (Starc et al., 2019). Toutefois, les facteurs qui permettent d’expliquer ces difficultés chez les couples ayant recours à la PMA ont été très peu étudiés à ce jour. Ainsi, en utilisant une approche biopsychosociale de la compréhension de l’infertilité (Gerrity, 2001; Grinion, 2005; Williams et al., 1992) et de la sexualité (Althof et al., 2005; McCabe et al., 2010), cette thèse examine à la fois les facteurs spécifiques à l'infertilité et les facteurs dyadiques sous-jacents au bien-être sexuel des couples infertiles. Afin de mieux comprendre les facteurs spécifiques à l'infertilité associés à la fonction sexuelle des couples qui ont recours à la PMA, une première étude transversale dyadique a été menée auprès de 185 couples de sexes mixtes en processus de PMA qui ont rempli en ligne l’outil Fertility Quality of Life Tool et soit le Female Sexual Function Index (femmes) ou le International Index of Erectile Function (hommes). L'étude a examiné les facteurs de stress personnels et relationnels, et le désir sexuel, l’orgasme, l’excitation et la satisfaction sexuelle des deux partenaires. Les associations entre les caractéristiques liées au diagnostic de l’infertilité et au traitement et les domaines de fonction sexuelle et la satisfaction sexuelle des deux partenaires ont également été examinées pour déterminer si ces variables seraient incluses comme covariables dans les analyses principales. Les analyses acheminatoires ont révélé que pour les hommes et les femmes, les facteurs de stress émotionnels liés à l'infertilité étaient associés à leur propre désir sexuel et à celui de leurs partenaires. Pour les femmes, les facteurs de stress émotionnels liés à l'infertilité étaient également associés à une satisfaction sexuelle plus faible chez leur partenaire et les facteurs de stress corps-esprit étaient associés à une excitation sexuelle plus faible chez leur partenaire. Les facteurs de stress relationnels liés à l'infertilité étaient également associés à une excitation et satisfaction sexuelle plus faibles des individus et à une satisfaction sexuelle plus faible chez leur partenaire. Pour les femmes, les facteurs de stress relationnels liés à l'infertilité étaient également associés à leur propre désir sexuel et orgasme. Ces résultats suggèrent que les interventions portant sur les sphères émotionnelles, psychocorporelles et relationnelles des couples en PMA pourraient aider à faciliter l'amélioration de la fonction et de la satisfaction sexuelles et à mieux répondre aux besoins des couples infertiles. S'appuyant sur les résultats de la première étude, qui suggèrent que l'expérience subjective des couples en matière d'infertilité et de traitement, en particulier les facteurs de stress relationnels, semblent être plus fortement associés à leur santé sexuelle que les facteurs objectifs liés au traitement, le deuxième article visait à étudier les processus relationnels qui sous-tendent le bien-être sexuel des couples. Plus précisément, l'étude a examiné si les perceptions de gestion du stress dyadique (GSD) du partenaire et de la façon dont les deux partenaires gèrent ensemble le stress (GSD commun) sont associées au bien-être sexuel des deux partenaires chez les couples en processus de PMA. Les participants comprenaient 232 couples avec une infertilité médicale qui ont rempli des questionnaires évaluant la gestion du stress dyadique et le bien-être sexuel (préoccupations sexuelles liées à l'infertilité, détresse sexuelle et satisfaction sexuelle). Les analyses acheminatoires ont révélé que les perceptions que le partenaire utilise plus de stratégies de GSD négatives étaient associées à un bien-être sexuel plus faibles des individus. Les perceptions que le partenaire utilise plus de stratégies de GSD positives étaient associées à une satisfaction sexuelle plus élevée pour les hommes et à des préoccupations sexuelles liées à l'infertilité plus élevées pour les femmes. Les perceptions d’une utilisation plus élevée de GSD commun étaient associées à un bien-être sexuel plus élevé chez les deux partenaires. Pour les hommes, les perceptions d’une utilisation plus élevée de GSD commun étaient également associées à des préoccupations sexuelles liées à l'infertilité plus faibles chez leur partenaire. Les analyses étaient ajustées pour la satisfaction relationnelle. Ces résultats suggèrent que le bien-être sexuel des couples pendant les traitements de fertilité pourrait être facilité en favorisant une gestion de stress dyadique commun plus élevée et soulignent que le contexte interpersonnel entourant la