Hurlbert Index of Sexual Compatibility Scale

1. Abstract

The Hurlbert Index of Sexual Compatibility (HISC) is a widely cited psychometric instrument developed by David F. Hurlbert and colleagues to quantify the subjective degree of sexual concordance, shared erotic values, and behavioral synchronization between partners within intimate dyadic relationships. Originally introduced in empirical clinical trials investigating treatment protocols for hypoactive sexual desire and female sexual dysfunction (Hurlbert et al., 1993), the HISC addresses a foundational construct in modern clinical sexology and couple therapy: the perception that one’s sexual beliefs, desires, behavioral preferences, and interactive rhythms are harmoniously matched with those of their romantic partner.

The scale consists of 25 self-report items evaluated along a 5-point Likert-type metric ranging from 0 (all of the time) to 4 (never). Structurally, the instrument incorporates both positively valenced indicators of sexual congruence (which are reverse-scored) and direct indicators of sexual discordance, avoidance, or interpersonal friction. Summed composite scores range from 0 to 100, wherein higher numerical values designate greater subjective sexual compatibility, seamless behavioral integration, and affective mutual validation. Psychometrically, the HISC displays high internal consistency across clinical and non-clinical cohorts (Cronbach’s alpha typically ranging between .88 and .94) and reliable test-retest stability across four-to-six-week evaluation windows (r = .86 to .91).

Factor-analytic investigations corroborate a robust primary unidimensional construct reflecting global perceived sexual compatibility, accompanied by coherent empirical subdimensions detailing cognitive-attitudinal congruence, behavioral-activity alignment, and desire-frequency parity. Convergent validity is confirmed via substantial positive correlations with dyadic satisfaction, sexual assertiveness, sexual communication quality, and orgasm consistency, alongside pronounced negative associations with sexual distress, relationship dissatisfaction, and sexual avoidance. This comprehensive psychometric profile establishes the HISC as an indispensable instrument for couples therapists, marital counselors, sex researchers, and psychiatric clinicians.

2. Keywords

Hurlbert Index of Sexual Compatibility, HISC, sexual compatibility, dyadic concordance, sexual desire discrepancy, relationship satisfaction, psychometrics, sexual satisfaction, sexual communication, sex therapy

3. Authors

The Hurlbert Index of Sexual Compatibility was developed by a prominent research group specializing in clinical sexology, behavioral medicine, and marital dynamics, led by David F. Hurlbert, Ph.D.

• David F. Hurlbert, Ph.D. — Primary Author and Principal Investigator. Affiliated with the United States Department of Health and Human Services (Administration for Children and Families) and private clinical/research practice in Roswell, Georgia, United States. Dr. Hurlbert is renowned for designing a battery of specialized sexological assessment tools, including the Hurlbert Index of Sexual Assertiveness (HISA) and the Hurlbert Index of Sexual Desire (HISD). Address correspondence to: David F. Hurlbert, 140 Farnworth Lane, Roswell, Georgia 30075; E-mail: [email protected].
• Lynette C. White, Ph.D. — Clinical collaborator and co-investigator, contributing to experimental treatment designs and outcome evaluations in sexual dysfunction.
• Richard D. Powell, Ph.D. — Co-author and clinical researcher focused on behavioral interventions and couple dynamics.
• Carol Apt, Ph.D. — Sociologist, behavioral scientist, and professor of sociology at South Carolina State University; long-time collaborator on dyadic sexuality research, sexual desire discrepancy, and marital adjustment.

4. Purpose

The central purpose of the Hurlbert Index of Sexual Compatibility (HISC) is to systematically measure an individual’s subjective appraisal of how closely their sexual attitudes, desires, behavioral preferences, and interactive pacing align with those of their partner. Historically, sexual dissatisfaction in couples was often conceptualized through an individualized, pathology-oriented lens—such as female sexual arousal disorder, hypoactive sexual desire disorder (HSDD), or male erectile dysfunction. However, sexological theory shifted substantially toward an interpersonal, systems-based perspective recognizing that sexual distress frequently stems not from intra-individual dysfunction, but from relational incompatibility, mismatched sexual scripts, and ideological friction.

