Satisfaction and Health Within Four Sexual Identity Relationship Options – 4 Options Survey
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Satisfaction and Health Within Four Sexual Identity Relationship Options

Lefevor, Beckstead, Schow, Raynes, Mansfield, & Rosik

Citation: Lefevor, G. T., Beckstead, A. L., Schow, R. L., Raynes, M., Mansfield, T. R., & Rosik, C. H. (2019). Satisfaction and health within four sexual identity relationship options. The Journal of Sex and Marital Therapy, 45, 355-369.


–Survey data collected from Sept 2016 to June 2017 on internet Survey Monkey

N=1782 (See Table 1)

  • Relationship Options
    • Single Celibate. (SC). 434 (25%)
    • Single Non Celibate (SNC) 433 (24%)
    • Mixed Orientation Relationship (MOR) 522 (29%)
    • Same Sex Relationship (SSR) 393 (22%)
  • 69% Raised LDS, 54% Currently LDS
  • 69% male, 25% female, 6% other
  • 38% Identify SSA, etc, 62% Identify LGB, etc (also experience SS attraction)
  • All participants experienced SS attraction at some point
  • Survey
    • 30 diverse scholars provided feedback on questions
    • Research team included diverse perspectives
    • Wide efforts led to broad diverse participation in survey
    • Two pilot studies preceded data collection
    • These 4 measures were used so findings were interpreted fairly

–The final survey contained 97 questions (+subquestions) (30-40 min estimate to respond) including questions on demographics plus 10 domains

  1. Satisfaction with relationship option
  2. Companionship + sexuality
  3. Social support + group resources
  4. Internal strength + self direction
  5. Satisfaction specifics for partner or as single
  6. Changes in sexuality
  7. Values
  8. Attitudes about SSA/LGB
  9. Eroticism
  10. Religious/Spiritual

-Within the survey, questions were included generally using a 7 point Likert for the following based on pre-existing or created measures

  • internalized homonegativity
  • depression
  • anxiety
  • life satisfaction
  • sexual attraction and aversion
  • physical health
  • sense of self
  • social desirability-attitudes to sexuality and connection
  • relationship option satisfaction


–Possible covariates such as age, time in option, etc were considered but only length of time in option was found to need control and was controlled in our analysis

Satisfaction in option (see Table 2)

  • Total Satisfaction——–Very Satisfied
    • SC= 42%                               6%
    • SNC= 40%                               6%
    • MOR= 80%                              28%
    • SSR= 95%                               61%

–ANOVA showed all options were significantly different from each other except between SC and SNC

Kinsey Attraction during the past year was measured and found to be significantly different across groups (see Table 3)

1-Anxiety, 2-depression, 3-internalized homonegativity, 4-physical health, and 5-life satisfaction (see Table 4) were each found to be significantly different across the 4 groups with SSR showing the most favorable findings and the single groups showing the least favorable findings.

Using simultaneous regression we identified 9 variables that were found to account for option satisfaction.  This is reported for the total group and each option (see Table 5).

These variables were found to explain 25% to 40% of the relationship satisfaction depending on group

Table 5 shows important predictors of satisfaction for various groups

“I meet my needs for connection, intimacy and mutual understanding” was the single most important predictor of satisfaction across all 4 groups

other important predictors–

  • authentic sexual expression
  • resolving conflicts with religion
  • reducing depression and anxiety


1) Satisfaction was highest in SSR, followed by MOR while SC and SNC were markedly less satisfied

2) Relationship option has health implications beyond satisfaction in all 5 measured areas

3) Those in SSR and SNC showed the most SS attraction and those in MOR and SC the least, although the explanation for this needs further study

4) Meeting needs for connection is most important for all groups followed by other factors including authentic sexual expression and religious conflict resolution and mental health issues.

5) For both partnered groups, the older participants were and longer they had been in a relationship, the less satisfied they were in their relationship option. That is, MOR and SSR groups evidenced more satisfaction than the SC or SNC groups, even when time in status was controlled for. In fact, the differences in satisfaction between groups would likely be more pronounced with time in status controlled for since people had been in MORs longer than in any other option.

Therapy Implications

  1. Although results indicate that being in a SSR was rated more satisfactorily for our SSA sample, this does not mean that all SSA individuals would be more satisfied in a SSR or should be counseled to do so, especially as 28% of SSA individuals in our sample reported being very satisfied in a MOR and 80% reported some level of satisfaction in that relationship option. Similarly, 6% reported being very satisfied being single and celibate with 40.4% reporting some level of satisfaction and another 6% reported being very satisfied being single and non-celibate with 41.5% reporting some level of satisfaction in that life option.
  2. Psychotherapy to increase sexual minorities’ satisfaction in their relationship option, regardless of the option, might explore how to help such clients meet these needs: (a) connection, intimacy, and mutual understanding; (b) authentic sexual expression; (c) resolution of conflicts with religion; and (d) reduction of depression and anxiety. Psychotherapist and client can examine how important these needs are for the client and address any other concerns affecting satisfaction (e.g., family conflicts).