What Does It Mean to Be Hyposexual?

Mature couple fighting at home sitting on the sofa

courtneyk/E+/Getty

Table of Contents
View All
Table of Contents

Hypoactive sexual desire disorder, also known as HSDD or as being hyposexual, is a clinical diagnosis. The diagnosis is used only for women, and there is a separate, but exactly similar, condition known as male hypoactive sexual desire disorder, or MHSDD, for men.

There is no different specific diagnosis for nonbinary or gender nonconforming people. A diagnosis for HSDD can be given if a person has not felt sexual in six months or more, and is frustrated by that.

Hyposexuality

Hyposexuality is the opposite of hypersexuality. Inasmuch as someone with hyposexuality does not think about sex, someone with hypersexuality may find themselves compulsively obsessed with it.

Being hyposexual is often mistakenly thought of as a sexual identity, but it isn't one. Instead, it's a biological phenomenon in which a person does not want to engage sexually, and is bothered by that fact. While much attention has been paid to to the clinical elements of HSDD, and to cisgender women with it, it can affect the life of a person of any gender.

Ahead, we'll take an in-depth look at what living with HSDD is like. From the underlying causes to how it's different from sexuality, you'll learn all about what it means to be hyposexual.

Using The Term HSDD

We're using HSDD in this article to refer to both MHSDD and HSDD. Because HSDD can, and does, affect people of all genders, and because MHSDD has similar causes and symptoms, we're opting to use the term inclusively, and not separate the two diagnoses.

Understanding the Causes of Hyposexuality

HSDD can be caused by many different factors, and some are easier to contend with than others. These are some of the known causes.

Hormone Therapy

Gender affirming care may involve the use of hormones for transition. For trans women, feminizing hormones such as estrogen are prescribed, and they can cause HSDD.

HSDD is heavily present in trans women, with over 62% of women experiencing a decrease in sexual desire after gender affirming care. 22% were diagnosed with HSDD. Because affirming care for trans men utilizes testosterone, which increases sex drive, the rates for trans men experiencing HSDD are far lower than for trans women.

Stress, Anxiety, and Life Problems

Studies have shown a "significant" relationship between stress and anxiety and sexual dysfunction. It's well known that stress cause reduce your libido, and in turn, managing your stress can enable it to stay more easily in your life.

However, often life throws us curveballs beyond what we can capably meditate our way through. In these instances, where you experience something that is beyond your control to get over quickly, HSDD or feeling hyposexual can have more likelihood of creeping up.

Medication

Some antidepressants, specifically the category known as SSRIs, can cause HSDD. There are ways to reduce the impact of sexual dysfunction caused by antidepressants, such as lowering your dose or trying a different medications. HSDD can be caused by other types of medication as well, including the following:

  • anti-epiletics
  • anti-hypertensives
  • anti-psychotics
  • anti-androgens

Low Sex Hormone Levels

As we age, our libidos tend to drop. This makes sense biologically, since we are less inclined to parent children at an older age. Hormones responsible for our sex drives, such as testosterone, naturally decrease with age.

For women experiencing menopause, other sex hormones like estrogen and progesterone also drop. This can happen to some people at younger ages, as well.

Body Image Issues and Dysphoria

Not feeling comfortable in your body can understandably lead to an aversion of intimacy. Whether you are struggling with your body image because you don't feel beautiful, or you experience dysphoria and don't feel that your physical form aligns with your gender, trouble with how you feel in your body can lead to HSDD.

In situations of dysphoria for trans people, HSDD can potentially be mitigated through gender affirming surgery.

Sexual Abuse and Trauma

Rape trauma syndrome is a form of PSTD that occurs after sexual assault. While it may be short for some people, for others it can go on for years. You don't need to have been raped in the standard definition of the word for your body to respond traumatically.

RTS can make a person averse to connecting intimately with others, and even non-sexual physical closeness may be triggering for them. This syndrome may require therapy in order to recover from, and therapy can be very effective at helping a person move on and lead a healthy sexual life after sexual assault.

Now that we understand the various causes of HSDD, let's look at how it's different from a sexual identity.