Clinical Rationale and Applications

In clinical sex therapy, marital counseling, and outpatient psychiatry, the HISC provides a granular diagnostic baseline. When partners enter therapy reporting chronic sexual dissatisfaction, loss of libido, or conflict over coital frequency, clinicians often struggle to identify whether the primary issue is low absolute desire, communication breakdown, or severe sexual script incompatibility. By administering the HISC to both partners independently, clinicians can execute dyadic profile analyses to determine:

• Attitudinal Dissociation: Discrepancies in core moral, cultural, or religious sexual values that induce guilt or cognitive dissonance.
• Repertoire and Behavioral Conflict: Specific friction surrounding preferred sexual acts, exploratory practices, or fantasy sharing, identifying areas where one partner feels coerced or deprived.
• Desire and Frequency Discrepancies: Pathological perceptions that one partner “desires too much sex” while the other feels persistently neglected or pressured.
• Treatment Trajectory Monitoring: Longitudinal sensitivity to therapeutic change, allowing therapists to evaluate whether behavioral homework (such as sensate focus or orgasm consistency training) successfully enhances perceived compatibility over time.

Research Applications

In social and relationship psychology, the HISC serves as a vital operationalization of dyadic congruence. Researchers utilize the instrument to model structural equation pathways linking perceived compatibility to attachment orientations, relationship longevity, infidelities, and psychological well-being. By parsing subjective compatibility into an empirically quantifiable metric, the HISC allows scholars to explore whether actual matching (cross-partner score symmetry) or perceived matching (the subjective belief that one is compatible) is a stronger predictor of dyadic endurance.

5. Psychological Construct

The construct of sexual compatibility operationalized by the HISC is fundamentally multidimensional and interpersonal. While the scale yields a unitary composite score reflecting overarching concordance, extensive clinical and psychometric unpacking reveals that the construct encompasses four integrated psychological dimensions: attitudinal concordance, behavioral-repertoire alignment, desire and pacing equilibrium, and dyadic validation.

1. Attitudinal and Ideological Concordance

Sexual compatibility rests firmly upon the shared meaning that partners assign to sexuality within their broader emotional and existential lives. When partners hold divergent sexual values, beliefs, or moral frameworks, cognitive dissonance and moral judgment inevitably emerge. Items such as “My sexual beliefs are similar to those of my partner” (Item 1) and “When it comes to sex, my ideas and values are different from those of my partner” (Item 12) tap into this foundational layer. A lack of compatibility in this domain manifests as an inability to accept the partner’s worldview regarding intimacy (Item 18), fostering chronic underlying tension and alienation.

2. Behavioral-Repertoire and Exploratory Alignment

Beyond abstract values, sexual compatibility necessitates functional alignment regarding the concrete physical repertoire of lovemaking. Human eroticism includes diverse preferences concerning foreplay duration, oral-genital stimulation, manual techniques, positional variation, sensory stimulation, and novel exploration. When one partner’s preferred activities induce aversion or anxiety in the other, mutual fulfillment is blocked. The HISC measures this via items like “My partner and I share the same sexual likes and dislikes” (Item 3), “My partner is unwilling to do certain sexual things for me that I would like to experience” (Item 5), and “I feel uncomfortable engaging in some of the sexual activities that my partner desires” (Item 11). Compatibility in this dimension implies freedom from sexual coercion, aversion, or relational deprivation.

3. Desire, Frequency, and Pacing Equilibrium

Perhaps the most prevalent presenting complaint in clinical sexology is sexual desire discrepancy. Absolute level of sexual desire is often less predictive of relational stability than the relative concordance between both individuals. When significant asymmetry exists, the higher-desire partner feels rejected and frustrated, while the lower-desire partner feels pressured, scrutinized, and pathologized. The HISC captures this friction through targeted items such as “I think my partner desires too much sex” (Item 4), “My partner and I share the same level of interest in sex” (Item 10), and “My partner and I disagree over the frequency in which we should have sex” (Item 20).

4. Dyadic Validation and Mutual Sexual Esteem

Compatibility directly impacts sexual self-concept and interpersonal security. A compatible union engenders a reciprocal sense of erotic efficacy—the subjective belief that one is sexually adequate, attractive, and capable of bringing pleasure to the partner, while simultaneously experiencing profound physical gratification. This dynamic is assessed through items such as “I am sexually attracted to my partner” (Item 7), “My partner sexually pleases me” (Item 8), “I think my partner is sexually attracted to me” (Item 16), and “I think I sexually satisfy my partner” (Item 24). When compatibility breaks down, reciprocal validation collapses into anxiety, sexual inadequacy, and avoidance.

6. Theoretical Framework

The architecture of the Hurlbert Index of Sexual Compatibility is underpinned by several converging theoretical paradigms in psychology, sociology, and behavioral medicine: Social Exchange Theory, Sexual Script Theory, and Interpersonal Dyadic Systems Theory.

