Objective: Research has indicated that adolescent or adulthood sexual assault (ASA) is associated with sexual functioning difficulties; less research has examined mechanisms behind this relationship. The current study tested domains of trauma-related symptomatology as mediators of the relationship between ASA and domains of sexual functioning, while considering a history of childhood sexual abuse (CSA) as a covariate. Method: A sample of 501 sexually active college women from a midwestern university completed paper-and-pencil surveys assessing sexual assault history, trauma-related symptomatology (i.e., dissociation, anxiety, depression, sexual abuse trauma index, sleep difficulties), and sexual functioning (i.e., desire, arousal, lubrication, orgasm, pain). Results: Neither ASA nor CSA was directly related to sexual functioning. However, anxiety mediated the relationship between ASA and greater sexual pain and between ASA and fewer desire difficulties. A higher sexual abuse trauma index mediated the relationship between ASA and greater orgasm difficulties and fewer desire difficulties. Depression mediated the relationship between ASA and sexual pain. Conclusions: Results suggest potential unique psychological mediators of the relationship between ASA and sexual functioning difficulties. Integrative mental and sexual health care among college women survivors of sexual trauma is warranted. Future research should examine whether women who experience sexual pain and have a history of ASA benefit from psychological treatment targeting both trauma symptoms and anxiety related to pain.