sexualité de ces couples devrait être systématiquement abordé auprès des deux membres du couple. / Infertility is recognized as being not only a medical illness, but also a social and emotional condition (Burns & Covington, 2006; Pawar et al., 2020; The Lancet Global Health, 2022). Although studies have increasingly begun to investigate the impact of infertility on psychological and social well-being (e.g., Drosdzol & Skrzypulec, 2008; Hasanpoor-Azghdy et al., 2015), little remains known about the sexual well-being of couples undergoing fertility treatment. Research has shown that couples seeking assisted reproductive technology (ART) are more likely to experience sexual difficulties than fertile couples (Starc et al., 2019). However, very few studies have examined the factors that may explain these difficulties in couples seeking ART. Hence, using a biopsychosocial approach to the understanding of infertility (Gerrity, 2001; Grinion, 2005; Williams et al., 1992) and sexuality (Althof et al., 2005; McCabe et al., 2010), this thesis examines both infertility-specific and dyadic factors underlying the sexual well-being of infertile couples. To better understand the infertility-specific factors associated with the sexual function of couples seeking ART, a first dyadic cross-sectional study was conducted with 185 mixed-sex couples seeking ART who completed online the Fertility Quality of Life Tool and either the Female Sexual Function Index (women) or the International Index of Erectile Function (men). The study examined the association between personal and relational stressors and the sexual desire, orgasm, arousal, and sexual satisfaction of couples seeking ART. The associations between diagnosis and treatment-related factors and both partners’ domains of sexual function and sexual satisfaction were also examined to determine whether these variables should be included as covariates in the main analyses. Path analyses revealed that for men and women, infertility-related emotional stressors were associated with their own and their partners’ lower sexual desire. For women, experiencing greater infertility-related emotional stressors was also associated with their partner’s lower sexual satisfaction and experiencing greater infertility-related mind-body stressors was associated with their partner’s lower sexual arousal. Infertility-related relational stressors were also associated with individuals’ own lower sexual arousal and satisfaction and their partner’s lower sexual satisfaction. For women, experiencing greater relational stressors was also associated with their own lower sexual desire and orgasm. These results suggest that interventions addressing the emotional, mind-body, and relational spheres of couples seeking ART may help facilitate improvements in sexual function and satisfaction and better serve infertile couples’ needs. Building on the results of the first study, which suggest that couples’ subjective experience of infertility and treatment, particularly relational stressors, seem to be more strongly associated with their sexual well-being than objective treatment-related factors, the second study aimed to investigate the relational processes that underly couples’ sexual well-being. More specifically, the study examined whether perceptions of the partner’s dyadic coping (DC) and of how both partners cope together (common DC) are associated with both partners’ sexual well-being in couples seeking ART. Participants included 232 couples with medical infertility who completed questionnaires assessing dyadic coping and sexual well-being (infertility-related sexual concerns, sexual distress, and sexual satisfaction). The path analyses revealed that perceptions of partners’ use of higher negative DC were associated with individuals’ own lower sexual well-being. Perceptions of partners’ use of higher positive DC were associated with higher sexual satisfaction for men and greater infertility-related sexual concerns for women. Perceptions of higher use of common DC were associated with both partners’ higher sexual well-being. For men, perceptions of higher use of common DC were also associated with their partner’s fewer infertility-related sexual concerns (partner effect). Analyses adjusted for relationship satisfaction. These results suggest that couples’ sexual well-being during fertility treatment could be facilitated by promoting greater common DC and highlight that the interpersonal context surrounding these couples’ sexuality should be routinely discussed with both members of the couple.