This is a subject that's very difficult for me to write about so I'll try to be as gentle as possible....
While in college, I attended a talk given by a mother. The auditorium was mostly filled with women. As the mom talked, she told us the story of her daughter. Her beautiful daughter who while in college went over to a friend's house to watch a movie. Her friend raped her. Devastated the daughter told her boyfriend. He dumped her. So she called her mother for months and talked only about being dumped. After a while, her mother's sympathy waned. She told her daughter to get over him. The mother came back from vacation to find her daughter on the couch. Her daughter had killed herself. The mother had no idea until she read the suicide note that her daughter had been raped.
The mother told us that she was talking about the silent killer. Sexual abuse. She felt it needed to be talked about. The conversation needed to go on. And for how others who needed to learn how to talk to people who had been sexually abused.
I read a book by Christopher West and in it he described his incredible guilt about not preventing his roommate from date raping a girl.
There are estimates that one in four women are raped. The statistics are higher if you include other forms of sexual abuse and if you include that sexual abuse is chronically underreported. This doesn't include the number of men who sexual abused or raped. Men are even worse at underreporting.
Now I realize that not everyone who has been sexual abused gets married, but let's give a rough estimate that 1 in 3 couples are effected (meaning at least one or both spouses have experienced some level of sexual abuse either in childhood, adolescence, or adult hood).
This means that depending on the level and duration of sexual abuse intimacy can be affected. It can manifest itself in post traumatic stress and depression. It can also manifest itself in sexual dysfunction like the need to be choked during intercourse or the need to view pornography in order to achieve an erection.
Yet very few self-help books talk about how sexual dysfunction affects marriage even though it's so outreaching. Even if a self-help book does talk about it, it's usually to say that if you know that your spouse has experienced sexual abuse (and some spouses may have no idea), that you should encourage them to seek individual counseling along with couples therapy. The reason is because sexual abuse affects every individual and couple differently.
But people would have you think that the reason a person says "not tonight dear" rests on other mitigating factors. And I'm not saying it doesn't. What I'm saying is that as a society we shouldn't automatically jump to the conclusion that it's those mitigating factors alone. And more importantly just like the mother who gave the speech, it needs to be said and not closeted. The conversation needs to be had. We need to say that sexual dysfunction within a marriage happens sometimes because an individual(s) has experienced sexual abuse.
Catholic Newlywed has a beautiful series called Broken that talks about women who have been in damaging relationships including ones involving sexual abuse/rape. I encourage anyone who is dealing with a spouse who confided in you that they were abused in some fashion to read some of the posts. It really will help you understand their prospective.