What Is Sexual Aversion Disorder?

Sexual aversion disorder was a diagnosis that involved an unwillingness to engage in sexual activity, including avoiding behaviors or signals that might convey sexual interest or lead to a sexual relationship. It is no longer considered a distinct condition, however, and this diagnosis was removed from the DSM-5.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) previously defined sexual aversion disorder as1 the “persistent or recurrent extreme aversion to, and avoidance of, all or almost all, genital sexual contact with a sexual partner,” which causes distress or interpersonal difficulty. The condition was thought to even go so far as leading to the avoidance of all physical contact with a partner.

Sex aversion disorder was removed from the DSM-5 due to the lack of research. Today, this condition would be diagnosed as a sexual dysfunction.

Signs and Symptoms of Sexual Aversion Disorder

Sexual aversion disorder is associated with an extreme aversion to genital sexual contact with a partner. This avoidance can lead to distress and may result in interpersonal problems.

Avoidance of Sex

Aversion to sex can manifest in reactions of anxiety, fear, and even disgust at the potential of a sexual opportunity. For some people, they have a fear of one specific aspect of sexual intercourse, like semen or vaginal secretions. In these cases, it may be possible for them to avoid any act that could put them in direct contact with sexual bodily fluids to reduce the onset of a panic attack.

In general, this can lead to symptoms that are typically associated with severe anxiety and depression. It can also lead to avoidant behaviors that spill over into other areas of life.

Sexual Aversion and Anxiety

In 1987 when the disorder was listed in the DSM, sex therapist Helen Singer Kaplan noted the characteristics of 373 patients with sexual avoidance. She found some commonalities between other disorders:1

• 9% of the patients who reported avoiding sex met the criteria for panic disorders
• 25% of the women who reported avoiding sex and have a phobia of sex also had panic disorder
• Another 25% who had both phobias and avoidance in regard to sex experienced other symptoms that are associated with panic disorder but didn’t meet the full criteria.

Later, psychologists would note that sexual aversion disorder was characterized by a disgust at the idea of sex, whereas phobias were classified as fears.

Prevalence of Sexual Aversion Disorder

There are very few statistics on the prevalence of sexual aversion disorder, and this is because it can so easily be confused with other disorders. It’s one of only two sexual disorders listed in the DSM (the other is hypoactive sexual desire disorder). Sexual aversion disorder wasn’t added to the DSM until 1987.1

Unfortunately, sexual aversion disorder often goes unaddressed since many people feel the issue is private and difficult to discuss.2

Types of Sexual Aversion Disorder

There are two types of sexual aversion disorders:1

Lifelong

This is when a person experiences sexual aversion no matter what relationship they’re in or what person they’re coming into contact with.

Acquired

This can refer to a person who experiences sexual aversion disorder in response to a particular relationship. However, when this person is outside of this specific relationship, they can function normally.

Causes of Sexual Aversion Disorder

While it is common in people who display other anxiety-based disorders or panic disorders, sexual aversion disorder is especially prevalent in women with a history of sexual trauma, such as rape, incest, and molestation.

It is also more common in women who show signs of PTSD.3 Unfortunately, very little is known about the prevalence of sexual aversion disorders in men versus women.

It has been noted that there is a decrease in sex hormones, like estrogen and adrenal androgens, in people who have sexual aversion disorders.4 However, this could also be a result of increased stress.

Treatment of Sexual Anxiety Disorder

Cindy M. Meston of the Sexual Psychophysiology Laboratory at the University of Texas at Austin notes that sexual anxiety disorder is, in some ways, much more similar to an anxiety disorder than it is to a sexual disorder. This is why many of the treatments are similar to those dealing with extreme anxiety.

Meston explains that sexual aversion disorder is often treated using anxiety-reduction techniques. Helpful approaches may include:

Systematic Desensitization

Systematic desensitization involves working with a therapist to create a list of sexual activities, with each one causing increasing levels of anxiety. The patient would then be exposed to the anxiety-causing stimuli while working through supervised relaxation exercises with their therapist.

The patient and therapist work together through sessions until the person no longer feels intense anxiety by a particular stimulus. Then, they move down the list to the next one.

Once the patient has made it through the entire list of stimuli with the therapist, the same technique of going through each one is initiated with their partner.

Integrative Treatment

This would combine treatments from physicians, psychologists, sex therapists, and maybe even a physical therapist. This type of treatment may be most ideal, but may also be more expensive and difficult to access.

Medical Treatment

This could include going on medications. Many of the medications that would be prescribed for people with sexual aversion disorder would also be commonly prescribed to those with other anxiety disorders.

Psychological Treatment

This would involve working with a sex therapist or other mental health professional. It is important to make sure that you’re searching for a therapist that is board-certified. The American Association of Sexuality Educators, Counselors, and Therapists (AASECT) and the American College of Sexologists both have directories that allow you to search by specialty, location, insurance, and more.