What Is Sexual Aversion Disorder?

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What Is Sexual Aversion Disorder?

The Diagnostic and Statistical Manual of Mental Disorders (DSM) defines sexual aversion disorder as 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. It can even go so far as leading to the avoidance of all physical contact with a partner.

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. Sexual aversion disorder wasn't added to the DSM until 1987.

People are usually diagnosed with this disorder in their early 20s, indicating the age at which many people become sexually active.

This article covers the signs and symptoms of sexual aversion disorder, its types, and any factors that may lead to or cause it. It also covers treatment options for this sexual disorder.

Signs and Symptoms of Sexual Aversion Disorder

The only characteristic associated with sexual aversion disorder is the extreme aversion to genital sexual contact with a partner.

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.

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:

  • 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.

Kaplan believed that people with sexual aversion disorder were especially prone to developing panic disorder because they both shared the characteristics of separation anxiety, rejection sensitivity, and overreaction to criticisms from loved ones. Kaplan even noted that she wasn't sure this should be classified as a phobia or sexual dysfunction.

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

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.
  2. 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. 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. However, this could also be a result of increased stress.

The increased anxiety levels could be more prevalent due to a genetic history, often present for those with panic disorders.

Treatment of Sexual Aversion Disorder

Cindy M. Meston of the Sexual Psychophysiology Laboratory at the University of Texas at Austin notes that sexual aversion 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:

  • Systematic desensitization: This 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.
  • 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. 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.

A Word From Verywell

Sexual disorders can be hard to talk about with loved ones and therapists alike. That said, keep in mind that you owe it to yourself to seek out happiness in your sex life. While it might not be easy, it is possible to identify treatment plans and move into a happy, satisfying sex life with a partner.

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2 Sources
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  1. Brotto LA. The DSM diagnostic criteria for sexual aversion disorder. Arch Sex Behav. 2010;39(2):271-7.

  2. Porst H, Buvat J. Standard Practice in Sexual Medicine. Malden, MA: Blackwell Publishing; 2006.