Study design: Clinimetric study. Objectives: To develop the Perceived Sexual Distress Scale (PSDS) in Hindi language (that is, PSDS-H) for persons with spinal cord injury (SCI), and to establish its content validity, internal consistency and test-retest reliability. Setting: New Delhi, India. Methods: Following a comprehensive literature review and semi-structured interviews, a 43-item questionnaire was drafted. Each item was rated on a 5-point scale. Content validity was established both qualitatively and quantitatively. Inter-item, item total correlations, internal consistency and test-retest reliability were calculated. Results: Expert panel opinion and content validity ratio (CVR) validated the content of the PSDS-H. Five items were dropped because of low CVR, resulting in a 38-item questionnaire. Internal consistency reliability (Cronbach's alpha) was 0.965. The test-retest reliability was 0.647. Conclusion:The PSDS-H is a valid, self/interviewer-rated tool that can help inform the rehabilitation team about the level of an individual's perceived sexual distress post SCI. It also provides an outcome measure to evaluate the efficacy of interventions related to sexuality post injury. Spinal Cord (2014) 52, 712-716; doi:10.1038/sc.2014.83; published online 1 July 2014 INTRODUCTIONThe World Health Organization has described sexual health as 'the integration of the somatic, emotional, intellectual and social aspects of sexual being in ways that are positively enriching and that enhance personality, communication and love' . 1 Spinal cord injury (SCI) frequently concerns women and men in their sexually active and reproductive periods of life. 2 In a study done by Reitz et al. 2 on 120 persons with SCI, 63 reported that the major impact of SCI was on sexual functions. Consequences and complications of SCI, such as inability to move, neurogenic bladder and bowel dysfunction, spasticity and pain, all influence quality of life and sexuality.Sexual readjustment after SCI depends greatly on the particular person's wishes, experiences and sexual habits in their pre-SCI life. It may also, to a great extent, depend on the co-operation and helpfulness of the partner. The psychosexual functioning of persons with paraplegia is not different from quadriplegia. 3 Sexuality and sensuality can be an expression of confidence, validation of the self and one's perceived lovability. A review of the existing literature on sexuality and SCI explains the powerful influence of sexual problems and dysfunctions on psychology of the subjects, including issues of the affected body image, self concept, gender roles, general psychological health and basic sense of self-esteem. 4,5 These problems may give rise to sexuality-related distress in persons with SCI. 6,7 There is little available empirical research on the psychological distress experienced due to sexual dysfunctions post SCI. The available measures primarily examine physical aspects of sexual