What it means to be sexually anorexic

The term sexual anorexia ^[1] isn’t a clinical diagnosis or mental health condition. But sometimes, it’s used to describe a severe aversion to sexual activity or emotional intimacy. 

At one point, the Diagnostic and Statistical Manual of Mental Disorders ^[2] (DSM) included the diagnosis of sexual aversion disorder. This term was used for people who experienced a strong disgust toward genital contact that negatively impacted their relationships. However, this diagnosis has since been removed ^[3]. 

Human sexuality is incredibly complex. Not having an interest in sexual activity or emotional closeness doesn’t automatically mean that you have a mental health concern. However, if sexual revulsion is negatively impacting your well-being or relationships, it may be something worth exploring. Learning more about sexual anorexia can help you better understand your experiences and help you know when to seek support.

A note on language: We want to mention that, in certain contexts, the term sexual anorexia can be considered offensive. Some understandably feel that it creates an unfair comparison with the life-threatening eating disorder anorexia nervosa. Simply put, people need to eat food to stay alive. But they don’t need to engage in sexual activity. So the road to recovery from these experiences isn’t the same. While we’ll be using the term sexual anorexia throughout this article, we want to affirm this important distinction.

Signs and symptoms of sexual anorexia

There isn’t a concrete list of symptoms for sexual anorexia. But broadly speaking, it’s characterized by disgust around sexual and emotional intimacy. 

Here are some examples of how sexual anorexia might show up: 

• Anytime your partner attempts to initiate physical contact, you start to panic. You feel physically sick at the thought of having sex. So you avoid nonsexual physical contact, like hugs, because you worry about escalation.

• When you’re watching a movie and a sex scene begins, you turn away or change the channel. You find any display of intimacy gross, and it’s uncomfortable to watch. You try to avoid any media that could include depictions of sexual activity.

• You’re more comfortable in relationships when you feel like you can keep your partner at an emotional distance. You might even prefer to have a partner who lives far away, because it’s easier to keep them “at arm's length.”

Sexual anorexia vs. asexuality vs. low libido

Sexual anorexia, asexuality, and having a low libido are distinct experiences. It’s important to consider a person’s history, functioning, and the full picture of their physical and emotional health when assigning these labels. 

At a basic level, here’s what sets these terms apart:

• If you have sexual anorexia, you may feel disgusted at the thought of genital contact and/or emotional intimacy. But you don’t like feeling this way.

• Asexuality exists on a spectrum. Some people who identify as asexual may have little to no interest in sex. While others might experience sexual attraction in non-normative ways ^[4].

• Having a low libido means a person has low sexual desire. It can be temporary or permanent and may be caused by mental or physical health issues, stress, and other lifestyle factors.    

What causes intimacy anorexia?

There’s limited data on sexual and intimacy anorexia. So we aren’t yet entirely sure what causes someone to have these experiences. However, research shows that there might be a link between sexual aversion and trauma ^[5]. For example, a survivor of childhood sexual abuse might develop an aversion to sexual activity. 

Studies also suggest a link between sexual anorexia and various mental health concerns ^[5]. These include obsessive compulsive disorder (OCD), depression, and anxiety. There also appears to be a connection to poor body image as well as having other forms of sexual dysfunction. 

What sexual anorexia can lead to

People can have little to no interest in sexual activity and still lead healthy, happy lives. They can also have full and satisfying relationships. But with sexual anorexia, a person experiences distress due to their aversion to sexual experiences. 

Without support, this can lead to ^[5]:

• Fear, anxiety, and disgust at the thought of sexual interactions

• Social isolation and societal stigma

• Avoiding medical appointments due to fear of genital exams

• Relationship conflict

• Lower levels of overall well-being

How to overcome sexual anorexia

If you want to overcome sexual anorexia, know that help is available. Therapy can help you identify and understand the source of your sexual aversion. In treating the underlying concerns, you may become more comfortable with sexual or emotional intimacy. Sometimes, depending on the person, medical or psychiatric care can also support recovery from sexual anorexia. 

In addition to seeking professional help, you can also use some individual strategies to change how you feel about sex. Again, if the way you feel about sexual or emotional intimacy isn’t a problem for you, that’s OK. 

But if you want to increase your desire for physical closeness, these tips might help: 

• Talk to your partner. If your partner doesn’t know how you’re feeling about sex, it will be harder for them to offer support. They might also feel confused, hurt, or rejected. You can offer clarity by saying something like, “I’ve noticed myself getting really uncomfortable around physical intimacy. But I want you to know that it’s not because you aren’t a desirable person. I think this might have something to do with my past, and it’s something I want to work on.”

• Practice stress management. Incorporating stress-management activities ^[6] into your daily routine can help regulate your nervous system. You might find that this helps reduce the anxiety or “fight-or-flight” response you experience around sexual activity. This can include things like breathing exercises, gentle movement, and journaling. 

• Experiment with other forms of intimacy. There are many ways to increase connection that have nothing to do with sex or physical touch. So take it slow, and look for other ways to build intimacy. For example, sometimes sharing experiences — like making dinner together or reading the same book and talking about it — can foster closeness.

Clinician’s take

Not wanting sex can feel neutral. It can feel like a preference or a simple ‘not right now.’ Sexual aversion is different. It often comes with distress, dread, or even panic. Many clients struggle to describe this because they feel guilty or ashamed.

Brandy Chalmers, LPC

Clinical reviewer