| Asexuality (experiencing little or no sexual attraction) has a prevalence of 0.4% to 4%. 1 |
Asexuality is a general term that includes demisexuality (experiencing sexual attraction only after emotional bonds are formed) and greysexuality (experiencing sexual attraction rarely or under specific circumstances). 2 Asexual people can have sex and experience romantic attraction. 2
| Asexual people have a higher prevalence of anxiety, depression, and other mood disorders than people of other sexualities. 3 |
These adverse mental health outcomes are often the result of minority stress and stigma, which are further exacerbated by discrimination at other intersections. Asexual people also have unique physical and sexual health needs, such as coping with arousal without attraction and learning to set boundaries in relationships. 2
| Asexual people often face barriers to accessing affirming healthcare due to misunderstanding and pathologization. |
Pathologization (viewing the absence of sexual attraction as an inherent disorder) has been reported by many asexual people in healthcare settings and may lead to avoidance of healthcare. 4
| Improving healthcare requires recognizing asexuality as an identity , not a pathology. 2 |
Providers can use inclusive and affirming language (for example, using “if” instead of “when” for questions about sex); allow patients to identify themselves; avoid assuming that lack of sex is problematic; connecting patients with asexual communities; ensuring that approaches are specifically asexual rather than generalized to the entire LGBTQIA2S+ community; include asexual-friendly options on forms and questionnaires; and educate yourself about asexuality. 2
Providers must also improve their skills in non-binary affirming care, as asexual communities often have higher proportions of non-binary gender identification. 5
| Asexuality is different from disorders of sexual arousal and desire. 5 |
Desire and arousal belong to physiological experiences of wanting to have sexual relations. Attraction refers to directing desire to specific individuals. 5 Desire and arousal disorders refer to distressing decreases in a person’s typical level of arousal and desire.
If a patient presents with concern, providers should ask questions to elucidate whether desire, arousal, or attraction is absent and establish the patient’s goals. 5
Bibliographic references
- Rothblum ED, Heimann K, Carpenter K. The lives of asexual individuals outside of sexual and romantic relationships: education, occupation, religion and community. Psychol Sex 2018; 10 :83–93. Google Scholar
- Schneckenburger SA, Tam MWY, Ross LE. Asexual competent practices in healthcare: a narrative review. J Gay Lesbian Ment. Health 2023 June 6. doi: 10.1080/19359705.2023.2214528. CrossRef Google Scholar
- Yule MA, Brotto LA, Gorzalka BB. Mental health and interpersonal functioning in self-identified asexual men and women. Psychol Sex 2013; 4 :136–51. Google Scholar
- Foster AB, Scherrer KS. Asexual-identified clients in clinical settings: implications for culturally competent practice. Psychol Sex Orientat Gend Divers 2014; 1 :422–30. Google Scholar
- Bogaert AF. Asexuality: what it is and why it matters. J Sex Res 2015; 52 :362–79. CrossRef Google Scholar
