What You Should Know About Sexual Anorexia

Sexual anorexia, a term made popular by sex addiction expert 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. 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 that sexual anorexics build their lives around. This can include: 

• Persistent fear of intimacy, sexual contact, sexual pleasure, sexually transmitted diseases, 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

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

Individuals 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.

Sexual anorexics may be prone to occasional periods of sexual promiscuity, or "sleeping around," a bit like bulimics—people who periodically starve themselves of food, then binge and purge what they have eaten. For example, a sexual anorexic may abstain from sex except when he's intoxicated. In this case, the rigid boundaries around sexual expression crumble when inhibitions are lowered.

Despite their aversion to sex, sexual anorexics may be engaged in "sexual" relationships, including marriage, although the quality of the relationship is likely to be impaired by the sex avoidance of one or both partners. Ironically, a sexual anorexic may even form a relationship with an "acting out" sex addict, as one partner loses control over their sexuality while the other has excessive control. In a situation like this, one partner may be promiscuous, while the other abstains from sex.

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 your 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.