We have described the assessment approach to couples with sexual complaints used in the McMaster Human Sexuality Clinic. Our approach takes into account a number of individual factors including intrapersonal and biological ones as well as issues of sexual socialization, gender role socialization and sexual orientation. Couple factors include relationship factors as well as factors dealing with sexual behaviours, attitudes and responses. In our view, the issues of sexual socialization and gender role socialization needs special emphasis in assessing such couples. We stress as well that the dichotomy between organic and functional is a misleading one and that for each individual and couple, any biological factors and the many supra-biological factors listed above, must be prioritized in terms of their role in symptom production. Such a priority list can then be used to map out treatment strategies.