This study identified frequency of sexual dysfunction, degree of satisfaction with sexual relationship, differences in sexual function, overall satisfaction and life quality, and desire for and receipt of instruction regarding sexual dysfunction in kidney, pancreas/kidney, and liver transplant recipients. Of the 768 adult recipients surveyed by mailed questionnaire, 39% responded. Intimate relationships were reported by 69.9%; 66.7% indicated satisfaction with their relationship. Twenty-six percent were not sexually active. Transplant groups did not differ significantly regarding satisfaction, sexual function, or quality of life. Satisfaction groups differed significantly regarding intimacy and expected future life and health quality. Frequency of intercourse, desire, orgasm, erection dysfunctions, and the acceptance of partners' advances related to relationship satisfaction. Sixty-seven percent received no instruction concerning sexuality or fertility. Education efforts could validate and support sexual identity among this patient population.