Sexual self-schemas are cognitive generalizations regarding sexual aspects of the self that represent a core component of one's sexuality. We contend that individual differences in the sexual self-view represent an important cognitive diathesis for predicting sexual difficulty or dysfunction. We illustrate the role of sexual self-schemas on sexual behavior and responsiveness in healthy female and male samples. Next, we describe how diathesis—stress models of psychopathology have been applied to the sexual arena, and discuss the critical features of clinically useful diathesis variables. Drawing from these criteria, we examine the diathetic properties of sexual self-schemas. Finally, we discuss an empirical test of the proposed diathesis—stress interaction, reviewing the role of women's sexual self-views on sexual morbidity following diagnosis and treatment for gynecologic cancer.