•Caregivers often interpret patients’ ambiguous physical symptoms negatively.•Gender affects how individuals interpret their partners’ physical symptoms.•Caregivers’ biased interpretations can exaggerate patients’ challenges. It has been suggested that family caregivers of chronic pain patients may develop cognitive biases similar to those observed among patients in previous studies. However, there is a gap in knowledge regarding the effect of such biases on patients’ adaptation to pain. In this study, we examined the relationship between partner-caregivers’ interpretation bias and sexual satisfaction among married heterosexual couples. We further examined the relationship between caregivers’ interpretation bias and congruency in the beliefs that patients and caregivers hold about the experience of pain. The sample comprised 32 married couples in a caregiving relationship and 28 married individuals who were neither patients nor caregivers, serving as control participants. Caregivers and controls completed a modified version of the interpretation bias task. Patients and caregivers filled out the Sexual Satisfaction Index and a Patient’s Pain-Related Disabilities Checklist. Results confirmed that a biased negative interpretation exists among caregivers when compared to partners of pain-free individuals. A noticeable gender effect was observed in the effect of interpretation bias on patients’ sexual satisfaction. Female partner-caregivers’ negative interpretation bias was associated with a lower level of sexual satisfaction among male patients. In contrast, the same bias was associated with higher levels of sexual satisfaction among female patients when observed among male partner-caregivers. Furthermore, a moderate but not symmetrical positive interpretation was associated with higher levels of congruence on the level of patients’ disability within couples. The findings are another step toward incorporating the social circuit of individuals with chronic pain conditions into intervention protocols.