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We examined the degree and direction of sexual desire discrepancies (SDD) between partners and how this relates to sexual function, sexual satisfaction, relationship satisfaction in 100 Saudi Arabian couples, taking into account both partners' attachment orientation. Men and women reported better outcomes when they matched on higher levels of sexual desire. In case of a mismatch, women reported higher sexual satisfaction when their partner's level of sexual desire was higher than their own. Attachment anxiety and avoidance moderated the associations between SDD and the outcome variables. This study offers unique information on SDD in couples with strong gender role expectations and cultural restrictions regarding sexuality. Therapeutic interventions should be directed at understanding the attachment meaning of sexual desire.

Background: Attachment and intimacy play an important role in shaping sexual and relational experiences. Yet, their interrelation has rarely been investigated in the context of sexual problems and never been tested in Saudi Arabian women., Aim: The present study examined the interrelations of attachment orientation and sexual function, distress, satisfaction, and relational satisfaction in a sample of Saudi Arabian women and explored whether this link can be explained by 2 important aspects of (sexual) intimacy, namely perceived partner responsiveness (PPR) and sexual assertiveness., Method: This is a cross-sectional, observational study in a sample of 50 heterosexual women with sexual problems and 50 control women without problems, who completed an Arabic version of questionnaires on attachment orientation, sexual assertiveness, PPR, relationship satisfaction, sexual satisfaction, sexual distress, and sexual function., Results: We found that both attachment anxiety and sexual refusal showed a significant association with the level of sexual function, sexual distress, and sexual satisfaction (P < .01) in the clinical group. No mediating effects of sexual refusal were found. In the control group, sexual function, sexual distress, and sexual satisfaction were predicted by attachment avoidance (P < .01). Level of sexual function was also predicted by sexual initiation (P < .05). PPR fully mediated the association between attachment anxiety and relational satisfaction in the clinical group (P < .01), while in the control group the link between attachment avoidance and relational satisfaction was only partially mediated by PPR (P < .01)., Strengths & Limitations: This study offers unique information on relational and sexual functioning in a culture in which sexual expression and intimate behavior are restricted, particularly in women., Clinical Implications: Perceiving the partner as being more responsive is an important target of intervention to increase satisfaction with the relationship., Conclusions: Our results suggest that attachment anxiety and low sexual assertiveness, as indicated by lower tendencies to refuse sex when not desired, play a significant role in predicting negative sexual experiences in women who cope with sexual difficulties. Attaky A, Kok G, Dewitte M. Attachment Insecurity and Sexual and Relational Experiences in Saudi Arabian Women: The Role of Perceived Partner Responsiveness and Sexual Assertiveness. J Sex Med 2020;17:1383-1394., (Copyright © 2020 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)