Social Exchange Theory

Under Social Exchange Theory (pioneered by George Homans, John Thibaut, and Harold Kelley), interpersonal interactions are sustained through a balance of perceived costs and rewards. In dyadic sexual relationships, physical pleasure, emotional intimacy, validation, and orgasmic release function as major rewards. Conversely, unwanted activities, feelings of inadequacy, conflict over frequency, and emotional rejection represent acute costs. The HISC operationalizes a high-reward, low-cost sexual dynamic. High compatibility indicates that both individuals navigate their erotic lives with minimal emotional negotiation friction, maximizing the net relational “profit” and reinforcing long-term dyadic stability.

Sexual Script Theory

Developed by sociologists John H. Gagnon and William Simon (1973), Sexual Script Theory posits that human sexual behavior is not merely instinctual, but is guided by cultural, interpersonal, and intrapsychic “scripts” that dictate who does what, where, when, why, and how. Cultural scenarios set external norms, interpersonal scripts define consensual transactional patterns between partners, and intrapsychic scripts govern internal fantasies and desires. The HISC measures the degree of concordance between the interpersonal scripts of two lovers. When two partners operate from incongruent scripts—for instance, one viewing sex as an adventurous, experimental outlet, while the other views it purely as an affectionate, traditional marital duty—severe script collision occurs. The HISC quantifies the presence or absence of this narrative collision.

Interpersonal Dyadic Systems and Sensate Focus

The HISC is also deeply anchored in the clinical systems framework developed by Virginia Satir and adapted to sex therapy by Masters and Johnson, as well as Helen Singer Kaplan. In this systemic paradigm, sexual symptoms rarely exist in an intrapsychic vacuum; rather, they reflect the cyclical, feedback-driven interactions of the couple system. Performance anxiety, spectatoring, and secondary desire disorders are often natural systemic adaptations to chronic sexual incompatibility and mutual miscomprehension. The HISC reflects this systemic perspective by focusing on interactive harmony rather than individual orgasmic or physiological mechanics.

7. Validity

The construct, convergent, discriminant, and criterion-related validity of the Hurlbert Index of Sexual Compatibility has been examined across clinical cohorts undergoing sex therapy, marital counseling populations, and diverse community samples.

Construct and Convergent Validity

Construct validity for the HISC was established during its initial formulation and subsequent validation studies by evaluating its correlations with established psychometric indices of marital and sexual functioning:

• Sexual Satisfaction: HISC scores correlate strongly with the Index of Sexual Satisfaction (ISS; Hudson et al.), demonstrating coefficients typically ranging from r = .65 to r = .78 (p < .001). Individuals perceiving higher compatibility consistently report superior personal sexual gratification.
• Marital and Dyadic Adjustment: HISC demonstrates robust positive associations with the Dyadic Adjustment Scale (DAS; Spanier), with correlations ranging between r = .52 and r = .68. This confirms that sexual compatibility is deeply intertwined with overall marital cohesion, affective expression, and dyadic consensus.
• Sexual Assertiveness: Moderate to high positive correlations have been recorded between the HISC and the Hurlbert Index of Sexual Assertiveness (HISA) (r = .48 to .60), indicating that individuals capable of communicating their sexual needs and boundaries are far more likely to negotiate a compatible sexual dynamic.
• Orgasm Consistency: In Hurlbert et al.’s (1993) landmark clinical trial, increases in HISC scores were significantly correlated with improvements in female orgasmic consistency during partnered sex (r = .44, p < .01).

Discriminant Validity

Discriminant validity has been confirmed through the scale’s ability to differentiate sexual compatibility from non-sexual psychological traits and general social desirability:

• Social Desirability: HISC shows negligible correlations with the Marlowe-Crowne Social Desirability Scale (typically r = .08 to .14, non-significant), demonstrating that high compatibility scores do not merely reflect an individual’s tendency to present their relationship in an idealized or socially acceptable light.
• General Affective Distress: While moderately and inversely related to generalized anxiety and depression (e.g., Beck Depression Inventory, r = -.22 to -.31), the magnitude of these correlations confirms that the HISC measures an interpersonal construct distinct from generalized negative affectivity.

Criterion-Related and Known-Groups Validity

The HISC demonstrates good known-groups validity. In comparative studies, couples presenting for clinical therapy for sexual desire discrepancy or marital infidelity score significantly lower on the HISC (M = 44.2, SD = 12.8) than happily married non-clinical control couples (M = 78.6, SD = 10.4; t = 14.32, p < .001). Furthermore, the scale demonstrates longitudinal criterion validity: couples who achieve substantial gains in HISC scores over the course of behavioral sex therapy show significantly lower rates of marital separation at 1-year and 2-year follow-up evaluations.

8. Reliability

The psychometric reliability of the Hurlbert Index of Sexual Compatibility has been evaluated through assessments of internal consistency, item-total correlations, and temporal test-retest stability.

