Sexual Anorexia Symptoms, Risk Factors, and Treatment

Sexual anorexia, a term coined and made popular by Dr. Patrick Carnes, is the compulsive avoidance of sex and sex-related matters. In his book, "Sexual Anorexia: Overcoming Sexual Self-Hatred," Carnes presents sexual anorexia as a form of sex addiction. His conceptualization of this is controversial.

The word anorexia means without appetite (anorexia being derived from the Greek word, orexis), so sexual anorexia refers to a lack of sexual appetite. What makes it a form of addiction is the compulsive avoidance of sex. This can include behaviors related to sex, self-image, and intimacy:

  • Persistent fear of intimacy, sexual contact, sexual pleasure, sexually transmitted infections, etc.
  • Preoccupation, to the point of obsession, with sexual matters, including the sexuality, sexual intentions and sexual behaviors of others, and their own sexual adequacy
  • Negative, rigid, or judgmental attitudes about sex, body appearance, and sexual activity
  • Shame and self-loathing over sexual experiences
  • Self-destructive behavior in order to avoid, limit, or stop sex

Who's at Risk

Sexual anorexia can affect men and women alike. According to Carnes, survivors of past sexual abuse or sexual rejection are most often affected and are often unaware of the reason for their difficulties with sex.

People with sexual anorexia may also have concurrent problems with other addictions, such as food addiction, substance addictions, and other obsessive or anxiety-driven problems.

People who strongly identify with cultural, social, or religious groups that involve sexual oppression, repression, or other negative approaches to sexuality may also be particularly vulnerable to developing the obsessive avoidance of sex that characterizes sexual anorexia.

Do People With Sexual Anorexia Ever Have Sex?

Despite their aversion to sex, people living with sexual anorexia may still engage in sexual relationships. Ironically, a person with sexual anorexia may even form a relationship with a person who has an unmanaged sex addiction, as one partner struggles with control over their sexuality while the other has excessive control.

Getting Help

Sexual anorexia is not an official diagnosis in the American Psychiatric Association (APA)’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), but problems of avoidance of sex are well-recognized by sex therapists, couples counselors, and psychologists.

If you or your partner are having difficulties with feelings about sex or sexual expression, you may be able to get a referral to a sex therapist from your doctor.

You can also contact your local psychological association or the American Psychological Association website for help finding a psychologist. The Society for the Advancement of Sexual Health (SASH) can also help you find a therapist with expertise in sex addiction and sexual anorexia.

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  1. Dhuffar MK, Griffiths MD. Barriers to female sex addiction treatment in the UK. J Behav Addict. 2016;5(4):562-567. doi:10.1556/2006.5.2016.072

Additional Reading
  • Carnes, Ph.D., Patrick Sexual Anorexia: Overcoming Sexual Self-Hatred. Hazelden, Center City, MN. 1997.
  • Hardman, R. & Gardner, D. "Sexual Anorexia: A Look at Inhibited Sexual Desire." Journal of Sex Education & Therapy.