Asexuality is an Orientation
“Aѕеxuаlitу” is a sexual orientation characterized by a persistent lack of sexual attraction towards any gender. Like every other sexual orientation, asexuality is not a choice. My asexual clients never report just waking up one day and saying, “You know what? I’m tired of sex. I’m not going to feel attracted to anyone anymore.” Asexuality must not be confused with the choice of celibacy or abstinence. Most of my clients report that they were born like this, and many of them went through periods in their lives where they wondered why they were so different from everyone else.
Asexuality is not a medical condition. It is not caused by low hormones or a brain tumor, nor is it the result of childhood trauma, a temporary phase, or a response to a relationship gone wrong. However, as mental health providers, it is your job to rule out many of these potential etiologies when your client does come in reporting asexuality. Make sure to take a thorough medical history and trauma history when seeing these clients. In addition, it is a good idea to refer them out to their primary care physicians to have a full physical.
There is a myth in our culture that without a healthy sex life, one cannot have a healthy connected relationship. I have personally seen hundreds of couples that have satisfying relationships without sex. There are multiple ways to develop intimacy in relationships, such as intellectual intimacy and power exchange. Many of these ways will be discussed in later chapters. Asexual individuals spent decades feeling lost, lonely, and inadequate as a product of these hypocritical assumptions made by our culture. Our culture continues to send mixed messages in reporting that sex is required in healthy relationships but is also dirty, nasty, and should only be done for procreation with your martial spouse. Thus, creating distress and hopelessness for those patients who identify as asexual.
Several studies have indicated that at least 1% of the population is asexual. The famous Kinsey Report on sexuality in 1948 had a scale for an individual’s sexual orientation, ranging from zero for “exclusively heterosexual” to six for “exclusively homosexual.” In his research, he found that some people, around 1.5% of the adult male population, did not really fit on the scale because they were not particularly sexually interested in anyone, so he labeled them as “X” and left them off the scale (1948). Today, this “X” group would likely be recognized as asexual.
A more recent study, conducted by Dr. Anthony Bogaert in 2004, found that approximately 1% of the adult population could be classified as asexual, using the results of a survey conducted in the UK during the 1990ѕ. However, Bogaert believed that the actual number of asexual people is likely higher, as it is conceivable that people who are not terribly interested in sex would be less likely to spend the time to take a survey about sex, and would, therefore, be underrepresented in the results.
There is no single asexual experience. In my clinical experience, an asexual individual will often come into the practice hopeless and concerned that there is something terribly wrong with them because they lack a sexual desire or need. Traditionally, these clients have already undergone the medical route for help and ultimately get referred to counseling when there lacks a concrete physiological issue. If they have not, I always refer them to have a complete physical and rule out any medical issues, which may interfere with their ability to desire sex. Asexuality is, in fact, a true minority; sexuality is not something that is required for healthy relationships unless the couple is not a match in their sexual desire needs.
Asexuality is not a diagnosis in the DSM-V and there is no absolute agreed upon criteria that has been established by the medical community. The Asexual Visibility and Education Network (AVEN) is the current association to which we as clinicians look for the latest on research and education for this sexual orientation. According to asexuality.org, the website for AVEN:
“Asexuality and sexuality are not necessarily black and white. There is a spectrum of sexuality, with sexual and asexual as the endpoints and a gray area in-between. Many people identify in this gray area under the identity of ‘gray-asexual,’ or ‘gray-a.’ Examples of gray-asexuality include an individual who does not normally experience sexual attraction but does experience it sometimes; experiences sexual attraction but has a low sex drive; experiences sexual attraction and drive but not strongly enough to want to act on them; and/or can enjoy and desire sex but only under very limited and specific circumstances. Even more, many gray-sexuals still identify as asexual because they may find it easier to explain, especially if the few instances in which they felt sexual attraction were brief and fleeting.
Furthermore, an asexual person can want or choose to engage in sex for several reasons. Some asexual people in relationships might choose or even want to have sex with their partner as a way of showing affection, and they might even enjoy it. Others may want to have sex in order to have children, to satisfy a curiosity, or for other reasons” (Asexual Visibility and Education Network, 2001-2012)Asexual Visibility and Education Network, 2001-2012
When working with clients who identify as asexual, once medical pathology and relationship or sexual trauma are ruled out as sources for lack of sexual desire, then it is important to help the client educate themselves on their orientation and normalize their lack of desire. It is also important to show them that they are healthy and can have healthy relationships. Redefining sexuality and intimacy is important for these clients. When working with relationships and asexuality, it is important to coach them in other forms of intimacy and the difference between eroticism and sex. This will help them to ensure the health of their relationships and reduce the anxiety associated with sexuality.
Asexual Visibility and Education Network. (2001-2012). About. Retrieved from https://asexualoutreach.org/
Bogaert, A. (2012). Asexuality: Prevalence and associated factors in a national probability sample. Journal of Sex Research, 41(3), 279-287.
Kinsey, A (1948). Sexual behavior in the human male. Bloomington, IN: Indiana Press University.
Kinsey, A., Wardell, P., Martin, C., & Gebhard, P. (1953). Sexual behavior in the human female. Bloomington, IN: Indiana University Press.