Sexual relationship disorder is a disorder where a person has difficulties in forming or maintaining a sexual relationship because of their gender identity or sexual orientation. The World Health Organization lists sexual relationship disorder in the ICD-10, under "Psychological and behavioural disorders associated with sexual development and orientation". The WHO describes it thus:
The gender identity or sexual orientation (heterosexual, homosexual, or bisexual) is responsible for difficulties in forming or maintaining a relationship with a sexual partner. (F66.2)
The WHO applies the following note to the entirety of part F66: "Sexual orientation by itself is not to be regarded as a disorder."
A significant number of men and women experience conflict surrounding homosexual expression within a mixed-orientation marriage. Therapy may include helping the client feel more comfortable and accepting of same-sex feelings and to explore ways of incorporating same-sex and opposite-sex feelings into life patterns. Although a strong homosexual identity was associated with difficulties in marital satisfaction, viewing the same-sex activities as compulsive facilitated commitment to the marriage and to monogamy.
Other LGBT people may want to have a family with an opposite-sex spouse. They may seek to change their sexual orientation. Research from the 1970s showed that a minority of patients who undergo therapy ultimately married someone of the opposite sex, though it is not clear what role therapy contributed to the marriage. Recent research does not permit any attribution of marital outcomes to therapy, though it appears that sexual orientation identity reconstruction can help clients develop a heterosexual orientation identity.
^Schneider JP, Schneider BH (1990). "Marital satisfaction during recovery from self-identified sexual addiction among bisexual men and their wives". J Sex Marital Ther.16 (4): 230–50. doi:10.1080/00926239008405460. PMID2079706.