Sexual satisfaction, quality of life and the transaction of intimacy in hospital patients' accounts of their (hetero)sexual relationships

Twenty-three people attending hospitals in a city in southern England were interviewed to explore their perceptions and experiences of sexual dysfunction and satisfaction, and the relationship between these issues and subjective understandings of quality of life. Their responses are examined to inform theories concerning the relationship between intimacy and sexuality in heterosexual relationships. Disturbances to sexual function are framed by wider social realities and echo sociological understandings of disability and chronic illness. Informants' accounts utilised a mechanistic 'urge' model of sexuality, although issues of intimacy and emotion were central to their understandings of quality and satisfaction. Sexual activity in the relationship was understood as a mutual exchange of intimacy, suggesting a construction of sexual intercourse as a form of transaction between gendered sex 'workers', mimicking commodity relations. Accounts of the devastation brought by sexual dysfunction reflected highly socialised expectations of sexual performance. There is a need for further theoretical and empirical scrutiny of the relationship between sexual function and quality of life.