Sexual coercion in couples with infertility: prevalence, gender differences, and associations with psychological outcomes

ABSTRACT

Infertility can create challenges for couples’ sexual negotiation and could set the stage for sexual coercion (i.e. use of verbal pressure or force to obtain sex from an unwilling partner). This study investigated the occurrence and correlates of sexual coercion during intercourse for conception among infertile couples. A convenience sample of heterosexual couples (N = 105) with infertility were recruited from clinics and online forums. Members of the couple separately completed an online questionnaire. Members of the couple answered questions about their partner's use of sexual coercion during intercourse for conception and not for conception. Then they completed measures of psychological distress, relationship adjustment, and sexual functioning. A significantly higher proportion of men (37%) than women (12%) reported being verbally pressured by their partner to engage in intercourse for the purposes of conception. For men, but not women, experiencing sexual coercion during intercourse for conception was associated with psychological distress and poor relationship adjustment. Qualitative data provided context for understanding the impact of infertility on participants’ sexual relationships. These findings suggest that sexual coercion may be a problem for some men within infertile couples. Experiencing sexual coercion in the context of infertility may represent a double threat to men's masculine identity.

KEYWORDS:

• Infertility
• sexual coercion
• depression
• anxiety
• sexual dysfunction
• relationship satisfaction

Acknowledgments

This project was supported by a grant from the University of Missouri Research Board. The authors are grateful to Dr Elan Simckes and the staff at Fertility Partnership for their help in recruiting participants for this study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. We also created continuous variables measuring sexual coercion during intercourse for conception by summing the number of instances (0 to 3 or more) of verbal pressure, threat, and force that each member of the couple reported. Consistent with results using the dichotomous variables, the mean on this measure was higher for men (M = 0.92; SD = 1.57) than women (M = 0.29; SD = 0.87), p = .001. We also examined correlations between that continuous variable and the measures of psychological outcomes. The pattern of results was similar to what we found with the dichotomous variable. For men, sexual coercion was significantly correlated with the DASS total score (r = .25, p = .01), the DAS total score (r = −.21, p = .03), and the IIEF total score (r = −.21, p = .03). For women, the continuous coercion variable was not significantly related to the DASS total score (r = .09, p = .38) or the FSFI total score (r = .10, p = .35) and the effect sizes were small to near zero. However, the continuous coercion measure was moderately associated with the DAS total score for women (r = −.23, p. = .02). Nevertheless, because these continuous measures of coercion demonstrated substantial problems with skewness (2.14 for men and 3.37 for women) and kurtosis (5.04 for men and 11.41 for women), we focused on the results using the dichotomous sexual coercion variables.

2. Quotes are presented as writtenby the participant, including any spelling or grammatical errors.

3. For ethical reasons, when quoting participants, we indicate whether that individual reported coercion for the purposes of conception but not whether his or her partner reported coercion for the purposes of conception. This ensures participant confidentiality; if participants read this and recognized their own quotes, we would not want them to know how their partner responded to the sexual coercion items.

Additional information

Funding

University of Missouri Research Board Grant.

Notes on contributors

Zoë D. Peterson

Zoë D. Peterson is an associate professor of psychological sciences and the director of the Sexual Assault Research and Education Program at the University of Missouri-St. Louis and a research fellow of the Kinsey Institute for Research in Sex, Gender, and Reproduction. Her research focuses on experiences of unwanted and non-consensual sex.

Sarah K. Buday

Sarah K. Buday is a staff psychologist at Community Psychological Service, Center for Behavioral Health at the University of Missouri-St. Louis and is in a private practice at The Center for Mindfulness & CBT.  Her research focuses on sexual coercion and sexual functioning.