Sexual Aversion Disorder

Cindy M. Meston, Alessandra Rellini, & Christopher HarteĀ 

Sexual aversion is conceptualized as a phobic reaction to sexual contact and, in many ways, is more similar to an anxiety disorder than to a sexual disorder. In the DSM-IV-TR, it is defined as the recurrent or persistent extreme avoidance of, or aversion to, all, or nearly all, genital sexual contact with a sexual partner. It can be so severe that an individual may avoid any type of physical contact including holding hands for fear that such contact may lead to sexual interaction. There is a paucity of information on the prevalence of aversion disorder but it is generally not thought to be a rare disorder.

Little is known about the etiology of sexual aversion disorder other than people with sexual aversion report high levels of anxiety in anticipation of potential sexual contact. The aversion is not always towards intercourse, but may be towards specific sexual elements such as semen, which, over time, may or may not become more generalized.

Sexual aversion disorder is commonly treated with anxiety-reduction techniques such as systematic desensitization which involves creating a hierarchy of sexual activities that provoke increasing levels of anxiety and then exposing the person to the anxiety-producing stimuli while he engages in relaxation exercises. After several sessions of pairing the fear-arousing stimuli with a state of relaxation, the person is usually able to imagine the scenario without becoming intensely anxious, and they can then proceed to the next scenario on the hierarchy. Once the person is able to imagine all of the scenarios on the hierarchy without experiencing substantial distress, the same technique is applied to experiencing the scenarios in real life either alone or with a partner.

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