Sexual desire discrepancy is one of the most common, and potentially distressing, aspects of couples' sexual health. There are gaps in the literature exploring desire discrepancy specifically in distressed couples, as well as in queer (sexual and/or gender minority) couples. This study sought to gather qualitative data regarding long-term couples' experiences with distressing desire discrepancy. Semi-structured interviews were conducted with both heterosexual and queer partners of varying gender identities (n = 26) to fill these research gaps. Interviews included couple interviews, as well as individual interviews with partners. Data analysis was conducted with thematic analysis, which yielded four primary themes across the course of relationships: Sexual and relationship satisfaction; Changes in sexual frequency, desire, and behavior; Changes in barriers to sex; and Coping with desire discrepancy. Findings can inform clinical interventions focused on desire discrepancy, as well as future research investigating couple's sexual health.