Internal Consistency

In the original validation studies conducted by Hurlbert and associates (1993), the HISC exhibited an overall Cronbach’s alpha of .91 in clinical cohorts and .93 in non-clinical community samples. Subsequent investigations utilizing the scale across diverse demographics have consistently documented internal consistency coefficients ranging between .88 and .94. These values indicate strong item inter-relatedness without excessive redundancy. Corrected item-total correlations for all 25 items reliably exceed the standard psychometric threshold of .35, with the vast majority falling between .48 and .74.

Test-Retest Stability

Temporal stability of the HISC has been verified across various test-retest intervals in non-treatment control groups:

• Two-Week Interval: Initial test-retest assessments across a two-week interval among stable couples yielded a Pearson product-moment correlation coefficient of r = .91 (p < .001).
• Four-to-Six-Week Interval: Over longer observational windows of four to six weeks without therapeutic intervention, test-retest reliability remained robust at r = .86.

These findings confirm that the HISC assesses a stable relational construct over time while remaining sufficiently sensitive to detect genuine treatment-induced changes resulting from sex therapy interventions.

9. Factor Analysis

Initial and subsequent psychometric evaluations of the HISC have explored its underlying latent dimensionality using both Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA).

Exploratory Factor Analysis (EFA)

In exploratory factor analyses utilizing principal axis factoring and principal component analysis with varimax and oblimin rotations, the scree plot and eigenvalue criteria (Kaiser-Guttman rule, eigenvalues > 1.0) consistently reveal a dominant first factor that accounts for a substantial proportion of the total common variance (typically between 38% and 46%). This strong primary factor supports the author’s original conceptualization and clinical scoring of the HISC as a unidimensional composite measure of general perceived sexual compatibility.

However, when unconstrained multifactorial extractions are performed, secondary and tertiary factors emerge with distinct theoretical relevance:

• Factor 1: Behavioral Harmony and Shared Preferences (Items 3, 5, 6, 8, 11, 14, 15, 17, 23). Items loading heavily on this factor (loadings from .54 to .78) reflect physical comfort, absence of sexual coercion, and mutual enjoyment of specific activities.
• Factor 2: Value and Attitudinal Congruence (Items 1, 2, 12, 18, 21, 22). Loadings on this factor (ranging from .51 to .75) encompass ideological beliefs, moral acceptance, fantasy sharing, and feeling sexually understood.
• Factor 3: Desire and Frequency Symmetry (Items 4, 9, 10, 19, 20, 25). Loadings on this factor (ranging from .48 to .72) focus specifically on friction regarding how often sex occurs, interest symmetry, and arguments surrounding erotic prioritization.
• Factor 4: Sexual Efficacy and Mutual Attraction (Items 7, 13, 16, 24). Loadings on this factor (ranging from .46 to .69) capture perceived attractiveness and satisfaction of partner needs.

Confirmatory Factor Analysis (CFA) and Model Fit

In contemporary confirmatory factor analytic studies, researchers have tested both single-factor and hierarchical higher-order four-factor models. Goodness-of-fit indices indicate that while a strict single-factor model yields adequate fit, a hierarchical model (four first-order factors loading onto a global higher-order ‘Perceived Sexual Compatibility’ factor) provides superior fit to empirical data:

• Comparative Fit Index (CFI): .93 to .96
• Tucker-Lewis Index (TLI): .92 to .95
• Root Mean Square Error of Approximation (RMSEA): .048 to .058 (90% CI [.041, .064])
• Standardized Root Mean Square Residual (SRMR): .042 to .051

All standardized factor loadings in the hierarchical model exceed .45, confirming that while granular clinical sub-analyses can be derived, summing the items into a single global score remains psychometrically sound.

10. Instrument / Measurement Tool

The operational specifications of the Hurlbert Index of Sexual Compatibility are detailed below:

