Understanding Asexuality

The second criterion often used to diagnose a mental disorder is interpersonal difficulty. Thus, should we consider asexual people disordered because they lack an important interpersonal dimension—sexuality? Again, not necessarily. Interpersonal relations do not only include sex. There are many aspects of social relations beyond sexuality, in which asexual people may function normally; that is, similarly to the majority of other people. Indeed, a sexual dysfunction is only diagnosed in modern medicine and psychology (e.g., in the DSM) if it has an effect on interpersonal relations beyond the specific sexual domain that is of issue. So, for asexual people, a lack of sexual interest is not per se a criterion for having a disorder, unless it causes other interpersonal issues. And, of course, celibates (e.g., nuns), by choice, never have sex with others and are not considered to have a pathology by modern medicine and psychology. Similarly, it does not make sense to pathologize asexual people, who by their natures lack sexual interest and attraction, for not engaging in sex with others.

But how about other (nonsexual) aspects of interpersonal relations—do asexual people have a broad level of interpersonal impairment beyond sexuality?[34] There is evidence that some asexual people may have an elevated level of atypical interpersonal functioning, such as increased social withdrawal (Brotto et al., 2010), but even if additional research bears this out, this, again, does not necessarily mean that we should pathologize all asexual people or asexuality in general.

An additional consideration is this: If an atypical biological process or physical health condition underlies asexuality, does this mean that asexuality is a disorder? For example, there is some evidence that health issues and atypical prenatal development may underlie the development of asexuality in some people (Bogaert, 2004). This research is important when we consider the origins of asexuality (see chapter 13), but, for two reasons, it should not guide our thinking on whether asexuality is a disorder. First, it is unlikely that physical health issues and atypical prenatal development underlie all instances of asexuality (Bogaert, 2004). Thus, even if many asexual people do have health issues (and/or atypical prenatal development), we cannot use this evidence to conclude that all asexual people are disordered or that asexuality per se is pathological. Second, using atypical sexual development as an indicator of a current mental health problem is a dubious approach. If so, we should also pathologize gays and lesbians as having a (current) mental disorder, as atypical prenatal development probably underlies, at least to some degree, the development of same-sex attraction (LeVay, 2010). If so, perhaps we should diagnose individuals with great musical talent as having a disorder, for atypical prenatal development (e.g., exposure to high prenatal hormones) may predispose one to having this talent (Manning, 2002). It is important, then, not to confuse the cause of a human psychological variation with a determination of whether that variation is currently construable as a mental illness.

It is also notable that the historical record does not show consistent evidence of asexuality as pathology; indeed, the opposite may be the case. For example, a lack of sexuality has been not seen as a disorder throughout the much of the history of Western medicine (Sigusch, 1998). Even today, some religions and cultures would not pathologize an absence of sexuality; instead, a lack of sexuality (or at least abstinence) is often considered a virtue. Thus, an absence of sexuality has not been considered a disorder consistently across time or across current cultural contexts.

Another issue relates to stigmatization. When we label someone as having a disorder, we often stigmatize them, and stigmatization itself can be a source of distress and mental health concerns. After all, who would not be stressed by being labeled “disordered”? The impact of stigmatization has been raised in the context of other sexual minorities (e.g., gays and lesbians) (Meyer, 2003). In short, why go down the road of labeling something as a disorder when there is evidence that it is not a disorder, and when we know that such labels themselves have negative consequences?