Hyposexual vs. Asexual

Asexuality is a sexual identity. An asexual person rarely or never experiences sexual desire and attraction to other people. Asexual people often learn of their sexuality at a young age, and it might stay the same their entire lives. Asexual people can lead very happy lives, and can be completely content to not experience sexual desire.

Conversely, HSDD is a clinical diagnosis that can be mitigated with treatment. It isn't an identity, and a hyposexual person might find themself very frustrated with their lack of sexual desire and attraction to others. Where an asexual person is content to not behave sexually, a hyposexual person can miss the act of sex and may still be attracted to others even if they don't want to engage intimately.

Hyposexual vs. Graysexual

Graysexuality is also a sexual identity. It's different than asexuality in that an asexual person rarely or never experiences sexual desire for others, whereas a graysexual person experiences sexual desire on occasion.

A graysexual person has a reduced amount of sexual desire, but does not identify as asexual because they do experience desire sometimes. A graysexual person can be completely happy with their level and frequency of desire, and can live a fulfilled life.

Just like asexuality versus HSDD, HSDD is different from graysexuality because people with it experience HSDD in the shorter term, not as an identity, and it may be mitigated with treatment.

Both asexuality and graysexuality are ways a person identifies regardless of outside circumstances, whereas HSDD is primarily caused by outside circumstances, and can be treated with different methods. Read on to learn what those are.

How HSDD Can Be Treated

In some instances, HSDD can go away on its own. If you've been very stressed with life problems, and then they eventually clear, you might find that your sex drive returns on its own. If you've been experience dysphoria but you receive gender affirming care, you also might discover that you have a desire to have sex again.

In other situations, HSDD does not go away on its own. A combination of medication and therapy can be effective for those who are diagnosed with HSDD. Testosterone is often used because it boosts libido and sex drive. Exercise, communication, and estrogen patches also may be helpful in improving HSDD.

A Word From Verywell

If you're suffering from HSDD, help is available. In order to be diagnosed with it, you'll need to have at least six months consecutively of reduced sexual desire that is impacting your life. Talk to a practitioner about the right treatment for you, and know that you have a great chance of feeling like yourself again soon.

8 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Hypoactive sexual desire disorder [Internet]. [cited 2022 May 17].

  2. Overview of feminizing hormone therapy | gender affirming health program [Internet]. [cited 2022 May 17].

  3. Wierckx K, Elaut E, Van Hoorde B, Heylens G, De Cuypere G, Monstrey S, et al. Sexual desire in trans persons: associations with sex reassignment treatment. J Sex Med. 2014 Jan;11(1):107–18. doi:10.1111/jsm.12365

  4. Yazdanpanahi Z, Nikkholgh M, Akbarzadeh M, Pourahmad S. Stress, anxiety, depression, and sexual dysfunction among postmenopausal women in Shiraz, Iran, 2015. J Family Community Med. 2018;25(2):82–7. doi:10.4103/jfcm.JFCM_117_17

  5. Pachano Pesantez GS, Clayton AH. Treatment of hypoactive sexual desire disorder among women: general considerations and pharmacological options. Focus (Am Psychiatr Publ). 2021 Jan;19(1):39–45. doi:10.1176/appi.focus.20200039

  6. Singh M, Bathla M, Martin A, Aneja J. Hypoactive sexual desire disorder caused by antiepileptic drugs. J Hum Reprod Sci. 2015;8(2):111–3. doi:10.4103/0974-1208.158619

  7. Holmberg M, Arver S, Dhejne C. Supporting sexuality and improving sexual function in transgender persons. Nat Rev Urol. 2019 Feb;16(2):121–39. doi: 10.1038/s41585-018-0108-8

  8. Clayton AH, Kingsberg SA, Goldstein I. Evaluation and management of hypoactive sexual desire disorder. Sex Med. 2018 Mar 6;6(2):59–74. doi:10.1016/j.esxm.2018.01.004

By Ariane Resnick, CNC
Ariane Resnick, CNC is a mental health writer, certified nutritionist, and wellness author who advocates for accessibility and inclusivity.