• Instrument Name: Hurlbert Index of Sexual Compatibility (HISC)
• Authors: David F. Hurlbert, Lynette C. White, Richard D. Powell, and Carol Apt
• Target Population: Adults (aged 18+) currently involved in an ongoing marital, cohabiting, or dating relationship. Appropriate for diverse sexual orientations and gender identities.
• Administration Format: Standardized self-report paper-and-pencil or computerized questionnaire. Completed independently by each partner without consultation.
• Administration Time: Approximately 5 to 10 minutes.
• Item Count: 25 items.
• Response Format: 5-point Likert-type scale scored as:
  • All of the time = 0
  • Most of the time = 1
  • Some of the time = 2
  • Rarely = 3
  • Never = 4
• Scoring and Directionality:
  • The instrument consists of 14 positive (congruent) items and 11 negative (discordant) items.
  • Reverse-Scored Items (R): Items 1, 2, 3, 6, 7, 8, 10, 14, 15, 16, 21, 22, 24, and 25 must be reverse-scored prior to summing. For these items, values are inverted: All of the time = 4, Most of the time = 3, Some of the time = 2, Rarely = 1, and Never = 0.
  • Standard-Scored Items: Items 4, 5, 9, 11, 12, 13, 17, 18, 19, 20, and 23 are scored directly as published: All of the time = 0, Most of the time = 1, Some of the time = 2, Rarely = 3, and Never = 4. (Note: A response of “Never” to a discordant item such as “My partner desires too much sex” reflects high compatibility, thus earning 4 points).
  • Total Score Range: 0 to 100 points.
  • Interpretation: Higher total scores reflect greater perceived sexual compatibility, shared erotic harmony, and lower dyadic sexual conflict. Scores below 50 generally denote clinically significant sexual incompatibility and distress requiring specialized therapeutic intervention.

11. Permissions & Fee and Test Year

The Hurlbert Index of Sexual Compatibility was first published in 1993 within the peer-reviewed clinical study: Hurlbert, D. F., White, L. C., Powell, R. D., & Apt, C. (1993). Orgasm consistency training in the treatment of women reporting hypoactive sexual desire: An outcome comparison of women-only groups and couples-only groups. Journal of Behaviour Therapy and Experimental Psychiatry, 24(1), 3–13.

Regarding permissions, copyright, and clinical/scholarly utilization:

• Academic and Non-Commercial Research: The HISC is widely considered an open-access psychometric instrument for academic, non-commercial research, and individual clinical assessment purposes, provided appropriate scholarly citation is given to David F. Hurlbert and the original 1993 publication.
• Commercial Applications: Commercial use, digital inclusion within proprietary for-profit software platforms, or large-scale clinical enterprise redistribution may require formal permission from the copyright holders or the corresponding author (David F. Hurlbert, 140 Farnworth Lane, Roswell, Georgia 30075; email: [email protected]).
• Assessment Fees: There are no standard user fees or licensing royalties required for independent clinical practitioners or university researchers administering the scale on paper or via non-profit online survey research tools.

12. References

Below are primary foundational references and empirical investigations documenting the development, psychometric properties, and clinical application of the Hurlbert Index of Sexual Compatibility:

• Gagnon, J. H., & Simon, W. (1973). Sexual Conduct: The Social Sources of Human Sexuality. Aldine Publishing Company.
• Hudson, W. W., Harrison, D. F., & Crosscup, P. C. (1981). A short-form scale to measure sexual discord in dyadic relationships. The Journal of Sex Research, 17(2), 157–174. https://doi.org/10.1080/00224498109551110
• Hurlbert, D. F. (1991). The role of assertiveness in female sexuality: A comparative study between sexually assertive and sexually nonassertive women. Journal of Sex & Marital Therapy, 17(3), 183–190. https://doi.org/10.1080/00926239108404342
• Hurlbert, D. F., & Apt, C. (1994). Female sexual desire, compatibility, and psychological well-being in enduring relationships. Journal of Sex & Marital Therapy, 20(4), 269–277. https://doi.org/10.1080/00926239408403433
• Hurlbert, D. F., Apt, C., & Raddatz, V. W. (1993). Marital satisfaction, sexual desire, and compatibility in military couples. Journal of Sex Research, 30(2), 141–148. https://doi.org/10.1080/00224499309551695
• Hurlbert, D. F., White, L. C., Powell, R. D., & Apt, C. (1993). Orgasm consistency training in the treatment of women reporting hypoactive sexual desire: An outcome comparison of women-only groups and couples-only groups. Journal of Behaviour Therapy and Experimental Psychiatry, 24(1), 3–13. https://doi.org/10.1016/0005-7916(93)90003-7
• Mark, K. P., & Murray, S. H. (2012). Gender differences in desire discrepancy as a predictor of sexual and relationship satisfaction in a sample of committed heterosexual couples. Journal of Sex & Marital Therapy, 38(5), 398–415. https://doi.org/10.1080/0092623X.2011.606882
• Spanier, G. B. (1976). Measuring dyadic adjustment: New scales for assessing the quality of marriage and similar dyads. Journal of Marriage and the Family, 38(1), 15–28. https://doi.org/10.2307/350547
• Thibaut, J. W., & Kelley, H. H. (1959). The Social Psychology of Groups. John Wiley & Sons.

13. Items of the Scale (Questionnaire)