Sally entered my office with her eyes downcast, shyly saying that she had something very wrong with her. Her husband had told her that if she didn’t do something about it, they were headed for a divorce.
After I got her psychologically comfortable, and after some very gentle prodding, she told me that she could not stand to have sex.
Sally revealed that she couldn’t stand the sight of her husband’s genitals, and that she found the idea of sex absolutely abhorrent.
She had come from a religious family, and had even remained celibate until marriage.
She and her husband, Kai had been relatively chaste during their courtship. They had done some intimate touching, but always with their clothes on. That was the extent of her sexual experience.
When she came to see me, they had been married for nine months, and she knew something was seriously wrong.
On their honeymoon in Hawaii, she had a panic attack when they began to have sex. Her new husband, being a kind and sexually conservative himself, was content to kissing and touch as they had before the marriage, not wanting to ruin their special trip.
Even without sex, Hawaii was wonderful. Sally was delighted that she and Kai could have such a good time together, even if they had not consummated their marriage. She felt very much in love.
But every time Kai tried to initiate sex again, Sally came up with some excuse for why she couldn’t do it.
As the months went by on, Kai’s patience wore thin. He had not signed up for a sexless marriage, and he insisted that she get help.
Kai offered to come with her to see me, but Sally was shy and wanted to come by herself.
But after our first session, I felt that the reason she didn’t want Kai there was that she didn’t want him to know how serious the situation was.
Sally was in a total panic. Luckily, sexual aversion is treatable, if you overcome your embarrassment and seek expert help.
Chronic feelings of sexual disgust, often called sexual aversion disorder (SAD), plague some women. In fact, it’s not an unusual diagnosis at all.
But the condition was removed from the current Diagnostic and Statistical Manual (DSM), for reasons I cannot fathom. Here is the way SAD was defined in previous DSMs: “A 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’s hard to get good statistics on the prevalence of SAD, but I can assure you that if you suffer with it, you’re not alone. In one Internet study of more than 4,000 women, almost one-third reported that they had suffered with sexual aversion at one point or another in their lives.
Sally’s symptoms were classic, but they’re not the only way that SAD presents. If you find almost any part of the sexual act or you or your partner’s body revolting, if the idea of running across what upsets you provokes anxiety, you most likely have a sexual aversion.
The treatment for sexual aversion is a bit idiosyncratic — that is to say, it varies with whatever the probable cause for it.
If your anxiety is high enough, a sex therapist might recommend psychopharmacological treatment (medications) to lower your anxiety enough for treatment to be effective. I have prescribed medication for sexual aversion patients, and it can be a great help.
Of course, some patients are dead-set against taking medications, and that’s fine too.
The most important thing to remember is that sexual aversion almost never goes away on its own. That’s because it is almost impossible for the sufferer to stop avoiding the trigger situation without support and encouragement from an expert.
If you suffer from this condition, please find yourself an experienced and certified sex therapist to begin treatment.
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